Mealtime interactions between nursing home staff and residents with dementia: a behavioral analysis of Language characteristics

BMC Geriatrics

Research

Wen Liu¹  Si On Yoon²  Anju Paudel³  Ying-Ling Jao³ 

[1] College of Nursing, The University of Iowa, 50 Newton Rd, 52242, Iowa City, IA, USA;Department of Communicative Sciences and Disorders, New York University, 665 Broadway, 10012, New York, NY, USA;Ross and Carol Nese College of Nursing, The Pennsylvania State University, 307B Nursing Sciences Building, 16802, University Park, PA, USA;

关键词: Language;    Communication;    Mealtime;    Nursing home;    Dementia;    Dyadic interaction;    Dyadic research;    Secondary analysis;   

DOI  :  10.1186/s12877-023-04320-3

 received in 2023-04-15, accepted in 2023-09-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundQuality staff-resident communication is crucial to promote outcomes in nursing home residents with dementia requiring assistance during mealtimes. Better understanding of staff-resident language characteristics in mealtime interactions help promote effective communication, yet evidence is limited. This study aimed to examine factors associated with language characteristics in staff-resident mealtime interactions.MethodsThis was a secondary analysis of 160 mealtime videos involving 36 nursing staff and 27 residents with moderately severe to severe dementia in 9 nursing homes. Mixed-effects models was used to examine the relationships between factors and language characteristics in staff-resident mealtime interactions. The independent variables were speaker (resident vs. staff), utterance quality (negative vs. positive), intervention (pre- vs. post-communication intervention), and resident dementia stage and comorbidities. The dependent variables were expression length (number of words in each utterance) and addressing partner by name (whether staff or resident named their partner in each utterance). All models included staff, resident, and staff-resident dyad as random effects.ResultsStaff (utterance n = 2990, 99.1% positive, mean = 4.3 words per utterance) predominated conversations and had more positive, longer utterances than residents (utterance n = 890, 86.7% positive, mean = 2.6 words per utterance). As residents progressed from moderately severe to severe dementia, both residents and staff produced shorter utterances (z=-2.66, p = .009). Staff (18%) named residents more often than residents (2.0%; z = 8.14, p < .0001) and when assisting residents with more severe dementia (z = 2.65, p = .008).ConclusionsStaff-resident communication was primarily positive, staff-initiated, and resident-oriented. Utterance quality and dementia stage were associated with staff-resident language characteristics. Staff play a critical role in mealtime care communication and should continue to initiate resident-oriented interactions using simple, short expressions to accommodate resident declining language abilities, particularly those with severe dementia. Staff should practice addressing residents by their names more frequently to promote individualized, targeted, person-centered mealtime care. Future work may further examine staff-resident language characteristics at other levels of language using more diverse samples.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 1