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Interaction between nursing staff and residents with aphasia in long-term care: A mixed method case study

Journal article
Authors Charlotta Saldert
Hannah Bartonek Åhman
Steven Bloch
Published in Nursing Research and Practice
Volume 2018
Publication year 2018
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
University of Gothenburg Centre for person-centred care (GPCC)
Language en
Links https://doi.org/10.1155/2018/941869...
Keywords Person centered care; Communication; Conversational Interaction; Long-term residential care; Nursing; Aphasia; Discourse analysis
Subject categories Logopedics and phoniatrics, Nursing, Linguistics

Abstract

Thousands of individuals with communication disorders live in long-term residential care. Nursing staff are often their primary communication partners. The positive effects of social interaction and person-centred care have been recognised but there remains a paucity of research on the content and quality of communicative interaction between long-term care staff and residents with aphasia. This mixed method study investigates the discourse in interaction between nursing staff and residents with aphasia. Methods. A routine care activity was explored in 26 video-recordings featuring four enrolled nurses and four elderly persons with severe aphasia. Factors such as goals and roles in the activity weremapped out and a qualitative discourse analysis was performed. Based on the findings a coding scheme was constructed and the amount of time spent in different interactional foci of discourse was explored. Results. Fromthe qualitative findings three broad, but distinct, foci in the nurse-initiated interaction could be distinguished: (1) a focus on getting the task done with minimum interaction; (2) topics related to the task, but not necessary to get the task done; and (3) personal topics related to themes beyond the caring task.The analysis of distribution of time revealed that althoughmost of the interaction was focused on themain care activity, between 3 and 17% of the time was spent in either task-related or non task-related interaction. The distribution varied between dyads and could not be related to the residents’ severity of aphasia nor the activity as such. Conclusions. An endeavour to interact socially with the residents with aphasia influences the nurses’ foci of interaction. Contextual and personal factors of the residents and nurses need to be considered in clinical work as well as research on how communicationmay be supported to facilitate social interaction and person-centredness in long-term care of people with aphasia.

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