Williams Kristine N, Herman Ruth, Gajewski Byron, Wilson Kristel
School of Nursing, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Am J Alzheimers Dis Other Demen. 2009 Feb-Mar;24(1):11-20. doi: 10.1177/1533317508318472. Epub 2008 Jun 30.
Resistiveness to care is common in older adults with dementia. Resistiveness to care disrupts nursing care, increasing costs of care by 30%. Elderspeak (infantilizing communication used by nursing staff) may trigger resistiveness to care in individuals with dementia. Videotaped care episodes (n = 80) of nursing home residents with dementia (n = 20) were coded for type of staff communication (normal talk and elderspeak) and subsequent resident behavior (cooperative or resistive to care). Bayesian statistical analysis tested relationships between staff communication and subsequent resident resistiveness to care. The probability of resistiveness to care varied significantly with communication (Bayes P = .0082). An increased probability of resistiveness to care occurred with elderspeak (.55, 95% CrI, .44-.66), compared with normal talk (.26, 95% CrI, .12-.44). Communication training has been shown to reduce elderspeak and may reduce resistiveness to care in future research.
痴呆症老年人中抗拒护理的情况很常见。抗拒护理会扰乱护理工作,使护理成本增加30%。老年化语言(护理人员使用的幼稚化交流方式)可能会引发痴呆症患者对护理的抗拒。对20名患有痴呆症的养老院居民的80次护理录像片段进行编码,记录工作人员的交流类型(正常交谈和老年化语言)以及随后居民的行为(配合护理或抗拒护理)。贝叶斯统计分析测试了工作人员交流与随后居民抗拒护理之间的关系。抗拒护理的概率因交流方式而异(贝叶斯P = .0082)。与正常交谈(.26,95%可信区间,.12-.44)相比,使用老年化语言时抗拒护理的概率增加(.55,95%可信区间,.44-.66)。在未来的研究中,沟通培训已被证明可以减少老年化语言,并且可能会降低对护理的抗拒。