Tilburg University, Noord-Brabant, The Netherlands.
J Intellect Disabil Res. 2013 Jan;57(1):53-66. doi: 10.1111/j.1365-2788.2011.01515.x. Epub 2012 Jan 29.
Client-centred models of care imply that clients should have a collaborative relationship with staff providing support. This study investigates whether dialogues between staff and clients in naturally occurring contexts reflect this collaborative ideal.
Nineteen staff members video recorded a social interaction with one of their clients. The topic of the interaction concerned an aspect of their support needs. The recordings were transcribed and analysed using the Initiative Response Analysis designed by Linell et al.
Staff were more dominant than clients, albeit the level of asymmetry in the dialogues was relatively small. However, a different pattern of turns was used by staff and clients. Staff asked more direct questions and sometimes neglected meaningful client contributions. Clients, on the other hand, provided more extended turns in response to staff members' questions, thereby helping to maintain the dialogue. However, in a notable minority of communicative turns, the clients failed to link with the staff member's contribution.
The interactional patterns found in this study suggest that staff and clients can face difficulties establishing collaborative dialogues on shared topics. Future research should take account of what staff and clients want to achieve in dialogues, along with the nature of their non-verbal communication.
以客户为中心的护理模式意味着客户应该与提供支持的工作人员建立协作关系。本研究旨在调查在自然发生的情境中，工作人员和客户之间的对话是否反映了这种协作理想。
19 名工作人员用视频记录了他们与其中一位客户的社交互动。互动的主题涉及他们支持需求的一个方面。使用 Linell 等人设计的倡议反应分析对录音进行了转录和分析。
工作人员比客户更具主导地位，尽管对话中的不对称程度相对较小。然而，工作人员和客户使用了不同的轮次模式。工作人员提出了更直接的问题，有时忽略了客户有意义的贡献。另一方面，客户对工作人员的问题做出了更长的回应，从而有助于维持对话。然而，在少数有意义的交流轮次中，客户未能与工作人员的贡献建立联系。
本研究中发现的互动模式表明，工作人员和客户在共同话题上建立协作对话可能会遇到困难。未来的研究应该考虑到工作人员和客户在对话中想要实现的目标，以及他们的非言语沟通的性质。
