Bennett Michelle K, Ward Elizabeth C, Scarinci Nerina A
The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia.
Centre for Functioning and Health Research (CFAHR), Queensland Health, Brisbane, QLD, Australia.
Int J Lang Commun Disord. 2016 May;51(3):296-309. doi: 10.1111/1460-6984.12207. Epub 2015 Nov 17.
There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in residential-aged care and factors impacting optimal communication management is lacking.
To use data triangulation across multiple sources to describe resident-staff communication and communication management in residential-aged care.
METHODS & PROCEDURES: Participants included a sample of 14 residents and 29 staff directly involved in communication interactions with residents. Data were obtained from: (1) resident file review (n = 14), (2) observation of resident-staff communication (n = 14), (3) resident surveys (n = 14) and (4) staff surveys (n = 29). Data from each source were examined separately then triangulated.
OUTCOMES & RESULTS: All residents had limited opportunity for meaningful communication with staff. Documentation of residents' communication needs and strategies to facilitate resident-staff communication was insufficient to provide individualized recommendations. Although staff were observed to use various strategies to facilitate communication with residents, staff agreement about the applicability of these strategies to individual residents was inconsistent. Differences in resident-staff communication for residents who experience nil/mild versus moderate/severe communication difficulty were also found.
CONCLUSIONS & IMPLICATIONS: Resident-staff communication and communication management in residential-aged care is limited in scope and challenged in meeting residents' individual communication needs. Improvements in both documentation and staff knowledge of residents' communication needs are necessary. Strategies to facilitate communication with individual residents must be tailored, evidence based, documented in care plans and delivered to staff through ongoing education. Increased involvement of specialist providers such as speech pathologists to support better communication management in residential-aged care may provide one way of facilitating such change.
居住在老年护理机构中的老年人存在沟通困难的比例很高。这种功能缺陷会对居民的生活质量、工作人员的工作场所满意度以及优质护理的提供产生负面影响。目前缺乏对老年护理机构中沟通管理的本质以及影响最佳沟通管理的因素进行系统研究。
运用多源数据三角测量法来描述老年护理机构中居民与工作人员之间的沟通及沟通管理情况。
参与者包括14名居民和29名直接参与与居民沟通互动的工作人员。数据来自：（1）居民档案审查（n = 14），（2）居民与工作人员沟通的观察（n = 14），（3）居民调查（n = 14）以及（4）工作人员调查（n = 29）。对每个来源的数据分别进行检查，然后进行三角测量。
所有居民与工作人员进行有意义沟通的机会有限。关于居民沟通需求以及促进居民与工作人员沟通的策略的记录不足以提供个性化建议。尽管观察到工作人员使用各种策略来促进与居民的沟通，但工作人员对于这些策略对个别居民的适用性的共识并不一致。还发现了沟通困难程度为无/轻度与中度/重度的居民在与工作人员沟通方面的差异。
老年护理机构中居民与工作人员之间的沟通及沟通管理范围有限，在满足居民的个人沟通需求方面面临挑战。改善记录以及工作人员对居民沟通需求的了解是必要的。促进与个别居民沟通的策略必须是量身定制的、基于证据的，记录在护理计划中，并通过持续教育提供给工作人员。增加言语病理学家等专科提供者的参与，以支持改善老年护理机构中的沟通管理，可能是促进这种改变的一种方式。
