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居家护理中与老年人沟通的特点:居家护理访视录音的定性分析

Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits.

作者信息

Kristensen Dorte V, Sundler Annelie J, Eide Hilde, Hafskjold Linda, Ruud Iren, Holmström Inger K

机构信息

Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway.

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.

出版信息

J Clin Nurs. 2017 Dec;26(23-24):4613-4621. doi: 10.1111/jocn.13807. Epub 2017 Jun 22.

Abstract

AIMS AND OBJECTIVES

To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective.

BACKGROUND

The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial.

DESIGN

A descriptive design with a qualitative inductive approach was used.

METHOD

Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis.

RESULTS

Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being.

CONCLUSIONS

The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students.

RELEVANCE TO CLINICAL PRACTICE

Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication.

摘要

目的与目标

描述65岁以上老年人与护士助理在家庭护理访视中的沟通实践特点,并从以人为本的角度讨论研究结果。

背景

全球老年人口在增加,同时对居家医疗服务的需求也在增加。为了实现高质量护理,以人为本的沟通至关重要。

设计

采用定性归纳法的描述性设计。

方法

通过定性内容分析,对挪威12名护士助理与13名老年人之间自然发生的15段对话录音进行了分析。

结果

通过分析揭示了四个类别:(i)支持老年人与日常生活的联系;(ii)支持老年人参与自身护理;(iii)关注老年人的身体和生存需求;(iv)连续性和可预测性对老年人幸福感的影响。

结论

老年人与护士助理在家庭护理访视期间的沟通主要以任务为导向,但也与个人相关。老年人参与了要执行的任务,幽默是沟通的一部分。对身体需求的关注多于生存需求。沟通以多种方式与老年人的日常生活相关联。时间框架和中断困扰着老年人;听力和言语障碍对沟通构成挑战。为了加强以人为本的沟通,需要进一步研究,特别是针对医疗保健专业人员和学生的干预研究。

与临床实践的相关性

响应老年人的主观体验对于满足他们在家庭护理中的需求很重要。解决信任和可预测性需求的沟通对老年人很重要。应对生存需求需要更多关注。家庭护理环境对沟通有影响。

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