Vachon Marie, Veilleux Marie-Christine, Macoir Joël
Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada.
Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada, Centre de recherche, Institut universitaire en santé mentale, Québec, Canada.
Geriatr Psychol Neuropsychiatr Vieil. 2017 Jun 1;15(2):185-195. doi: 10.1684/pnv.2017.0665.
The goal of this literature review was to determine communication strategies that foster interactions between individuals with Alzheimer's disease (AD) and caregivers or medical staff. A search of PubMed and PsycINFO databases was conducted using combinations of the following terms: Alzheimer, family, caregiver, communication, language, treatment, intervention, therapy, communication strategies, functional communication and daily living activities. Studies were chosen based on the original language of the text, year of publication, peer-review status and specificity of the results regarding communication strategies in AD. This review covers 14 articles published between 1994 and 2014. The in-depth analysis of these studies shows that various communication strategies used by caregivers and medical staff are effective to promote interactions with people with AD at different stages of the disease. For caregivers, these strategies include producing short and syntactically simple sentences, relying on semantic memory rather than on episodic memory, providing more information and reformulate, removing potential distractions from the environment, specifying the topic of the conversation, using precise terms to identify communication breakdowns. Other strategies also appeared to be effective for medical staff, such as asking close-ended questions, providing response choices, verbalizing the actions performed during medical care and activities, paying attention to the needs expressed through verbal and non-verbal messages, adopting a supportive way of speaking. Furthermore, other communication strategies rather appear to be harmful to functional communication. These harmful strategies involve insisting that the person produce a specific word, asking him/her to repeat or tune out in case of communication breakdown. Finally, contradictory outcomes are reported for some strategies such as speaking slowly, repeating or rephrase questions and information. This article provides some useful avenues to better interact with people with AD. Further studies are needed to confirm and refine some results, in particular as regards the effectiveness of communication strategies at the different stages of the disease through longitudinal research design.
这篇文献综述的目的是确定能够促进阿尔茨海默病（AD）患者与护理人员或医护人员之间互动的沟通策略。我们使用以下术语组合在PubMed和PsycINFO数据库中进行了检索：阿尔茨海默病、家庭、护理人员、沟通、语言、治疗、干预、疗法、沟通策略、功能性沟通和日常生活活动。我们根据文本的原始语言、出版年份、同行评审状态以及关于AD沟通策略的结果特异性来选择研究。这篇综述涵盖了1994年至2014年间发表的14篇文章。对这些研究的深入分析表明，护理人员和医护人员使用的各种沟通策略对于促进与处于疾病不同阶段的AD患者的互动是有效的。对于护理人员来说，这些策略包括使用简短且句法简单的句子、依靠语义记忆而非情景记忆、提供更多信息并重新表述、消除环境中的潜在干扰、明确对话主题、使用精确术语来识别沟通障碍。其他策略对医护人员似乎也有效，比如问封闭式问题、提供回答选项、说出医疗护理和活动期间所执行的动作、关注通过言语和非言语信息表达的需求、采用支持性的说话方式。此外，其他沟通策略似乎对功能性沟通有害。这些有害策略包括坚持让患者说出特定的单词、在沟通出现障碍时要求其重复或不予理会。最后，对于一些策略，如慢慢说话、重复或重新表述问题及信息，报告了相互矛盾的结果。本文提供了一些与AD患者更好互动的有用途径。需要进一步的研究来证实和完善一些结果，特别是关于通过纵向研究设计探讨沟通策略在疾病不同阶段的有效性。
