School of Nursing and Midwifery, College of Medicine and Health, Brookfield Health Sciences Complex University College Cork, College Road, Cork T12 AK54, Ireland.
Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, SE1 8WA, United Kingdom.
Nurse Educ Today. 2018 Apr;63:87-93. doi: 10.1016/j.nedt.2018.01.024. Epub 2018 Jan 31.
People living with dementia have complex communication needs, especially during acute hospital admissions. The VERA framework (validation, emotion, reassurance, activity) was designed to promote person centred communication between student nurses and people living with dementia, but there is limited evaluation of its impact.
To measure the impact of dementia communication training (based on VERA) plus older adult unit (OAU) placement on students' ability to recognise opportunities for person centred (PC) communication compared to OAU placement alone.
A control pre-post-study design was used. Dementia communication training plus follow-up during OAU placement was delivered to 51 students (5 OAU, two hospitals) while 66 students (7 OAUs, five hospitals) acted as controls. The primary outcome was students' ability to recognise PC communication assessed using case vignettes. Data were collected using electronic survey and focus group interviews. Data analysis used independent non-parametric Mann-Whitney U test and thematic analysis.
In total 52 students (response rate 40%) completed surveys at the end of placements (38 intervention, 14 control group students). In the intervention group, participants were significantly more likely to identify PC responses with a mean score of 10.5 (SD 3.0) compared with 7.5 (SD 3.0) in the control group (p = 0.006). In focus group interviews (n = 19 students), the main themes were connecting with patients, VERA in practice, communication challenges, and learning environment. VERA was described as a flexible approach that added to participants' communication toolkit. The learning environment, complexity of patients and organisational resources were important contextual factors.
The VERA framework has potential as a foundation level dementia communication training intervention, but it requires more rigorous testing. Nursing can lead the way in developing and embedding evidence-based, interdisciplinary dementia communication training in preregistration curricula.
患有痴呆症的人有复杂的沟通需求，尤其是在急性住院期间。VERA 框架（验证、情感、保证、活动）旨在促进护生与痴呆症患者之间以患者为中心的沟通，但对其影响的评估有限。
衡量以 VERA 为基础的痴呆症沟通培训加上老年病房（OAu）安置对学生识别以人为中心（PC）沟通机会的能力的影响，与单独的 OAu 安置相比。
采用对照前后研究设计。在老年病房安置期间，对 51 名学生（5 个老年病房，2 家医院）进行了痴呆症沟通培训和后续培训，而 66 名学生（7 个老年病房，5 家医院）作为对照组。主要结果是使用案例情景评估学生识别 PC 沟通的能力。使用电子调查和焦点小组访谈收集数据。数据分析使用独立的非参数曼-惠特尼 U 检验和主题分析。
共有 52 名学生（回应率 40%）在安置结束时完成了调查（38 名干预组，14 名对照组学生）。在干预组中，参与者更有可能识别出 PC 反应，平均得分为 10.5（SD 3.0），而对照组为 7.5（SD 3.0）（p=0.006）。在焦点小组访谈中（n=19 名学生），主要主题是与患者建立联系、实践中的 VERA、沟通挑战和学习环境。VERA 被描述为一种灵活的方法，增加了参与者的沟通工具包。学习环境、患者的复杂性和组织资源是重要的背景因素。
VERA 框架作为一种基础水平的痴呆症沟通培训干预措施具有潜力，但需要更严格的测试。护理可以在制定和嵌入基于证据的跨学科痴呆症沟通培训方面发挥主导作用，将其纳入预科课程。
