Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Faculty of Health, Federation University, Ballarat, Victoria, Australia.
J Clin Nurs. 2019 Apr;28(7-8):1050-1069. doi: 10.1111/jocn.14697. Epub 2018 Nov 20.
To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes.
Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia.
Systematic review and meta-analysis.
Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted through reviewing the reference lists of relevant articles. The screening and selection of studies were based on the inclusion/exclusion criteria for eligibility and the methodological quality assessment checklist. Random-effects meta-analyses were conducted on comparable quantitative data. The review is reported following the PRISMA reporting guidelines.
Seventeen studies were included in the final review, including 12 randomised controlled trials (RCTs), three nonrandomised controlled trials (NRCTs) and two controlled before-after interventions. The intervention designs, settings and outcome measures were varied. The findings suggest that the communication training had a positive impact on both carer and care-receiver outcomes, albeit to different degrees. The intervention effects were found to be strongest on carer communication skills and knowledge.
There is solid evidence for the positive impact of communication training on the skills and knowledge of carers. More research is needed regarding the effects of such educational interventions on carer physio-psychological outcomes and care-receiver neuropsychiatric symptoms. It is important to establish best practices in training design, develop validated outcome measures and adopt consistent reporting approaches.
The increasing global prevalence of people with dementia manifests across clinical and community contexts. The profound impact of dementia on communication and associated care raises the imperative for enhanced health worker and carer communication skills to meet the needs of this particular client group. The findings of this review indicate that educational interventions incorporating face-to-face and diverse instructional delivery methods in dementia communication showed positive outcomes for communication skills in all carer groups and warrant inclusion as strategies in dementia training.
回顾旨在改善各种环境中痴呆症患者及其照顾者之间常规护理互动的沟通干预措施；并研究这些干预措施对照顾者和护理接受者结果的影响。
有效的沟通对于确保痴呆症患者的护理质量至关重要。由于神经退行性变化，痴呆症患者在理解和表达自己方面都遇到了持续且逐渐加剧的困难。这反过来又给照顾者带来了挑战，这凸显了需要为他们配备必要的沟通技能，以满足痴呆症患者的特定沟通需求。
系统综述和荟萃分析。
检索了 Medline、Embase、CINAHL、ProQuest 和 PsycINFO 数据库中所有已发表日期的相关干预措施。还通过查看相关文章的参考文献进行了手工搜索。研究的筛选和选择基于纳入/排除标准和方法学质量评估清单。对可比的定量数据进行了随机效应荟萃分析。该综述按照 PRISMA 报告指南进行报告。
最终综述纳入了 17 项研究，包括 12 项随机对照试验（RCT）、3 项非随机对照试验（NRCT）和 2 项对照前后干预。干预设计、设置和结果测量各不相同。研究结果表明，沟通培训对照顾者和护理接受者的结果都有积极影响，但程度不同。干预效果在照顾者沟通技巧和知识方面最强。
有确凿的证据表明沟通培训对照顾者的技能和知识有积极影响。需要更多关于此类教育干预对照顾者生理心理结果和护理接受者神经精神症状影响的研究。重要的是要在培训设计中建立最佳实践，开发经过验证的结果测量方法，并采用一致的报告方法。
痴呆症患者的全球患病率不断增加，在临床和社区环境中都有体现。痴呆症对沟通的深远影响以及由此产生的护理需求，凸显了增强卫生工作者和照顾者沟通技巧的必要性，以满足这一特定患者群体的需求。本综述的结果表明，纳入面对面和多种教学方法的痴呆症沟通教育干预措施，对所有照顾者群体的沟通技巧都产生了积极影响，值得将其作为痴呆症培训策略纳入。
