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就座于桌旁:支持严重痴呆症患者表达其偏好。

A Seat at the Table: Supporting Persons with Severe Dementia in Communicating Their Preferences.

机构信息

Communication Sciences and Disorders, University of South Florida, Tampa, Florida, USA.

出版信息

Clin Gerontol. 2022 May-Jun;45(3):647-660. doi: 10.1080/07317115.2020.1764686. Epub 2020 Jul 7.

DOI:10.1080/07317115.2020.1764686
PMID:32633699
Abstract

: Persons with severe dementia are less likely to have a role in preference assessment due to communication challenges associated with the disease. Research is limited on how to support preference communication while using existing preference assessment tools (e.g., the Minimum Data Set 3.0).: This study examined the effect of two assessment conditions (standard verbal; visual-and-text supported;) on residents' (N = 21) social and leisure preference consistency over 1-week and utterance types (acknowledgment, elaboration, off-topic, request for clarification) in response to preference questions. Residents with severe dementia were recruited from four nursing homes (n = 11) and three assisted living facilities (n = 10). As a preliminary measure of provider acceptability and social validity, a sample of 10 naïve judges (University students) listened to the interviews and rated residents' communication clarity and their confidence with understanding residents' preferences.: Neither assessment condition promoted significantly greater levels of consistency (i.e., the same preference rating at Time 1 and Time 2). Residents expressed significantly fewer requests for clarification in the visual-and-text supported condition. Naïve judges rated residents' communication positively, with no significant differences between conditions.: This study addresses a gap in current research and holds important implications for enhancing care planning participation by residents with severe dementia.: Residents with severe dementia can successfully participate in activity preference discussions without proxy participation. Residents may comprehend interview questions better when provided in a supported format.

摘要

严重痴呆症患者由于与疾病相关的沟通挑战,不太可能在偏好评估中发挥作用。关于如何在使用现有偏好评估工具(例如,最低数据集合 3.0)的同时支持偏好沟通的研究有限。本研究考察了两种评估条件(标准口头;视觉和文本支持)对居民(N=21)在一周内的社会和休闲偏好一致性以及对偏好问题的反应类型(认可、详细说明、离题、要求澄清)的影响。从四家养老院(n=11)和三家辅助生活设施(n=10)招募了患有严重痴呆症的居民。作为提供者可接受性和社会有效性的初步衡量标准,10 名天真评判者(大学生)听取了访谈,并对居民的沟通清晰度及其理解居民偏好的信心进行了评分。两种评估条件均未显著提高一致性水平(即,第一次和第二次的相同偏好评分)。在视觉和文本支持条件下,居民表达的澄清请求明显减少。天真的评判者对居民的沟通给予了积极评价,两种条件之间没有显著差异。本研究解决了当前研究中的一个空白,并对增强严重痴呆症居民的护理计划参与具有重要意义。严重痴呆症患者无需代理人参与即可成功参与活动偏好讨论。当以支持格式提供时,居民可能会更好地理解访谈问题。

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