Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Duboisdomein 30, 6221 GT, Maastricht, the Netherlands; Living Lab in Aging and Long-Term Care, Duboisdomein 30, 6221 GT, Maastricht, the Netherlands.
Int J Nurs Stud. 2021 Jan;113:103776. doi: 10.1016/j.ijnurstu.2020.103776. Epub 2020 Oct 2.
Communication between nursing staff and people with dementia can be challenging. According to the literature, communication is seen as a process of social- and/or informational exchange between a sender and a receiver in a context. Factors related to these elements determine the quality of communication. Insight into the factors involved in the communication process between nursing staff and people with dementia is limited and a comprehensive model of communication in dementia care is lacking.
To identify and visualize factors associated with communication between nursing staff and people with dementia.
A scoping review of scientific literature.
Scientific articles were retrieved from the bibliographic databases of PubMed, CINAHL and PsycINFO.
The reviewing process was directed by the Joanna Briggs guidelines for scoping reviews. Full-text articles describing the communication process between nursing staff and people with dementia were eligible for inclusion. A data extraction form was used to identify factors associated with communication. Following a directed content analysis approach, factors were categorized in one of three categories: nursing staff; people with dementia; or context. Each category was thematically analysed to identify themes and subthemes. Results were visualized into a communication model.
The review included 31 articles; in total, 115 factors were extracted. Thematic analysis of nursing staff factors (n = 78) showed that communication is associated with professional characteristics, individual experiences, verbal- and non-verbal communication skills, communication approach and values. Factors attributed to people with dementia (n = 22) concerned client characteristics, functional status, behaviour, verbal communication skills and values. Contextual factors (n = 15) related to organization of care, time and situation. Based on these results, the Contac-d model was constructed.
The Contac-d model gives a comprehensive overview of factors involved in the communication process between nursing staff and people with dementia, providing insight in potential starting points for communication improvement, e.g. respect for needs, identity and privacy of people with dementia, a flexible and adapted communication approach and matching language. Additionally, results suggest that an appealing location, longer duration of the interaction, and music in the surrounding may improve communication in certain situations. However, it was not feasible based on current literature to recommend what works to improve communication in which situations. Future studies should study factors and their interrelatedness in specific care situations. Authors further believe that more attention should be paid to strengths and capabilities of people with dementia and to non-modifiable factors that influence communication.
护理人员与痴呆症患者之间的沟通可能具有挑战性。根据文献，沟通被视为发送者和接收者在特定背景下进行的社会和/或信息交换过程。与这些要素相关的因素决定了沟通的质量。然而，目前对于护理人员与痴呆症患者之间沟通过程中涉及的因素的了解有限，并且缺乏痴呆症护理沟通的综合模型。
确定和可视化与护理人员和痴呆症患者之间沟通相关的因素。
对科学文献进行范围综述。
从 PubMed、CINAHL 和 PsycINFO 的书目数据库中检索科学文章。
审查过程遵循 Joanna Briggs 指南进行。符合条件的文章包括描述护理人员与痴呆症患者之间沟通过程的全文文章。使用数据提取表确定与沟通相关的因素。采用定向内容分析方法，将因素分为护理人员、痴呆症患者或背景三个类别。对每个类别进行主题分析，以确定主题和子主题。结果以沟通模型的形式呈现。
综述纳入 31 篇文章，共提取 115 个因素。对护理人员因素（n=78）的主题分析表明，沟通与专业特征、个人经验、言语和非言语沟通技巧、沟通方法和价值观有关。归因于痴呆症患者的因素（n=22）涉及患者特征、功能状态、行为、言语沟通技巧和价值观。与背景相关的因素（n=15）涉及护理组织、时间和情况。基于这些结果，构建了 Contac-d 模型。
Contac-d 模型全面概述了护理人员与痴呆症患者之间沟通过程中涉及的因素，为改善沟通提供了潜在的起点，例如尊重痴呆症患者的需求、身份和隐私、灵活和适应的沟通方法以及匹配的语言。此外，结果表明，在某些情况下，吸引人的地点、更长的互动时间和周围的音乐可能会改善沟通。然而，根据当前文献，无法推荐在哪些情况下使用哪些方法来改善沟通。未来的研究应在特定护理情况下研究因素及其相互关系。作者进一步认为，应该更加关注痴呆症患者的优势和能力，以及影响沟通的不可改变因素。
