College of Nursing, The University of Iowa, Iowa City, IA, USA.
School of Nursing, The University of Kansas, Kansas City, KS, USA.
J Adv Nurs. 2021 Mar;77(3):1244-1257. doi: 10.1111/jan.14647. Epub 2020 Nov 22.
To characterize dyadic mealtime verbal interactions and examine the associations with staff and resident characteristics.
A secondary analysis of 110 videotaped mealtime observations collected from a dementia communication trial during 2011-2014.
Videos involved 25 residents with dementia and 29 staff in nine nursing homes. Verbal behaviours (utterances) were coded during 2018-2019 using the Cue Utilization and Engagement in Dementia mealtime video-coding scheme, addressing eight positive behaviours and four negative behaviours. Bivariate analyses and multivariate regression models were used.
Staff spoke three times more frequently (76.5%) than residents (23.5%). Nearly all staff utterances were positive (99.2%); 85.1% of residents' utterances were positive and 14.9% negative. Staff positive utterances were correlated with their negative utterances and resident positive and negative utterances. Staff negative utterances were correlated with resident negative utterances. Resident positive and negative utterances were correlated. Resident positive utterances were significantly associated with staff care-giving length in the current nursing home (OR = 1.430, 95% CI = 1.008, 2.027). Resident negative utterances were significantly associated with resident gender (female versus male, OR = 11.892, 95% CI = 1.237, 114.289) and staff years worked as a caregiver (OR = 0.838, 95% CI = 0.710, 0.989). Staff positive and negative utterances were not associated significantly with any participant characteristics.
Staff engage residents using primarily positive verbal strategies. Staff-resident mealtime verbal interactions were dynamic, interactive, and complex and related to multiple individual characteristics.
Positive dyadic mealtime interactions are critical to engage residents in eating. Little work has characterized dyadic mealtime interactions, limiting the development of effective interventions. Findings showed staff-resident mealtime verbal interactions were primarily positive, inter-related, and associated with multiple individual characteristics. Findings inform directions to improve mealtime care practice and develop person-centred mealtime interventions targeting modifiable factors, including staff care-giving experiences.
描述双重用餐时的言语互动，并探讨其与员工和居民特征的关系。
这是对 2011 年至 2014 年进行的痴呆症沟通试验中收集的 110 段录像用餐观察的二次分析。
录像涉及 9 家养老院的 25 位痴呆症患者和 29 位员工。在 2018 年至 2019 年期间，使用 Cue Utilization and Engagement in Dementia 用餐视频编码方案对言语行为（话语）进行了编码，该方案涉及 8 种积极行为和 4 种消极行为。使用了双变量分析和多变量回归模型。
员工的发言频率是居民的三倍（76.5%）（23.5%）。几乎所有员工的话语都是积极的（99.2%）；85.1%的居民话语是积极的，14.9%是消极的。员工的积极话语与他们的消极话语以及居民的积极和消极话语相关。员工的消极话语与居民的消极话语相关。居民的积极和消极话语相互关联。居民的积极话语与员工在当前养老院的护理时间显著相关（OR=1.430，95%CI=1.008，2.027）。居民的消极话语与居民的性别（女性与男性，OR=11.892，95%CI=1.237，114.289）和员工作为护理人员的工作年限（OR=0.838，95%CI=0.710，0.989）显著相关。员工的积极和消极话语与任何参与者的特征均无显著关联。
员工主要通过积极的言语策略与居民互动。员工与居民之间的用餐时间言语互动是动态的、互动的和复杂的，与多个个体特征有关。
积极的双重用餐互动对于吸引居民进食至关重要。很少有工作对双重用餐互动进行了描述，这限制了有效干预措施的发展。研究结果表明，员工与居民的用餐时间言语互动主要是积极的、相互关联的，并且与多个个体特征有关。研究结果为改善用餐护理实践和开发以可修改因素为目标的以患者为中心的用餐干预措施提供了信息，这些因素包括员工的护理经验。
