Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.
School of Health Studies, Western University, London, Ontario, Canada.
Int J Older People Nurs. 2021 Nov;16(6):e12401. doi: 10.1111/opn.12401. Epub 2021 Aug 1.
Little is known about formal caregivers' lived experiences communicating with persons living with dementia (PLWD) who live in their own homes. Most information comes from research conducted in long-term care settings or home care settings involving family care partners. Yet, there are expected needs and rising demands for formal caregivers to provide support within clients' homes.
Accordingly, this study aimed to understand the lived experiences of personal support workers (PSWs) regarding their communication with PLWD who live in their own homes.
The study was grounded in a hermeneutic phenomenological research approach. Data were collected as part of the Be EPIC project, an evidence-informed, person-centred communication intervention for PSWs caring for PLWD. One, in-depth semi-structured interview was conducted with each of the PSWs (N = 15). Thematic analysis was completed on the interviews.
Three major themes emerged: (1) Challenged by dementia-related impairments; (2) Valuing communication in care; and (3) Home is a personal space. Findings revealed that PSWs experience difficulties communicating with PLWD because of dementia-related impairments, despite PSWs recognizing the importance of communication when they provide optimal care in the homes of PLWD. This suggests that PSWs view communication as a crucial component of quality care but do not possess the skills necessary to ensure effective interactions. Findings also demonstrated the importance, uniqueness and impact of the personal home space on PSWs' experiences with communication.
Overall, findings indicate that PSWs acknowledge the importance of communication as an integral element of providing optimal care, but dementia-related impairments and the intimate, personal home-based care context can hinder successful communication between PSWs and PLWD. The implications of the findings are that additional and targeted education and training are required for PSWs, especially on how dementia-related impairments impact communication within the context of home care based services for PLWD.
对于居住在自己家中的痴呆症患者（PLWD），照护者在与其沟通方面的实际经验鲜为人知。这些信息主要来自于长期护理机构或家庭护理环境中针对家庭护理伙伴开展的研究。然而，对于居住在自己家中的患者，人们对正式照护者提供支持的需求预计会增加，且要求也会提高。
因此，本研究旨在了解个人支持工作者（PSWs）在与居住在自己家中的 PLWD 沟通方面的实际经验。
该研究基于解释学现象学研究方法。数据是作为 Be EPIC 项目的一部分收集的，该项目是一项针对照顾 PLWD 的 PSWs 的循证、以人为主导的沟通干预措施。对每位 PSWs（N=15）进行了一次深入的半结构化访谈。对访谈进行了主题分析。
出现了三个主要主题：（1）受到与痴呆症相关的损伤的挑战；（2）重视护理中的沟通；（3）家庭是一个私人空间。研究结果表明，由于与痴呆症相关的损伤，PSWs 在与 PLWD 进行沟通时会遇到困难，尽管 PSWs 认识到在 PLWD 的家中提供最佳护理时沟通的重要性。这表明 PSWs 将沟通视为优质护理的关键组成部分，但不具备确保有效互动所需的技能。研究结果还表明，家庭环境的重要性、独特性和对 PSWs 沟通体验的影响。
总体而言，研究结果表明，PSWs 承认沟通作为提供最佳护理的一个组成部分的重要性，但与痴呆症相关的损伤以及亲密、私人的家庭护理环境可能会阻碍 PSWs 与 PLWD 之间的成功沟通。研究结果表明，需要为 PSWs 提供额外的、有针对性的教育和培训，特别是关于与痴呆症相关的损伤如何影响家庭护理服务中针对 PLWD 的沟通。
