Wilson Rozanne, Small Jeff
School of Audiology and Speech Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.
JMIR Nurs. 2020 Sep 29;3(1):e21881. doi: 10.2196/21881.
Long-term care (LTC) homes provide 24-hour care for people living with complex care needs. LTC staff assist older adults living with chronic conditions such as Alzheimer disease, related dementias, and stroke, which can cause communication disorders. In addition to the complex cognitive challenges that can impact communication, further difficulties can arise from cultural-language differences between care staff and residents. Breakdowns in caregiver-resident communication can negatively impact the delivery of person-centered care. Recent advances in mobile technology, specifically mobile devices (tablets and smartphones) and their software apps, offer innovative solutions for supporting everyday communication between care staff and residents. To date, little is known about the care staff's perspectives on the different ways that mobile technology could be used to support communication with residents.
This study aims to identify care staff's perspectives on the different ways of using devices and apps to support everyday communication with adults living in LTC homes and the priority care areas for using mobile technology to support communication with residents.
This descriptive study employed concept mapping methods to explore care staff's perspectives about ways of using mobile technology with residents and to identify the usefulness, practicality, and probable uses of mobile technology to support communication in priority care areas. Concept mapping is an integrated mixed methods approach (qualitative and quantitative) that uses a structured process to identify priority areas for planning and evaluation. In total, 13 care staff from a single LTC home participated in this study. Concept mapping includes 2 main data collection phases: (1) statement generations through brainstorming and (2) statement structuring through sorting and rating. Brainstorming took place in person in a group session, whereas sorting and rating occurred individually after the brainstorming session. Concept mapping data were analyzed using multidimensional scaling and cluster analysis to generate numerous interpretable data maps and displays.
Participants generated 67 unique statements during the brainstorming session. Following the sorting and rating of the statements, a concept map analysis was performed. In total, 5 clusters were identified: (1) connect, (2) care management, (3) facilitate, (4) caregiving, and (5) overcoming barriers. Although all 5 clusters were rated as useful, with a mean score of 4.1 to 4.5 (Likert: 1-5), the care staff rated cluster 2 (care management) as highest on usefulness, practicality, and probable use of mobile technology to support communication in LTC.
This study provided insight into the viewpoints of care staff regarding the different ways mobile technology could be used to support caregiver-resident communication in LTC. Our findings suggest that care management, facilitating communication, and overcoming barriers are 3 priority target areas for implementing mobile health interventions to promote person-centered care and resident-centered care.
长期护理(LTC)机构为有复杂护理需求的人群提供24小时护理服务。LTC机构的工作人员协助患有慢性疾病的老年人,如阿尔茨海默病、相关痴呆症和中风患者,这些疾病可能导致沟通障碍。除了可能影响沟通的复杂认知挑战外,护理人员与居民之间的文化语言差异也可能引发更多困难。护理人员与居民之间的沟通不畅会对以人为主的护理服务产生负面影响。移动技术的最新进展,特别是移动设备(平板电脑和智能手机)及其软件应用程序,为支持护理人员与居民之间的日常沟通提供了创新解决方案。迄今为止,对于护理人员如何看待移动技术用于支持与居民沟通的不同方式知之甚少。
本研究旨在确定护理人员对于使用设备和应用程序支持与LTC机构成年居民日常沟通的不同方式的看法,以及使用移动技术支持与居民沟通的优先护理领域。
本描述性研究采用概念图方法,以探索护理人员对于与居民使用移动技术方式的看法,并确定移动技术在优先护理领域支持沟通的有用性、实用性和可能用途。概念图是一种综合的混合方法(定性和定量),使用结构化过程来确定规划和评估的优先领域。来自单个LTC机构的13名护理人员参与了本研究。概念图包括2个主要数据收集阶段:(1)通过头脑风暴生成陈述,(2)通过分类和评分构建陈述。头脑风暴在小组会议中亲自进行,而分类和评分在头脑风暴会议后单独进行。使用多维标度法和聚类分析法对概念图数据进行分析,以生成大量可解释的数据图和展示。
参与者在头脑风暴会议期间生成了67条独特的陈述。在对陈述进行分类和评分后,进行了概念图分析。总共确定了5个类别:(1)连接,(2)护理管理,(3)促进,(4)护理,(5)克服障碍。尽管所有5个类别都被评为有用,平均得分为4.1至4.5(李克特量表:1 - 5),但护理人员将类别2(护理管理)在移动技术支持LTC机构沟通的有用性、实用性和可能用途方面评为最高。
本研究深入了解了护理人员对于移动技术用于支持LTC机构中护理人员与居民沟通的不同方式的观点。我们的研究结果表明,护理管理、促进沟通和克服障碍是实施移动健康干预以促进以人为主的护理和以居民为主的护理服务的3个优先目标领域。