University of Iowa College of Nursing, Iowa City, Iowa, USA.
Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA; Department of Mathematics and Statistics, Faculty of Science, University of Calgary, Calgary, Canada.
Int J Nurs Stud. 2022 Aug;132:104259. doi: 10.1016/j.ijnurstu.2022.104259. Epub 2022 Apr 22.
Elderspeak communication is typically viewed as patronizing and infantilizing by older adults and can lead to resistive behaviors in persons living with dementia. Little is known about the presence of elderspeak communication in hospitals in the United States. Understanding this phenomenon in the hospital setting is needed in order to improve hospital dementia care.
The purpose of the Nurse Talk study was to (1) describe attributes of elderspeak use in hospital dementia care and to (2) determine what characteristics are associated with nursing staff use of elderspeak communication with hospitalized patients with dementia.
A cross-sectional observational study design was used to collect and analyze audio-recordings of nursing staff during care for hospitalized patients with dementia.
Three hospital units in one Midwestern university hospital in the United States.
A convenience sample of 53 staff nurses and nursing assistants that provided direct care to 16 patients with mild or more severe dementia recruited from October 2019 through mid-March 2020.
Eighty-eight care encounters were audio-recorded and coded for elderspeak communication using the Iowa Coding of Elderspeak scheme to determine the frequency and characteristics of elderspeak communication. A linear mixed effects model was used to determine what characteristics were associated with elderspeak and the frequency of elderspeak use by nursing staff to hospitalized patients with dementia.
Over a quarter (28.7%) of all nursing staff speech directed towards patients with dementia constituted elderspeak and nearly all (96.6%) care encounters included some elderspeak. Particularly common attributes of elderspeak were minimizing words and mitigating expressions, childish terms and phrases, and collective pronoun substitution. A statistically significant interaction was identified between staff role and age (95% CI: -0.02, -0.00, p = .008) in predicting the frequency of elderspeak use, indicating that elderspeak was used more often by older staff nurses, whereas the age of nursing assistants remained constant across elderspeak use. Statically significant effects for delirium and length of stay were also demonstrated. Elderspeak use was 12.5% higher with patients with delirium (95% CI: 0.02, 0.23, p = .025) and increased 1.5% for each additional day the patient with dementia was hospitalized (95% CI: 0.00, 0.03, p = .035).
Elderspeak is present and pervasive in the acute care setting. Interventions targeted towards older staff nurses and nursing staff from hospital units that care for patients with delirium and longer lengths of stay are needed.
This study identified that nursing staff are frequently using elderspeak (infantilizing speech) with hospitalized patients with dementia. @claireshaw_phd @IowaNursing.
长辈式沟通通常被老年人视为屈尊和幼稚的，并可能导致痴呆症患者产生抵触行为。在美国，关于医院中存在长辈式沟通的了解甚少。为了改善医院的痴呆症护理，了解这种在医院环境中的现象是必要的。
护士谈话研究的目的是（1）描述医院痴呆症护理中长辈式沟通的特征，并（2）确定哪些特征与护理人员与住院痴呆症患者使用长辈式沟通有关。
使用横断面观察性研究设计来收集和分析在照顾住院痴呆症患者时护理人员的录音。
美国中西部一所大学医院的三个医院病房。
2019 年 10 月至 2020 年 3 月期间，从 16 名轻度或更严重痴呆症患者中招募了 53 名方便样本的一线护士和护理助理，为他们提供直接护理。
对 88 次护理接触进行录音，并使用爱荷华州长辈式沟通编码方案对长辈式沟通进行编码，以确定长辈式沟通的频率和特征。使用线性混合效应模型确定与护理人员对住院痴呆症患者使用长辈式沟通相关的特征以及护理人员使用长辈式沟通的频率。
超过四分之一（28.7%）针对痴呆症患者的所有护理人员言语构成长辈式沟通，几乎所有（96.6%）护理接触都包含一些长辈式沟通。长辈式沟通特别常见的特征包括缩小词汇和减轻表达、幼稚的词语和短语以及集体代词替代。在预测长辈式沟通使用频率方面，发现工作人员角色和年龄之间存在统计学上显著的相互作用（95%CI：-0.02，-0.00，p=0.008），表明年长的护士更经常使用长辈式沟通，而护理助理的年龄在使用长辈式沟通时保持不变。还表现出谵妄和住院时间的统计学显著影响。患有谵妄的患者使用长辈式沟通的比例高 12.5%（95%CI：0.02，0.23，p=0.025），痴呆症患者住院时间每增加一天，使用长辈式沟通的比例增加 1.5%（95%CI：0.00，0.03，p=0.035）。
长辈式沟通在急症护理环境中普遍存在且普遍存在。需要针对老年护士和护理人员以及照顾谵妄和住院时间较长的患者的医院病房开展干预措施。
这项研究表明，护理人员经常对住院痴呆症患者使用长辈式沟通（幼稚的言语）。@claireshaw_phd @IowaNursing。
