Murawski Alaine, Ramirez-Zohfeld Vanessa, Schierer Allison, Olvera Charles, Mell Johnathan, Gratch Jonathan, Brett Jeanne, Lindquist Lee A
Division of Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL 60208, USA.
School of Computer Science, University of Central Florida, Orlando, FL 32816, USA.
Geriatrics (Basel). 2023 Mar 8;8(2):36. doi: 10.3390/geriatrics8020036.
Family caregivers of older people with Alzheimer's dementia (PWD) often need to advocate and resolve health-related conflicts (e.g., determining treatment necessity, billing errors, and home health extensions). As they deal with these health system conflicts, family caregivers experience unnecessary frustration, anxiety, and stress. The goal of this research was to apply a negotiation framework to resolve real-world family caregiver-older adult conflicts.
We convened an interdisciplinary team of national community-based family caregivers, social workers, geriatricians, and negotiation experts ( = 9; Illinois, Florida, New York, and California) to examine the applicability of negotiation and conflict management frameworks to three older adult-caregiver conflicts (i.e., caregiver-older adult, caregiver-provider, and caregiver-caregiver). The panel of caregivers provided scenarios and dialogue describing conflicts they experienced in these three settings. A qualitative analysis was then performed grouping the responses into a framework matrix.
Upon presenting the three conflicts to the caregivers, 96 responses (caregiver-senior), 75 responses (caregiver-caregiver), and 80 responses (caregiver-provider) were generated. A thematic analysis showed that the statements and responses fit the interest-rights-power (IRP) negotiation framework.
The interests-rights-power (IRP) framework, used in business negotiations, provided insight into how caregivers experienced conflict with older adults, providers, and other caregivers. Future research is needed to examine applying the IRP framework in the training of caregivers of older people with Alzheimer's dementia.
阿尔茨海默病痴呆症患者（PWD）的家庭照顾者经常需要进行倡导并解决与健康相关的冲突（例如，确定治疗必要性、计费错误和家庭健康护理延期）。在处理这些医疗系统冲突时，家庭照顾者会经历不必要的挫折、焦虑和压力。本研究的目的是应用一个谈判框架来解决现实世界中家庭照顾者与老年人之间的冲突。
我们召集了一个跨学科团队，成员包括全国社区家庭照顾者、社会工作者、老年病医生和谈判专家（共9人；来自伊利诺伊州、佛罗里达州、纽约州和加利福尼亚州），以研究谈判和冲突管理框架对三种老年人 - 照顾者冲突（即照顾者 - 老年人、照顾者 - 提供者和照顾者 - 照顾者）的适用性。照顾者小组提供了描述他们在这三种情况下所经历冲突的场景和对话。然后进行定性分析，将回答分组到一个框架矩阵中。
向照顾者呈现这三种冲突后，共产生了96条回答（照顾者 - 老年人）、75条回答（照顾者 - 照顾者）和80条回答（照顾者 - 提供者）。主题分析表明，这些陈述和回答符合利益 - 权利 - 权力（IRP）谈判框架。
商业谈判中使用的利益 - 权利 - 权力（IRP）框架，为了解照顾者如何与老年人、提供者和其他照顾者发生冲突提供了见解。未来需要进行研究，以考察在阿尔茨海默病痴呆症患者家庭照顾者的培训中应用IRP框架的情况。
