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ACTs 的混合方法评估:通过叙事建立联系——一种提高韩国养老院中老年人参与和员工互动的新方法。

Mixed Method Evaluation of ACTS: Advancing Connection Through Storytelling-A Novel Approach to Improve Older Adult Engagement and Staff Interactions in Korean Nursing Homes.

机构信息

College of Nursing, Sustainable Health Research Institute, Gyeongsang National University, Jinju, Gyeongsangnam-do, South Korea.

College of Nursing, Gyeongsang National University, Jinju, Gyeongsangnam-do, South Korea.

出版信息

West J Nurs Res. 2024 Jun;46(6):445-455. doi: 10.1177/01939459241247809. Epub 2024 Apr 24.

Abstract

BACKGROUND

A culture centered on relationships and communication is necessary to improve the quality of life of older adults living in nursing homes.

OBJECTIVES

To examine the effects of a storytelling program by examining the cognitive, emotional, and psychosocial changes in older adults in facilities and explore staff experience of changes in care.

METHODS

This mixed method study delivered a 6-week storytelling program based on relationship-centered care for residents of nursing homes (aged >65 years). Changes in emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and the person-centered environment as perceived by older adults were quantitatively analyzed using pre-intervention and post-intervention surveys. Qualitative data were collected through weekly stories created by residents, followed by focus group interviews with nursing home staff, analyzed using reflexive thematic analysis to enhance understanding of the program's outcomes.

RESULTS

The 42 residents reported significant changes in their emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and person-centered environment scores after the 6-week intervention. Analysis of the residents' stories identified 5 themes. The staff focus group interviews identified 2 themes and 7 subthemes. Intervention group residents were more likely to initiate conversations, express themselves, carefully observe themselves and others, and actively participate in social activities.

CONCLUSIONS

The storytelling program was useful in reducing older adults' negative emotions by allowing them to express their thoughts and feelings and improve their relationships, creating opportunities for social interaction. These effects could help foster relationship- and communication-centered facility cultures.

摘要

背景

以关系和沟通为中心的文化对于提高养老院中老年人的生活质量是必要的。

目的

通过考察老年人在养老院的认知、情感和心理社会变化,来检验以关系为中心的叙事疗法的效果,并探索工作人员在护理方面的变化体验。

方法

本混合方法研究为养老院(年龄>65 岁)的居民提供了为期 6 周的以关系为中心的叙事疗法。采用预干预和后干预调查,对老年人的情感表达、抑郁、沟通技巧、社会支持、人际关系、护患互动和以患者为中心的环境变化进行了定量分析。通过居民每周创作的故事收集定性数据,随后对养老院工作人员进行焦点小组访谈,采用反思性主题分析进行分析,以增强对项目结果的理解。

结果

42 名居民在 6 周的干预后,在情感表达、抑郁、沟通技巧、社会支持、人际关系、护患互动和以患者为中心的环境评分方面均有显著变化。对居民故事的分析确定了 5 个主题。工作人员焦点小组访谈确定了 2 个主题和 7 个子主题。干预组的居民更有可能主动发起对话、表达自己、仔细观察自己和他人,并积极参与社交活动。

结论

叙事疗法通过让老年人表达自己的想法和感受,改善他们的人际关系,为社交互动创造机会,有助于减轻老年人的负面情绪,从而建立以关系和沟通为中心的机构文化。

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