ABSTRACT
This study investigates the use of a range of conversational strategies in a nurse-led socialization group with long-term care residents who have dementia. Eight residents whose Mini-Mental State Examination (MMSE) scores ranged from 0 to 19 participated in weekly group sessions for 10 weeks. All sessions were tape recorded and transcribed verbatim. Analysis of transcribed sessions resulted in two taxonomies: a taxonomy of nurse conversational strategies (clarifying, exploring, moderating, validating, rescuing, and general discourse markers) and a taxonomy of patient responses (discourse markers, limited engagement, expanded responses, personalized response, self-initiated participation, and disconnected or fragmented participation). The effectiveness of the nurse conversational strategies was reflected in the encouraging level of resident participation rates. The findings of this study suggest that with effective support and prompting, patients with advanced dementia are able to engage in social conversations beyond what would be expected given their diagnosis and MMSE scores.
Subject(s)
Communication , Dementia/nursing , Dementia/psychology , Geriatric Nursing/methods , Nurse-Patient Relations , Aged , Aged, 80 and over , Geriatric Assessment , Group Processes , Humans , Models, Nursing , Nursing Assessment , Nursing Research , Qualitative Research , Skilled Nursing Facilities , Social FacilitationABSTRACT
Follow-up of patients discharged from the intensive care unit (ICU) is recommended as a means of service evaluation (Department of Health (2000). Comprehensive Critical Care: a Review of Adult Critical Care Services), in order to monitor the quality of the services provided Without patient follow-up, ICU staff have only 'death' or 'discharge alive from hospital' as clinical outcomes from which to judge practice performance, and limited evidence exists on which to base decisions about improvements to critical care practice (Audit Commission (1999). Critical to Success--the Place of Efficient and Effective Critical Care Services Within the Acute Hospital) To address these issues the Regional Intensive Care Unit (RICU) obtained information from patient assessment/interview on problems experienced by patients within 8-9 days (mean), following discharge from RICU A nurse-administered questionnaire was used to identify functional outcomes, nutrition and psychological issues such as anxiety and sleep disturbances Benefits of patient follow-up introduced and planned include: patient diaries for long-term patients, input from clinical psychologis, review of sedation used in RICU.
