Journal article
A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial
The Gerontologist, Vol.57(4), pp.707-718
08/01/2017
DOI: 10.1093/geront/gnw047
PMCID: PMC5881770
PMID: 27048705
Abstract
Nursing home (NH) residents with dementia exhibit challenging behaviors or resistiveness to care (RTC) that increase staff time, stress, and NH costs. RTC is linked to elderspeak communication. Communication training (Changing Talk [CHAT]) was provided to staff to reduce their use of elderspeak. We hypothesized that CHAT would improve staff communication and subsequently reduce RTC.
Thirteen NHs were randomized to intervention and control groups. Dyads (n = 42) including 29 staff and 27 persons with dementia were videorecorded during care before and/or after the intervention and at a 3-month follow-up. Videos were behaviorally coded for (a) staff communication (normal, elderspeak, or silence) and (b) resident behaviors (cooperative or RTC). Linear mixed modeling was used to evaluate training effects.
On average, elderspeak declined from 34.6% (SD = 18.7) at baseline by 13.6% points (SD = 20.00) post intervention and 12.2% points (SD = 22.0) at 3-month follow-up. RTC declined from 35.7% (SD = 23.2) by 15.3% points (SD = 32.4) post intervention and 13.4% points (SD = 33.7) at 3 months. Linear mixed modeling determined that change in elderspeak was predicted by the intervention (b = -12.20, p = .028) and baseline elderspeak (b = -0.65, p < .001), whereas RTC change was predicted by elderspeak change (b = 0.43, p < .001); baseline RTC (b = -0.58, p < .001); and covariates.
A brief intervention can improve communication and reduce RTC, providing an effective nonpharmacological intervention to manage behavior and improve the quality of dementia care. No adverse events occurred.
Details
- Title: Subtitle
- A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial
- Creators
- Kristine N Williams - College of Nursing, University of IowaYelena Perkhounkova - College of Nursing, University of IowaRuth Herman - Center for Public Partnerships and Research, University of Kansas, LawrenceAnn Bossen - College of Nursing, University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Gerontologist, Vol.57(4), pp.707-718
- DOI
- 10.1093/geront/gnw047
- PMID
- 27048705
- PMCID
- PMC5881770
- ISSN
- 0016-9013
- eISSN
- 1758-5341
- Grant note
- R01 NR011455 / NINR NIH HHS
- Language
- English
- Date published
- 08/01/2017
- Academic Unit
- Nursing
- Record Identifier
- 9984083879202771
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