Mealtime verbal interactions among nursing home staff and residents with dementia: A secondary behavioural analysis of videotaped observations.

To characterize dyadic mealtime verbal interactions and examine the associations with staff and resident characteristics. A secondary analysis of 110 videotaped mealtime observations collected from a dementia communication trial during 2011-2014. Videos involved 25 residents with dementia and 29 staff in nine nursing homes. Verbal behaviours (utterances) were coded during 2018-2019 using the Cue Utilization and Engagement in Dementia mealtime video-coding scheme, addressing eight positive behaviours and four negative behaviours. Bivariate analyses and multivariate regression models were used. Staff spoke three times more frequently (76.5%) than residents (23.5%). Nearly all staff utterances were positive (99.2%); 85.1% of residents' utterances were positive and 14.9% negative. Staff positive utterances were correlated with their negative utterances and resident positive and negative utterances. Staff negative utterances were correlated with resident negative utterances. Resident positive and negative utterances were correlated. Resident positive utterances were significantly associated with staff care-giving length in the current nursing home (OR = 1.430, 95% CI = 1.008, 2.027). Resident negative utterances were significantly associated with resident gender (female versus male, OR = 11.892, 95% CI = 1.237, 114.289) and staff years worked as a caregiver (OR = 0.838, 95% CI = 0.710, 0.989). Staff positive and negative utterances were not associated significantly with any participant characteristics. Staff engage residents using primarily positive verbal strategies. Staff-resident mealtime verbal interactions were dynamic, interactive, and complex and related to multiple individual characteristics. Positive dyadic mealtime interactions are critical to engage residents in eating. Little work has characterized dyadic mealtime interactions, limiting the development of effective interventions. Findings showed staff-resident mealtime verbal interactions were primarily positive, inter-related, and associated with multiple individual characteristics. Findings inform directions to improve mealtime care practice and develop person-centred mealtime interventions targeting modifiable factors, including staff care-giving experiences. 目的: 描述二元进餐时的言语互动, 并检查工作人员和养老院患者病症的相关性。 设计: 对2011-2014年痴呆症交流试验过程中收集的110个用餐时间录像观察进行二次分析。 方法: 视频涉及25名养老院痴呆患者和9家养老院的29名工作人员。2018-2019年间, 研究人员利用痴呆患者用餐时间视频编码方案中的线索利用和参与要求对言语行为(话语)进行编码, 共处理8种积极行为和4种消极行为。采用双变量分析和多元回归模型。 结果: 工作人员的说话频率 (76.5%) 是养老院患者(23.5%) 的三倍。几乎所有工作人员都积极谈话(99.2%) ; 85.1%的养老院患者积极谈话,而14.9%的养老院患者消极谈话。工作人员的话语积极性与其话语消极性、患者的话语积极性和患者的话语消极性相关。工作人员的话语消极性与养老院患者的话语消极性相关。养老院患者的话语积极性和消极性相关。养老院患者的话语积极性与目前疗养院工作人员的护理时间显著相关 (OR=1.430,95%CI=1.008,2.027) 。养老院患者的话语消极性与其性别 (女性对比男性, OR=11.892,95%CI=1.237114.289) 和护理人员工作年限 (OR=0.838,95%CI=0.710,0.989) 显著相关。工作人员的话语积极性和消极性与参与者特征无显著相关。 结论: 工作人员主要通过积极的语言策略来引起养老院患者注意。工作人员--养老院患者的进餐言语互动具有动态、互动、复杂的特点,得益于复杂的个人特征。 影响: 积极的二元进餐互动对养老院患者进餐至关重要。目前, 鲜有研究对进餐时的互动进行描述, 致使有效干预措施的采取受限。研究结果显示, 工作人员与养老院患者在进餐时的言语互动以积极、相互关联为主, 并且与复杂的个人特征相关。研究结果可为进餐护理实践的改进和以人为本的进餐干预措施的制定提供指导, 此类干预措施主要针对可改变的因素, 包括工作人员的护理经验。.

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