Verbal and Nonverbal Expressions of Persons Living With Dementia as Indicators of Person-Centered Caregiving.
Dementia
Outcome measurement
Person-centered care
Personhood
Journal
The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327
Informations de publication
Date de publication:
19 10 2022
19 10 2022
Historique:
received:
24
06
2021
pubmed:
30
1
2022
medline:
21
10
2022
entrez:
29
1
2022
Statut:
ppublish
Résumé
Improved measures capable of capturing the influence of person-centered caregiving by staff in formal care settings on people living with dementia beyond deficit-oriented outcomes such as absence or reduction of symptoms are important for measuring progress toward improvements in well-being. This exploratory ethnographic study aimed to identify verbal and nonverbal expressions evidenced by people living with dementia surrounding person-centered caregiving approaches and to consider their use in informing temporally specific observational measures. This study adopted a microethnographic approach through secondary analysis of 5.3 h of audiovisual observations of people living with dementia (N = 9) in nursing home settings at mealtimes. We observed expressions surrounding person-centered caregiving approaches. A systematic review of audiovisual observations generated codes (observable indicators) of expressions that were characterized at their most discrete and unambiguous level. Drawing from 82 observable verbal and nonverbal expressions by people living with dementia, 14 discrete observable indicators were identified, broadly evidencing shifts in engagement and communication. We found that people living with dementia's expressions served both responsive and initiatory communicative purposes. Efforts to expand positive outcome measurement for people living with dementia should extend beyond characterizing them as passive respondents toward active participants in their lived experiences. Identified observable indicators can inform efforts to refine and validate measures of expressions among people living with dementia. Further research can extend this inquiry into different contexts and engage input from people living with dementia and caregivers.
Sections du résumé
BACKGROUND AND OBJECTIVES
Improved measures capable of capturing the influence of person-centered caregiving by staff in formal care settings on people living with dementia beyond deficit-oriented outcomes such as absence or reduction of symptoms are important for measuring progress toward improvements in well-being. This exploratory ethnographic study aimed to identify verbal and nonverbal expressions evidenced by people living with dementia surrounding person-centered caregiving approaches and to consider their use in informing temporally specific observational measures.
RESEARCH DESIGN AND METHODS
This study adopted a microethnographic approach through secondary analysis of 5.3 h of audiovisual observations of people living with dementia (N = 9) in nursing home settings at mealtimes. We observed expressions surrounding person-centered caregiving approaches. A systematic review of audiovisual observations generated codes (observable indicators) of expressions that were characterized at their most discrete and unambiguous level.
RESULTS
Drawing from 82 observable verbal and nonverbal expressions by people living with dementia, 14 discrete observable indicators were identified, broadly evidencing shifts in engagement and communication. We found that people living with dementia's expressions served both responsive and initiatory communicative purposes.
DISCUSSION AND IMPLICATIONS
Efforts to expand positive outcome measurement for people living with dementia should extend beyond characterizing them as passive respondents toward active participants in their lived experiences. Identified observable indicators can inform efforts to refine and validate measures of expressions among people living with dementia. Further research can extend this inquiry into different contexts and engage input from people living with dementia and caregivers.
Identifiants
pubmed: 35092676
pii: 6517376
doi: 10.1093/geront/gnac012
pmc: PMC9579465
doi:
Types de publication
Systematic Review
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1299-1310Subventions
Organisme : NIA NIH HHS
ID : K76 AG060005
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG062715
Pays : United States
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
Patient Educ Couns. 2002 Apr;46(4):243-51
pubmed: 11932123
Am J Alzheimers Dis Other Demen. 2015 Dec;30(8):713-22
pubmed: 24449039
Am J Geriatr Psychiatry. 2009 Apr;17(4):299-307
pubmed: 19307858
Geriatr Gerontol Int. 2019 Jan;19(1):30-34
pubmed: 30460747
Clin Interv Aging. 2017 Feb 17;12:381-397
pubmed: 28255234
Aging Ment Health. 2018 Jun;22(6):723-729
pubmed: 28513210
BMC Geriatr. 2020 Nov 17;20(1):477
pubmed: 33203379
Qual Health Res. 2020 Jan;30(1):23-42
pubmed: 31550999
PLoS One. 2019 Aug 1;14(8):e0220195
pubmed: 31369590
Clin Interv Aging. 2021 Feb 25;16:363-378
pubmed: 33664568
Evid Based Nurs. 2017 Oct;20(4):98-100
pubmed: 28889095
Front Neurol. 2012 May 07;3:73
pubmed: 22586419
J Pediatr Psychol. 2015 Jan-Feb;40(1):154-64
pubmed: 25416837
Lancet Neurol. 2008 Apr;7(4):362-7
pubmed: 18339351
Geriatrics (Basel). 2016 Oct 21;1(4):
pubmed: 31022818
BMC Nurs. 2013 Dec 20;12(1):29
pubmed: 24359589
Gerontologist. 2010 Dec;50(6):834-46
pubmed: 20566834
Geriatr Nurs. 2015 Mar-Apr;36(2 Suppl):S10-5
pubmed: 25784080
Behav Ther. 2011 Mar;42(1):89-99
pubmed: 21292055
J Consult Psychol. 1957 Apr;21(2):95-103
pubmed: 13416422
J Neuropsychiatry Clin Neurosci. 2012 Spring;24(2):125-40
pubmed: 22772661
Front Psychol. 2018 May 24;9:690
pubmed: 29881360
Fam Pract. 2019 Nov 18;36(6):808
pubmed: 31617894
Innov Aging. 2020 Jan 04;4(1):igz043
pubmed: 32405541
Int Psychogeriatr. 2017 Aug;29(8):1281-1296
pubmed: 28511738
Int J Nurs Stud. 2014 Oct;51(10):1395-415
pubmed: 24815772
Trials. 2019 Jan 6;20(1):12
pubmed: 30612587
Gerontologist. 2018 Jan 18;58(suppl_1):S10-S19
pubmed: 29361064
Dementia (London). 2019 Jan;18(1):303-322
pubmed: 27856694
Gerontologist. 2015 Jun;55 Suppl 1:S61-6
pubmed: 26055782
BMJ. 2015 Mar 02;350:h369
pubmed: 25731881
AMA J Ethics. 2017 Jul 1;19(7):693-703
pubmed: 28813242
J Clin Nurs. 2004 Mar;13(3a):31-8
pubmed: 15028037
J Med Ethics. 2021 Sep 11;:
pubmed: 34509984
Med Health Care Philos. 2020 Dec;23(4):665-676
pubmed: 32865694
Health Expect. 2018 Dec;21(6):1056-1065
pubmed: 29920881
Aging Ment Health. 2011 May;15(4):456-66
pubmed: 21500012
Psychol Med. 2018 Oct;48(13):2130-2139
pubmed: 29734962
Arch Gerontol Geriatr. 2017 Jul;71:122-128
pubmed: 28431307
J Clin Exp Neuropsychol. 2010 Apr;32(4):408-16
pubmed: 19787523
Res Gerontol Nurs. 2009 Jan;2(1):6-11
pubmed: 20077988
Clin Interv Aging. 2016 Nov 25;11:1733-1740
pubmed: 27932869
PLoS One. 2017 Aug 1;12(8):e0180395
pubmed: 28763445
Am J Alzheimers Dis Other Demen. 2016 Mar;31(2):115-23
pubmed: 26340962
Psychiatry Res. 2015 Jul 30;228(1):59-64
pubmed: 25933478
J Clin Nurs. 2010 Sep;19(17-18):2611-8
pubmed: 20586833
Ageing Soc. 1992;12:269-87
pubmed: 11654434