Bakgrund: Att ha kontakt med närstående till personer med demenssjukdom ingår i omvårdnadspersonalens dagliga arbete. Det finns i forskning beskrivet hur närstående upplever sin situation och i riktlinjer beskrivs vikten av att kommunicera med närstående utifrån ett personcentrerat förhållningssätt.  Syfte: Att beskriva omvårdnadspersonalens erfarenheter av att kommunicera med närstående till personer med demenssjukdom.  Metod: Kvalitativ intervjustudie med induktiv ansats. Åtta semistrukturerade intervjuer med undersköterskor anställda på särskilt boende anpassat för personer med demenssjukdom. Resultat: I studien identifierades fyra huvudkategorier och tolv underkategorier. Huvudkategorierna var: strävan efter att vara professionell, relationen mellan omvårdnadspersonal och närstående, bemötande av närståendes behov och behov av teamsamverkan. Slutsats: Ett professionellt förhållningssätt och ett gott bemötande är några av de viktigaste förmågorna som omvårdnadspersonalen innehar. Att förekomma och ta initiativ till kontakt även om det inte finns någon egentlig anledning skapar trygga och välmående närstående. En närvarande sjuksköterska och ett väl sammansvetsat multiprofessionellt team ökar kvaliteten på omvårdnaden av personer med demenssjukdom. / Background: Contact with relatives to people with dementia is included in the daily work of the nursing staff. In research, it is described how relatives experience their situation and guidelines describe the importance of communicating with relatives based on a personcentered approach. Aim: To describe the nursing staff's experiences of communicating with relatives to people with dementia. Method: Qualitative interview study with inductive approach. Eight semi-structured interviews with nursing staff employed on nursing-home specially adapted for people with dementia. Result: The study identified four main categories and twelve subcategories. The main categories were: the pursuit of being professional, the relationship between nursing staff, addressing the needs of relatives and relatives and the need for team collaboration.  Conclusion: A professional approach and good treatment is one of the most important abilities that nursing staff possess. To occur and initiate contact even if there is no real reason creates safe and prosperous relatives. A present nurse and a well-knit multi-professional team increase the quality of care for people with dementia.

There is some evidence about the efficacy of preferred music on agitation in elders with dementia; however, little is known about its effectiveness on agitation when implemented by nursing staff in long-term care facilities. Even less is known about use of preferred music for managing anxiety in those with dementia. This quasi-experimental study aimed to evaluate the implementation of a preferred music intervention delivered by nursing staff on agitation and anxiety of institutionalised elders with dementia. The sample comprised of 57 elders with dementia residing in two building complexes which provided similar care routines and staffing in a large Taiwanese residential care facility. These two building complexes were randomly assigned as the experimental and control group. Nursing staff in the experimental group received a facilitation program to prepare them for implementing the preferred music intervention; whereas nursing staff in the control group received no facilitation program. The music intervention based on each resident's music preferences was then provided by the trained nursing staff for 32 experimental residents twice a week for six weeks. Meanwhile, 25 residents in the control group only received the usual standard care without music. All residents were assessed by Cohen-Mansfield Agitation Inventory (CMAI) for overall and three subtypes of agitated behaviours and by Rating of Anxiety in Dementia for anxiety at baseline and week 6. Additionally, the modified CMAI measured the 30-minute occurrence of agitation at baseline, session 4, and session 12. The results indicate that institutionalised elders with dementia who received six weeks of preferred music intervention implemented by trained nursing staff had significant reductions on overall, three subtypes of agitated behaviours, anxiety, and 30-minute occurrence of agitation over time compared to those who received the usual standard care without music. Preferred music shows promise as a strategy for reducing agitation and anxiety in those with dementia when implemented by trained nursing staff. Such intervention can be incorporated into routine activities to improve the quality of care provided by nursing staff and the quality of life of those with dementia in long-term care settings. Our study results provide clinically relevant evidence which contribute to closing the gap between research and practice.

The impact of a short-term training program upon learned helplessness among nursing home staff and residents was studied. Learned helplessness among staff was defined in terms of depression, self-monitoring, short-term memory, absenteeism, and turnover. Among residents, urinary incontinence was the selected measure of helplessness.

Professional and personal caregivers of persons with Alzheimer’s disease (AD) receive little or no training with regards to the nature, course and accompanying communication challenges of this illness (Haak, 2003). The main aim of the research study was to investigate the interaction between nursing home staff and persons with AD with in a nursing home context, before and after attending a communication-orientated educational workshop for the nursing home staff. Research was carried out by using multiple single case studies. A pre-experimental design was used as the research method. The four participants’ communication skills (verbal, nonverbal and paralinguistic) were evaluated by using the Pragmatic Protocol (Prutting and Kirchner, 1987). Their listening skills were observed and scored according to the Checklist of listening behaviours (Hartley, 1995). A questionnaire was designed to measure the participants’ knowledge and perceptions of different AD aspects. Various shortcomings were identified in the interaction process which highlights the importance of training staff to become competent in using communication strategies that facilitate more successful interaction with persons with AD. The communication-orientated educational workshop (event of the study) was designed according to the data that was collected and based on the person-centred approach of Kitwood (1997). The participants’ communication and listening skills, knowledge and perceptions were evaluated again in the posttest (after the workshop) to determine whether or not there had been a change in these areas. A general view of all the participants’ results showed that there was a significant change in their communication and listening skills. The interaction process was more appropriate during the posttest in comparison to the results that were obtained in the pretest. The participants’ interaction were based more on the principles of the person-centred approach to dementia care than the pretest. There had been a noticeable increase after the workshop in the participants’ knowledge and change to a more positive perception towards persons with AD and the illness. The conclusion has been reached that attendance and participation in a communication-orientated educational workshop leads to more positive interaction with persons with AD. This study has motivated the need for dementia care that is based on the principles of the person-centred approach. It is suggested that an increase in the person-centred approach leads to improvement in quality of life of persons with AD as well as the decrease of the effect of institutionalization in a nursing home setting. Suggestions for future research include that attention should be given to educational programmes with regards to communication strategies for persons with AD. It has furthermore been suggested to approach managers of nursing homes regarding future inservice training of their nursing home staff. / Dissertation (M(Communication Pathology))--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / unrestricted

Contexte : Le personnel non médical des Etablissements d’Hébergements pour Personnes Agées Dépendantes (EHPAD) est exposé à des contraintes physiques et psychiques élevées du fait de la prise en charge de résidents de plus en plus dépendants et polypathologiques. Notre démarche de recherche s’appuie sur le modèle de santé publique de Green et Kreuter. Il s’agit de préciser l’état de santé physique et psychique du personnel (diagnostic épidémiologique) et d’explorer les conditions de travail perçues par les salariés (diagnostic comportemental et environnemental). Matériels et Méthode : Une étude transversale a été menée par 78 médecins du travail auprès 2649 salariés (706 agents de service, 1565 agents de soins et 378 infirmiers) provenant de 105 maisons de retraite de la Région Rhône Alpes. Plusieurs questionnaires standardisés validés ont été utilisés pour recueillir des informations auprès des salariés. Les analyses statistiques ont été réalisées à partir du logiciel SAS, version 9.3. Résultats : Le personnel interrogé exprime un fort niveau de pénibilité et souhaite recevoir plus fréquemment une formation continue aux soins palliatifs. Il est fortement exposé aux contraintes psychosociales (efforts élevés, récompenses faibles, déséquilibre effort/récompense et surinvestissement). Les plaintes musculo-squelettiques du cou et des membres supérieurs et les signes de détresse psychique de ce personnel sont significativement liées à l’exposition aux contraintes psychosociales. Conclusions : La prochaine étape de recherche consisterait à établir le diagnostic éducationnel en précisant les facteurs organisationnels associés aux contraintes psychosociales de ce personnel / Background: Non-medical staff in nursing homes for the elderly are exposed to high levels of physical and psychological stress related to managing increasingly dependent residents with multiple pathologies. Our research approach is based on Green and Kreuter's public health model. This is intended to describe the physical and mental health (epidemiological diagnosis) and to explore working conditions as experienced by nursing home staff (behavioral and environmental diagnosis). Methods: A cross-sectional descriptive survey was conducted by 78 occupational physicians on 2,649 employees (706 housekeepers, 1,565 nursing assistants and 378 nurses) in 105 nursing homes for the elderly in the Rhône-Alpes Region of France. Employee data were collected on several validated questionnaires. All statistical analyses were performed on SAS software, version 9.3. Results: Respondents related elevated hardship and desired more continuous training in palliative care. They were highly exposed to psychosocial stress (strong effort, low reward, effort/reward imbalance, overcommitment). Neck and upper limb musculoskeletal complaints and signs of psychological distress were significantly associated with exposure to psychosocial stress. Conclusions: The next phase of the research plan should consist in establishing an educational diagnosis by assessing the organizational factors associated with psychosocial stress in nursing home staff

Thesis subject: The Role of Family Carers in the Nursing Home for Persons with Cognitive Impairment. The theme of this thesis is the role of the family carers in the nursing home for persons with cognitive impairment. This topic is very actual due to the aging of society and to the increasing of life expectancy. A proportion of the old people in society increases but in the same time there is a decreasing number of people who could take care of them at home (due to negative population balance, disintegration of traditional family, economic situation and high requirements of the care etc.). Many seniors who are depending on the help of the others (such as people with dementia) spend their old age in institutional care. The qualitative research in this thesis shows that families continue in caregiving even after the admission of their relatives to a nursing home. The aim of this research was to describe the involvement of families in the institutional care and to identify factors that influence this phenomenon. Research was conducted in one nursing home for persons with cognitive impairment. Semistructured interviews were conducted with a sample of informants consisting of five professional nurses and four family carers. The analysis of data was carried out using the grounded theory. Research...