Continuity of care for patients on a waiting list for institutional long-term care.

The aim of this study was to examine patients' satisfaction with continuity of care while on a waiting list for residential care or nursing home care. Two hundred and seventy-eight patients participated in the study, all living in the community setting of two cities in the Netherlands. These patients were positively assessed and on a waiting list for admission in a nursing home or a residential home. The respondents were interviewed by telephone, using a structured questionnaire. From the results, it appeared that people waiting for residential care are in general over 80 years of age and dependent on help for their daily activities. They used several types of home care facility, such as home help services, home nursing and meals on wheels. Patient satisfaction was moderately high as regards the supply of substitute care and the length of time it took to receive a home care package. There was dissatisfaction, however, with the coordination of care and the amount of information on procedures regarding the waiting list. Patients on the waiting list also reported a lack of guidance in case of problems and would not know where to turn to if their situation became more severe. The establishment of a service desk to provide information or real help in these circumstances is recommended.

Effects of video interaction analysis training on nurse-patient communication in the care of the elderly.

This paper describes an empirical evaluation of communication skills training for nurses in elderly care. The training programme was based on Video Interaction Analysis and aimed to improve nurses' communication skills such that they pay attention to patients' physical, social and emotional needs and support self care in elderly people. The effects of the training course were measured in an experimental and control group. They were rated by independent observers, by comparing videotapes of nursing encounters before and after training. Forty nurses participated in 316 videotaped nursing encounters. Multi-level analysis was used to take into account similarity among same nurse encounters. It was found that nurses who followed the training programme, provided the patients with more information about nursing and health topics. They also used more open-ended questions. In addition, they were rated as more involved, warmer and less patronizing. Due to limitations in the study design, it could not be demonstrated that these findings can entirely be ascribed to the training course. Further research, incorporating a randomized controlled design and larger sample sizes, is recommended to determine whether the results can be attributed to this specific type of training.

Factors related to nurse communication with elderly people.

This study explores variables that might influence nurses' communication with elderly patients. Three groups of variables arise from the literature that seem to affect the quality or quantity of nurse-patient communication: variables related to nurses, to patients, and to the setting in which nursing care takes place. The study was conducted in two different care settings: a home for elderly people and a home care organization. In a sample of 181 video-taped nursing encounters, involving 47 nurses and 109 patients a study was made of nurse-patient communication. In addition, relevant data related to patients, nurses and situation were gathered by questionnaires and were combined with the results of observations of videotaped nurse-patient interactions. It was found that the educational level of nurses was related most strongly to the way nurses communicate with their elderly patients. Patient characteristics such as age, gender and subjective state of health appeared to play a minor role in the way nurses communicate.

Non-verbal behaviour in nurse-elderly patient communication.

This study explores the occurrence of non-verbal communication in nurse-elderly patient interaction in two different care settings: home nursing and a home for the elderly. In a sample of 181 nursing encounters involving 47 nurses a study was made of videotaped nurse-patient communication. Six non-verbal behaviours were observed: patient-directed eye gaze, affirmative head nodding, smiling, forward leaning, affective touch and instrumental touch. With the exception of instrumental touch these non-verbal behaviours are important in establishing a good relationship with the patient. To study the relationship between non-verbal and verbal communication, verbal communication was observed using an adapted version of Roter's Interaction Analysis System, which distinguishes socio-emotional and task-related communication. Data were analysed in hierarchical linear models. The results demonstrated that nurses use mainly eye gaze, head nodding and smiling to establish a good relation with their patients. The use of affective touch is mainly attributable to nurses' personal style. Compared to nurses in the community, nurses in the home for the elderly more often display non-verbal behaviours such as patient-directed gaze and affective touch.

Nurse-elderly patient communication in home care and institutional care: an explorative study.

This study explores communication patterns between nurses and elderly patients in two different care settings. In a sample of 181 video-taped nursing encounters, involving 47 nurses and 109 patients, a study was made of nurse-patient communication. The video recordings were observed using an adapted version of Roter's Interaction Analysis System, which yields frequencies of 23 types of verbal behaviours. These data were analyzed using correspondence analysis, to reduce them to a smaller number of verbal categories, in which two socio-emotional categories and three categories with task-related communication, could be distinguished. For each encounter five summary statistics corresponding to these categories were calculated. Using analysis of variance, it was shown that the amount of socio-emotional interaction in both settings appeared to be higher than was reported in previous studies into nurse-patient communication. Compared with the home for the elderly, communication was more task-related in home care.

The role of communication in nursing care for elderly people: a review of the literature.

Communication in nursing care is an important topic assessing the specific needs of elderly patients and providing nursing care that is tailored to the individual patient's needs. In this review of the literature, we describe the role attributed to communication in theoretical nursing models and we report how research in communication in nursing elderly patients has taken place over the last ten years. It appears that since the eighties there has been an increase in observation studies into nurse-patient communication. There still is, however, a lack of observation instruments to do justice to the interactive nature of nurse-patient communication. Special attention should be paid to reliability and validity.