Observational assessment of communication to empower patients with dementia to make legally effective decisions - revalidation of CODEMamb.

Objectives: Communication enables humans to exercise their rights. Dementia research consistently shows that communication skills decrease as the disease progresses. Nonverbal communication abilities decline more slowly than verbal skills and often become more important as the disease advances. However, resources and deficits in nonverbal and verbal communication behavior differ between persons with dementia and contexts. Knebel et al. proposed the observational assessment tool CODEMamb that we believe to be the first standardized instrument to differentiate between content-related and relationship aspects of nonverbal communication behavior. Until now, evaluations of CODEMamb have been exploratory and used small samples.Method: We therefore retested the psychometric criteria of CODEMamb in persons with a suspected dementia in an ambulatory setting. Data was drawn from 326 older adults (aged 52 - 91) during routine screening in Germany.Results: Our findings support the three-factorial structure of CODEMamb. Internal consistency of the overall scale and the three subscales of CODEMamb was high. Correlations with CERAD-NP subscales revealed similarities to CODEMamb, indicating sufficient convergent validity. Finally, CODEMamb was able to differentiate between persons according to the stage of their disease.Conclusion: CODEMamb is a theoretically based, reliable and valid observational assessment tool and its use in ambulatory settings can help foster individual, person-centered communication by identifying the resources of people with dementia, thereby empowering them in rights-exercising situations.

[Structuring and supporting specialist training in general practice: Evaluation of a Hesse-wide mentoring program for doctors]. / Strukturiert und unterstützt durch die Weiterbildung Allgemeinmedizin: Evaluation eines hessenweiten Mentoringprogramms für Ärzte/innen in Weiterbildung Allgemeinmedizin.

INTRODUCTION: Due to the growing shortage of general practitioners (GPs), solutions are being sought to improve the structure and attraction of specialist training in general practice. In 2012, the Competence Center for Specialist Training in General Practice was set up in the federal state of Hesse, Germany, in order to provide a seminar- and mentoring program to complement standard specialist training. The present paper examines whether the mentoring program, which was based on needs assessment, supports doctors in training (DiT) to become specialists in general practice. METHODS: A mixed-methods design was used for the evaluation of the mentoring program. The pilot cohort monitored in this study was surveyed using a guideline-based interview. The cohort consisted of the first cohort of participants in the Specialist Training Academy (n=21), which was divided into two mentoring groups. Responses were evaluated with the help of the MAXQDA 11 program and qualitative content analysis to structure content. Furthermore, all 16 group meetings were assessed by means of evaluation sheets (n=132) and analyzed descriptively using the statistics program SPSS (IBM statistics, Version 20). RESULTS: Of the 21 DiTs of the total sample that took part in the interviews, two-thirds of the surveyed mentees were female (71.4 %). The mentoring and seminar programs encouraged the mentees in their decision for and their identification with specialist training in general practice and helped them overcome any doubts about their choice. The decisive factors in the mentoring process were interacting with like-minded people, discussing organizational questions and having a fixed contact person in case of questions and doubts. The evaluation sheets made it clear that the mentees regarded the mentoring as supportive (99.3 % positive). Compared to the other mentoring group, participants in the one group felt they were better supported by mentoring, found the interaction with other DiTs more helpful, the interaction between mentors and the group exactly right, and the topics they discussed more relevant. CONCLUSION: The provided mentoring program fulfilled the expectations of the DiTs in general practice. Combined with the Specialist Training Academy's seminar program, the two programs complement each other and are an important step towards making specialist training in general practice more attractive.