Abstract
Introduction Thousands of individuals with communication disorders live in long-term residential care. Nursing staff are often their primary communication partners. The positive effects of social interaction and person-centred care have been recognised but there remains a paucity of research on the content and quality of communicative interaction between long-term care staff and residents with aphasia. This mixed method study investigates the discourse in interaction between nursing staff and residents with aphasia. Methods A routine care activity was explored in 26 video-recordings featuring four enrolled nurses and four elderly persons with severe aphasia. Factors such as goals and roles in the activity were mapped out and a qualitative discourse analysis was performed. Based on the findings a coding scheme was constructed and the amount of time spent in different interactional foci of discourse was explored. ResultsFrom the qualitative findings three broad, but distinct, foci in the nurse-initiated interaction could be distinguished: (1) a focus on getting the task done with minimum interaction; (2) topics related to the task, but not necessary to get the task done; and (3) personal topics related to themes beyond the caring task. The analysis of distribution of time revealed that although most of the interaction was focused on the main care activity, between 3 and 17% of the time was spent in either task-related or non task-related interaction. The distribution varied between dyads and could not be related to the residents' severity of aphasia nor the activity as such. Conclusions An endeavour to interact socially with the residents with aphasia influences the nurses' foci of interaction. Contextual and personal factors of the residents and nurses need to be considered in clinical work as well as research on how communication may be supported to facilitate social interaction and person-centredness in long-term care of people with aphasia.
Highlights
Thousands of individuals with communication disorders live in long-term residential care
Despite the fact that all four of the residents had similar problems due to their severe aphasia, there was some variation between the dyads in terms of how much of the time was focused on task-central, taskrelated, or non task-related interaction; see Figure 1
The qualitative analysis in this study showed that the interactional foci in the studied routine care tasks were affected by both a goal aimed at getting the resident ready for the day/night and a goal aimed at social interaction
Summary
Thousands of individuals with communication disorders live in long-term residential care. The positive effects of social interaction and person-centred care have been recognised but there remains a paucity of research on the content and quality of communicative interaction between long-term care staff and residents with aphasia. This mixed method study investigates the discourse in interaction between nursing staff and residents with aphasia. Contextual and personal factors of the residents and nurses need to be considered in clinical work as well as research on how communication may be supported to facilitate social interaction and person-centredness in long-term care of people with aphasia.
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