Strategies for working with elderly clients: a qualitative analysis of elderly client/nurse practitioner communication

Older Adults’ Interpretation of Nurses’ Nonverbal Communication in Cameroon: A Grounded Theory Inquiry

Communication is central to nursing care. Yet, the nonverbal aspect of communication tends to be neglected or underestimated in nursing studies. Research has shown that older patients interpret nurses’ communication messages during the clinical encounter. This article conceptualizes older adults’ interpretation of and need for nonverbal communication (NVC) to enhance patient-centered communication advocated by the World Health Organization. The Corbin and Strauss (2015) inductive Grounded Theory approach was used to collect data from 3 hospital units in Cameroon using in-depth interviews with eight older adults, thirteen nurses, and four student nurses between July 2018 and January 2020. Open coding, axial coding, and selective coding were used for analysis, which reveals that interpretations of NVC can be positive or negative. It means that older adults view nurses either as angels or as difficult persons, depending on the nurses’ positive or negative NVC and behaviors. These interpretations lead to consequences ranging from a preference for some nurses to noncompliance with care. The results further show that older adults need active listening, humor, and affection from nurses. Information regarding older adults’ interpretation of and need for NVC can be used to improve curriculum content and to develop skills in and awareness of NVC with older adults. It is recommended that further research expand on effective nonverbal techniques during COVID-19 times where the meaning of facial expressions and voice inflection can be disrupted.

Evidence of nonverbal communication between nurses and older adults: a scoping review

BACKGROUND

Communication is an integral part of life and of nurse-patient relationships. Effective communication with patients can improve the quality of care. However, the specific communication needs of older adults can render communication between them and nurses as less effective with negative outcomes.

METHODS

This scoping review aims at describing the type of nonverbal communication used by nurses to communicate with older adults. It also describes the older adults' perceptions of nurses' nonverbal communication behaviors. It followed (Int J Soc Res 8: 19-32, 2005) framework. Grey literature and 11 databases were systematically searched for studies published in English and French, using search terms synonymous with nonverbal communication between nurses and older adults for the period 2000 to 2019.

RESULTS

The search revealed limited published research addressing nonverbal communication between older adults and nurses. The studies eligible for quality assessment were found to be of high quality. Twenty-two studies were included and highlighted haptics, kinesics, proxemics, and vocalics as most frequently used by nurses when communicating with older adults; while studies showed limited use of artefacts and chronemics. There was no mention of nurses' use of silence as a nonverbal communication strategy. Additionally, there were both older adults' positive and negative responses to nurses' nonverbal communication behaviors.

CONCLUSION

Nurses should be self-aware of their nonverbal communication behaviors with older adults as well as the way in which the meanings of the messages might be misinterpreted. In addition, nurses should identify their own style of nonverbal communication and understand its modification as necessary in accordance with patient's needs.

Rural geriatric glue: a nurse practitioner-led model of care for enhancing primary care for frail older adults within an ecosystem approach

OBJECTIVES

This article describes the implementation of the Care for Seniors model of care, an innovative approach to improving care coordination and integration, and provides preliminary evidence of effective use of specialist resources and acute care services.

DESIGN

Retrospective.

SETTING

Primary care; cross-sector.

PARTICIPANTS

Older adults living in a rural area in southwestern Ontario, Canada.

MEASUREMENTS

Number of new geriatrician referrals and follow-up visits before and after the launch of the Care for Seniors program, number of Nurse Practitioner visits in a primary care setting, in-home, retirement home and hospital, number of discharges home from hospital and length of hospital stay between.

RESULTS

In the 2 years before the launch of the program, the total number of visits to the geriatrician for individuals from this FHT was relatively low, 21 and 15, respectively for 2005-06 and 2006-07, increasing to 73 for the 2011-12 year. Although the absolute number of individuals supported by the NP-Geri has remained relatively the same, the numbers seen in the primary care office or in the senior's clinic has declined over time, and the number of home visits has increased, as have visits in the retirement homes. The percentage of individuals discharged home increased from 19% in 2008-09 to 31% in 2009-10 and 26% in 2011-12 and the average length of stay decreased over time.

CONCLUSIONS

This model of care represents a promising collaboration between primary care and specialist care for improving care to frail older adults living in rural communities, potentially improving timely access to health care and crisis intervention.

Breaking bad news: a guide for effective and empathetic communication

Breaking negative news to patients is a common occurrence for nurse practitioners. This difficult task requires patience and refined communication skills, and must be approached with empathy for all parties involved. There are several ways to deliver bad news to patients successfully using patient-centered communication techniques and methods.

Health literacy and the role of the speech-language pathologist

PURPOSE

This article reviews concepts of health literacy and discusses the role of speech-language pathologists in improving the health literacy of individuals with and without communication disorders.

METHOD

A literature review was completed of health literacy definitions, concepts, and health literacy assessment and intervention studies with various populations. A literature review was also conducted regarding health literacy or related studies in the field of speech-language pathology.

CONCLUSION

There is a paucity of information available on health literacy within the field of speech-language pathology. Suggestions are offered regarding increasing health literacy research and intervention by speech-language pathologists.

An exploration of nurse practitioner care to homebound frail elders

PURPOSE

To identify and classify care activities of nurse practitioners (NPs) providing primary care for frail homebound elders and to describe NPs' perceptions of the outcomes of their care activities.

DATA SOURCES

Three focus groups were held with 24 NPs with at least 1-year experience in caring for frail homebound elders to elicit NPs' descriptions of their practice. In addition, individual interviews with 10 NPs and participant observation of 2 NPs visiting elders in their homes validated the data. The total sample size was 36 NPs. Field notes and audiotapes were transcribed for analysis and coded using Brykczynski's existing domains and competencies of NP practice.

CONCLUSIONS

Most of the care activities of NPs providing primary care to frail elders in their home involve management of patient health and illness, case management, and the teaching-coaching function. The NP informants believe that they prevent medication errors, falls, emergency room visits, hospitalizations, and even death. They reported that they improve their patients' quality of life and help to provide a peaceful death when death is imminent.

IMPLICATIONS FOR RESEARCH

Further refinement of the proposed model is needed in order to examine the effectiveness of NP care on clinically relevant patient outcomes.

Postintervention Focus Groups

This study examined whether effects of person-centered care and person-centered mentoring were sustained postintervention from the perspective of long-term care nursing staff. Separate focus groups for administration, nurse mentors, and certified nursing assistants (CNAs) were used to assess perception of change in behaviors. CNAs sustained person-centered care skills on the job while nurse mentors experienced less change. With regard to nurse-CNA relationships, a discrepancy in the perceptions of nurses and CNAs was evident. The non-threatening environment of focus groups allowed staff to share their perceptions of the barriers to behavior change needed to sustain the intervention over time.