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Förhållningssätt och kommunikation i mötet med personer med demenssjukdom: utvärdering av ett träningsprogram med validationsmetoden
Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle, Sektionen för omvårdnad (Karolinska institutet, Department of Neurobiology, Care Science and Society, Department of Nursing).ORCID iD: 0000-0002-4169-2061
2013 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Communication difficulties among residents with dementia disease living in nursing homes may complicate care situations. These residents can have difficulties describing how they experience their everyday lives, which can lead to withdrawal, social isolation, or feelings of homelessness. Research indicates that nurses involved in dementia care experience communication as difficult and challenging. The validation method developed by Feil is held to facilitate communication through emphatic and confirmatory approaches. Scientific reviews show insufficient evidence for recommending the use of the method, in spite of this the method is used in dementia care. Evaluations of the validation method have primarily focused on the residents’ perspective, and reports on nurses’ experiences of the validation method are sparse. The overall aim for this thesis was to evaluate Feils’ validation method by describing nurses’ experiences and skills in communication observed during implementation of a training programme. Twelve nurses participated in the validation method training programme that included 10 days of theoretical training with supervision about once a month, and practical training integrated in everyday work. During practical training nurses had conversation with 3 residents each 2-3 times a week, and videotaped one conversation per month. Methods: The design is based on naturalistic scientific approach. Data were collected with interviews (I, II) and a questionnaire (II) before and after the programme, and videotaped conversations during the programme (III, IV). An interview was conducted as a comparison with nurses from another nursing home, who had long experiences of using the validation method (I). The result showed that nurses improved their communication and had closer relationships with residents with dementia disease after validation method training, in accordance with nurses with long experiences (I). The training strengthened the nurses, but also posed an extra strain on them. Even though the nurses described an extra strain on the entire nursing staff, this was not reflected in the results from the questionnaire about the work climate (II). Videotaped one-to-one conversations between nurses and residents showed that the nurses developed their approaches and communication skills, although to different degrees. An overall pattern revealed nurses’ movements within and between various paths when improving their communication skills (III). The findings were in congruence with the nurses described experiences (I). In videotaped conversations from the end of the programme, the residents had the possibilities to use their remaining communication abilities and to communicate what was currently on their mind (IV). This may be related to the development of the nurses’ communication skills during the programme. Conclusions of this thesis were that the nurses developed their skills in caring approach and communication when communicating with residents with dementia disease, which gave these residents possibilities to communicate according to their abilities. In order to integrate new knowledge about communication the results showed that it was necessary to combine theoretical and practical training with supervision and reflection. To provide nursing staff with this type of training could be seen as an investment for nursing homes, an opportunity to increase job satisfaction for nurses and to increase social community for residents.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2013. , p. 55
Keywords [en]
Validation method, Evaluation studies, Dementia care, Communication skills, Caring approach, Videotaped conversations, Qualitative analyses
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-2444Libris ID: 14715529ISBN: 9789175492773 (print)OAI: oai:DiVA.org:esh-2444DiVA, id: diva2:655043
Public defence
2013-10-04, Ersta Sköndal högskola, Aulan, Stigbergsgatan 30, Stockholm, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-10-09 Created: 2013-10-09 Last updated: 2020-06-03Bibliographically approved
List of papers
1. Implementation of the validation method: Nurses’ descriptions of caring relationships with residents with dementia diseaseValidation method implementation:  
Open this publication in new window or tab >>Implementation of the validation method: Nurses’ descriptions of caring relationships with residents with dementia diseaseValidation method implementation:  
2012 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 11, no 5, p. 567-585Article in journal (Refereed) Published
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-189 (URN)10.1177/1471301211421225 (DOI)
Available from: 2010-06-02 Created: 2010-06-02 Last updated: 2020-06-03Bibliographically approved
2. Nurses’ movements within and between various paths when improving their communication skills – an evaluation of validation method training
Open this publication in new window or tab >>Nurses’ movements within and between various paths when improving their communication skills – an evaluation of validation method training
Show others...
2013 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, p. 265-273Article in journal (Refereed) Published
Keywords
Training Communication Skills, Dementia Care, Validation Method, Qualitative Analysis of Videotapes
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:esh:diva-2394 (URN)10.4236/ojn.2013.32036 (DOI)
Available from: 2013-09-17 Created: 2013-09-17 Last updated: 2021-04-12Bibliographically approved
3. Validation method training: nurses' experiences and ratings of work climate
Open this publication in new window or tab >>Validation method training: nurses' experiences and ratings of work climate
2014 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 1, p. 79-89Article in journal (Refereed) Published
Abstract [en]

Background: Training nursing staff in communication skills can impact on the quality of care for residents with dementia and contributes to nurses' job satisfaction. Changing attitudes and practices takes time and energy and can affect the entire nursing staff, not just the nurses directly involved in a training programme. Therefore, it seems important to study nurses' experiences of a training programme and any influence of the programme on work climate among the entire nursing staff.

Aims and objectives: To explore nurses' experiences of a 1-year validation method training programme conducted in a nursing home for residents with dementia and to describe ratings of work climate before and after the programme.

Design: A mixed-methods approach.

Methods: Twelve nurses participated in the training and were interviewed afterwards. These individual interviews were tape-recorded and transcribed, then analysed using qualitative content analysis. The Creative Climate Questionnaire was administered before (n = 53) and after (n = 56) the programme to the entire nursing staff in the participating nursing home wards and analysed with descriptive statistics.

Results: Analysis of the interviews resulted in four categories: being under extra strain, sharing experiences, improving confidence in care situations and feeling uncertain about continuing the validation method. The results of the questionnaire on work climate showed higher mean values in the assessment after the programme had ended.

Conclusion: The training strengthened the participating nurses in caring for residents with dementia, but posed an extra strain on them. These nurses also described an extra strain on the entire nursing staff that was not reflected in the results from the questionnaire. The work climate at the nursing home wards might have made it easier to conduct this extensive training programme.

Implications for practice: Training in the validation method could develop nurses' communication skills and improve their handling of complex care situations.

Keywords
Dementia care, Implementation study, Mixed-methods study, Validation method training, Work climate
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-2390 (URN)10.1111/opn.12027 (DOI)23601158 (PubMedID)
Available from: 2013-09-17 Created: 2013-09-17 Last updated: 2020-06-03Bibliographically approved
4. Conversations between residents with dementia disease and nurses: evaluation of an intervention with the Validation method
Open this publication in new window or tab >>Conversations between residents with dementia disease and nurses: evaluation of an intervention with the Validation method
(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-2443 (URN)
Note

SENARE PUBLICERAD SOM/LATER PUBLISHED AS:

Söderlund, M., Cronqvist, A., Norberg, A., Ternestedt, B-M., & Hansebo, G. (2015). Conversations between persons with dementia disease living in nursing homes and nurses: qualitative evaluation of an intervention with the validation method. Scandinavian Journal of Caring Sciences. Epub ahead of print. doi:10.1111/scs.12219

Available from: 2013-10-09 Created: 2013-10-09 Last updated: 2021-04-12Bibliographically approved

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