A pilot study of a video-feedback intervention to enhance long-term care aides’ person-centred dementia communication

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O'Rourke, Deanne
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Problem: With the dawning of the person-centred care movement within the long-term care and dementia care settings, the facilitation of person-centred communication strategies and enhancement of relationships between care providers and residents has drawn increasing attention. One evident requisite in these transformative efforts is the ability to offer self-reflective learning opportunities for providers that impact their internal caregiver values and ultimately influence their outward person-centred behaviours. Thus, the primary aim of this research is to pilot test the effectiveness of a novel communication intervention incorporating a video-feedback component on the person-centred dementia communication skills of long-term care aides. The secondary aim is to investigate the acceptability, utility and feasibility of the intervention in a long-term care setting. Methods: A quasi-experimental single group pre-test/post-test design was employed in this pilot study. The use of language-based and person-centred dementia communication skills was measured using video-recorded observations of usual care interactions. Outcomes of self-reflection, relationship closeness with the resident and confidence in communicating with individuals with dementia were measured using self-report questionnaires. Focus groups and interviews with health care aides and nursing leadership were held to explore the feasibility of the intervention. Results: Eleven health care aide-resident dyads participated in the study. There was a significant increase in the use of language-based reciprocity and continuity skills, as well as language-based and person-centred statements overall. Individual analysis of each dyad’s pre- and post-intervention videos also revealed at least one enhancement in communication behaviour based on self-established improvement goals. Global reports of self-reflection at work and relationship closeness with the resident, as well as interaction comfort increased significantly. Themes from the focus groups and interviews indicate the intervention was highly acceptable and relevant. The key feasibility challenges included resistance to the video-recording component and time/resource challenges to implement the intervention. Conclusion: The communication intervention with a video-feedback component showed promise as an acceptable, effective approach to enhance person-centred dementia communication behaviours in health care aides. These results support undertaking a larger trial to more fulsomely examine the intervention’s effectiveness and feasibility enablers in the context of long-term care and dementia care.
person-centred, communication, video, feedback, long term care, dementia