Providing tailored approaches to communication-enhancement education may be necessary for changes in practice to occur.

A B S T R A C TObjectives: This systematic review will describe the theoretical grounding, components, duration, mode of delivery, and outcomes of communication interventions for health care providers delivering care in residential care settings and will evaluate the effectiveness of these interventions.Methods: We conducted a comprehensive literature search of multiple databases published from January 1985 to the first week of December 2007, supplemented by a hand search of the references in all relevant articles, to find studies that met the inclusion criteria. Intervention details were extracted, and the studies' validity was evaluated independently by two researchers using a standardized data collection form based on Cooper and Hedges' (1994) approach to quality assessment.Results: Of the six studies that met the inclusion criteria (three randomized controlled trials, three quasi-experimental designs), three used a theoretical framework to guide intervention design. Across the six studies, the most commonly used components were (1) cognitive (to teach staff about communication), (2) behavioral (including practice at the bedside), and (3) psychological (involving individualized feedback). Despite the studies' variability in methodological quality, their results indicated that communication interventions have a positive effect on staffs' knowledge and communication skills and on residents' agitation and challenging behaviors. However, none of the studies provided sufficient information on the duration of the intervention and on determining which interventions were most effective. This made it difficult to draw conclusions about the effectiveness of the interventions' different components.Conclusion: Although communication training has been shown to have positive effects on staffs' communication knowledge and skills as well as on resident outcomes, future controlled intervention research is needed to assess the effectiveness of individual intervention components.