Communication strategies for nursing research with older adults diagnosed with schizophrenia using life course theory

Abstract

Purpose: To explore effective communication strategies that may be used to promote efficacious research with older adults diagnosed with schizophrenia.Design: A theoretical framework of Life Course Theory was used to examine the problems of communicating in research settings with older adults diagnosed with schizophrenia and present potential effective solutions to these problems.Methods: Using Life Course Theory as an underpinning, a literature review was conducted regarding communication strategies/methods commonly used in psychiatric nursing. This paper deductively presents how these strategies/methods could theoretically improve nursing research with older adults diagnosed with schizophrenia.Results: Four main potential effective strategies for communication with older adults diagnosed with schizophrenia in nursing research were identified which were (1) giving space; (2) shortened intervals; (3) the use of simple, meaningful phrases; and (4) showing engagement. Conclusions:Older adults diagnosed with schizophrenia may be given more opportunities to share their input regarding their perceptions and valuable input regarding health care systems if these effective strategies of communication are used when conducting nursing research. Clinical relevance:There is a need to gain more information regarding the perceptions of older adults diagnosed with schizophrenia as they are living longer and are entering into a health care system that is often at a quandary as to how to best care for them.The strategies delineated in this paper are part of an ongoing project to co-develop a model with older adults diagnosed with schizophrenia specifically tailored to improve their health outcomes and quality of life.

Elder’s life course theory and person‐centered research: A lens for conducting ethical nursing research and mental health nursing practice with older adults aging with the diagnosis of schizophrenia

“…The necessity of disproportionately juxtaposing the safety of an older adult aging with schizophrenia and the ethical principle of autonomy is frequently encountered by those who engage in mental health nursing practice and research (Steenbergen, 2021;Walker & Walker, 2021). To keep an older adult aging with mental illness safe during times of decompensation and psychosis may require actions that oppose the person's autonomy or will, because safety in these instances can include court-ordered medications, restraints and seclusions, as well as involuntary hospitalizations (Bauer & Weust, 2017;National Alliance on Mental Illness, 2019;Starr, 2021).…”

“…Nurses conducting research and/or engaging in mental health practice with older adults diagnosed with schizophrenia must be aware that the cognition of these patients may preclude them from immediately understanding informed consent for research or medical procedures (American Psychiatric Association, 2013). Other limiting factors to ethical nursing practice and research with older adults diagnosed with schizophrenia include physiological issues such as potentially poor eyesight or hearing problems (Tian et al., 2021; Walker, 2021). Thus, a meticulous method for obtaining informed consent might be necessary when engaging this population in nursing research and practice.…”

“…Older adults aging with the diagnosis of schizophrenia present a vulnerable population, with a mean life expectancy 20 years shorter than the general population's. Their vulnerability is due in part to impairments associated with their diagnosis, which can include cognitive, behavioral, linguistic and perceptual issues (American Psychiatric Association, 2013; Angers et al., 2021; Medvedev et al., 2021; National Institute of Mental Health, 2018; Walker, 2021). Thus older adults diagnosed with schizophrenia suffer from multiple physical and psychological comorbidities—high rates of diabetes, cardiovascular disease, substance use and depression (American Psychiatric Association, 2013; Brooks et al., 2019).…”

“…The deinstitutionalization movement of the 1960s released many older adults diagnosed with schizophrenia from asylums to the care of community settings with limited resources, with the result that they have actually been trans-institutionalized or moved to homeless settings, nursing homes and prisons (Allison-Kolb, 2020;Kim, 2016;Norris, 2017). Such a model of care presents grievous problems, and caregivers report that they are untrained or unequipped to treat this complex population adequately (Gauillard, 2016;Kaldy, 2018;Sorrell, 2017;Walker, 2019;Walker & Walker, 2021).…”