Effects of snoezelen, integrated in 24h dementia care, on nurse–patient communication during morning care

Abstract

Objective: To investigate the effectiveness of snoezelen, integrated in 24-hour care, on the communication of Certified Nursing Assistants (CNAs) and demented nursing home residents during morning care. Methods: A quasi-experimental pre-and post-test design was conducted, comparing sic psychogeriatric wards, that implemented snoezelen, to six control wards, that continued in giving usual care. Measurements were performed at baseline and 18 months after a training 'snoezelen for caregivers'. Independent assessors analysed 250 video-recordings directly from the computer, using an adapted version of the Roter Interaction Analysis System (RIAS) and non-verbal measurements. Results: Trained CNAs showed a significant increase of resident-directed gaze, affective touch and smiling. The total number of verbal utterances also increased (more social conversation, agreement, talking about sensory stimuli, information and autonomy). Regarding residents, a significant treatment effect was found for smiling, CNA-directed gaze, negative verbal behaviours (less disapproval and anger) and verbal expressed autonomy. Conclusion: The implementation of snoezelen improved the actual communication during morning care. Practice implications: Teaching CNAs to provide snoezelen has added value for the quality of care. Morning care by trained CNAs appeared to take more time. This suggests that (some) time investment might be required to achieve positive effects on CNA-resident communication.

Hospice Nurse Communication with Patients with Cancer and their Family Caregivers

“…[41][42][43][44][45] We found that RIAS was suited to capture the general content and process of hospice encounters. However, these encounters provide some unique challenges compared to traditional applications of RIAS (e.g., primary care, hospital, and clinic settings).…”

Making Sense(s) in Dementia

“…It has been recommended that, in the middle to late stages of the disease, the activities should focus on fine-and gross-motor and sensory activities 2,7,10 . Consistent with this recommendation, there are currently two main approaches with promising results in people with moderate to severe dementia: Multisensory Stimulation and Motor Stimulation [11][12][13][14] .…”

“…Observers were trained to use the software previously to video-recording analyzes. This methodology was used in previous studies with people with dementia to reduce observation bias with good reliability results 12,14 .…”

“…By stimulating the senses in a format that can be understood by the individual, it is expected that people with dementia will respond appropriately to their surroundings and communicate with others 18 , for example, by giving a smile or thanking to the caregiver 15 . MSS has been found to reduce the frequency of behavior problems and apathy 14,16 , improve communication 7,19 and functional performance 20 and increase residents' attentiveness 12,21 . Motor stimulation (MS) aims to maintain or improve, as long as possible, the remaining physical abilities of people with dementia 12,22 .…”

Five years of EACH (European Association for Communication in Healthcare)

“…Given the topics of EACH committee members' most recent publications, new areas of interest include, for instance, the role of the broader context in which a problem is presented [11], unconventional outcome measures such as skin conductance and cortisol [12] and new interaction analysis systems, such as sequence analysis and cue-responding [13][14][15][16][17][18]. There also appears to be an increasing interest in the role of the nurse-patient communication [19,20] and role delineation [21,22] as well as a renewed interest in decision-making [23], breaking bad news [24,25], training effects [26][27][28] and somatization [29,30]. In addition, since 2001, a number of new assessment and observation instruments have been developed [31,32] and existing ones have been (re)validated [33,34] or re-evaluated [35,36].…”