The importance of moral sensitivity when including persons with dementia in qualitative research

Heggestad, Anne Kari Tolo; Nortvedt, Per; Slettebø, Åshild

doi:10.1177/0969733012455564

Cited by 62 publications

(90 citation statements)

References 35 publications

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“…We strongly recommend having a recruiter or screener with a mental health background make the initial contact with potential participants and families. Much of what needs to happen in that first contact is what Heggestad, Nortvedt, and Slettebø () describe as “moral sensitivity” or attention to the values involved in a conflict‐laden situation. A mental health background is invaluable for negotiating these situations.…”

Section: Recruitment Issues Relevant To the Participants And Familiesmentioning

confidence: 99%

The Triple Challenge of Recruiting Older Adults With Dementia and High Medical Acuity in Skilled Nursing Facilities

Kolanowski

Mulhall

Yevchak

et al. 2013

J of Nursing Scholarship

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Purpose To describe strategies, culled from experience, for responding to several recruitment challenges in an ongoing randomized clinical trial of delirium in persons with dementia. Organizing Construct Delirium in people with dementia is common across all cultures. Little research supports the use of specific interventions for delirium. Recruitment of an adequate sample is critical to the validity of findings from intervention studies that form the foundation for evidence-based practice. Methods The trial referenced in this article tests the efficacy of cognitive stimulation for resolving delirium in people with dementia. Participants are recruited at the time of admission to one of eight community-based skilled nursing facilities (SNFs). Eligible participants are 65 years of age or older and community dwelling, and have a diagnosis of dementia and delirium. Recruitment challenges and strategies were identified during weekly team meetings over a 2-year period. Findings Recruitment challenges include factors in the external and internal environment and the participants and their families. Strategies that address these challenges include early site evaluation and strong communication approaches with staff, participants, and families. Conclusions The recruitment of an adequate sample of acutely ill older adults with dementia in SNFs can pose a challenge to investigators and threaten the validity of findings. Recruitment strategies that help improve the validity of future studies are described. Clinical Relevance Worldwide, over 100 million people will have dementia by 2050, placing them at increased risk for delirium. Recruitment strategies that improve the quality of nursing research and, by extension, the care and prevention of delirium in older adults with dementia during rehabilitation in SNFs are greatly needed.

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Section: Recruitment Issues Relevant To the Participants And Familiesmentioning

confidence: 99%

The Triple Challenge of Recruiting Older Adults With Dementia and High Medical Acuity in Skilled Nursing Facilities

Kolanowski

Mulhall

Yevchak

et al. 2013

J of Nursing Scholarship

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“…To preserve the integrity of the person with dementia during the observations, we maintained a constant dialogue with relatives and nursing staff who knew the person with dementia well. Moral sensitivity, as described by Heggestad, Nortvedt, and Slettebø (), was used, as well as a double‐consent procedure; the observer continuously evaluated the participants for any signs that they no longer wished to participate and informed and received consent from a proxy (Dewing, ). All staff members were given verbal and written information about the study, and all agreed to participate.…”

Section: Methodsmentioning

confidence: 99%

Human capabilities in advanced dementia: Nussbaum's approach

Melander

Sävenstedt

Wälivaara

et al. 2017

Int J Older People Nursing

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“…It is important to consider the risk of violating the integrity of those who are being videotaped, which in this study was both persons with DD and nurses. Extra attention is needed when participants can forget that they have given informed consent to participate . In this study, the nurses were asked to get permission from the persons with DD every time they had conversations as part of their VM training.…”

Section: Methodsmentioning

confidence: 99%

Conversations between persons with dementia disease living in nursing homes and nurses – qualitative evaluation of an intervention with the validation method

Söderlund

Cronqvist

Ternestedt

et al. 2015

Scandinavian Caring Sciences

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Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons' communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one-to-one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one's mind and speaking more freely about what is on one's mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses' communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.

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The importance of moral sensitivity when including persons with dementia in qualitative research

Cited by 62 publications

References 35 publications

The Triple Challenge of Recruiting Older Adults With Dementia and High Medical Acuity in Skilled Nursing Facilities

The Triple Challenge of Recruiting Older Adults With Dementia and High Medical Acuity in Skilled Nursing Facilities

Human capabilities in advanced dementia: Nussbaum's approach

Conversations between persons with dementia disease living in nursing homes and nurses – qualitative evaluation of an intervention with the validation method

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