March 03, 2016

journals - Journal of Gerontological Nursing -

Volume 42, Number 1, January 2016


How are your communication skills?? A tool to assess providers’ interactions with people living with dementia

Development and Psychometric Testing of the Caregiver Communication Competence Scale in Patients With Dementia
Chao, et al. (pp. 32-39)
Appropriate communication skills are essential for understanding patient needs, particularly those of patients with dementia. Assessing health care providers' competence in communicating with patients with dementia is critical for planning a communication education program. However, no formally established scale can be used. The purpose of the current study was to develop a valid and reliable instrument for determining the communication competence of health care providers with patients with dementia. Through use of a literature review and previous clinical experience, an initial 28-item scale was developed to assess the frequency of use of each item by health care providers. Fourteen items were extracted and three factors were distinguished. Results indicated that the internal consistency reliability of the 14-item scale was 0.84. Favorable convergent and discriminant validities were reached. The communication competence scale provides administrators or educators with a useful tool for assessing communication competence of health care providers when interacting with patients with dementia so a suitable education program can be planned and implemented.

Exploring the Relationship Between Premorbid Personality and Dementia-Related Behaviors
Zielin, S., & McCabe, M. (pp. 40-48).
The purpose of the current study was to investigate whether premorbid personality traits (i.e., neuroticism, extroversion, openness, agreeableness, and conscientiousness) can predict behavioral and psychological symptoms of dementia (BPSD). In particular, agitation-related behaviors were examined. The current study used convenience sampling from 14 residential care facilities in Melbourne, Australia. Demographic and health data, cognitive ability, BPSD, and premorbid personality characteristics were collected from 62 female and 27 male older adults. Close informants of participants were asked to provide premorbid personality data (i.e., before the development of dementia) using the NEO-Five-Factor Inventory. Residential care staff used the Cohen-Mansfield Agitation Inventory to rate agitation-related behaviors over a 2-week period. Correlational analyses revealed associations between premorbid agreeableness and verbally nonaggressive behaviors, and between premorbid conscientiousness and verbally nonaggressive behaviors. Although the findings provide some support that premorbid personality shapes problematic behaviors exhibited in dementia, they are inconsistent with previous research and the hypotheses were generally not supported.

Optimizing Medication Use Through Deprescribing: Tactics for This Approach
Brandt, N. J. (pp. 10-14).
As older adults age, it is imperative to constantly reevaluate medications. Deprescribing, the process of identifying and discontinuing drugs that could potentially harm rather than benefit a patient, should therefore be considered in all older adults on an individual basis. Nurses are a critical part of the team in addressing this issue. The current article discusses deprescribing, tactics to this approach, and important areas for future development.

Engaging Patients With Advance Directives Using an Information Visualization Approach
Woollen, J., & Bakken, S. (pp. 16-20)
Despite the benefits of advance directives (AD) to patients and care providers, they are often not completed due to lack of patient awareness. The purpose of the current article is to advocate for creation and use of an innovative information visualization (infovisual) as a health communication tool aimed at improving AD dissemination and engagement. The infovisual would promote AD awareness by encouraging patients to learn about their options and inspire contemplation and conversation regarding their end-of-life (EOL) journey. An infovisual may be able to communicate insights that are often communicated in words, but are much more powerfully communicated by example. Furthermore, an infovisual could facilitate vivid understanding of options and inspire the beginning of often difficult conversations among care providers, patients, and loved ones. It may also save clinicians time, as care providers may be able to spend less time explaining details of EOL care options. Use of an infovisual could assist in ensuring a well-planned EOL journey.

Familism and Health Care Provision to Hispanic Older Adults
Savage, et al. (pp. 21-23).

the hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. familism, or familismo, a traditional hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for hispanic older adults. the current article discusses familism, which is upheld by some hispanic older adults, and the potential for underuse of health care services. the traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. clinical implications for the provision of health care to hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described.

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