Review
Interventions to improve communication between people with dementia and nursing staff during daily nursing care: A systematic review

https://doi.org/10.1016/j.ijnurstu.2016.11.017Get rights and content

Abstract

Background

To provide adequate nursing care it is important for nursing staff to communicate effectively with people with dementia. Due to their limited communication skills, people with dementia have difficulties in understanding communication and expressing themselves verbally. Nursing staff members often report communication difficulties with people with dementia, which emphasises the urgent need for interventions to improve their communication with people in this specific target group.

Objectives

To provide an up-to-date overview of communication interventions that are applicable during daily nursing care activities, irrespective of care setting, and to describe the effects on communication outcomes in people with dementia and nursing staff.

Data sources

The Cochrane Library, CINAHL, PsycINFO, and Pubmed databases were searched for all articles published until the 23rd of February 2016.

Review methods

Papers were included, if: (1) interventions focused on communication between nursing staff and people with dementia and were applicable during daily nursing care; (2) studies were (randomised) controlled trials; (3) papers were written in English, Dutch, or German. Data were extracted on content and communication outcomes of interventions, and on methodological quality of the studies. The data extraction form and methodological quality checklist were based on the Method Guidelines for Systematic Reviews for the Cochrane Back Review Group.

Results

Six studies on communication interventions were included. All of the studies incorporated a communication skills training for nursing staff with a broad range in frequency, duration and content. In addition, there was wide variation in the communication outcome measures used. Four studies measured non-verbal communication, all found positive effects on at least some of the communication outcomes. Four studies measured verbal communication, of which three found positive effects on at least one of the measured outcomes. Methodological quality assessment demonstrated a high risk of bias in five of the six studies.

Conclusions

Few studies have been identified with wide variation in interventions and outcome measures. In addition, the methodological shortcomings make it difficult, to draw conclusions about the effectiveness. More research is needed to develop and evaluate communication interventions. Additionally, it is useful to reach consensus on defining and measuring communication.

Section snippets

What is already known about the topic?

  • Communication between people with dementia and nursing staff is important in daily nursing care to provide adequate care.

  • Communication with people with dementia may be challenging due to their limited communication skills. Earlier literature reviews aimed to identify communication interventions, however, did not focus solely on interventions which are applicable during daily nursing care.

What this paper adds

  • Few communication interventions were identified that are applicable during daily nursing care. All identified interventions incorporated a communication skills training component.

  • Existing interventions show much variation in (1) frequency, duration and content, and (2) outcome measures and reported results. In addition, the identified studies showed methodological shortcomings.

Methods

A systematic literature review was performed based on the principles of the Cochrane Handbook for reviews (Higgins and Green, 2011). This type of design is used to provide a description of the content and effects of existing communication interventions which are empirically tested.

Search results

The search strategy resulted in 3815 hits. After removing duplicates (n = 1537), 2278 potentially relevant titles were identified. The title screening resulted in 539 potentially relevant abstracts. The abstract screening resulted in potentially relevant 37 full-text articles. From the 37 full-text articles, six articles were included for data extraction. Most articles were excluded during the search due to the intervention not being focused on communication (n = 1469). Detailed information on the

Discussion

This systematic review aimed to provide an up-to-date description of communication interventions which are applicable during daily nursing care irrespective of the care setting, and to describe their effects on communication outcomes. The focus on communication during nursing care activities is highly relevant as a fundamental of care (Kitson et al., 2010). In addition, communication is an important component in the establishment of the nurse-patient relationship which contributes to meaningful

Conflict of interests

There are no conflicts of interest.

Acknowledgements

We would like to thank Fabian Groven> (FG) who was involved as reviewer. Furthermore, this study is conducted with financial support from ZonMw (grant #80-80705-98-025).

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