The nurses' process of recognizing the demented elderly patients' patterns of verbal and non-verbal expressions

• Project/Area Number: 09672427
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Nursing
• Research Institution: The Japanese Red Cross College of Nursing
• Principal Investigator: SAKAGUCHI Chizuru The Japanese Red Cross College of Nursing Nursing associate professor, 看護学部・看護学科, 助教授 (60248862)
• Project Period (FY): 1997 – 1998
• Project Status: Completed (Fiscal Year 1998)
• Budget Amount: ¥600,000 (Direct Cost: ¥600,000); Fiscal Year 1998: ¥300,000 (Direct Cost: ¥300,000); Fiscal Year 1997: ¥300,000 (Direct Cost: ¥300,000)
• Keywords: demented / elderly patient / the pattern of non-verbal expresion / the pattern of verbal expression / nurse / tIle process of recognition / 看護婦

Research Abstract

The subjects were seven elderly patients, who were thought of being demented, and eighteen nurses in an neurological unit in an urban hospital. The patients, who were four wamen and three men, were from sixty-eight to eighty-five years old. The mean of nurses' age was about twenty-nine years old.
The nurses' processes of recognizimg the demented elderly patients' patterns of verbal and non-verbal expressions was composed of two processes ; <a shift from uncertainty to certainty> and <a inquire of the patinets' will>.
The process of <a shift from uncertainty to certainty> was composed of four comporments. The nurses forcused on the cues which were the changes of the patients' verbal and non-verbal expressions <recognizing cue>, made inference by asking the patients their qeustions about the meaning of cues <clarifying question>, and then confirmed the inference by taking other informations <confirming inference>. Through this proccess, the nurses' certainty of the patients' will influence d on their making the decisions for the patients' care. Many nurses tried to lake care of the demented elderly patients in the face of uncertainty.
The process of <a inquire of the patient's will> was composed of four dimensions ; 1) <ascertaining response to instruction> was the dimension of the nurses' making sure of the patinets' responses to their instructions of body movements, 2) <appraising discomfort> was the dimension of the nurses' assessing the presence of the patients' discomfort as pain, 3) <grasping decision-making> was the dimension of the nurses giving the chances of and getting hold of the patients' decision-making, 4) <interpretating inner experience> was the dimension of the nurses' interpretating the stories of the patients' inner experiences which might be not reality.
By observing the interaction between the demented elderly patients and the nurses in daily care, what the nurses tried to recognize was the patients' will. For the nurses, the inquire of the patinets' will was main theme in interacting with the patients, and the nurses tried to make certainty of the patients' will for their care.