Myungsun Yi

doi:10.4040/jkan.2009.39.2.166

Articles

Page Path: HOME > J Korean Acad Nurs > Volume 39(2); 2009 > Article

Original Article
Analysis of Conversation between Elderly Patients with Dementia and Nurses: Focusing on Structure and Sequential Patterns: Myungsun Yi; Journal of Korean Academy of Nursing 2009;39(2):166-176.
DOI: https://doi.org/10.4040/jkan.2009.39.2.166
Published online: April 28, 2009

Professor, College of Nursing, Seoul National University, Researcher, Research Institute of Nursing Science, Seoul National University, Seoul, Korea.

Address reprint requests to: Yi, Myungsun. College of Nursing, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-799, Korea. Tel: 82-2-740-8829, Fax: 82-2-740-8837, donam@snu.ac.kr

• Received: September 17, 2008 • Accepted: February 11, 2009

29 Views
0 Download

prev next

Full Article

Download PDF

Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility.
Methods
Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005.
Results
Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding.
Conclusion
It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in health-care institutions for elders.
Keywords: Communication; Dementia; Nurse-patient relations; Geriatric nursing; Qualitative research

This research was funded by the Korea Research Foundation in 2007 (KRF-2006-079-AM0049).

REFERENCES

1. Adams T. The discursive construction of dementia care: Implications for mental health nursing. Journal of Advanced Nursing. 1998;28:614–621.PubMed
2. Atkinson M, Heritage J. Structures of social action: Studies in conversation analysis. 1984;Cambridge, Cambridge University Press.
3. Bak YI. Introduction into the dialog analysis. 2001;Seoul, Doseochoolpan Yeog Lag.
4. Caris-Verhallen WM, Kerkstra A, Bensing JM. The role of communication in nursing care for elderly people: A review of the literature. Journal of Advanced Nursing. 1997;25:915–933.Article PubMed PDF
5. Deppermann A. Bak Y.I . Conversation analysis. 2002;Seoul, Doseochoolpan Yeog Lag.
6. Drew P, Chatwin J, Collins S. Conversation analysis: A method for research into interactions between patients and health-care professionals. Health Expectations. 2001;4:58–70.PubMed PMC
7. Drew P, Heritage J. In: Talk at work: Interaction in institutional settings. 1998;New York, NY, Cambridge University Press.
8. Giles H, Noels KA, Williams A, Ota H, Lim TS, Ng SH, et al. Intergenerational communication across cultures: Young people's perception of conversations with family elders, non-family elders and same-age peers. Journal of Cross-Cultural Gerontology. 2003;18:1–32.PubMed
9. Hewison A. Nurses' power in interactions with patients. Journal of Advanced Nursing. 1995;21:75–82.Article PubMed
10. Hutchby I, Wooffitt R. Conversation analysis. 1998;Malden, MA, Blackwell Publishers Inc.
11. Jones A. Nurses talking to patients: Exploring conversation analysis as a means of researching nurse-patient communication. International Journal of Nursing Studies. 2003;40:609–618.PubMed
12. Kettunen T, Poskiparta M, Gerlander M. Nurse-patient power relationship: Preliminary evidence of patients' power messages. Patient Education and Counseling. 2002;47:101–113.Article PubMed
13. Lee HJ. A conversational analysis about patient's discomfort between a patient with cancer and a nurse. Journal of Korean Academy of Nursing. 2007;37:145–155.Article PubMed PDF
14. Mitcheson J, Cowley S. Empowerment or control? An analysis of the extent to which client participation is enabled during health visitor/client interactions using a structured health needs assessment tool. International Journal of Nursing Studies. 2003;40:413–426.PubMed
15. Oh JJ. The effect of hand-massage on the relaxation of dementia patients. Journal of Korean Academy of Nursing. 2000;30:825–835.Article PDF
16. Psathas G. Conversation analysis: The study of talk-in-interaction. 1995;Thousand Oaks, CA, Sage Publications.
17. Schegloff EA. Analyzing single episodes of interaction: An exercise in conversation analysis. Social Psychology Quarterly. 1987;50:101–114.Article
18. Son HM. Functional phases and patterns of dialogue sequence in nurse-patient conversation about medication. Journal of Korean Academy of Nursing. 2007;37:52–63.Article PubMed PDF
19. Ten Have P. Boden D, Zimmerman DH. Talk and institution: A reconsideration of the "asymmetry" of doctor-patient interaction. In: Talk & social structure: Studies in ethnomethodology and conversation analysis. 1991;Cambridge, Polity Press. 138–165.
20. Yi M. Secondary analysis of qualitative data: Methodological issues and implications. Journal of Nursing Query. 2003;12:82–96.
21. Yi M. Secondary analysis: Focusing on qualitative research. Journal of Korean Academy of Nursing. 2004;34:35–44.Article PubMed PDF
22. Yi M. Conversation analysis for improving nursing communication. Journal of Korean Academy of Nursing. 2007;37:772–780.Article PubMed PDF
23. Yi M, Yih BS. A conversation analysis of communication between patients with dementia and their professional nurses. Journal of Korean Academy Nursing. 2006;36:1253–1264.Article PDF

Table 1

Functional Phases and Sequential Patterns of Conversation between Elderly Patients with Dementia and Nurses

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Analysis of Conversation between Elderly Patients with Dementia and Nurses: Focusing on Structure and Sequential Patterns

J Korean Acad Nurs. 2009;39(2):166-176. Published online April 28, 2009

DOI: https://doi.org/10.4040/jkan.2009.39.2.166

XML Download

We recommend

Analysis of Conversation between Elderly Patients with Dementia and Nurses: Focusing on Structure and Sequential Patterns

Table 1

Functional Phases and Sequential Patterns of Conversation between Elderly Patients with Dementia and Nurses

Table 1 Functional Phases and Sequential Patterns of Conversation between Elderly Patients with Dementia and Nurses