Faktorer som orsakar stress bland sjuksköterskor
En litteraturstudie
StressStressorsNursing perspectivePatient safetySOCStressStressfaktorerSjuksköterskans perspektivPatientsäkerhetKASAM
Dementia may cause difficulties in communicating. People suffering from dementia are therefore often described as being unable to take part in meaningful conversation. The responsibility to create understanding in a conversation is shared by all participants. By means of different strategies, participants in conversation can construct understanding through collaboration. How these strategies are utilized in conversation where one or more of the participants suffer from dementia is relatively unknown. The purpose of the present study was therefore to investigate a number of strategies that people suffering from dementia and their conversational partners use to collaboratively create understanding in a conversation. Four (4) participants with dementia and three (3) relatives were recruited. Five everyday conversations were recorded. The collected material consisted of 3 hours and 57 minutes. The material was transcribed and analyzed according to conversation analytic-principles. The phenomena that were identified were divided into three categories; co-constructions that constitute a syntactical unit, clarification requests and candidate understandings. In co-constructions that constitute a syntactical unit it was more common that the person without dementia contributed with a second utterance like a completion. There were, however, a few examples of how two participants with dementia performed the second utterance in co-constructions that constitute a syntactical unit. Clarification requests and candidate understandings were more common than co-constructions that constitute a syntactical unit. The most commonly used strategy was that the person without dementia asked for a clarification request or a candidate understanding of an utterance from a person suffering from dementia. Two of the participants suffering from dementia also used these strategies on numerous occasions. Strategies that have been shown to be used in conversation between people without communicative difficulties have in the present study also been shown to occur in conversation where one or more of the participants suffer from dementia. These strategies, combined with the person without dementia paying attention to non-verbal communication from the person with dementia and acknowledging these signals as intentional, make it possible to achieve and maintain understanding in conversation. If the person without dementia recognizes the initiatives from the person with dementia, the person with dementia may get the opportunity to control the conversation and choose topics to talk about.