치매 노인환자와 간호사의 대화 분석: 대화의 구조와 연속체 형태를 중심으로 = Analysis of Conversation between Elderly Patients with Dementia and Nurses: Focusing on Structure and Sequential Patterns

다국어 초록 (Multilingual 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 healthcare
institutions for elders.

다국어 초록 (Multilingual 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 healthcare
institutions for elders.

참고문헌 (Reference)

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