Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
권호 표지
DOI QR코드

DOI QR Code

The Communication Repair Strategy Characteristics According to Communication Breakdown of Elderly Man With Alzheimer's Dementia

알츠하이머 치매 노인의 의사소통 단절에 따른 의사소통 회복전략 특성

  • Kim, Sun-Young (Dept. of Speech and Hearing Therapy, Catholic University of Pusan) ;
  • Park, Hee-June (Dept. of Speech and Hearing Therapy, Catholic University of Pusan)
  • 김선영 (부산가톨릭대학교 언어청각치료학과) ;
  • 박희준 (부산가톨릭대학교 언어청각치료학과)
  • Received : 2019.08.07
  • Accepted : 2019.09.11
  • Published : 2019.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : Many communication recovery strategies should be used when communication breakdowns occur for successful communication, however, communication problems increase due to inadequate use of such strategies in older people with dementia. The purpose of this study was to investigate the difference of recovery strategy between dementia and the elderly in conversational discourse. Method : The subjects were eight of Alzheimer's dementia and 10 general elderly. Conversation discourse tasks were conducted face-to-face with the subjects. Communication breakdown and communication recovery strategies were analyzed based on 200 utterances collected in the conversation discourse. Result : First, the AD group had more communication breakdown than the control group, but the recovery rate did not differ between the groups. Second, in the AD group, the nonspecific recovery strategy and the clarification demand strategy were used as the expression strategy. The recovery rate after using expressive strategy was more than 90% in explanation strategy, combined strategy, nonspecific repair strategy, and repetition confirmation strategy. The response strategy used a lot of paraphrase strategy and combined strategies, and the recovery rate after using the response strategy was 100% for the simplification strategy, repeat strategy and gesture strategy. Conclusion : The AD group showed more breakdown of research subjects and breakdown of researchers than control group, and it showed ability to use various expression strategy and response strategy though there was difference in repair rate between communication repair strategy. AD group used nonspecific repair strategy in expression strategy the most and paraphrase strategy in response strategy the most. This shows different characteristic from ordinary elderly people. Therefore, it is necessary to utilize this repair strategy for rehabilitation of AD elderly.

목적 : 성공적인 대화를 위해서 의사소통 단절이 일어났을 때 여러 가지 의사소통 회복 전략을 사용해야 하지만 치매 노인의 경우 그 전략을 적절하게 사용하지 못하여 의사소통 문제가 증가된다. 이에 대화 담화에서 치매 노인의 의사소통 단절 유형에 따른 의사소통 회복 전략 특성이 일반 노인과 어떻게 다른지 알아보고자 하였다. 연구방법 : 본 연구는 65세 이상 여성 노인 중 알츠하이머 치매(Alzheimer's dementia; AD) 노인 8명과 일반 노인 10명을 대상으로 집단 간 대화 담화에서 의사소통 단절 유형에 따른 의사소통 단절 수와 회복률 차이와 집단별 회복전략의 특성에 대해 알아보았다. 연구자는 연구대상자와 1:1로 대화 담화 과제를 실시하였으며 수집된 발화 중 200 발화를 기준으로 의사소통 단절과 의사소통 회복전략을 기준으로 분석하였다. 결과 : 첫째, AD 집단은 일반 집단보다 의사소통 단절 수가 많았으나 의사소통 단절의 회복률은 집단 간 차이가 나지 않았다. 둘째, AD 집단에서 의사소통 회복전략 중 표현 전략은 비구체적 회복 전략, 명료화 요구 전략이 많이 사용되었으며 표현 전략 사용 후 회복률은 설명 전략, 복합 전략, 비구체적 전략, 반복 확인 전략이 90% 이상으로 나타났다. 반응 전략은 바꾸어 말하기 전략, 복합 전략이 많이 사용되었으며, 반응 전략 사용 후 회복률은 간략히 말하기 전략, 반복하기 전략, 몸짓 전략이 100%로 나타났다. 결론 : AD 집단은 의사소통 단절이 일반 집단에 비해 많았으며, 의사소통 회복 전략 간 회복 빈도의 차이는 있지만 다양한 표현 전략과 반응 전략을 사용하는 능력이 있음을 알 수 있었다. 특히 AD 집단은 표현 전략에서는 비구체적 전략을 많이 사용하였으며, 반응 전략에서는 바꾸어 말하기 전략을 가장 많이 사용했다. 이는 일반 집단과 다른 특성으로 AD 노인의 언어 재활에 활용되길 기대해 본다.

Keywords

References

  1. National Institute Demnetia. (2019). Korean dementia observatory 2018. Retrieved from https://www.nid.or.kr.
  2. Stastics Korea. (2019). Future population estimate: Main population indicators. Retrieved from http://kostat.go.kr/.
  3. Appell, J., Kertesz, A., & Fisman, M. (1982). A study of language functioning in Alzheimer patients. Brain and Language, 17(1), 73-91. doi:10.1016/0093-934X(82)90006-2
  4. Bayles, K. A. (1982). Language function in senile dementia. Brain and Language, 16(2), 265-280. doi:10.1016/0093-934X(82)90086-4
  5. Choi, I. J. (2001). Responses to requests for clarification in normal and deaf children (Master's thesis). Ewha Womans University, Seoul.
  6. Choi, S. H., Na, D. L., Lee, B. H., Hahm, D. S., Jeong, J. H., Jeong, Y., ... Ahn, S. S. (2002). The validity of the Korean version of Global Deterioration Scale. Journal of the Korean Neurological Association, 20(6), 612-617.
  7. Dijkstra, K., Bourgeois, M. S., Allen, R. S., & Burgio, L. D. (2004). Conversational coherence discourse analysis of older adults with and without dementia. Journal of Neurolinguistics, 17(4), 263-283. doi:10.1016/S0911-6044(03)00048-4
  8. Garcia, L. J., & Joanette, Y. (1994). Conversational topic-shifting analysis in dementia. Discourse Analysis and Applications: Studies in Adult Clinical Populations, 161-183. doi:10.1111/0023-8333.51997005
  9. Golinkoff, R. M. (1986). ‘I beg your pardon?’: The preverbal negotiation of failed messages. Journal of Child Language, 13(3), 455-476. doi:10.1017/S0305000900006826
  10. Kang, Y. W., Na, D. L., & Hahn, S. H. (1997). A validity study of the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. Journal of the Korean Neurological Association, 15(2), 300-308.
  11. Kempler, D. (1991), Language changes in dementia of the Alzheimer type. In R. Lubinski(Eds.), Dementia and Communication(pp. 98-114). Philadelphia: B. C. Decker, inc.
  12. Mentis, M., Briggs-Whittaker, J., & Gramigna, G. D. (1995). Discourse topic management in senile dementia of the Alzheimer's type. Journal of Speech and Hearing Research, 38(5), 1054-1066. doi:10.1044/jshr.3805.1054
  13. Min, J. S., Yoon, J. H., Na, D. L., & Lee, Y. K. (2018). Characteristics of conversation in frontotemporal dementia: Comparison with dementia of the Alzheimer’s type. Communication Sciences and Disorders, 23(1), 146-159. doi:10.12963/csd.18468
  14. Orange, J. B., Lubinski, R. B, & Higginbotham, D. J. (1996). Conversational repair by individuals with dementia of the Alzheimer's type. Journal of Speech, Language, and Hearing Research, 39(4), 881-895. doi:10.1044/jshr.3904.881
  15. Orange, J. B., Van Gennep, K. M., Miller, L., & Johnson, A. M. (1998). Resolution of communication breakdown in dementia of the Alzheimer's type: A longitudinal study. Journal of Applied Communication Research, 26(1), 120-138. doi:10.1080/00909889809365495
  16. Roth, F. P., & Spekman, N. J. (1984). Assessing the pragmatic abilities of children: Part 1. Organizational framework and assessment parameters. Journal of Speech and Hearing Disorders, 49(1), 2-11. doi:10.1044/jshd.4901.02
  17. Shon, E. N., & Park, S. H. (2008). A comparative study of discourse specification on types of dementia. Journal of Special Education and Rehabilitation Science 47(2), 143-166.
  18. Suh, H. K., & Choi, H. J. (2010). An analysis of caregivers' recognition of communication problems in patients with dementia. Journal of Speech and Hearing disorders, 19(3), 1-18.
  19. Tye-Murray, N. (2015). Foundations of aural rehabilitation children, adults, and their family members (4th ed.). Stanford: Cengage Learning.
  20. Watson, C. M., Chenery, H. J., & Carter, M. S. (1999). An analysis of trouble and repair in the natural conversations of people with dementia of Alzheimer's type. Aphasiology, 13(3), 195-218. doi:10.1080/026870399402181
  21. Williams, L. J., Abdi, H., French, R., & Orange, J. B. (2010). A tutorial on multiblock discriminant correspondence analysis (MUDICA): A new method for analyzing discourse data from clinical populations. Journal of Speech, Language, and Hearing Research, 53(5), 1372-1393. doi:10.1044/1092-4388(2010/08-0141)