The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
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A Grounded Theory Approach to Person Centered Communication between People Living with Dementia and Their Caregivers

사람중심 치매커뮤니케이션에 대한 근거 이론적 연구

  • 김동선 (우송대학교 사회복지학과) ;
  • 신수경 (가톨릭대학교 사회복지대학원)
  • Received : 2022.02.22
  • Accepted : 2022.03.29
  • Published : 2022.05.28
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Abstract

Communication breakdown has been mentioned causing a heavy burden for dementia caregivers. This study aims to inspect and structure the process and results of communication between people with dementia and their caregivers. The impeding/facilitating elements of communication are also extracted. Interviews with 21 of dementia care experts about the direct and indirect experiences of communication with people with dementia were analyzed based on the grounded theory. Results show that combination of the cognitive and communication decline of the people with dementia, confusing environment and caregivers' inappropriate attitude and lack of communication skills leads to communication breakdown and relations severance. Minimal contacts and task-oriented conversation results in conflicts and people with dementia's increasing agitation, anxiety and violent behaviors while understanding of individuality and listening with heart lead to recovered lucidity in the state of serious dementia, recovered pleasure and voluntary participation in the daily activities for people with dementia. Core paradigm was defined as 'Person Centered Care through relation formation'. There are 4 types of communication with people with dementia : partnering, patronizing, conflicting, avoiding types. Researchers suggest that Person Centered based communication skills be educated and trained for dementia caregivers.

커뮤니케이션 장애는 치매 돌봄 부담의 주된 원인으로 지적되고 있다. 본 연구는 케어자와 치매노인 간의 커뮤니케이션 과정 및 결과를 구조화하여 커뮤니케이션의 촉진요인을 찾는 것을 목적으로 한다. 시설의 치매 케어자 21명을 대상으로 커뮤니케이션 직·간접 경험을 인터뷰해, 수집된 자료를 근거이론에 따라 분석하였다. 연구 결과, 치매인과의 커뮤니케이션 과정은 치매인의 인지·언어기능 저하가 원인으로 작용하지만, 소란스러운 환경이나 커뮤니케이션 기술 부족 등이 맥락적 조건으로 작용하여 커뮤니케이션 실패 현상이 이루어진다. 이때, 최소한의 접촉, 업무중심의 대화로 대응하는 경우, 갈등과 회피로 나아가는 부정적 커뮤니케이션이 이루어지는 반면, '개인에 대한 이해', '경청', '마음으로 이해' 등의 중재를 통해 긍정적 커뮤니케이션이 가능하다는 것을 확인했다. 중재적 조건에 따라 치매노인의 배회, 폭력적 행동이 악화되기도 하지만 반대로 치매인의 인지 능력이 개선되거나 즐거움 회복, 일상생활에의 참여 등 긍정적 결과가 나타났다. 본 연구에서의 핵심범주는 '관계 맺음을 통한 사람중심케어'이며 범주유형은 갈등형, 무시형, 보호형, 파트너형으로 나뉘어진다. 본 연구결과를 토대로 사람중심케어에 입각한 치매 커뮤니케이션 교육 및 훈련을 제언한다

Keywords

Acknowledgement

본 연구는 대전사회서비스원의 지원으로 이루어진 현장연구 '사람중심 치매커뮤니케이션 가이드라인 개발연구:전문가 경험 및 현장사례연구'(ISBN 978-89-98568-95-5)의 자료 일부를 토대로 작성되었습니다.

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