치매 환자와 간호사의 의사소통에 관한 대화분석 = A Conversation Analysis of Communication between Patients with Dementia and Their Professional Nurses

다국어 초록 (Multilingual Abstract)

A Conversation Analysis of Communication between Patients
with Dementia and Their Professional Nurses*

Yi, Myungsun1)․Yih, Bong-Sook2)

1) Professor, College of Nursing, Seoul National University; Researcher, The Research Institute of Nursing Science, Seoul National University
2) Doctoral Candidate, Graduate School, Seoul National University


Purpose: The purpose of this study was to understand conversations and to identify typical conversational problems between nurses and patients with dementia. Method: A conversation analysis method was used. The data was collected in a geriatric institutional setting, using a videotape recorder, and transcribed. The transcribed data was analyzed in terms of expressions, contents, and relationships to identify communicative problems and their resolutions. Results: Among a total of 532 episodes, 440(82.7%) were identified as nurse-involved episodes. In addition, 66 of the 440 episodes were selected based on the significance of the conversation. The communicative problems between nurses and patients in terms of expressions were identified as “directive and authoritative expressions”, “emotional and competitive expressions”, “evasive and on-looking expressions”, and “excessive use of title only”, such as calling them granny or grandpa without proper names. In terms of content and relationships, “lack of themes in psychosocial areas” and “nurse-led relations” were identified respectively as communicative problems. Conclusion: The results of this study will provide substantial guidelines for nurses in caring for elderly patients with dementia by deeply understanding linguistic structures and problems of everyday conversations between nurses and patients with dementia.

국문 초록 (Abstract)

간호사들은 노인들의 삶에 대한 이해를 높이고 이들의 관심 영역을 무시하거나 방관하기 보다는, 이들의 주관적인 체험에 더욱 많은 관심과 주의를 기울임과 동시에, 이들의 관심 주제를 대화로 이끌어 내는 공감적인 대화를 도모해야 한다. Haak(2002)이 지적한대로 치매 환자와의 효율적인 대화를 위해서는 충분한 시간을 가지고 환자의 증상만이 아닌 총체적인 차원에서 환자를 이해해야 하며, 이것이 환자가 편안함을 느낄 수 있는 치료 환경을 마련하는 토대가 됨과 동시에 치매 환자를 돌보는 최적의 간호가 될 수 있다.다음은 환자의 취미를 소재로 한 가벼운 친교 관계를 잘 보여주는 대화이다.

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