Dementia and aggressiveness: stimulated recall interviews with caregivers after video-recorded interactions.
BACKGROUND
In a previous study, nine caregivers and two residents with dementia showing aggressive behaviour, were video recorded. Caregivers who reported problems when dealing with such behaviour and caregivers, who did not, were included in this study.


OBJECTIVE
The aim of the present study was to obtain insight into the reasoning of the caregivers who had reported problems when dealing with older people with dementia and aggressiveness and those who did not relative to their respective video-recorded interactions with these residents. A further aim was to gain insight by discussing their reasoning in relation to each other.


METHODS
Stimulated recall interviews were carried out with all the caregivers who had been video taped in the previous study. The text was analysed by thematic content analysis.


RESULTS
Two main ways of thinking and discussing the care situations emerged. The caregivers, who had reported problems in handling behavioural and psychiatric symptoms in dementia earlier, reasoned that they were more focused on their duties, this included being responsible for the resident receiving her weekly shower. For this group of caregivers, the well being of the resident was in focus, but their attention was concentrated on the resident's well being and comfort after their shower. However, these caregivers seemed therefore unwittingly to prevent a positive interaction with the resident. The other caregivers were able to reflect spontaneously and appeared to be self-critical. This caregiver group seemed to sustain a positive interaction with the resident both during and after the shower.


CONCLUSIONS
In this study a nurturing and supportive climate and competence seemed to be the conditions necessary to facilitate reflections and promote creativity in the caregivers such that they are able to develop possible ways of handling difficult situations like aggressiveness in residents with dementia.
Skovdahl
Kirsti
K
Centre for Nursing Science, Orebro University Hospital, Sweden. kirsti.skovdahl@orebroll.se
Kihlgren
Annica Larsson
AL
Kihlgren
Mona
M
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology*; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing / Q000523:psychology; D005260:Female; D016352:Group Homes; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008128:Logic; D008297:Male; D011939:Mental Recall; D009723:Nurse-Patient Relations; D009728:Nursing Assistants / Q000523:psychology*; D015404:Nursing Methodology Research; D009736:Nursing Process; D009740:Nursing Staff / Q000523:psychology*; D016272:Occupational Health; D011209:Power, Psychological; D013548:Sweden; D014741:Video Recording; D014754:Violence / Q000517:prevention & control / Q000523:psychology