Measuring Behavior 2005: Levy-Storms

Video-based ethnographic approaches to defining an emotional connection between caregivers and care recipients in nursing homes

L. Levy-Storms

UCLA School of Public Affairs-Social Welfare, Los Angeles, CA, USA

Several weaknesses exist in well-established approaches to measuring the affective qualities of verbal and non-verbal communication. The main limitation is the focus on either one person or the other in a dyadic interaction instead of the affective quality of the relationship between them. However, the affective quality of the relationship can have important effects on behaviors of one or both of the dyad members. The purpose of this paper will be:

to present preliminary results from adapting established coding protocols that have captured the affective quality of verbal and non-verbal communication of either physicians/patients or teachers/students to caregivers/care recipients’ interactions during mealtime in nursing homes
and to define relational qualities of caregiver/care recipient interactions that can be measured.

A total of thirty volunteer caregivers and care recipients from a skilled nursing facility were video- and audio-taped during mealtime interactions (32 minutes and 28 seconds (32:28); range: 06:25 to 55:55). Preliminary results on the specific types of affective verbal and non-verbal communication of 10 of these caregivers and their global affect follow. The proportion of the total verbal utterances that were affective by subtype included: social behavior (32%), agreement (10%), paraphrase (4%), shows concern or worry (1%), empathy (.3%), and reassurance (.2%). The average proportion of total observed time that caregivers’ displayed affective non-verbal communication behaviors included: smiles (10%), eye gaze (20%), head nods (8%), touch (5%), and forward leans (4%). The average proportion of observed time that caregivers displayed ‘attentiveness’ was 38%, ‘involved attitude’ was 27%, and appeared ‘warm’ was 14%. Although these data suggest that affective levels of nursing aides’ communication vary by channel and specificity of the unit of observation (i.e., particular behaviors or global affect), they do not explicitly incorporate the care recipients’ communication behaviors simultaneously as they relate to the caregivers’ behaviors. That is, they fail to describe the affective quality of the relationship between the caregivers and care recipients. Using excerpts of video and audio from these interactions, strategies for emotionally connecting caregivers with care recipients via their relationship with one another will be illustrated and defined operationally by specific observational criteria.

Paper presented at Measuring Behavior 2005 , 5^th International Conference on Methods and Techniques in Behavioral Research, 30 August - 2 September 2005, Wageningen, The Netherlands.