Methods: The principal investigator recruited twenty eight non-Korean NAs and twenty KA older adults with dementia residing in a skilled nursing facility in United States. After an intensive eight hour training, research assistants directly observed and recorded NAs’ social interaction competency, using the Dementia Social Interaction (DSI) coding scheme and Korean-culture Social Interaction Coding Schema (CSI). The KA residents' BPSDs were direclty observed and recorded using the Modified Agitated Behavior Rating Scale (mABRS). The descriptive statistics included demographic information, MMSE, BPSDs, and NAs’ social interaction competency. Total 93 NA-resident interaction encounter during 3 days was analyzed to explore the relationship between NAs' social interaction competency and KA residents' BPSDs.
Results: Seventeen KA-residents (85%) were female and their primary language was Korean. Among 4,090 BPSDs, restlessness (39.41%) and problematic vocalization (25.45%) were most frequently observed behaviors. Twenty seven NAs were Hispanic, primarily speaking Spanish. The NAs' dementia-competent social interaction behavior included providing a gentle pace of care (83.87%) of the time, and using simple words or phrases (97.92%) of the time while providing direct care for the KA-residents. The NAs’ culturally-competent social interaction behavior included addressing the resident appropriately (54.30%) and occasional making eye contact (51.65%) of the time. Findings showed a trend of decreasing BPSDs, when NAs are more competent in dementia and cultural social interaction. Particularly, the more NAs provided both dementia and culturally competent social interaction in the afternoon, KA residents' BPSDs were likely to decrease more rapidly.
Conclusion: Although results were not significant, this study suggests that NAs’ quality of social interaction may influence the BPSDs. This finding also suggests the need for training of NAs on effective communication. Replicated study with lager sample size and more rigorous data analysis methods may be beneficial for better understanding the influence of social interaction on BPSDs in ethnic minority nursing home residents.