Communication Assessment Based on Person-Centered Care: Mixed Methods Analysis

Abstract

This study aims to assess person-centeredness in communication between people with dementia (PWD) and caregivers in a nursing home, focusing on the effectiveness of IoT-based communication monitoring and training. Caregivers received pre-education on Person-Centered Care (PCC) and mid-term feedback, during which natural conversations with PWD were unobtrusively recorded using a long-distance audio device. Transcribed conversations were analyzed using a mixed-methods approach that combined quantitative and qualitative analyses to evaluate the quantity and quality of communication in dementia care. Quantitative results demonstrated that communication time increased for both caregivers and PWD, particularly after the mid-term feedback. Additional piecewise and spline regression analyses indicated that the caregiver’s communication time and the PWD’s emotional state positively influenced the increase in PWD communication. For the qualitative analysis, Dementia Care Mapping—an analytical framework grounded in PCC—was used to evaluate communication based on the five psychological needs of PWD. Initially, negative aspects such as outpacing, infantilization, invalidation, and accusation were frequently observed; however, following the feedback, communication shifted toward personhood-enhancing behaviors such as a relaxed pace, warmth, respect, and acceptance. Drawing on findings from this mixed-methods analysis, the authors conclude that the changes in communication may have been facilitated by field-based training and feedback. However, more rigorous research designs and additional studies are needed to support generalization. This pilot study suggests the potential of technology-enhanced, field-based training to improve caregivers’ person-centered communication skills.