Comparing Audio and Video Data Using the Emotional Tone Rating Scale Kristine Williams, RN, PhD, Ruth Herman, PhD, & Daniel Bontempo, PhD Council for the Advancement of Nursing Science 2012 State of the Science Conference on Nursing Research September 14, 2012

Use of Video Data in Nursing Research Advantages  Current technology supports  Additional nonverbal data on complex processes with multiple variables  Can rewind/replay to visually examine different factors & establish reliability Disadvantages  Consent for video recording often harder than audio only  Data storage issues  Larger file sizes  HIPAA security issues  Encryption  Video recording more likely to alter natural behaviors

Added Nonverbal Information Elderspeak Communication Research  Patronizing messages with verbal/ nonverbal conflicts  Nonverbal features  Gaze  Proxemics  Facial Expression  Gestures  Touch

Emotional Tone  Imbalance  Care  Respect  Control  Three types of communication  Overly nurturing  Directive  Affirming

Emotional Tone Rating Scale Ratings not at all very 1……...2……..3…….4……. 5  Care  Nurturing  Caring  Warm  Supportive  Respect  Affirming  Respectful  Polite  Patronizing  Control  Directive  Bossy  Controlling  Dominating Ryan, E. B., Hummert, M. L., & Boich, L. H. (1995). Communication predicaments of aging; Patronizing behavior toward older adults. Journal of Language and Social Psychology, 14(1-2),

Do Audio and Video Ratings Vary for Emotional Tone Ratings?  20 1-minute recordings of staff-resident interactions in dementia care  Two groups of raters  Group 1 – Audio only  Group 2 – Video  Raters recruited from University Medical Center faculty, staff, students  Group 1 & 2 equivalent on descriptive factors

Results: Audio-Video Comparisons

Audio Care Audio Control Audio Respect Resistiveness to Care Audio Care **.972 ** Audio Control ** **.486 * Audio Respect.972 ** ** Resistiveness to Care * Video Care Video Control Video Respect Resistiveness to Care Video Care1-875 **.989 ** Video Control-875 ** **.443 * Video Respect.989 ** ** Resistiveness to Care * ** Correlation is significant at the 0.01 level (1-tailed). * Correlation is significant at the 0.05 level (1 tailed). ** Correlation is significant at the 0.01 level (1-tailed). * Correlation is significant at the 0.05 level (1 tailed). Audio-Video Correlations with RTC

Exploratory Factor Analysis ETRS Note: Scree plots similarly suggest on ly 2 dimensions in both conditions.

Comparing 2-Factor Solutions by Recording  In both recording conditions, RESPECT scale items group with CARE items.  Exception is “Patronizing”, which is behaving oddly in several respects.  Very similar 2-factor solutions in Audio and Audio/Visual conditions  Because the pattern of loadings is the same, factors have the same interpretation.  Scale items also have loadings of comparable size, with a few minor exceptions.  Same inter-factor correlation in Audio and Audio/Visual conditions.

Thank You The project described was supported by Award Numbers R03NR and R01NR from the National Institute Of Nursing Research. Some statistical analyses were supported by the National Institute of Deafness and Communication Disorders (P30DC05803). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Nursing Research, Deafness and Communication Disorders, or the National Institutes of Health. Williams, K., Boyle, D., Herman, R., Coleman, C., & Hummert, M.L. (in press). Psychometric Analysis of the Emotional Tone Rating Scale: A Measure of Person-Centered Communication, Clinical Gerontologist.