Ward Sandy, Opie Janet, O'Connor Daniel W
Department of Psychological Medicine, Monash University, Clayton 3168, Australia.
Int J Geriatr Psychiatry. 2003 Nov;18(11):1007-12. doi: 10.1002/gps.1005.
To describe the responses of family carers to the behavioural and psychological symptoms associated with dementia.
Thirty family carers of people with dementia were identified in a survey of mental disorder in general practice. Another 20 were referred by local aged mental health services. Carers were interviewed using the Manchester and Oxford University Scale for the Psychopathological Assessment of Dementia (MOUSEPAD) which rates behavioural and psychological disturbances. Carers' customary responses to current symptoms were recorded verbatim and categorised using a structured typology.
Symptom frequency increased in line with dementia severity. Disturbances were generally well tolerated. Most were ignored where possible, except for wandering from home. Other common responses included avoiding triggers, providing reassurance, reality orientation, diversion, and collusion with false beliefs. Restrictive or punitive responses were uncommon.
Few carers articulated clear strategies to deal with behavioural and psychological symptoms. For most, tolerance proved more effective and less distressing than arguments and reprimands. Carers' responses are likely to be influenced by social and cultural factors and may differ in other settings.
描述家庭照顾者对与痴呆症相关的行为和心理症状的反应。
在一项全科医疗中的精神障碍调查中确定了30名痴呆症患者的家庭照顾者。另外20名是由当地老年心理健康服务机构转介的。使用曼彻斯特和牛津大学痴呆症心理病理学评估量表（MOUSEPAD）对照顾者进行访谈，该量表对行为和心理障碍进行评分。逐字记录照顾者对当前症状的惯常反应，并使用结构化类型学进行分类。
症状频率随痴呆症严重程度增加。这些障碍通常耐受性良好。除了离家出走外，大多数情况在可能的情况下都被忽视了。其他常见的反应包括避免触发因素、给予安慰、现实定向、转移注意力以及认同错误信念。限制性或惩罚性反应并不常见。
很少有照顾者阐明应对行为和心理症状的明确策略。对大多数人来说，宽容被证明比争论和斥责更有效且痛苦更小。照顾者的反应可能受到社会和文化因素的影响，并且在其他环境中可能有所不同。
