Paton Joni, Johnston Kate, Katona Cornelius, Livingston Gill
Department of Mental Health Sciences/Camden and Islington Mental Health and Social Care Trust, University College London, London, UK.
Int J Geriatr Psychiatry. 2004 Jun;19(6):527-32. doi: 10.1002/gps.1118.
To gain insight into caregivers' understanding of the causes of behaviours they find problematic in people with Alzheimer's disease in order to inform the development of educational strategies.
A qualitative, semi-structured interview was used. Participants were 205 caregivers for a person with Alzheimer's disease, all of whom were aware of the diagnosis and who had been recruited as part of a larger longitudinal study. Participants were from inner-city and suburban London/semi-rural Essex. The main outcome measures were caregivers' understanding of: the cause of problematic behaviour; the ability of the person with dementia to control this behaviour; the prognosis of the illness.
Most carers attribute the cognitive, behavioural and psychological symptoms of dementia to causes other than dementia; many believe that the person with dementia has control over their behaviour and substantial numbers believe the person with dementia will return to normal.
This study suggests that providing facts about the illness to caregivers is not enough, as caregivers may not understand that the symptoms they observe are related to the diagnosis. Education by clinicians should focus on the understanding of caregivers and in particular explore the caregivers' attributions of the symptoms which are present in the person for whom they care.
深入了解护理人员对他们认为阿尔茨海默病患者存在问题的行为原因的理解，以便为教育策略的制定提供依据。
采用定性的半结构式访谈。参与者为205名阿尔茨海默病患者的护理人员，他们均知晓诊断情况，且是作为一项更大规模纵向研究的一部分被招募而来。参与者来自伦敦市中心和郊区/埃塞克斯郡半乡村地区。主要结局指标包括护理人员对以下方面的理解：问题行为的原因；痴呆患者控制这种行为的能力；疾病的预后。
大多数护理人员将痴呆的认知、行为和心理症状归因于痴呆以外的原因；许多人认为痴呆患者能够控制自己的行为，相当一部分人认为痴呆患者会恢复正常。
本研究表明，仅向护理人员提供有关疾病的事实是不够的，因为护理人员可能不理解他们观察到的症状与诊断有关。临床医生的教育应侧重于对护理人员的理解，特别是要探究护理人员对他们所照顾患者出现的症状的归因。
