Langdon Shani A, Eagle Andrew, Warner James
Department of Psychology, CNWL NHS Mental Health Trust, Pall Mall Mental Health Centre, 150 Barlby Road, London W10 6BS, UK.
Soc Sci Med. 2007 Feb;64(4):989-1000. doi: 10.1016/j.socscimed.2006.10.029. Epub 2006 Dec 6.
The reactions of others can have a significant effect on the lived experience of dementia. Although the literature contains some theories of dementia that take this into account, few studies have asked people with early stage dementia about their experiences of other people's reactions to their changed condition and social status. In the present study, 12 men and women aged 66-87 with early stage dementia, recruited through an Older Adult Mental Health Unit in London, England, were interviewed to elicit their views on others' reactions to them since receiving the diagnosis. They were also asked what they thought others understood by the terms 'dementia' and 'Alzheimer's Disease'. Transcripts were analysed using Interpretative Phenomenological Analysis. Participants displayed somewhat negative reactions to the term dementia, and were concerned others would associate it with being 'demented'. In connection with this, although they were comfortable sharing their diagnosis with those closest to them, they were reluctant to do so beyond this private inner circle. Participants were keen for those who did know about the condition to respond authentically and honestly to them, helping them when necessary but as far as possible carrying on life as normal. A number of the participants seemed to be trying to work out how dementia differed from age-related memory loss and compared themselves with others to aid their understanding of this. The implications of these findings for clinical practice, carers and wider society are discussed.
他人的反应会对痴呆症患者的生活体验产生重大影响。尽管文献中有一些考虑到这一点的痴呆症理论,但很少有研究询问早期痴呆症患者关于他人对其病情变化和社会地位反应的经历。在本研究中,通过英国伦敦的一个老年心理健康机构招募了12名年龄在66 - 87岁之间的早期痴呆症男女患者,对他们进行访谈,以了解他们自确诊以来对他人反应的看法。他们还被问及他们认为其他人对“痴呆症”和“阿尔茨海默病”这两个术语的理解是什么。使用解释现象学分析方法对访谈记录进行了分析。参与者对“痴呆症”一词表现出一定程度的负面反应,并担心其他人会将其与“精神错乱”联系起来。与此相关的是,尽管他们愿意与最亲近的人分享自己的诊断,但不愿在这个私密的小圈子之外这样做。参与者渴望那些知道他们病情的人真诚、诚实地对待他们,在必要时帮助他们,但尽可能让生活照常进行。一些参与者似乎在试图弄清楚痴呆症与年龄相关的记忆丧失有何不同,并将自己与他人进行比较以帮助理解这一点。本文讨论了这些发现对临床实践、护理人员和更广泛社会的影响。