van der Roest Henriëtte G, Meiland Franka J M, Maroccini Raffaella, Comijs Hannie C, Jonker Cees, Dröes Rose-Marie
Department of Psychiatry/Alzheimer Center, VU Medical Center/GGZ Buitenamstel, Amsterdam, The Netherlands.
Int Psychogeriatr. 2007 Jun;19(3):559-92. doi: 10.1017/S1041610206004716. Epub 2007 Jan 4.
Insight into the individual care needs of the growing number of people with dementia is necessary to deliver more customized care. Our study aims to provide an overview of the literature on the subjective needs of people with dementia.
Electronic databases were searched for publications on subjective needs between January 1985 and July 2005, and reference lists were cross-referenced. Extracts of needs were classified within problem areas of the (Dutch) National Dementia Program and quality of life domains, and the extracts were classified as a "need" (an implicitly communicated felt state of deprivation), "want" (expression of a need) or "demand" (suitable solution to fulfill a need).
Subjective needs were found in 34 studies with various research aims, such as awareness and coping. Few studies aimed to measure needs of people with dementia. The most frequently reported needs of people with dementia were the need to be accepted and respected as they are, the need to find adequate strategies to cope with disabilities, and the need to come to terms with their situation. Explicit wants or demands were reported less frequently than needs.
The high number of reported needs and the limited number of wants and demands show that people with dementia do not frequently mention how they want their needs to be met. Most reported needs are not instrumental, but are related to well-being and coping. Further research to inventory these needs could help achieve more demand-directed and better attuned care in the future.
了解越来越多痴呆症患者的个体护理需求对于提供更具个性化的护理至关重要。我们的研究旨在概述有关痴呆症患者主观需求的文献。
检索电子数据库，查找1985年1月至2005年7月间关于主观需求的出版物，并交叉引用参考文献列表。需求摘录根据（荷兰）国家痴呆症计划的问题领域和生活质量领域进行分类，这些摘录被归类为“需求”（一种隐含传达的匮乏感状态）、“愿望”（需求的表达）或“要求”（满足需求的合适解决方案）。
在34项具有各种研究目的（如认知和应对）的研究中发现了主观需求。很少有研究旨在衡量痴呆症患者的需求。痴呆症患者最常报告的需求是按其本来面目被接受和尊重的需求、找到应对残疾的适当策略的需求以及接受自身状况的需求。明确的愿望或要求的报告频率低于需求。
大量报告的需求以及有限的愿望和要求表明，痴呆症患者并不经常提及他们希望如何满足自己的需求。大多数报告的需求并非工具性的，而是与幸福感和应对能力有关。进一步研究这些需求的清单可能有助于未来实现更以需求为导向且更协调一致的护理。
