McIlvane Jessica M, Popa Mihaela A, Robinson Bruce, Houseweart Kathleen, Haley William E
School of Aging Studies, University of South Florida, Tampa, FL 33620, USA.
Alzheimer Dis Assoc Disord. 2008 Jul-Sep;22(3):284-92. doi: 10.1097/WAD.0b013e318169d714.
Despite greater attention to mild cognitive impairment (MCI), little is known about reactions to this potentially threatening diagnosis among persons with MCI (PWMCI) and their care partners. Psychologic reactions, perceptions of illness, and coping responses of 46 individuals recently diagnosed with MCI and 29 care partners were assessed with questionnaires assessing psychologic well-being, illness perceptions, coping, and perceived needs for services. Care partners and PWMCI report normal levels of psychologic well-being, showing less distress than is commonly found in Alzheimer disease (AD) caregivers. Problem-focused (eg, active coping) and emotion-focused coping strategies (eg, acceptance) were used more often than dysfunctional coping strategies (eg, self-distraction) by PWMCI and care partners. Both groups tended to minimize the likelihood of conversion to AD, and endorsed mental and physical exercise, optimism, dietary changes, and stress reduction as strategies to prevent conversion. Although PWMCI minimized their impairment, care partners reported providing an average of 24 hours per week of caregiving and reported that the PWMCI did need significant help with complex activities. Respondents reported using few formal services but they anticipate substantial future need for services. Results suggest that PWMCI and care partners are likely to minimize the threat of AD and to perceive that conversion is controllable and preventable with health promotion activities. Study implications for the development of intervention programs for PWMCI and their care partners are discussed.
尽管对轻度认知障碍（MCI）的关注有所增加，但对于MCI患者（PWMCI）及其护理伙伴对这一潜在威胁性诊断的反应却知之甚少。通过评估心理健康、疾病认知、应对方式以及对服务的感知需求的问卷，对46名最近被诊断为MCI的个体和29名护理伙伴的心理反应、疾病认知和应对反应进行了评估。护理伙伴和PWMCI报告的心理健康水平正常，显示出的痛苦程度低于阿尔茨海默病（AD）护理者中常见的程度。PWMCI和护理伙伴使用以问题为中心的应对策略（如积极应对）和以情绪为中心的应对策略（如接受）的频率高于功能失调的应对策略（如自我分心）。两组都倾向于将转化为AD的可能性降至最低，并认可心理和体育锻炼、乐观态度、饮食改变以及减压作为预防转化的策略。尽管PWMCI尽量淡化自己的损伤，但护理伙伴报告称平均每周提供24小时的护理，并表示PWMCI在复杂活动方面确实需要大量帮助。受访者报告使用的正规服务很少，但他们预计未来对服务的需求会大幅增加。结果表明，PWMCI和护理伙伴可能会尽量减少AD的威胁，并认为通过健康促进活动，转化是可控且可预防的。本文讨论了该研究对为PWMCI及其护理伙伴制定干预计划的启示。
