Faculty of Nursing, Université de Montréal, Québec, Canada.
Int Psychogeriatr. 2010 Nov;22(7):1172-84. doi: 10.1017/S1041610209991670. Epub 2010 Feb 2.
Screaming is common among older persons living with dementia in nursing homes. Research on this population has not provided a useful basis for understanding such behavior that could help determine appropriate interventions. The purpose of this study was to explore the meanings of screams in older people living with dementia and their influencing factors.
Critical ethnography was selected as the research design. Seven triads, each composed of an older person living with dementia who screamed, a primary family caregiver, and one or two formal caregivers, were recruited in a nursing home. Various data collection methods and Spradley's (1979) ethnographic analysis were used.
Screaming is related to vulnerability, suffering, and loss of meaning experienced by older persons. This singular behavior also expresses various final outcomes that can be differentiated through modulation criteria. The meanings of screams are influenced by stability and flexibility in the nursing care organization and reciprocal effects between older persons who scream and others in the nursing home environment. Each person's screams constitute a unique language that can be learned. Other influencing factors include respect for the older person's wishes, needs, and personality, shifts in power relations within the triad, and feelings of powerlessness and guilt in family and formal caregivers.
This study advances knowledge of the meanings of screams in older persons living with dementia. It has implications for and offers insight on culturally congruent care for older persons living with dementia and the people around them.
在养老院中，患有痴呆症的老年人经常会尖叫。针对这一人群的研究并没有为理解这种行为提供有用的基础，而这种理解可能有助于确定适当的干预措施。本研究旨在探讨患有痴呆症的老年人尖叫的含义及其影响因素。
选择批判民族志作为研究设计。在一家养老院中招募了 7 个三人小组，每个小组由一名患有痴呆症并尖叫的老年人、一名主要家庭照顾者和一名或两名正式照顾者组成。使用了多种数据收集方法和斯普拉德利（1979 年）的民族志分析。
尖叫与老年人所经历的脆弱性、痛苦和意义丧失有关。这种单一的行为也表达了各种可以通过调节标准来区分的最终结果。尖叫的含义受到护理组织的稳定性和灵活性以及养老院环境中尖叫的老年人和其他人之间的相互影响的影响。每个人的尖叫构成了一种独特的语言，可以被学习。其他影响因素包括尊重老年人的意愿、需求和个性、三人小组内部权力关系的转变，以及家庭和正式照顾者的无力感和内疚感。
本研究提高了对患有痴呆症的老年人尖叫含义的认识。这对文化上一致的痴呆症老年人护理以及他们周围的人提供了启示和见解。
