Krohne Kariann, Slettebø Ashild, Bergland Astrid
Faculty of Health Sciences, Oslo University College, Oslo, Norway.
Scand J Caring Sci. 2011 Dec;25(4):679-87. doi: 10.1111/j.1471-6712.2011.00878.x. Epub 2011 Mar 1.
Older people admitted to geriatric wards in hospitals are often screened for cognitive impairments. The validity and diagnostic concerns of cognitive screening tests have been subjected to comprehensive research. However, the qualitative knowledge available on how older patients themselves experience these screening tests is limited. The aim of this study is to explore the cognitive screening test experience from the older patients' perspective. Drawing on fieldwork, qualitative interviews were performed with 18 older patients who had completed cognitive screening tests while hospitalised. Data from the interviews were analysed according to a phenomenological approach. The results were supported by Nordenfelt's theory on dignity of identity, which underscores that dignity is related to integrity, autonomy, life history and relationships. The findings suggest that the occupational therapists' initial presentation of the screening test is not fully understood by the older patient, leaving the patient to interpret the experience in light of the questions answered and the tasks solved in the screening. The significance of the screening may, thus, not be understood by the patient until it is over. The patients found the screening strenuous, mostly due to a felt pressure to perform. Depending on how patients assessed their own performance, feelings ranging from shame and irritation to pride and relief were stirred up. Voicing these experiences proved difficult and, for some, was even an emotional challenge. Our material reflects the impact the screening had on the older patients' dignity. Furthermore, the threat the screening experience poses to individuals' dignity and, more specifically, to their self-respect should be monitored and dealt with by healthcare professionals.
入住医院老年病房的老年人通常会接受认知障碍筛查。认知筛查测试的有效性和诊断问题已得到全面研究。然而，关于老年患者自身如何体验这些筛查测试的定性知识却很有限。本研究的目的是从老年患者的角度探索认知筛查测试的体验。基于实地调查，对18名住院期间完成认知筛查测试的老年患者进行了定性访谈。访谈数据根据现象学方法进行分析。研究结果得到了诺登费尔特关于身份尊严理论的支持，该理论强调尊严与完整性、自主性、生活史和人际关系有关。研究结果表明，老年患者并未完全理解职业治疗师最初对筛查测试的介绍，这使得患者只能根据筛查中回答的问题和完成的任务来解读体验。因此，在筛查结束之前，患者可能并不理解其意义。患者们觉得筛查很费劲，主要是因为有一种要表现好的压力。根据患者对自身表现的评估，会引发从羞耻、恼怒到自豪和宽慰等不同的情绪。说出这些经历很困难，对一些人来说甚至是一种情感挑战。我们的资料反映了筛查对老年患者尊严的影响。此外，医疗保健专业人员应监测并应对筛查体验对个人尊严，更具体地说是对其自尊构成的威胁。
