Höwler Elisabeth
Pflege Z. 2011 Oct;64(10):612-5.
The aim of this study was to explore the connection between the nature of agitated behaviour and meaningful biographical experiences within two types of dementia in a moderate stadium. The two dementia types included Alzheimer Disease (SDAT) and Multi-infarction aphrenia (MID). Biographical narrative interviews with 26 nursing home residents suffering from dementia have been concluded. Topics were their first thirty years of life (based on a foreign anamnesis). The challenging behaviour has been observed systematically in nursing situations. The data has been evaluated with the comparative casuistics method (Jüttemann, 1990). The behaviour has been measured with the CMAI-scale before and also after having moved to a nursing home. Residents behaviour patterns can be divided into three biographical central characters: Life as finding, life as emotional disorder and life as struggle. Institutional characteristics: Loss of near rhythms of life, losing control over the personal area, experience of social isolation and certain characteristics from nurses: staff detractions and the exercise of nursing actions which appears threats contribute to the phenomena. A disparity is shown between the types of dementia in terms of patterns of demonstrated behaviour. In addition gender differences could be shown. The recognition of the phenomena by means of the CMAI-scale elucidate that the phenomena appears for the first time or is stronger after the resettlement to a nursing home. These findings can improve nurses' understanding of the phenomena within long-term care.
本研究的目的是在中度阶段探讨两种类型痴呆症中激越行为的本质与有意义的个人经历之间的联系。这两种痴呆症类型包括阿尔茨海默病(SDAT)和多发梗死性痴呆(MID)。对26名患有痴呆症的养老院居民进行的个人经历叙述访谈已经结束。访谈主题是他们生命的头三十年(基于国外的既往病史)。在护理情境中对挑战性行为进行了系统观察。采用比较案例法(Jüttemann,1990)对数据进行了评估。在居民入住养老院前后,均使用CMAI量表对其行为进行了测量。居民的行为模式可分为三个个人经历核心特征:寻求生活、情绪紊乱的生活和挣扎的生活。机构特征:生活节奏丧失、个人领域失控、社会隔离体验以及护士的某些特征:员工贬低和看似具有威胁性的护理行为实施,这些都促成了这些现象。在表现出的行为模式方面,两种痴呆症类型之间存在差异。此外,还发现了性别差异。通过CMAI量表对这些现象的认识表明,这些现象在入住养老院后首次出现或更为严重。这些发现可以提高护士对长期护理中这些现象的理解。