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为生存而挣扎——老年精神障碍患者的生活状况体验。

Struggling for existence-Life situation experiences of older persons with mental disorders.

机构信息

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

出版信息

Int J Qual Stud Health Well-being. 2012;7. doi: 10.3402/qhw.v7i0.18422. Epub 2012 Jun 7.

Abstract

Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons' experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. "Struggling for existence" emerged as a main theme in the older persons' narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care.

摘要

患有精神障碍的老年人是一个弱势群体,他们有着广泛而复杂的需求。全球老年人口正在迅速增加,由于精神卫生保健机构的去机构化,越来越多的老年人选择留在家里。尽管他们在人口中占很大比例,但患有精神障碍的老年人在研究和护理组织中都被忽视了。由于对老年人自身状况的经验知之甚少,因此本研究旨在阐明患有精神障碍(不包括痴呆症)的老年人的生活状况的意义。对 7 名老年人进行了访谈,并使用受保罗·利科哲学启发的现象学解释学研究方法对文本进行了分析。“为生存而挣扎”成为老年人叙述中的一个主要主题,被理解为身份尊严的丧失,涉及到烦恼和无力感,以及对尊重的渴望。老年人努力掌握自己的存在,并被视为真实的自己。该研究强调了护理人员(包括正式和非正式护理人员)的重要性,他们不应只关注诊断,而应承认老年人及其生活世界的存在,在关系中保持在场,并帮助他们重建身份尊严。这项研究对患有精神障碍的老年人有了新的认识,有助于减少污名化,并为未来的精神卫生保健规划做出贡献。

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