Kibi International University, Japan.
Dementia (London). 2013 Sep;12(5):551-68. doi: 10.1177/1471301211435193. Epub 2012 Mar 16.
In order to understand the words and deeds of dementia patients that we find very hard to explain or understand, we have paid attention to the self-awareness ability of dementia patients, the intellectual subject that integrates their own intellectual functions, and created 'a model for interpreting puzzling words and deeds of dementia patients from the viewpoint of self-awareness'. The purpose of this study is to explain the reasons why dementia patients become unable to successfully perform activities of daily living (ADL) with advancement of dementia, using our model to present viewpoints understandable to caregivers. We classified dementia inpatients of a geriatric health services facility into four stages, using the model of self-awareness ability (consisting of 'theory of mind', 'self-evaluation' and 'self-consciousness') that was constructed by combining 'theory of mind' and Lewis's developmental model of cognition and emotion. Furthermore, we observed and documented scenes from daily life, and we interpreted the reasons why patients become unable to seek assistance from others for ADL, based on the model. We came to understand why the patients could not seek assistance from others, because the patients who failed in the task of 'theory of mind' were unable to self-assess their own mind and the minds of others, and those having failed in the task of 'self-evaluation' could not evaluate their own situation.
为了理解我们觉得很难解释或理解的痴呆症患者的言行，我们关注了痴呆症患者的自我意识能力，这是一个整合了他们自身智力功能的智力主体，并创造了“从自我意识角度解释痴呆症患者令人费解的言行的模型”。本研究的目的是用我们的模型来解释痴呆症患者随着痴呆症的发展而变得无法成功进行日常生活活动（ADL）的原因，为护理人员提供可理解的观点。我们使用自我意识能力模型（由“心理理论”、“自我评估”和“自我意识”组成），将老年保健设施的住院痴呆症患者分为四个阶段，该模型是通过结合“心理理论”和刘易斯的认知和情感发展模型构建的。此外，我们观察并记录日常生活中的场景，并根据该模型解释患者无法寻求他人帮助进行 ADL 的原因。我们了解到为什么患者无法寻求他人的帮助，是因为在“心理理论”任务中失败的患者无法自我评估自己和他人的思维，而在“自我评估”任务中失败的患者无法评估自己的情况。
