van Gennip Isis E, Pasman H Roeline W, Oosterveld-Vlug Mariska G, Willems Dick L, Onwuteaka-Philipsen Bregje D
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Department of General Practice, Section of Medical Ethics, Academic Medical Center, Amsterdam, The Netherlands.
J Gerontol B Psychol Sci Soc Sci. 2016 May;71(3):491-501. doi: 10.1093/geronb/gbu137. Epub 2014 Sep 30.
This article examines how dementia affects personal dignity in individuals with mild to moderate dementia from their perspective.
In this qualitative cross-sectional study, in-depth interviews were carried out with 14 individuals, aged 50-94, with mild to moderate dementia who lived at home. Verbatim transcripts were analyzed making use of the principles of thematic analysis.
Although mild to moderate dementia resulted in a diminished sense of personal dignity, in general participants still felt reasonably dignified. The decline in personal dignity was generally caused by cognitive impairments resulting in diminished autonomy and changes to the individual's former identity. However, the intensity with which the decline in personal dignity was experienced depended to a large degree on the social context of the individual, with a marked difference between the private sphere of the home and the external, social environment. The study gives recommendations how others can help to sustain personal dignity in people with mild to moderate dementia.
Given the considerable impact the social environment has on the personal dignity of people with mild to moderate dementia, it is important in caregiving not to confine attention to health-related or even any individual aspects alone, but also to take interpersonal aspects into consideration.
本文从轻度至中度痴呆患者的角度,探讨痴呆症如何影响他们的个人尊严。
在这项定性横断面研究中,对14名年龄在50 - 94岁、患有轻度至中度痴呆且居家生活的患者进行了深入访谈。利用主题分析原则对逐字记录进行了分析。
尽管轻度至中度痴呆导致个人尊严感下降,但总体而言,参与者仍感觉自己有一定的尊严。个人尊严的下降通常是由认知障碍导致自主性降低以及个人原有身份改变引起的。然而,个人尊严下降的感受强度在很大程度上取决于个体的社会环境,家庭的私人领域与外部社会环境之间存在显著差异。该研究给出了关于他人如何帮助维持轻度至中度痴呆患者个人尊严的建议。
鉴于社会环境对轻度至中度痴呆患者个人尊严有相当大的影响,在护理中,重要的是不要将注意力仅局限于健康相关甚至任何个体方面,还应考虑人际方面。