Wang Chi-Jane, Pai Ming-Chyi, Hsiao Hua-Shan, Wang Jing-Jy
Department of Nursing, National Cheng Kung University, Tainan, Taiwan.
Division of Behavioral Neurology, Department of Neurology and Alzheimer's Disease Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Scand J Caring Sci. 2015 Dec;29(4):769-75. doi: 10.1111/scs.12208. Epub 2015 Feb 4.
Management of the disruptive behaviours is one of the most challenging aspects of caring for patients with Alzheimer's dementia (PwAD). The underlying needs of disruptive behaviours in PwAD had rarely been studied, especially the comparison of the underlying needs of disruptive behaviours in PwAD have never been mentioned.
The purpose of this study was to investigate and compare the underlying needs of five common disruptive behaviours including hoarding, aggressive behaviour, repetitive behaviour, altered eating behaviour and delusion in PwAD, as perceived by family caregivers, and to relate these needs from the perspective of Maslow's hierarchy.
An exploratory research design with qualitative data collection techniques was employed. Informed consent was obtained from each participant prior to the data collection. A total of 65 pairs of caregiver-patient with Alzheimer's disease participated in the study. A semi-structured interview guide was used during the interview, and the directed content analysis method was conducted to analyse data.
Four themes related to the underlying needs of the five selected disruptive behaviours emerged from the data, and these included a desire for comfort (physical and psychological), a desire for security (psychological and economic), a need for a sense of belonging (including a need to connect with the outside world and a need for attention) and a need for self-control. These behaviour features were found closely related to Maslow's hierarchy model of human needs.
Although the data were gathered from the caregivers, and the views of the patients were thus not included in the analysis, the findings provide information for health providers that can enable them to better understand the underlying needs of common disruptive behaviours in patients with Alzheimer's disease and thus help develop better patient-centred care plans.
管理破坏性行为是照顾阿尔茨海默病痴呆患者（PwAD）最具挑战性的方面之一。PwAD破坏性行为的潜在需求很少被研究，尤其是从未提及过对PwAD破坏性行为潜在需求的比较。
本研究的目的是调查和比较家庭照顾者所感知的PwAD中囤积、攻击行为、重复行为、饮食行为改变和妄想这五种常见破坏性行为的潜在需求，并从马斯洛需求层次理论的角度关联这些需求。
采用探索性研究设计和定性数据收集技术。在数据收集之前，从每位参与者处获得知情同意。共有65对患有阿尔茨海默病的照顾者-患者参与了该研究。访谈期间使用了半结构化访谈指南，并采用定向内容分析法对数据进行分析。
数据中出现了与所选五种破坏性行为的潜在需求相关的四个主题，这些主题包括对舒适（身体和心理）的渴望、对安全（心理和经济）的渴望、归属感需求（包括与外界联系的需求和关注需求）以及自我控制需求。这些行为特征与马斯洛的人类需求层次模型密切相关。
尽管数据是从照顾者那里收集的，因此患者的观点未纳入分析，但研究结果为医疗服务提供者提供了信息，使他们能够更好地理解阿尔茨海默病患者常见破坏性行为的潜在需求，从而有助于制定更好的以患者为中心的护理计划。
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