Quinn Catherine, Jones Ian Rees, Clare Linda
a Department of Psychology , REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter , Exeter , UK.
b WISERD - Wales Institute of Social & Economic Research, Data & Methods, Cardiff University , Cardiff , UK.
Aging Ment Health. 2017 May;21(5):553-561. doi: 10.1080/13607863.2015.1128882. Epub 2016 Jan 5.
Illness representations shape responses to illness experienced by the self or by others. The illness representations held by family members of those with long-term conditions such as dementia influence their understanding of what is happening to the person and how they respond and provide support. The aim of this study is to explore components of illness representations (label, cause, control and timeline) in caregivers of people with dementia.
This was an exploratory study; the data reported came from the Memory Impairment and Dementia Awareness Study (MIDAS). Data from semi-structured interviews with 50 caregivers of people with dementia were analysed using content analysis.
The majority of caregivers gave accounts that appeared to endorse a medical/diagnostic label, although many used different terms interchangeably. Caregivers differentiated between direct causes and contributory factors, but the predominant explanation was that dementia had a biological cause. Other perceived causes were hereditary factors, ageing, lifestyle, life events and environmental factors. A limited number of caregivers were able to identify things that people with dementia could do to help manage the condition, while others thought nothing could be done. There were varying views about the efficacy of medication. In terms of timeline, there was considerable uncertainty about how dementia would progress over time.
The extent of uncertainty about the cause, timeline and controllability of dementia indicated that caregivers need information on these areas. Tailored information and support taking account of caregivers' existing representations may be most beneficial.
疾病表征塑造了个体对自身或他人所患疾病的反应。患有痴呆症等长期病症患者的家庭成员所持有的疾病表征,会影响他们对患者情况的理解以及他们的应对方式和提供支持的方式。本研究的目的是探讨痴呆症患者照料者的疾病表征组成部分(标签、病因、可控性和病程)。
这是一项探索性研究;所报告的数据来自记忆障碍与痴呆症认知研究(MIDAS)。采用内容分析法对来自50名痴呆症患者照料者的半结构化访谈数据进行了分析。
大多数照料者给出的描述似乎认可医学/诊断标签,尽管许多人会交替使用不同的术语。照料者区分了直接病因和促成因素,但主要解释是痴呆症有生物学病因。其他被认为的病因包括遗传因素、衰老、生活方式、生活事件和环境因素。少数照料者能够指出痴呆症患者可以做些什么来帮助控制病情,而其他人则认为无能为力。对于药物疗效存在不同观点。在病程方面,对于痴呆症随时间如何发展存在相当大的不确定性。
痴呆症病因、病程和可控性方面的不确定性程度表明,照料者需要这些方面的信息。考虑到照料者现有认知的针对性信息和支持可能最为有益。