Perry-Young Lucy, Owen Gareth, Kelly Susan, Owens Christabel
School of Sociology and Social Policy, University of Nottingham, Nottingham, UK.
University of Exeter Medical School, Exeter, UK.
Dementia (London). 2018 Jan;17(1):34-60. doi: 10.1177/1471301215626889. Epub 2016 Jan 12.
Evidence suggests that there is usually a long delay between noticing first signs of dementia and seeking medical help. We conducted a systematic review of what people experience and how they make decisions during this time, and used a meta-ethnographic approach to synthesise the findings. Screening and quality assessment resulted in nine studies eligible for inclusion. People with dementia mainly report experiencing memory lapses, while carers focus on more subtle changes in personality. People respond to these changes in one of three ways: 1) they discount them as normal; 2) they reserve judgement as to their cause and significance, or 3) they misattribute them. Pivotal events can finally trigger help seeking. Active reflection and seeking of further evidence may lead to earlier recognition of the possibility of dementia and the need to seek help; it also reduces the risk of a pivotal event. Public education should aim to improve recognition of more subtle signs and to encourage repeated evaluation and reflection.
有证据表明，从注意到痴呆症的最初迹象到寻求医疗帮助之间通常会有很长的延迟。我们对人们在此期间的经历以及他们如何做出决策进行了系统回顾，并采用元民族志方法对研究结果进行了综合分析。筛选和质量评估后，有九项研究符合纳入标准。患有痴呆症的人主要报告经历记忆衰退，而照顾者则关注性格方面更细微的变化。人们对这些变化有三种反应方式：1）将其视为正常而不予理会；2）对其原因和重要性暂不做判断；3）对其进行错误归因。关键事件最终可能会促使人们寻求帮助。积极思考并寻求更多证据可能会使人们更早地认识到患痴呆症的可能性以及寻求帮助的必要性；这也降低了关键事件发生的风险。公众教育应旨在提高对更细微症状的认识，并鼓励反复评估和思考。
