Gleason Carey E, Dowling N Maritza, Benton Susan Flowers, Kaseroff Ashley, Gunn Wade, Edwards Dorothy Farrar
Wisconsin Alzheimer's Disease Research Center, Madison, WI; Division of Geriatrics, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI; Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI.
Wisconsin Alzheimer's Disease Research Center, Madison, WI; Geriatric Research, Education, and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI.
Am J Geriatr Psychiatry. 2016 Jul;24(7):537-46. doi: 10.1016/j.jagp.2015.08.005. Epub 2015 Sep 14.
Although at increased risk for developing dementia compared with white patients, older African Americans are diagnosed later in the course of dementia. Using the common sense model (CSM) of illness perception, we sought to clarify processes promoting timely diagnosis of mild cognitive impairment (MCI) for African American patients.
DESIGN, SETTING, PARTICIPANTS: In-person, cross-sectional survey data were obtained from 187 African American (mean age: 60.44 years). Data were collected at social and health-focused community events in three southern Wisconsin cities.
The survey represented a compilation of published surveys querying CSM constructs focused on early detection of memory disorders, and willingness to discuss concerns about memory loss with healthcare providers. Derived CSM variables measuring perceived causes, consequences, and controllability of MCI were included in a structural equation model predicting the primary outcome: Willingness to discuss symptoms of MCI with a provider.
Two CSM factors influenced willingness to discuss symptoms of MCI with providers: Anticipation of beneficial consequences and perception of low harm associated with an MCI diagnosis predicted participants' willingness to discuss concerns about cognitive changes. No association was found between perceived controllability and causes of MCI, and willingness to discuss symptoms with providers.
These data suggest that allaying concerns about the deleterious effects of a diagnosis, and raising awareness of potential benefits, couldinfluence an African American patient's willingness to discuss symptoms of MCI with a provider. The findings offer guidance to designers of culturally congruent MCI education materials, and healthcare providers caring for older African Americans. .
与白人患者相比,老年非裔美国人患痴呆症的风险更高,但他们在痴呆症病程中被诊断出来的时间较晚。我们运用疾病认知的常识模型(CSM),试图阐明促进非裔美国患者及时诊断轻度认知障碍(MCI)的过程。
设计、地点、参与者:通过面对面的横断面调查,从187名非裔美国人(平均年龄:60.44岁)那里获取数据。数据是在威斯康星州南部三个城市以社会和健康为重点的社区活动中收集的。
该调查汇总了已发表的针对CSM结构的调查,这些结构侧重于记忆障碍的早期检测,以及与医疗服务提供者讨论记忆力减退问题的意愿。在一个预测主要结果的结构方程模型中纳入了测量MCI感知原因、后果和可控性的派生CSM变量:与提供者讨论MCI症状的意愿。
两个CSM因素影响了与提供者讨论MCI症状的意愿:对有益后果的预期以及对MCI诊断相关低危害的感知预测了参与者讨论认知变化问题的意愿。未发现MCI的感知可控性和原因与与提供者讨论症状的意愿之间存在关联。
这些数据表明,减轻对诊断有害影响的担忧并提高对潜在益处的认识,可能会影响非裔美国患者与提供者讨论MCI症状的意愿。这些发现为符合文化背景的MCI教育材料的设计者以及照顾老年非裔美国人的医疗服务提供者提供了指导。