Nyman Samuel R, Szymczynska Paulina
Bournemouth University Dementia Institute and Department of Psychology, Faculty of Science & Technology, Bournemouth University, UK
Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development, Newham Centre for Mental Health, Queen Mary University of London, London, UK.
Perspect Public Health. 2016 Mar;136(2):99-107. doi: 10.1177/1757913915626193.
Dementia is being increasingly recognised as a major public health issue for our ageing populations. A critical aspect of supporting people with dementia is facilitating their participation in meaningful activities. However, research to date has not drawn on theories of ageing from developmental psychology that would help undergird the importance of such meaningful activity. For the first time, we connect existing activity provision for people with dementia with developmental psychology theories of ageing.
We reviewed the literature in two stages: first, we narratively searched the literature to demonstrate the relevance of psychological theories of ageing for provision of meaningful activities for people with dementia, and in particular focused on stage-based theories of adult development (Carl Jung and Erik Erikson), gerotranscendence (Tornstam), selective optimisation with compensation (Baltes and Baltes), and optimisation in primary and secondary control (Heckhausen and Schulz). Second, we systematically searched PubMed and PsycINFO for studies with people with dementia that made use of the aforementioned theories.
The narrative review highlights that activity provision for people with dementia goes beyond mere pleasure to meeting fundamental psychological needs. More specifically, that life review therapy and life story work address the need for life review; spiritual/religious activities address the need for death preparation; intergenerational activities address the need for intergenerational relationships; re-acquaintance with previously conducted leisure activities addresses the need for a sense of control and to achieve life goals; and pursuit of new leisure activities addresses the need to be creative. The systematic searches identified two studies that demonstrated the utility of applying Erikson's theory of psychosocial development to dementia care.
We argue for the importance of activity provision for people with dementia to help promote wellbeing among an increasing proportion of older people.
痴呆症日益被视为老龄化人口面临的一个重大公共卫生问题。为痴呆症患者提供支持的一个关键方面是促进他们参与有意义的活动。然而,迄今为止的研究尚未借鉴发展心理学中的衰老理论,而这些理论有助于巩固此类有意义活动的重要性。我们首次将现有的针对痴呆症患者的活动提供与发展心理学的衰老理论联系起来。
我们分两个阶段对文献进行了综述:首先,我们对文献进行叙述性检索,以证明衰老心理学理论与为痴呆症患者提供有意义活动的相关性,尤其关注基于阶段的成人发展理论(卡尔·荣格和埃里克·埃里克森)、老年超越理论(托恩斯泰姆)、选择性最优化与补偿理论(巴尔特斯和巴尔特斯)以及初级和次级控制中的最优化理论(黑克豪森和舒尔茨)。其次,我们在PubMed和PsycINFO上系统检索了使用上述理论的针对痴呆症患者的研究。
叙述性综述强调,为痴呆症患者提供活动不仅仅是为了带来愉悦,更是为了满足基本的心理需求。更具体地说,生活回顾疗法和生活故事工作满足了对生活回顾的需求;精神/宗教活动满足了对死亡准备的需求;代际活动满足了对代际关系的需求;重新参与以前进行的休闲活动满足了对控制感和实现生活目标的需求;追求新的休闲活动满足了创造力的需求。系统检索确定了两项研究,它们证明了将埃里克森的心理社会发展理论应用于痴呆症护理的效用。
我们认为为痴呆症患者提供活动对于帮助在越来越多的老年人中促进幸福感至关重要。