Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Postbox 7053, N- 3007, Drammen, Norway.
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
BMC Geriatr. 2018 Feb 1;18(1):33. doi: 10.1186/s12877-018-0728-0.
Identifying how persons with dementia experience lived space is important for enabling supportive living environments and creating communities that compensate for the fading capabilities of these persons. Several single studies have explored this topic; however, few studies have attempted to explicitly review and synthesize this research literature. The aim of this systematic meta-synthesis was therefore to interpret and synthesize knowledge regarding persons with dementia's experience of space.
A systematic, computerized search of AgeLine, CINAHL Complete, Embase, Medline and PsycINFO was conducted using a search strategy that combined MeSH terms and text words for different types of dementia with different descriptions of experience. Studies with 1) a sample of persons with dementia, 2) qualitative interviews as a research method and 3) a description of experiences of lived space were included. The search resulted in 1386 articles, of which 136 were identified as eligible and were read and assessed using the CASP criteria. The analysis was inspired by qualitative content analyses.
This interpretative qualitative meta-synthesis included 45 articles encompassing interviews with 672 persons with dementia. The analysis showed that living in one's own home and living in long-term care established different settings and posed diverse challenges for the experience of lived space in persons with dementia. The material revealed four main categories that described the experience of lived space: (1) belonging; (2) meaningfulness; (3) safety and security; and (4) autonomy. It showed how persons with dementia experienced a reduction in their lived space due to the progression of dementia. A comprehensive understanding of the categories led to the latent theme: "Living with dementia is like living in a space where the walls keep closing in".
This meta-synthesis reveals a process whereby lived space gradually becomes smaller for persons with dementia. This underscores the importance of being aware of the experiences of persons with dementia and the spatial dimensions of their life-world. To sustain person-centred care and support the preservation of continuity and identity, one must acknowledge not only the physical and social environment but also space as an existential experience for persons with dementia.
了解痴呆症患者的生活空间体验对于创造支持性的生活环境和社区至关重要，这些环境和社区可以弥补这些患者逐渐衰退的能力。已经有一些单项研究探讨了这一主题；然而，很少有研究试图明确地回顾和综合这一研究文献。因此，本系统元分析的目的是解释和综合关于痴呆症患者空间体验的知识。
使用一种搜索策略，对 AgeLine、CINAHL Complete、Embase、Medline 和 PsycINFO 进行了系统的、计算机化的搜索，该策略结合了痴呆症不同类型的 MeSH 术语和文本词，以及不同的体验描述。纳入了 1）痴呆症患者样本，2）作为研究方法的定性访谈，以及 3）生活空间体验描述的研究。该搜索共产生了 1386 篇文章，其中有 136 篇被确定为符合条件的文章，并使用 CASP 标准进行了阅读和评估。分析受到了定性内容分析的启发。
这项解释性的定性元分析包括 45 篇文章，涵盖了对 672 名痴呆症患者的访谈。分析表明，在自己的家中生活和在长期护理机构中生活为痴呆症患者的生活空间体验建立了不同的环境，并带来了不同的挑战。这些材料揭示了描述生活空间体验的四个主要类别：（1）归属感；（2）意义感；（3）安全感；（4）自主性。它展示了痴呆症患者如何因疾病的进展而经历其生活空间的缩小。对这些类别的全面理解导致了潜在的主题：“患有痴呆症就像生活在一个空间里，墙壁不断向你逼近”。
这项元分析揭示了痴呆症患者的生活空间逐渐缩小的过程。这凸显了了解痴呆症患者的体验以及他们生活世界的空间维度的重要性。为了维持以患者为中心的护理和支持连续性和身份的保持，人们不仅必须认识到物理和社会环境，还必须认识到空间是痴呆症患者的一种存在体验。
