a Division of Psychiatry and Applied Psychology , University of Nottingham , Nottingham , United Kingdom.
b School of Sociology and Social Policy , University of Nottingham , Nottingham , United Kingdom.
Aging Ment Health. 2019 Jun;23(6):651-659. doi: 10.1080/13607863.2018.1450836. Epub 2018 Mar 15.
Good interaction with family caregivers helps maintain positive identity in people with dementia. However, research in this area is limited. We aimed to systematically review the dyadic experience of dementia caring.
We searched on five databases: MedLine, EMBASE, PsycInfo, ASSIA, and CINAHL. Eligible studies employed qualitative or mixed method design, reported the experience of dyads of dementia with no comorbid organic or psychiatric disorders. No restrictions were made on language, year of publication, sex or age of participants. Two independent researchers conducted the quality appraisal of studies. We synthesise data through meta-ethnography and developed a behavioural model to explain dyadic interaction.
Seventeen studies were included in the review. The meta-ethnography generated two third-order constructs: Personal orientation and noises. When people with dementia and their carers have dyadic-oriented goals, their behavioural responses may promote positive interaction. When only one partner has dyadic goals, context-related stress may affect the interaction, because of no perceived shared understanding of the situation.
Our findings suggest that unequal power distribution within dyads, can cause significant stress, when coping strategies are impaired. We discussed implications for family carers, people with dementia, and health professionals deriving from greater understanding of dyadic dynamics to care.
与家庭照顾者良好互动有助于维持痴呆症患者的积极身份。然而，这方面的研究有限。我们旨在系统地回顾痴呆症护理的双重体验。
我们在五个数据库中进行了搜索：MedLine、EMBASE、PsycInfo、ASSIA 和 CINAHL。合格的研究采用定性或混合方法设计，报告了无合并器质性或精神障碍的痴呆症双体的体验。对语言、发表年份、参与者的性别或年龄没有限制。两名独立的研究人员对研究进行了质量评估。我们通过元民族学综合数据，并开发了一个行为模型来解释双重互动。
本综述纳入了 17 项研究。元民族学产生了两个三阶结构：个人取向和噪音。当痴呆症患者及其照顾者具有双重导向目标时，他们的行为反应可能会促进积极的互动。当只有一方有双重目标时，由于对情况没有共同的理解，与背景相关的压力可能会影响互动，因为应对策略受损。
我们的研究结果表明，当应对策略受损时，双重关系中权力分配不均会导致重大压力。我们从对双重动态的更深入理解中讨论了对家庭照顾者、痴呆症患者和卫生专业人员的影响，以便更好地照顾。
