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社区痴呆症患者及其家庭照顾者在接受治疗性集体歌唱后人际关系得到改善,幸福感增强:一项定性主题分析

Community-Dwelling People Living With Dementia and Their Family Caregivers Experience Enhanced Relationships and Feelings of Well-Being Following Therapeutic Group Singing: A Qualitative Thematic Analysis.

作者信息

Clark Imogen N, Tamplin Jeanette D, Baker Felicity A

机构信息

Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.

出版信息

Front Psychol. 2018 Jul 30;9:1332. doi: 10.3389/fpsyg.2018.01332. eCollection 2018.

Abstract

The progression of dementia can severely compromise interpersonal connection and relationship quality between people living with dementia (PwD) and their family caregivers (FCG), leading to social isolation and poor quality of life for both. Therapeutic group singing (TGS) is a socially engaging, stimulating, and supportive pursuit that community-dwelling PwD and their FCG can participate in together. This study aimed to build on the findings from previous research by undertaking a thematic analysis of interviews with nine PwD (five women, four men; mean age = 79.1 years) and nine FCG (five women, four men; mean age = 75.7 years). The interviews explored participants' perspectives and experiences of a 20-week TGS intervention, underpinned by Kitwood's model of person-centered care. Inductive thematic analysis resulted in the emergence of five themes which described how TGS for PwD and their FCG: (1) included supportive therapeutic facilitation and design features; (2) made group singing more accessible; (3) fostered new empathic friendships; (4) enhanced relationships between PwD and FCG; and (5) led to personal feelings of wellbeing for both PwD and FCG. Affinity with others who had similar life experiences and challenges created a sense of mutual understanding and camaraderie, which made group singing accessible without fear of judgment and social stigmas. For some PwD/FCG dyads, TGS meant they could continue a lifelong passion for singing together, while others enjoyed participating in singing together for the first time. Both PwD and FCG participants described personal feelings of acceptance, improved social confidence, mood, and purpose. Further, participants valued mental stimulation from TGS such as learning new skills and memory support. A model explaining relationships between themes suggests that TGS with person-centered facilitation features for PwD/FCG dyads led to affinity among group members with ripple effects, which enhanced accessibility to group singing, the formation of empathic friendships, PwD/FCG relationship quality, and personal wellbeing for both PwD and FCG. Psychoemotional, social and cognitive benefits from TGS described by participants in this study are known to promote self-identity, healthy relationships, and quality of life. This research highlights a need for improved availability of TGS for community-dwelling PwD/FCG dyads.

摘要

痴呆症的进展会严重损害痴呆症患者(PwD)与其家庭照顾者(FCG)之间的人际联系和关系质量,导致双方社会隔离且生活质量低下。治疗性集体歌唱(TGS)是一种社交性、刺激性且具有支持性的活动,社区居住的痴呆症患者及其家庭照顾者可以共同参与。本研究旨在基于先前研究的结果,对9名痴呆症患者(5名女性,4名男性;平均年龄 = 79.1岁)和9名家庭照顾者(5名女性,4名男性;平均年龄 = 75.7岁)的访谈进行主题分析。访谈探讨了参与者对以基特伍德的以人为本的护理模式为基础的为期20周的治疗性集体歌唱干预的看法和体验。归纳主题分析得出了五个主题,描述了针对痴呆症患者及其家庭照顾者的治疗性集体歌唱如何:(1)包括支持性的治疗促进和设计特点;(2)使集体歌唱更容易参与;(3)培养新的共情友谊;(4)增强痴呆症患者与家庭照顾者之间的关系;(5)使痴呆症患者和家庭照顾者都产生个人幸福感。与有相似生活经历和挑战的人建立亲密关系会产生相互理解和同志情谊,这使得集体歌唱变得容易参与,而无需担心被评判和社会污名。对于一些痴呆症患者/家庭照顾者组合来说,治疗性集体歌唱意味着他们可以继续共同拥有对唱歌的毕生热爱,而另一些人则首次享受一起唱歌的乐趣。痴呆症患者和家庭照顾者参与者都描述了个人的被接纳感、社交信心、情绪和目标感得到改善。此外,参与者重视治疗性集体歌唱带来的精神刺激,如学习新技能和记忆支持。一个解释主题之间关系的模型表明,针对痴呆症患者/家庭照顾者组合的具有以人为本促进特点的治疗性集体歌唱会导致小组成员之间产生亲密关系,并产生连锁反应,从而增强集体歌唱的可及性、共情友谊的形成、痴呆症患者/家庭照顾者的关系质量以及痴呆症患者和家庭照顾者双方的个人幸福感。本研究中参与者描述的治疗性集体歌唱带来的心理情感、社会和认知益处已知可促进自我认同、健康关系和生活质量。这项研究强调需要提高社区居住的痴呆症患者/家庭照顾者组合参与治疗性集体歌唱的可及性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5387/6077620/de4f4685bfdc/fpsyg-09-01332-g001.jpg

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