University of Wisconsin-Madison School of Nursing, Madison, Wisconsin.
Department of Medicine, Division of Geriatrics, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin.
J Clin Nurs. 2019 Feb;28(3-4):410-419. doi: 10.1111/jocn.14663. Epub 2018 Sep 24.
The objective of this analysis was to clarify the concepts of apathy and passivity in the context of dementia by identifying distinguishing and overlapping attributes for both concepts simultaneously.
Apathy is among the most common and persistent symptoms in dementia. The concept of apathy is often used interchangeably with passivity. Understanding similarities and differences between these concepts is of critical importance in clarifying clinical diagnostic criteria, developing consistent measurement in research and translating research evidence into nursing practice.
A systematic literature search of multiple databases identified relevant articles for review. A modified combination of Haase et al.'s simultaneous concept analysis method and Morses' principle-based concept analysis using qualitative content and thematic analysis procedures was applied to identify overlapping and distinguishing attributes.
A search of PubMed, CINAHL and PsycINFO databases identified 176 articles meeting inclusion criteria. The concepts of apathy and passivity were characterised using a standardised manual to identify attributes of definitions (conceptual and operational), related conditions, functional, behavioural and neurobiological correlates, antecedents and consequences. Thematic analysis identified common themes across each category which were tabulated and entered into comparative matrices to identify overlapping and distinguishing features.
There is considerable overlap across attributes of apathy and passivity. Apathy is distinguished as a clinical syndrome characterised by loss of motivation not due to emotional distress or cognitive impairment. Passivity is distinguished as a lack of interaction between the individual and environment in the context of cognitive impairment.
In contrast to passivity, apathy is a more robustly defined concept focused on motivational limitations within the individual associated with specific neuroanatomical deficits.
The identification of key distinguishing features of apathy and passivity in dementia is a critical first step in ensuring consistent measurement of each concept.
本分析的目的是通过同时确定两个概念的区别和重叠属性，澄清痴呆背景下的冷漠和被动概念。
冷漠是痴呆症中最常见和最持久的症状之一。冷漠的概念经常与被动性互换使用。理解这些概念之间的相似之处和差异对于澄清临床诊断标准、在研究中开发一致的测量方法以及将研究证据转化为护理实践至关重要。
对多个数据库进行了系统的文献检索，以确定审查的相关文章。采用 Haase 等人的同时概念分析方法和 Morse 基于原则的概念分析方法的改进组合，结合定性内容和主题分析程序，用于确定重叠和区别属性。
在 PubMed、CINAHL 和 PsycINFO 数据库中进行搜索，确定了符合纳入标准的 176 篇文章。使用标准化手册来确定冷漠和被动的概念属性，包括定义（概念和操作性）、相关条件、功能、行为和神经生物学相关性、前因和后果。主题分析确定了每个类别中的常见主题，并将其制表并输入到比较矩阵中，以确定重叠和区别特征。
冷漠和被动的属性有很大的重叠。冷漠被定义为一种临床综合征，其特征是动机丧失，不是由于情绪困扰或认知障碍引起的。被动性被定义为在认知障碍的背景下，个体与环境之间缺乏互动。
与被动性相比，冷漠是一个更严格定义的概念，侧重于与特定神经解剖缺陷相关的个体内部的动机限制。
在痴呆症中识别冷漠和被动的关键区别特征是确保每个概念的一致测量的关键第一步。
