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“在 flesh 中”:有早发性家族性阿尔茨海默病风险的家庭护理者的叙述。

"In the flesh": Narratives of family caregivers at risk of Early-onset Familial Alzheimer's Disease.

机构信息

Faculty of Psychology, University of Salamanca, Salamanca, Spain.

Faculty of Education, University of Salamanca, Salamanca, Spain.

出版信息

Dementia (London). 2020 Jul;19(5):1474-1491. doi: 10.1177/1471301218801501. Epub 2018 Sep 25.

Abstract

In the growing body of literature dealing with the consequences of family caregiving amongst people with dementia, there are few studies examining the impact of Early-onset Familial Alzheimer's Disease on caregivers. This study exposes the subjective experience of a group of family caregivers who themselves possess a genetic susceptibility to develop this form of dementia. We interviewed and analyzed the accounts of 27 caregivers belonging to family lineages carrying the E280A mutation for Early-onset Alzheimer's Disease. We utilized a phenomenological method to analyze these accounts, initially tracking seven theoretical categories (Anxiety, Depression, Burden, Resilience, Self-efficacy, Social Support, and Coping Strategies) and then subsequently two additional categories which emerged (Conceptions about the Disease and Other Vital Experiences Interfering with Caregiving). The results show that caring for a loved one while simultaneously running the risk of developing the same form of Alzheimer's Disease permeates the caregivers' experience both in a negative and a positive way. The continuous exposition to emotional stress in these caregivers should be seriously considered as they may be at risk of accelerating the onset of symptoms of Alzheimer's Disease, while simultaneously, early psychological symptoms of dementia may be masked by the emotional sequelae of caregiving, interfering with early diagnosis. Certainly, support services for the entire family group are suggested.

摘要

在越来越多的关于痴呆症患者家庭护理后果的文献中,很少有研究探讨早发性家族性阿尔茨海默病对护理人员的影响。本研究揭示了一组具有遗传易感性易患这种形式痴呆症的家庭护理人员的主观体验。我们采访并分析了 27 名属于携带早发性阿尔茨海默病 E280A 突变家族谱系的护理人员的叙述。我们利用现象学方法对这些叙述进行了分析,最初跟踪了七个理论类别(焦虑、抑郁、负担、韧性、自我效能、社会支持和应对策略),然后又出现了另外两个类别(对疾病的概念和干扰护理的其他重要经历)。结果表明,在照顾亲人的同时,又面临患上同一种阿尔茨海默病的风险,这对护理人员的体验产生了消极和积极的影响。这些护理人员持续面临情绪压力,应该引起重视,因为他们可能有加速阿尔茨海默病症状发作的风险,而与此同时,痴呆症的早期心理症状可能被护理的情绪后果所掩盖,从而干扰早期诊断。当然,建议为整个家庭群体提供支持服务。

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