Ferreira-Correia Aline, Barberis Tyler, Msimanga Lerato
Department of Psychology, University of the Witwatersrand, South Africa.
S Afr J Psychiatr. 2018 Jun 11;24:1163. doi: 10.4102/sajpsychiatry.v24.i0.1163. eCollection 2018.
Working memory (WM) deficits have a negative impact on treatment adherence and quality of life. Efficient and effective interventions are needed in order to improve the cognitive functioning of those affected, especially in low-resource communities. Computer-based rehabilitation programmes (CBRP) are low-cost therapeutic approaches for WM deficits. Perceptions and experiences of target users may influence whether CBRP constitute an effective therapeutic option for adults with cognitive impairment in under-resourced environments.
The goal of the study was to explore the experiences of a group of volunteers with WM deficits (associated with diagnoses of HIV and schizophrenia), in terms of the perceived barriers they encountered during their participation in a CBRP.
A qualitative, descriptive research design was implemented. Short interviews and field notes were used in order to investigate the experiences of nine participants in relation to the CBRP. The sample included four participants living with HIV and five with schizophrenia, all with WM deficits.
Using a thematic analysis, eight barriers were identified: unawareness of the cognitive deficit, anticipation of negative results, stigma, difficulties accessing a computer and/or Internet connection, ill health, negative emotional experiences, daily routine challenges and non-conducive or sabotaging environments. A representational model of these barriers is proposed.
The implementation of a cognitive rehabilitation strategy should not only take into consideration issues of access to particular strategies and materials but should also be preceded by an exploration of how individual and contextual barriers are experienced by the potential users, as these contribute to the risk of dropout.
工作记忆缺陷会对治疗依从性和生活质量产生负面影响。为改善受影响者的认知功能，尤其是在资源匮乏社区，需要高效且有效的干预措施。基于计算机的康复计划（CBRP）是针对工作记忆缺陷的低成本治疗方法。目标用户的认知和体验可能会影响CBRP是否能成为资源匮乏环境中患有认知障碍的成年人的有效治疗选择。
本研究的目的是探索一组患有工作记忆缺陷（与艾滋病毒和精神分裂症诊断相关）的志愿者在参与CBRP过程中所遇到的感知障碍方面的经历。
采用定性描述性研究设计。通过简短访谈和实地记录来调查九名参与者在CBRP方面的经历。样本包括四名感染艾滋病毒的参与者和五名患有精神分裂症的参与者，他们均存在工作记忆缺陷。
通过主题分析，确定了八个障碍：对认知缺陷的认识不足、对负面结果的预期、耻辱感、使用计算机和/或互联网连接困难、健康状况不佳、负面情绪体验、日常生活挑战以及不利或破坏性行为的环境。提出了这些障碍的代表性模型。
认知康复策略的实施不仅应考虑获取特定策略和材料的问题，还应在实施之前探索潜在用户如何体验个人和环境障碍，因为这些因素会导致退出风险。
