“宛如死神临近”：痴呆症患者家庭照料者博客文章中的自杀和杀人意念表达
"Like Death is Near": Expressions of Suicidal and Homicidal Ideation in the Blog Posts of Family Caregivers of People with Dementia.
作者信息
Anderson Joel G, Eppes Alexis, O'Dwyer Siobhan T
机构信息
College of Nursing, University of Tennessee, Knoxville, TN 37996, USA.
University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 1TX, UK.
出版信息
Behav Sci (Basel). 2019 Mar 3;9(3):22. doi: 10.3390/bs9030022.
BACKGROUND
The challenges of providing care for someone with Alzheimer's disease and related dementias (ADRD) have been associated with increased stress, poor mental and physical health, social isolation, and financial distress. More recently, caregiving has been associated with high rates of suicidal and homicidal ideation, but the research on these phenomena is limited. The present study analyzed a sample of blogs written by family caregivers of people with ADRD to explore thoughts of suicide and homicide expressed by these caregivers.
METHODS
Blogs written by self-identified informal caregivers of people with ADRD were identified using a systematic search method and data were analyzed using a qualitative thematic analysis.
RESULTS
Five themes related to thoughts of suicide and homicide by caregivers and people with ADRD were derived from the analysis: (1) end-of-life care; (2) thoughts of death and euthanasia by the person with ADRD; (3) surrogate decision making; (4) thoughts of suicide by the caregiver; and (5) thoughts of homicide and euthanasia by the caregiver.
CONCLUSIONS
The results capture the reality of suicidal and homicidal thoughts among family caregivers of people with ADRD, supporting calls for more research on these complex topics and highlighting the need for changes to clinical practice to prevent thoughts from becoming behaviors or actions.
背景
照顾患有阿尔茨海默病及相关痴呆症（ADRD）的患者所面临的挑战与压力增加、身心健康状况不佳、社会孤立以及经济困境有关。最近，护理工作与高自杀和杀人意念率相关，但对这些现象的研究有限。本研究分析了ADRD患者家庭护理人员撰写的博客样本，以探讨这些护理人员表达的自杀和杀人想法。
方法
使用系统搜索方法识别由自我认定的ADRD患者非正式护理人员撰写的博客，并使用定性主题分析对数据进行分析。
结果
通过分析得出了与护理人员和ADRD患者的自杀和杀人想法相关的五个主题：（1）临终护理；（2）ADRD患者的死亡和安乐死想法；（3）替代决策；（4）护理人员的自杀想法；（5）护理人员的杀人及安乐死想法。
结论
研究结果反映了ADRD患者家庭护理人员中自杀和杀人想法的现实情况，支持对这些复杂主题进行更多研究的呼吁，并强调需要改变临床实践以防止想法转化为行为或行动。
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