Dunham Annette, Mellor David, Rand Elizabeth, McCabe Marita, Lewis Matthew
School of Population Health, University of Auckland, Auckland, New Zealand.
School of Psychology, Deakin University, Melbourne, Australia.
Dementia (London). 2020 Nov;19(8):2658-2670. doi: 10.1177/1471301219844659. Epub 2019 Apr 19.
At time of diagnosis, people with dementia and their carers can access support services to help them to plan for their future care needs, but often they do not engage with these services. It is not clear why this occurs but a potential explanation explored in this paper is that disclosure of a dementia diagnosis is an overwhelming and highly stressful event that may lead to behavioural avoidance in the manner of post-traumatic stress. In this study we use a post-traumatic stress screening tool to determine whether being diagnosed with dementia shares some qualitative similarities with post-traumatic stress disorder and explore whether this is associated with a reduced likelihood to engage support services following diagnosis.
We conducted a small pilot study through the local memory clinic with eight people with dementia and 11 carers returning surveys. Participants completed the Impact of Events Scale-Revised, a validated post-traumatic stress disorder screening tool, and also provided information regarding their experience of the diagnosis and subsequent use of support services.
One person with dementia and two carers had scores on the Impact of Events Scale-Revised indicating a probable diagnosis of post-traumatic stress disorder and two people with dementia and two carers scored within the range of clinical concern. The average Impact of Events Scale-Revised score of those who had taken-up a referral to home support was significantly lower than those who had not.
A dementia diagnosis can be associated with symptoms that are consistent with post-traumatic stress, which in turn may affect engagement with support services.
在确诊时,痴呆症患者及其护理人员可以获得支持服务,以帮助他们规划未来的护理需求,但他们往往不参与这些服务。尚不清楚为何会出现这种情况,但本文探讨的一个潜在解释是,痴呆症诊断的披露是一个压倒性的、压力极大的事件,可能会导致类似创伤后应激的行为回避。在本研究中,我们使用一种创伤后应激筛查工具来确定痴呆症诊断是否与创伤后应激障碍存在一些定性相似之处,并探讨这是否与诊断后使用支持服务的可能性降低有关。
我们通过当地记忆诊所进行了一项小型试点研究,对8名痴呆症患者和11名护理人员进行了回访调查。参与者完成了事件影响量表修订版(一种经过验证的创伤后应激障碍筛查工具),并提供了有关他们诊断经历和后续支持服务使用情况的信息。
一名痴呆症患者和两名护理人员在事件影响量表修订版上的得分表明可能患有创伤后应激障碍,两名痴呆症患者和两名护理人员的得分在临床关注范围内。接受家庭支持转诊的患者在事件影响量表修订版上的平均得分显著低于未接受转诊的患者。
痴呆症诊断可能与创伤后应激相关的症状有关,这反过来可能会影响对支持服务的参与度。