Gibson Kirstian, Peacock Shelley, Bayly Melanie
College of Arts and Science (Psychology), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
BMJ Open. 2019 Sep 24;9(9):e031423. doi: 10.1136/bmjopen-2019-031423.
To understand how bereaved spousal caregivers of persons with dementia perceive and respond to changes over the course of their spouse's disease, from diagnosis into bereavement.
Qualitative interview study with convenience sampling and thematic analysis approach.
Participants included eight women and two men (n=10) who had been spousal caregivers for a person with dementia prior to his/her death. Participants were older adults who self-reported good health and were bereaved longer than a year.
Data collected in a small Canadian prairie city between fall 2014 and winter 2015.
Two overarching themes were developed as important components of participants' caregiving journey: emotional reactions to change and variation in social connectedness throughout the caregiving and bereavement journey. Four key sub-themes developed through the analysis of emotional reactions to events: memorable grief overshadows persistent grief, a progressive feeling of hopelessness and overwhelmed, relief is common but hidden and gratitude is a milestone in a constructive bereavement. Three key variations of social connectedness throughout the caregiving and bereavement journey were developed: the importance of social inclusion throughout a caregiving and bereavement journey, the repeated loss of companionship and withdrawing from social interactions is contingent on needs.
The findings suggest that emotional changes throughout caregiving and bereavement are not linear. The need for support from family, friends and new social supports is influential in enabling the caregiver to move forward during caregiving and bereavement.
了解痴呆症患者的丧偶照料者如何感知并应对其配偶患病过程中的变化，从诊断直至丧亲。
采用便利抽样和主题分析方法的定性访谈研究。
参与者包括8名女性和2名男性（n = 10），他们在配偶去世前一直是痴呆症患者的照料者。参与者为自称健康状况良好且丧亲时间超过一年的老年人。
2014年秋季至2015年冬季期间在加拿大一个小型草原城市收集的数据。
形成了两个总体主题，作为参与者照料历程的重要组成部分：对变化的情绪反应以及整个照料和丧亲历程中社会联系的变化。通过对事件情绪反应的分析得出四个关键子主题：难忘的悲伤掩盖持续的悲伤、逐渐产生的绝望感和不堪重负感、解脱感常见但隐藏以及感恩是建设性丧亲过程中的一个里程碑。在整个照料和丧亲历程中形成了社会联系的三个关键变化：整个照料和丧亲历程中社会融入的重要性、陪伴的反复丧失以及因需求而退出社交互动。
研究结果表明，整个照料和丧亲过程中的情绪变化并非呈线性。在照料和丧亲期间，家人、朋友和新的社会支持的支持需求对使照料者能够向前迈进具有重要影响。
