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指导痴呆照护全过程干预研究的概念框架

Conceptual Framework to Guide Intervention Research Across the Trajectory of Dementia Caregiving.

机构信息

UC Davis Betty Irene Moore School of Nursing, Sacramento, California.

Stanford University School of Medicine, California.

出版信息

Gerontologist. 2020 Feb 14;60(Suppl 1):S29-S40. doi: 10.1093/geront/gnz157.

Abstract

This article presents a comprehensive conceptual framework designed to foster research in the changing needs of caregivers and persons with dementia as they move through their illness trajectory. It builds on prior theoretical models and intervention literature in the field, while at the same time addressing notable gaps including inadequate attention to cultural issues; lack of longitudinal research; focus on primary caregivers, almost to the exclusion of the person with dementia and other family members; limited outcome measures; and lack of attention to how the culture of health care systems affects caregivers' quality of life. The framework emphasizes the intersectionality of caregiving, sociocultural factors, health care systems' factors, and dementia care needs as they change across time. It provides a template to encourage longitudinal research on reciprocal relationships between caregiver and care recipient because significant changes in the physical and/or mental health status of one member of the dyad will probably affect the physical and/or mental health of the partner. This article offers illustrative research projects employing this framework and concludes with a call to action and invitation to researchers to test components, share feedback, and participate in continued refinement to more quickly advance evidence-based knowledge and practice in the trajectory of dementia caregiving.

摘要

本文提出了一个全面的概念框架,旨在促进对照顾者和痴呆症患者需求变化的研究,这些变化发生在他们的疾病发展过程中。该框架建立在该领域先前的理论模型和干预文献基础上,同时解决了一些显著的差距问题,包括对文化问题关注不足;缺乏纵向研究;关注主要照顾者,几乎排除了痴呆症患者和其他家庭成员;有限的结果衡量标准;以及对医疗保健系统文化如何影响照顾者生活质量的关注不足。该框架强调了照顾、社会文化因素、医疗保健系统因素以及痴呆症护理需求在时间上的交叉性。它为鼓励对照顾者和被照顾者之间相互关系的纵向研究提供了一个模板,因为这对二人组中一个成员的身体和/或心理健康状况的重大变化可能会影响伴侣的身体和/或心理健康。本文提供了采用这一框架的说明性研究项目,并呼吁行动,邀请研究人员测试各个组成部分,分享反馈,并参与持续改进,以更快地推进痴呆症照顾发展轨迹的循证知识和实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02ac/7019661/e712a792d443/gnz157f0001.jpg

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