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成人对痴呆症的认知和体验的定性研究述评:我们在研究什么?研究谁?——来自黑种人、非洲裔和加勒比背景的研究

A Review of Qualitative Research of Perception and Experiences of Dementia Among Adults From Black, African, and Caribbean Background: What and Whom Are We Researching?

机构信息

Division of Psychiatry, University College London, UK.

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, UK.

出版信息

Gerontologist. 2021 Jul 13;61(5):e195-e208. doi: 10.1093/geront/gnaa004.

Abstract

BACKGROUND AND OBJECTIVES

Black, African, and Caribbean (BAC) families are disproportionately affected by dementia but engage less with services. Studies reporting their experiences of dementia have tended to aggregate people from diverse backgrounds, without considering the impact of this diversity, or researchers' ethnicities. We investigated participants' and researchers' ethnic identities, exploring how this relates to findings.

RESEARCH DESIGN AND METHODS

We searched electronic databases in September 2018, for qualitative studies exploring how participants of Black ethnicity understand and experience dementia and dementia care. We reported participants' and researchers' ethnicities, and meta-synthesized qualitative findings regarding how ethnicity influences experiences and understanding of dementia.

RESULTS

Twenty-eight papers reported 25 studies; in United States (n = 17), United Kingdom (n = 7), and Netherlands (n = 1). 350/492 (71%) of participants were in U.S. studies and described as African American; participants in U.K. studies as Caribbean (n = 45), African/Caribbean (n = 44), African (n = 28), Black British (n = 7), or Indo-Caribbean (n = 1); and in Netherlands as Surinamese Creole (n = 17). 6/25 (24%) of studies reported involving recruiters/interviewers matching participants' ethnicity; and 14/25 (56%) involved an author/advisor from a BAC background during analysis/procedures. We identified four themes: Dementia does not relate to me; Inappropriate and disrespectful services; Kinship and responsibility; Importance of religion.

DISCUSSION AND IMPLICATIONS

Studies were mostly from a U.S. African American perspective, by researchers who were not of BAC background. Themes of dementia diagnosis and services feeling less relevant to participants than the majority population resonated across studies. We caution against the racialization of these findings, which can apply to many differing minority groups.

摘要

背景和目的

黑种人、非洲裔和加勒比(BAC)人群受痴呆症的影响不成比例,但他们对服务的参与度较低。报告这些人群对痴呆症的体验的研究往往将来自不同背景的人群聚集在一起,而没有考虑到这种多样性的影响,或者研究人员的种族。我们调查了参与者和研究人员的种族身份,探讨了这与研究结果的关系。

研究设计和方法

我们在 2018 年 9 月检索了电子数据库,以寻找探索黑种人参与者如何理解和体验痴呆症和痴呆症护理的定性研究。我们报告了参与者和研究人员的种族,并对定性研究结果进行了元综合,以探讨种族如何影响对痴呆症的体验和理解。

结果

28 篇论文报告了 25 项研究;其中美国(n=17)、英国(n=7)和荷兰(n=1)。在美国研究中,有 350/492(71%)的参与者被描述为非裔美国人;在英国研究中,参与者被描述为加勒比裔(n=45)、非裔/加勒比裔(n=44)、非洲裔(n=28)、英国黑人(n=7)或印度裔加勒比裔(n=1);在荷兰,参与者为苏里南克里奥尔人(n=17)。25 项研究中有 6 项(24%)报告了参与者与招聘人员/访谈者的种族相匹配;14 项(56%)涉及具有 BAC 背景的作者/顾问在分析/程序期间参与其中。我们确定了四个主题:痴呆症与我无关;不适当和不尊重的服务;亲属关系和责任;宗教的重要性。

讨论与启示

这些研究大多来自美国的非裔美国人视角,由非 BAC 背景的研究人员进行。研究结果表明,与大多数人群相比,参与者对痴呆症诊断和服务的感受不太相关,这一主题在研究中得到了共鸣。我们警告不要将这些发现种族化,因为这可能适用于许多不同的少数群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6843/8276611/bc46471727ef/gnaa004f0001.jpg

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