痴呆症的体验和预防态度：参与预防试验的老年人的定性研究。
Experiences of dementia and attitude towards prevention: a qualitative study among older adults participating in a prevention trial.
机构信息
Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
LEASP, UMR 1027, INSERM/Université Toulouse III Paul Sabatier, University of Toulouse, Toulouse, France.
出版信息
BMC Geriatr. 2020 Mar 12;20(1):99. doi: 10.1186/s12877-020-1493-4.
BACKGROUND
A better insight into older adults' understanding of and attitude towards cognitive disorders and their prevention, as well as expectations and reasons for participation in prevention trials, would help design, conduct, and implement effective preventive interventions. This qualitative study aimed at exploring the knowledge and perceptions of cognitive disorders and their prevention among participants in a prevention trial.
METHODS
Semi-structured interviews were conducted among the participants of a multinational randomised controlled trial testing the efficacy of a lifestyle-based eHealth intervention in preventing cardiovascular disease or cognitive decline in community dwellers aged 65+. Participants were probed on their reasons for participation in the trial and their views on general health, cardiovascular disease, ageing, and prevention. The subset of data focusing on cognitive disorders (15 interviewees; all in Finland) was considered for this study. Data were analysed using content analysis.
RESULTS
Participants' knowledge of the cause and risk factors of cognitive disorders and prevention was limited and superficial, and a need for up-to-date, reliable, and practical information and advice was expressed. Cognitive disorders evoked fear and concern, and feelings of hopelessness and misery were frequently expressed, indicating a stigma. Strong heredity of cognitive disorders was a commonly held belief, and opinions on the possibility of prevention were doubtful, particularly in relation to primary prevention. Family history and/or indirect experiences of cognitive disorders was a recurrent theme and it showed to be linked to both the knowledge of and feelings associated with cognitive disorders, as well as attitude towards prevention. Indirect experiences were linked to increased awareness and knowledge, but also uncertainty about risk factors and possibility of prevention. Distinct fear and concerns, particularly over one's own cognition/risk, and high motivation towards engaging in prevention and participating in a prevention trial were also identified in connection to this theme.
CONCLUSIONS
Family history and/or indirect experiences of cognitive disorders were linked to sensitivity and receptiveness to brain health and prevention potential. Our findings may be helpful in addressing older adults' expectations in future prevention trials to improve recruitment, maximise adherence, and facilitate the successful implementation of interventions.
背景
深入了解老年人对认知障碍的理解和态度，以及对预防认知障碍的预期和参与意愿，有助于设计、开展和实施有效的预防干预措施。本定性研究旨在探讨参与预防试验的老年人对认知障碍及其预防的知识和看法。
方法
在一项针对社区居住的 65 岁及以上人群的、测试基于生活方式的电子健康干预预防心血管疾病或认知能力下降效果的多国随机对照试验中，对参与者进行了半结构化访谈。参与者被询问参与试验的原因以及他们对一般健康、心血管疾病、衰老和预防的看法。本研究考虑了聚焦于认知障碍的部分数据（15 名受访者；均来自芬兰）。使用内容分析法对数据进行分析。
结果
参与者对认知障碍的病因和危险因素以及预防措施的了解有限且肤浅，他们表示需要获取最新、可靠且实用的信息和建议。认知障碍引起了恐惧和担忧，经常表达出绝望和痛苦的情绪，表明存在污名化现象。认知障碍具有很强的遗传性，这是一种普遍的信念，对预防的可能性持怀疑态度，特别是在一级预防方面。认知障碍的家族史和/或间接经历是一个反复出现的主题，它与对认知障碍的了解和相关感受以及对预防的态度有关。间接经历与提高认知和知识水平有关，但也与危险因素和预防可能性的不确定性有关。与这一主题相关的还有明显的恐惧和担忧，特别是对自己认知/风险的担忧，以及对参与预防和参与预防试验的高度积极性。
结论
认知障碍的家族史和/或间接经历与对大脑健康和预防潜力的敏感性和接受度有关。我们的研究结果可能有助于满足老年人对未来预防试验的期望，以提高招募率、最大程度地提高依从性，并促进干预措施的成功实施。
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