“是什么”和“怎么做”：通过两种观点的结合，理解阿尔茨海默病意识缺失的新视角。
"What" and "How": A New Perspective for Understanding Unawareness in Alzheimer's Disease Through a Combination of Two Perspectives.
机构信息
University Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ Angers, F-44000 Nantes, France.
出版信息
Am J Alzheimers Dis Other Demen. 2020 Jan-Dec;35:1533317520925333. doi: 10.1177/1533317520925333.
OBJECTIVES
Assessments of unawareness in Alzheimer's disease mainly focus on the objects (the "what") of unawareness. A recent person-centered approach proposes to also assess the processes (the "how"). The present study combines 2 approaches to understand this heterogeneity in assessments of unawareness.
METHOD
We recruited 46 participants from 8 nursing homes. They underwent a semi-structured interview and were assessed using a prediction-performance paradigm. Spearman correlations were calculated, and generalized additive models were established.
RESULTS
The 2 approaches are associated through cognitive deficits, confrontation with difficulties and identity changes. Objects (the what), mechanisms, and modes of expression (the how) explain at least 29.6% of the variance of unawareness.
CONCLUSIONS
Unawareness is more than simply being unaware of something; it is a synergy between the objects and processes of arousal and expression. Moreover, unawareness extends beyond the disease to include the self. Considering the entire person seems to be necessary.
目的
阿尔茨海默病患者的意识缺失评估主要集中在意识缺失的对象（“什么”）上。最近提出的一种以患者为中心的方法建议也评估意识缺失的过程（“如何”）。本研究结合了 2 种方法来理解意识缺失评估中的这种异质性。
方法
我们从 8 家养老院招募了 46 名参与者。他们接受了半结构化访谈，并使用预测-表现范式进行评估。计算了 Spearman 相关系数，并建立了广义加性模型。
结果
这 2 种方法通过认知缺陷、面对困难和身份变化而相关。对象（“什么”）、机制和表达模式（“如何”）解释了意识缺失至少 29.6%的变异。
结论
意识缺失不仅仅是对某件事情的无知；它是唤起和表达的对象和过程之间的协同作用。此外，意识缺失不仅限于疾病，还包括自我。考虑整个人似乎是必要的。
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