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意识清晰在神经退行性疾病晚期的表现:概念分析。

Lucidity in the Context of Advanced Neurodegenerative Disorders: A Concept Analysis.

出版信息

J Gerontol Nurs. 2020 Dec 1;46(12):42-50. doi: 10.3928/00989134-20201106-06.

Abstract

Individuals with advanced dementias resulting from neurodegenerative disorders (NDs) occasionally surprise caregivers with episodes of clarity and cognitive function that are not usually present. Lucid episodes-aptly named paradoxical lucidity in the literature-seem to involve a return of the "old self" during advanced neurodegenerative changes. Lucid episodes pose a problem for theories of neurological degeneration, which position dementias as progressive, incurable, and irreversible. In addition, lucid episodes raise ethical questions about whether information gleaned during lucid episodes is appropriate to direct future patient-centered care. The concept requires analysis and clarification if it is to guide future theorizing and research. The underlying goals of the current concept analysis are twofold: (a) to clarify the meaning of lucidity in the context of advanced NDs; and (b) to develop a theoretical definition that can guide future practice, research, and policy development. Walker and Avant's method is used to identify uses of the concept, defining attributes, antecedents, consequences, and empirical referents. [Journal of Gerontological Nursing, 46(12), 42-50.].

摘要

患有神经退行性疾病(NDs)导致的晚期痴呆症的个体偶尔会出现意识清醒和认知功能的阶段,这些阶段通常不存在。清醒期——在文献中恰当地称为矛盾清醒——似乎涉及在高级神经退行性变化期间“旧自我”的回归。清醒期对神经退行性变理论提出了挑战,这些理论将痴呆症定位为进行性、不可治愈和不可逆转的疾病。此外,清醒期引发了关于在清醒期收集的信息是否适合指导未来以患者为中心的护理的伦理问题。如果要指导未来的理论化和研究,就需要对这一概念进行分析和澄清。目前概念分析的基本目标有两个:(a) 澄清在高级 NDs 背景下清醒的含义;(b) 制定一个理论定义,以指导未来的实践、研究和政策制定。沃克和奥凡特的方法用于确定概念的用法、定义属性、前因、后果和经验参考。[老年护理杂志,46(12),42-50]。

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