痴呆症日语术语替代的横断面调查：这是否减轻了家庭成员的不适？
Cross-sectional survey of the replacement of the Japanese term for dementia: Did it reduce discomfort in family members?
机构信息
Faculty of Human Sciences, University of Tsukuba, Tsukuba, Japan.
Course of Sign Language Interpretation, College of National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan.
出版信息
Brain Behav. 2021 Mar;11(3):e02012. doi: 10.1002/brb3.2012. Epub 2020 Dec 21.
OBJECTIVES
Decreasing discrimination and stigma of dementia is an international issue. In 2004, the Japanese government changed the previous Japanese stigmatic term of dementia ("Chiho") to the present one ("Ninchi-sho") a meaning near "neurocognitive disorder." This study aimed to examine cross-sectionally if the present term functioned well or not from the viewpoint of families of people with dementia (PWD), and to discover variables influencing their feelings of the term: the feelings about people surrounding PWD, and the family members' and PWD's attributes.
METHODS
Questions regarding the feelings about the present Japanese term and people surrounding PWD were asked to 155 family members accompanying PWD who visited three hospitals. For analyses, the degree of the discomfort about the present Japanese term was shown descriptively. The relationship of constructs of the feelings extracted by exploratory factor analysis (EFA) and the attributes was analyzed using structural equation modeling (SEM).
RESULTS
71.6% agreed that the present term discomforted them less than the previous one. Only 13.2% thought that the present term was discriminatory. However, about one third of the participants felt discomfort when they used even the present term. Using the constructs extracted by EFA, the analysis of SEM revealed that the negative feelings of the terminology were affected by hesitation to disclose to surrounding people that their family member had dementia, which the attributes of younger family members, wives, husbands, and siblings influenced. Moreover, because of disclosing the dementia, the feelings of support from people alleviated the feelings of hesitation, influenced by sex (female).
CONCLUSIONS
It was suggested that overall, the present term successfully reduced discomfort in families, compared with the result of the previous term surveyed by the Ministry of Health, Labour, and Welfare. However, unignorable numbers of family members still feel stigma. New policies are necessary considering the influencing factors.
目的
减少痴呆症的歧视和污名化是一个国际问题。2004 年，日本政府将以前对痴呆症的日本贬义词（“痴漢”）改为现在的“認知症”，意思是“神经认知障碍”。本研究旨在从痴呆症患者（PWD）家属的角度，横断性地探讨目前的术语是否有效，并发现影响他们对该术语看法的变量：他们对 PWD 周围人群的看法，以及家庭成员和 PWD 的属性。
方法
向陪同 155 名 PWD 到三家医院就诊的家属询问了他们对目前日本术语以及 PWD 周围人群的感受。为了进行分析，描述了对目前日本术语的不适程度。通过探索性因素分析（EFA）提取的感受结构与属性之间的关系，使用结构方程模型（SEM）进行分析。
结果
71.6%的人认为目前的术语比以前的术语让他们感到不适的程度更低。只有 13.2%的人认为现在的术语有歧视性。然而，约三分之一的参与者在使用现在的术语时感到不适。使用 EFA 提取的结构，SEM 分析表明，对术语的负面感受受到向周围人透露其家庭成员患有痴呆症的犹豫的影响，而年轻的家庭成员、妻子、丈夫和兄弟姐妹的属性影响了这种犹豫。此外，由于透露了痴呆症，来自他人的支持感减轻了犹豫感，这一感受受到性别的影响（女性）。
结论
与厚生劳动省之前调查的结果相比，目前的术语成功地减少了家庭的不适，但仍有相当数量的家庭成员感到耻辱。考虑到影响因素，需要制定新的政策。
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