《COVID-19 大流行前至早期阶段：中青年及晚发型痴呆患者的照护路径中的健康不公平现象》
Health Inequities in the Care Pathways for People Living with Young- and Late-Onset Dementia: From Pre-COVID-19 to Early Pandemic.
机构信息
Department of Primary Care & Mental Health, University of Liverpool, Liverpool L69 3GL, UK.
National Institute for Health Research Applied Research Collaboration North West Coast, Liverpool L69 3GL, UK.
出版信息
Int J Environ Res Public Health. 2021 Jan 14;18(2):686. doi: 10.3390/ijerph18020686.
BACKGROUND
Little is known about how people with dementia and/or their family carers access health and social care services after a diagnosis. The aim of this study was to explore potential inequalities in care pathways for people with young-onset and late on-set dementia (YOD/LOD), including their family carers, with coronavirus disease 2019 (COVID-19) occurring throughout the course of the study and enabling a comparison between pre-pandemic and COVID-19 times.
METHODS
People with YOD and LOD with their family carers were recruited via local support groups in the North West Coast region of England. Semi-structured interviews explored the experiences of people with YOD and LOD and family carers on their access to both health and social care services and community-based services. Transcripts were coded by two researchers and analysed using thematic analysis. Fifteen interviews were conducted with seven people with YOD or LOD and 14 family carers between January and March 2020. Some interviews were conducted only with the person with dementia, because they did not have a family carer, and others were conducted only with the family carer, because the person with dementia was in the severe stages of the condition.
RESULTS
Four themes emerged from the interviews: (1) Getting the ball rolling: the process of diagnosis; (2) Balancing the support needs of people with dementia and carers; (3) Barriers to accessing support; and (4) Facilitators to accessing support. Inequities existed for both YOD and LOD, with emerging evidence of unequal experiences in accessing care at the beginning of the COVID-19 pandemic.
DISCUSSION
People with YOD and LOD and their carers require better support in accessing services after a diagnosis. Greater understanding of the pathways through which inequalities materialise are needed, especially those that might have been disrupted or exacerbated by the COVID-19 pandemic.
背景
人们对痴呆症患者和/或其家庭照顾者在诊断后如何获得卫生和社会保健服务知之甚少。本研究旨在探讨在整个研究过程中发生冠状病毒病 2019（COVID-19）的情况下，早发性和晚发性痴呆（YOD/LOD）患者及其家庭照顾者的护理途径中潜在的不平等现象，包括将其与大流行前和 COVID-19 时期进行比较。
方法
通过英格兰西北海岸地区的当地支持小组招募 YOD 和 LOD 的患者及其家庭照顾者。半结构化访谈探讨了 YOD 和 LOD 患者及其家庭照顾者在获得卫生和社会保健服务以及社区服务方面的经验。两名研究人员对转录本进行编码，并使用主题分析进行分析。在 2020 年 1 月至 3 月期间，对 7 名 YOD 或 LOD 患者和 14 名家庭照顾者进行了 15 次访谈。由于一些人没有家庭照顾者，因此仅对一些患有痴呆症的人进行了访谈，而另一些访谈仅对家庭照顾者进行了访谈，因为患有痴呆症的人处于病情的严重阶段。
结果
访谈中出现了四个主题：（1）开始行动：诊断过程；（2）平衡痴呆症患者和照顾者的支持需求；（3）获得支持的障碍；（4）获得支持的促进因素。这两种情况都存在不平等现象，在 COVID-19 大流行初期，获得护理的不平等现象开始出现。
讨论
诊断后，YOD 和 LOD 患者及其照顾者需要更好的服务支持。需要更好地了解不平等现象出现的途径，特别是可能因 COVID-19 大流行而中断或加剧的途径。
Zotero 插件