School of Health and Related Research (ScHARR), 7315University of Sheffield, UK.
Centre for Applied Dementia Research, University of Bradford, UK; School of Health and Related Research (ScHARR), 7315University of Sheffield, UK.
Dementia (London). 2021 Nov;20(8):2668-2688. doi: 10.1177/14713012211007397. Epub 2021 May 6.
Health policy promotes post-diagnostic support for people affected by dementia. Evidence suggests psychosocial interventions can effectively support people living with dementia after diagnosis. Yet, what influences uptake of psychosocial interventions by people with early dementia is poorly understood. This research aimed to identify influences on uptake of psychosocial interventions by people with early dementia.
Sixteen face-to-face semi-structured interviews with people with early dementia, either alone or with a family member(s), were completed. Twelve staff participated in semi-structured interviews or a focus group. Thematic analysis and triangulation enabled identification of overall themes across different participant groups and interview types.
Four overarching themes influencing uptake were identified: (1) adjusting to a diagnosis, (2) appeal of activities and perception of benefit, (3) service and societal context, and (4) relationships and communication. Individual responses to diagnosis, experiences of dementia and dementia services influenced uptake. Group interventions were discussed the most by all participants. Group interventions offering social contact, peer support, information, enjoyable activities and mental stimulation were valued. However, group interventions specifically aimed at people with dementia did not appeal to all. Ability to travel and convenience of locations were important. Continuing with community activities not focused on dementia was valued. Stigma around dementia appeared to discourage uptake. Emotional and practical support from family was key to facilitating uptake as were the relationships between people with dementia and staff.
A complex interplay of individual, service and societal influences affect uptake of psychosocial interventions by people with early dementia. How interventions and which services can enable people with early dementia remain engaged in their everyday lives needs consideration. Further research examining uptake of specific interventions commonly offered to people living with early dementia is needed. Involving people with early dementia in designing interventions aiming to support them is paramount.
健康政策促进了对受痴呆影响的人的诊断后支持。有证据表明，心理社会干预可以在诊断后有效地支持痴呆患者。然而，人们对早期痴呆患者接受心理社会干预的影响因素知之甚少。本研究旨在确定影响早期痴呆患者接受心理社会干预的因素。
对 16 名早期痴呆症患者（单独或与家庭成员一起）进行了 16 次面对面的半结构化访谈。12 名工作人员参加了半结构化访谈或焦点小组。主题分析和三角测量使不同参与者群体和访谈类型之间能够识别出总体主题。
确定了影响接受程度的四个总体主题：（1）适应诊断，（2）活动吸引力和感知益处，（3）服务和社会背景，以及（4）关系和沟通。个人对诊断的反应、痴呆症的经历和痴呆症服务的体验影响了接受程度。所有参与者都讨论了小组干预最多。提供社交接触、同伴支持、信息、有趣活动和精神刺激的小组干预受到重视。然而，并非所有参与者都对专门针对痴呆症患者的小组干预感兴趣。出行能力和地点便利是很重要的。继续参加不以痴呆症为重点的社区活动受到重视。痴呆症的耻辱感似乎阻碍了接受程度。来自家庭的情感和实际支持是促进接受程度的关键，而痴呆症患者与工作人员之间的关系也是如此。
个人、服务和社会影响的复杂相互作用影响了早期痴呆症患者对心理社会干预的接受程度。需要考虑如何使干预措施和哪些服务能够使早期痴呆症患者继续参与他们的日常生活。需要进一步研究检查早期痴呆症患者普遍接受的特定干预措施的接受情况。让早期痴呆症患者参与设计旨在支持他们的干预措施至关重要。
