Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Aging Ment Health. 2022 Nov;26(11):2223-2232. doi: 10.1080/13607863.2021.1966748. Epub 2021 Aug 26.
Young onset dementias (YOD) - typically defined by symptom onset before age 65 - are frequently overlooked in medical and community settings. Persons with YOD and their spouses face logistical and emotional challenges on their journey to a diagnosis (e.g. uncertainty about symptoms, lack of medical knowledge, emotional distress). An in-depth understanding of couples' experiences before and immediately following a YOD diagnosis is warranted to inform early psychosocial services for couples.
We utilized dyadic qualitative semi-structured interviews ( = 23) to better understand the nuances of couples' pre-diagnostic and diagnostic experiences with YOD. We used a hybrid of deductive and inductive analytic strategies to identify couple-level themes.
Fifteen couple-level themes were extracted within four domains: (1) early indicators of symptoms, (2) obtaining a diagnosis, (3) experiences with health care providers, and (4) emotional reactions to the diagnosis. Couples expressed difficulties communicating about early symptoms, receiving accurate and timely diagnostic information, and managing multiple emotions. They described the value of working together to manage care, gain information, establish positive relationships with providers, and promote adjustment.
Findings highlight the shared experiences of couples during the early stages of YOD, including the importance of strong communication with each other and providers. Early and accessible psychosocial services that help couples cope with and communicate about individual and shared stressors are warranted.
早发性痴呆症(YOD)通常定义为症状在 65 岁之前出现,在医疗和社区环境中经常被忽视。YOD 患者及其配偶在寻求诊断的过程中面临着后勤和情感上的挑战(例如,对症状的不确定性、缺乏医学知识、情绪困扰)。深入了解夫妻在 YOD 诊断前后的经历对于为夫妻提供早期心理社会服务是必要的。
我们使用了对偶定性半结构化访谈( = 23)来更好地理解夫妻在 YOD 诊断前和诊断时的细微差别。我们使用演绎和归纳分析策略的混合方法来确定夫妻层面的主题。
在四个领域内提取了 15 个夫妻层面的主题:(1)症状的早期指标,(2)获得诊断,(3)与医疗保健提供者的经历,以及(4)对诊断的情绪反应。夫妻双方表示在沟通早期症状、获得准确和及时的诊断信息以及管理多种情绪方面存在困难。他们描述了共同努力管理护理、获取信息、与提供者建立积极关系以及促进调整的价值。
研究结果强调了夫妻在 YOD 早期阶段的共同经历,包括与彼此和提供者进行良好沟通的重要性。需要提供早期和可及的心理社会服务,帮助夫妻应对和沟通个人和共同的压力源。