Centre for Psychology of Religion, 364288Innlandet Hospital Trust, Ottestad, Norway.
Centre of Diakonia and Professional Practise, 87368VID Specialised University, Oslo, Norway.
Dementia (London). 2022 Feb;21(2):442-456. doi: 10.1177/14713012211042979. Epub 2021 Sep 16.
The aim of the study was to explore and articulate how meaning-making appears and how meaningfulness is experienced in persons with severe dementia. Although there is little knowledge about meaning-making and experience of meaningfulness for this group, this article assumes that persons with dementia are as much in need of meaningfulness in life as any others, and hence, that they are involved in the process of meaning-making.
The study was conducted using a qualitative method with exploratory design. Ten patients with severe dementia at a specialized dementia ward at an old age psychiatric department in hospital were observed through participant observation performed over four months. The field-notes from the observation contained narratives carrying with them a dimension of meaning played out in an everyday setting and thus named . The narratives were analyzed looking for expressions where experiences of meaning-making and meaningfulness could be identified.
The narratives demonstrate that persons with severe dementia are involved in processes of meaning-making. The narratives include expressions of meaning-making, and of interactions that include apparent crises of meaning, but also transitions into what may be interpreted as meaningfulness based on experiences of significance, orientation and belonging. The role of the body and the senses has proved significant in these processes. The findings also suggest that experiences of meaning contribute to experience of personhood.
The relevance to clinical practice indicates that working from a person-centred approach in dementia care also includes paying attention to the dimension of meaning. This dimension is important both for the person living with dementia and for the people caring for them. Acknowledging meaning as a central human concern, it is crucial to seek understanding and knowledge about the significance of meaning in vulnerable groups such as persons with dementia.
本研究旨在探索和阐明严重痴呆患者的意义建构过程以及意义体验。尽管人们对这一群体的意义建构和意义体验知之甚少，但本文认为，痴呆症患者和其他人一样，同样需要生活中的意义，因此他们也参与了意义建构的过程。
本研究采用定性方法和探索性设计。在医院老年精神病学部的专门痴呆病房中，观察了 10 名患有严重痴呆症的患者，通过为期四个月的参与式观察进行观察。观察过程中的现场记录包含了在日常环境中体现意义维度的叙述，因此被命名为. 这些叙述被分析，寻找可以识别意义建构和意义体验的表达方式。
这些叙述表明，严重痴呆症患者参与了意义建构过程。叙述中包含了意义建构的表达，以及包括明显的意义危机的互动，但也有基于意义、方向和归属感的体验过渡到有意义的表达。身体和感官的作用在这些过程中被证明是重要的。研究结果还表明，意义体验有助于个体的体验。
对临床实践的启示表明，以以人为本的方法进行痴呆症护理还包括关注意义维度。对于患有痴呆症的人和照顾他们的人来说，这个维度都很重要。承认意义是人类的核心关注点，因此，了解意义对脆弱群体（如痴呆症患者）的重要性至关重要。
