School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong.
J Adv Nurs. 2022 Apr;78(4):1100-1111. doi: 10.1111/jan.15088. Epub 2021 Oct 29.
To explore the lived experience of neuropsychiatric symptoms (NPS) among females with mild cognitive impairment (MCI).
A phenomenological study using individual, semi-structured, telephone-based interviews was conducted to explore how the NPS are aroused, evolve, and affect the overall well-being, illness perception and the corresponding coping responses adopted by females with MCI.
Twenty-nine participants with MCI were recruited from the community setting in Hong Kong between March and October 2020. Interviews were audio-recorded, transcribed verbatim, and analysed using an interpretative phenomenological analysis approach and constant comparison strategy.
Three themes were identified: (1) living vigilant lives with threats and uncertainty, (2) snowballing into further negative emotions and (3) seeking outlets for negative emotions. Our findings suggested that the participants' cognitive, functional and social challenges aroused intense emotional responses such as depression, agitation and anxiety. These noting negative emotions were further perpetuated by maladaptive coping responses, unrealistic expectations from coping strategies and overwhelming disease burden. Various internal and external strategies were adopted to enhance emotional adaptation, of which adopting a positive attitude appeared to be the most promising strategy.
This study shed light on the challenging experience of MCI. The cognitive afflictions and the resultant impacts on various life domains evoked a cluster of NPS. Support services need to enhance emotional adjustment through alleviating the various life stressors and strengthening the coping resources.
Elucidating the lived experience of NPS provides important insights into the development of a more effective, comprehensive and person-centred care planning for the population with MCI. Holistic care planning should extend beyond cognitive health optimization into enhancing disease knowledge, improve emotional coping, rebuild self-identity and bolstering social supports among this preclinical cohort.
探索轻度认知障碍(MCI)女性的神经精神症状(NPS)的生活体验。
采用个体、半结构化、电话访谈的现象学研究,探索 NPS 如何被激发、演变,以及如何影响整体幸福感、疾病认知和 MCI 女性采用的相应应对反应。
2020 年 3 月至 10 月期间,从香港社区环境中招募了 29 名 MCI 参与者。访谈进行了录音、逐字转录,并采用解释性现象学分析方法和恒定比较策略进行分析。
确定了三个主题:(1)生活在充满威胁和不确定性的警觉生活中,(2)雪球式地发展成进一步的负面情绪,(3)为负面情绪寻找出口。我们的研究结果表明,参与者的认知、功能和社会挑战引起了强烈的情绪反应,如抑郁、激动和焦虑。这些负面情绪进一步被适应不良的应对反应、应对策略的不切实际的期望和压倒性的疾病负担所加剧。各种内部和外部策略被采用来增强情绪适应,其中采取积极的态度似乎是最有前途的策略。
这项研究揭示了 MCI 的挑战性体验。认知障碍和由此对各种生活领域的影响引发了一系列 NPS。支持服务需要通过减轻各种生活压力源和增强应对资源来增强情绪调节。
阐明 NPS 的生活体验为制定更有效、全面和以患者为中心的 MCI 人群护理计划提供了重要的见解。整体护理计划应超越认知健康优化,扩展到增强疾病知识、改善情绪应对、重建自我认同和增强这一临床前队列的社会支持。