Department of Psychology, University of Bologna, Bologna, Italy.
Center for Cognitive Disorders and Dementia, Local Health Care Unit, Bologna, Italy.
Aging Ment Health. 2022 Nov;26(11):2243-2251. doi: 10.1080/13607863.2021.2008871. Epub 2021 Nov 28.
Although young-onset dementia (YOD) affects the whole family system, this population is still under-represented in literature, and no progress in care provision has been made. Hence, additional evidence is necessary to understand how family and social relationships are affected by YOD and care challenges, as to provide recommendations for clinical practice and service improvement from a family perspective.
Family carers were recruited via one memory clinic and the local Alzheimer's Associations in Italy. Semi-structured interviews explored their experiences with YOD, the impact of the condition on their lives, family and social relationships, and the support and care they received. Transcripts were coded by three researchers and analysed using inductive thematic analysis.
Thirty-eight interviews were conducted with 26 spouses and 12 adult children. Three themes emerged: 1) Problems around diagnosis, 2) Lack of post-diagnostic support, and 3) Living with YOD as a family. Overall, problems occurred across the dementia pathway. Without appropriate support, it was difficult for families to adjust to living with YOD and to the associated changes in family roles and relationships.
Since optimal care depends on good family relationships, better support for families in the adaptation to condition would likely benefit patient care while ensuring social inclusion and health equity for vulnerable groups.
尽管早发性痴呆(YOD)会影响整个家庭系统,但该人群在文献中仍未得到充分体现,并且在提供护理方面也没有取得任何进展。因此,需要更多的证据来了解 YOD 和护理挑战如何影响家庭和社会关系,以便从家庭角度为临床实践和服务改进提供建议。
通过意大利的一家记忆诊所和当地的阿尔茨海默氏症协会招募了家庭照顾者。半结构化访谈探讨了他们在 YOD 方面的经历、该疾病对他们生活、家庭和社会关系的影响,以及他们所获得的支持和护理。三位研究人员对转录本进行了编码,并使用归纳主题分析进行了分析。
共进行了 38 次访谈,涉及 26 名配偶和 12 名成年子女。出现了三个主题:1)诊断方面的问题,2)缺乏诊断后支持,以及 3)作为一个家庭与 YOD 共同生活。总体而言,在痴呆症的各个阶段都出现了问题。如果没有适当的支持,家庭很难适应 YOD 的生活以及家庭角色和关系的相应变化。
由于最佳护理取决于良好的家庭关系,因此更好地为家庭提供适应条件的支持,可能会有助于改善患者护理,同时确保弱势群体的社会包容和平等健康。