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阿尔茨海默病及其他痴呆症中的意识保留:护理人员的认知与沟通策略

Preserved Consciousness in Alzheimer's Disease and Other Dementias: Caregiver Awareness and Communication Strategies.

作者信息

Warren Alison

机构信息

The Department of Clinical Research and Leadership, The George Washington University, Washington, DC, United States.

出版信息

Front Psychol. 2021 Dec 7;12:790025. doi: 10.3389/fpsyg.2021.790025. eCollection 2021.

Abstract

Alzheimer's disease is an insidious onset neurodegenerative syndrome without effective treatment or cure. It is rapidly becoming a global health crisis that is overwhelming healthcare, society, and individuals. The clinical nature of neurocognitive decline creates significant challenges in bidirectional communication between caregivers and persons with Alzheimer's disease (AD) that can negatively impact quality-of-life. This paper sought to understand how and to what extent would awareness training about the levels of consciousness in AD influence the quality-of-life interactions in the caregiver-patient dyad. A literature review of multiple databases was conducted utilizing a transdisciplinary approach. The sum of findings indicates a positive relationship between enhanced caregiver awareness and training, positive interactions, and improved QOL measures among patients and caregivers. A multidirectional relationship was found among healthcare policies, training and education resources, caregivers, and persons with AD. Specifically, the current lack of policy and inadequate training and educational resources has various detrimental effects on patients and caregivers, while improvements in training and education of caregivers yields positive outcomes in communication and QOL. Furthermore, evidence of preserved consciousness in persons with AD was demonstrated from multiple disciplines, including neurobiological, psychological, and biopsychosocial models. The literature further revealed several methods to access the preserved consciousness in persons with AD and related dementias, including sensory, emotional, and cognitive stimulations. The evidence from the literature suggests a reframed approach to our understanding and treatment of persons with AD is not only warranted, but crucial to address the needs of those affected by AD.

摘要

阿尔茨海默病是一种起病隐匿的神经退行性综合征,目前尚无有效的治疗方法或治愈手段。它正迅速演变成一场全球性的健康危机,给医疗保健、社会和个人带来巨大压力。神经认知功能衰退的临床特性给护理人员与阿尔茨海默病患者之间的双向沟通带来了重大挑战,可能对生活质量产生负面影响。本文旨在了解关于阿尔茨海默病意识水平的培训如何以及在多大程度上会影响护理人员与患者二元组中的生活质量互动。采用跨学科方法对多个数据库进行了文献综述。研究结果表明,护理人员意识和培训的提高、积极互动以及患者和护理人员生活质量指标的改善之间存在正相关关系。在医疗政策、培训和教育资源、护理人员以及阿尔茨海默病患者之间发现了一种多向关系。具体而言,目前政策的缺乏以及培训和教育资源的不足对患者和护理人员产生了各种不利影响,而护理人员培训和教育的改善在沟通和生活质量方面产生了积极成果。此外,多个学科,包括神经生物学、心理学和生物心理社会模型,都证明了阿尔茨海默病患者存在意识保留的证据。文献还揭示了几种接触阿尔茨海默病及相关痴呆症患者保留意识的方法,包括感官、情感和认知刺激。文献证据表明,重新构建我们对阿尔茨海默病患者的理解和治疗方法不仅是必要的,而且对于满足受阿尔茨海默病影响者的需求至关重要。

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