Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
Division Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Int J Qual Stud Health Well-being. 2023 Dec;18(1):2176278. doi: 10.1080/17482631.2023.2176278.
This study is an in-depth exploration of the unfolding experiences of five persons who developed dementia while still in paid work/employment, and of their significant others. Namely, we explore how they experienced the actions and decisions taken with respect to work, and what the consequences meant to them.
A qualitative longitudinal case study design with multiple cases was used, including five participants with dementia and significant others of their choice. Interviews were undertaken longitudinally and analysed with the Formal Data-Structure Analysis approach.
The joint analysis resulted in two intertwined themes: 1) The significance and consequences of a dementia diagnosis: a double-edged trigger, and 2) Sensemaking and agency. The prevalent images of what dementia is, who can/cannot get it and what it will bring, were revealed as the critical aspects. Having the opportunity to make sense of what has happened and participate in decision-making, contributed decisively to the participants' experiences.
Findings illustrate how a dementia diagnosis is alien in work-life, but once diagnosed, it may trigger self-fulfiling expectations based upon stereotypical understanding of dementia. A shift is needed from a deficit-focused perspective, to viewing people with dementia as citizens capable of agency.
本研究深入探讨了五名在有偿工作/就业期间患上痴呆症的患者及其重要他人的经历。具体而言,我们探讨了他们如何体验与工作相关的行动和决策,以及这些行动和决策对他们意味着什么。
采用了定性纵向案例研究设计,包含五个痴呆症患者和他们选择的重要他人。进行了纵向访谈,并采用正式数据结构分析方法进行了分析。
联合分析得出了两个交织的主题:1)痴呆症诊断的意义和后果:一把双刃剑;2)意义构建和能动性。对痴呆症是什么、谁能/不能得痴呆症以及它会带来什么的普遍看法,被揭示为关键方面。有机会对所发生的事情进行意义构建并参与决策制定,对参与者的经历产生了决定性的影响。
研究结果表明,痴呆症诊断在工作生活中是陌生的,但一旦被诊断出来,它可能会根据对痴呆症的刻板理解引发自我实现的预期。需要从以缺陷为中心的视角转变为将痴呆症患者视为有能动性的公民。