Hirakawa Yoshihisa, Muraya Tsukasa, Yamanaka Takashi, Hirahara Satoshi, Okochi Jiro, Kuzuya Masafumi, Miura Hisayuki
Nagoya University Graduate School of Medicine, Japan.
Faculty of Design, Kyushu University, Japan.
J Rural Med. 2023 Apr;18(2):154-158. doi: 10.2185/jrm.2022-007. Epub 2023 Apr 5.
This quick literature review aimed to organize information on the detailed components of total pain in older people with advanced dementia in a holistic manner. The authors analyzed qualitative data from relevant clinical guidelines or textbooks, focusing on certain types of pain and distress in older people with advanced dementia, followed by an expert panel review by research team members. In the search, the authors defined a person with advanced dementia as having a functional assessment staging tool scale score greater than or equal to six. The model covered a wide variety of pain, from physical pain to dementia-related psychological and spiritual aspects of total pain, including living environment change, stigma, discrimination, lack of communication and understanding, loss of sense of control and dignity, and cultural distress. It also identified physical appearance as an important factor in dying with dignity, as established by existing research on individuals with incurable cancers. The conceptual model of total pain in people with advanced dementia is expected to help turn healthcare professionals' attention to physical, psychological, social, and spiritual contributors to total pain in advanced dementia.
这项快速文献综述旨在全面整理有关晚期痴呆症老年人全面疼痛详细组成部分的信息。作者分析了来自相关临床指南或教科书的定性数据，重点关注晚期痴呆症老年人的某些类型的疼痛和痛苦，随后由研究团队成员进行专家小组审查。在检索过程中，作者将晚期痴呆症患者定义为功能评估分期工具量表得分大于或等于6分的人。该模型涵盖了广泛的疼痛，从身体疼痛到与痴呆症相关的全面疼痛的心理和精神层面，包括生活环境变化、耻辱感、歧视、缺乏沟通和理解、失去控制感和尊严以及文化困扰。它还将身体外观确定为有尊严地离世的一个重要因素，这是现有针对无法治愈癌症患者的研究所确立的。晚期痴呆症患者全面疼痛的概念模型有望帮助医护人员将注意力转向晚期痴呆症全面疼痛的身体、心理、社会和精神影响因素。
