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探索痴呆症患者及其家庭护理人员的牙科治疗决策经历。

Exploring dental treatment decision-making experiences of people living with dementia and family carers.

作者信息

Geddis-Regan Andrew, Wassall Rebecca R, Abley Clare, Exley Catherine

机构信息

School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK.

North Cumbria Integrated Care NHS Foundation Trust, Carlisle Dental Centre, Carlisle, UK.

出版信息

Gerodontology. 2024 Mar;41(1):83-93. doi: 10.1111/ger.12687. Epub 2023 Apr 10.

Abstract

INTRODUCTION

People living with dementia can have complex dental care needs. Dentists and patients should make treatment decisions together, yet some people living with dementia may be unable to make their own decisions about their dental care. Dental treatment decision-making and patients' experiences of this process have not been comprehensively researched.

OBJECTIVE

This study aimed to explore the dental treatment decision-making perspectives and experiences of people living with dementia and their family members.

METHODS

Semi-structured interviews were undertaken with 8 people living with dementia and 17 family caregivers. A constructivist grounded theory approach was adopted, using a maximum variation sample. Qualitative data collection and analysis occurred concurrently. Data underwent initial open coding followed by more focused coding, supported by reflexive memo writing, which supported data categorisation.

RESULTS

People living with dementia reported wanting to be understood as unique individuals with specific needs. All participants described wanting to be actively involved in dental treatment decisions. However, many felt that they were insufficiently involved in treatment decision-making. This perceived underinvolvement meant that some people living with dementia and family members felt the treatment outcomes they sought were neither discussed nor considered.

CONCLUSION

People living with dementia and carers had specific expectations of dental care yet felt passive in decision-making despite their desire to be involved in this process. Dentists should seek to actively establish patients' preferences, regardless of mental capacity and consider these in discussions and decisions about dental treatment.

摘要

引言

痴呆症患者可能有复杂的牙科护理需求。牙医和患者应共同做出治疗决策,但一些痴呆症患者可能无法自行决定其牙科护理。牙科治疗决策制定以及患者在此过程中的经历尚未得到全面研究。

目的

本研究旨在探讨痴呆症患者及其家庭成员对牙科治疗决策的观点和经历。

方法

对8名痴呆症患者和17名家庭照顾者进行了半结构化访谈。采用建构主义扎根理论方法,使用最大差异样本。定性数据收集和分析同时进行。数据先进行初始开放编码,然后进行更聚焦的编码,并辅以反思性备忘录撰写,以支持数据分类。

结果

痴呆症患者表示希望被理解为有特定需求的独特个体。所有参与者都表示希望积极参与牙科治疗决策。然而,许多人觉得他们在治疗决策中参与不足。这种参与不足意味着一些痴呆症患者和家庭成员觉得他们所追求的治疗结果既没有被讨论也没有被考虑。

结论

痴呆症患者和照顾者对牙科护理有特定期望,但尽管他们希望参与这一过程,在决策中仍感到被动。牙医应积极寻求确定患者的偏好,无论其心理能力如何,并在有关牙科治疗的讨论和决策中予以考虑。

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