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在 COVID-19 大流行期间,痴呆老年人面临的挑战:一项专业人士访谈的定性研究。

Challenges faced by older people with dementia during the COVID-19 pandemic as perceived by professionals: a qualitative study with interviews.

机构信息

Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Center for Well-being and Society, Nihon Fukushi University, Nagoya, Japan.

出版信息

Psychogeriatrics. 2024 Jul;24(4):854-860. doi: 10.1111/psyg.13131. Epub 2024 May 20.

Abstract

BACKGROUND

Previous studies have highlighted a decline in the mental health of older adults over the course of the coronavirus disease 2019 (COVID-19) pandemic. Few studies have determined the possible causes of behavioural and psychological symptoms of dementia during COVID-19 in a comprehensive manner. We aimed to identify the challenges faced by older adults with dementia during the COVID-19 pandemic.

METHODS

This study adopted a qualitative approach to understanding the perceptions of healthcare professionals, such as regarding the negative effects of COVID-19 on the mental health of people with dementia. Between January and March 2022, the authors conducted individual in-depth interviews on how COVID-19 affected the stress levels, care, and self-determination of people with dementia. Qualitative data from the individual interviews were data cleansed to ensure the clarity and readability of the transcripts. The qualitative data were then analyzed by inductive manual coding using a qualitative content analysis approach. The grouping process involved reading and comparing individual labels to cluster similar labels into categories and inductively formulate themes.

RESULTS

Qualitative analysis extracted 61 different semantic units that were duplicated. Seven categories were inductively extracted using a grouping process. These were further integrated to extract the following four themes: fear of personal protective equipment (PPE), loneliness, dissatisfaction with behavioural restrictions and limitations of video calls, and family interference with service use.

DISCUSSION

People with dementia often faced mental distress during the pandemic owing to preventive measures against COVID-19, and a lack of awareness and understanding of such preventive measures worsened their distress. They experienced a severe sense of social isolation and loneliness. Findings also indicated that families tended to ignore the needs of people with dementia and their decisions and opinions regarding healthcare service use.

摘要

背景

先前的研究强调了在 2019 冠状病毒病(COVID-19)大流行期间,老年人的心理健康状况有所下降。很少有研究全面确定 COVID-19 期间痴呆症患者行为和心理症状的可能原因。我们旨在确定 COVID-19 大流行期间痴呆症老年人面临的挑战。

方法

本研究采用定性方法了解医疗保健专业人员的看法,例如 COVID-19 对痴呆症患者心理健康的负面影响。在 2022 年 1 月至 3 月期间,作者对 COVID-19 如何影响痴呆症患者的压力水平、护理和自决权进行了个人深入访谈。对个人访谈的定性数据进行了数据清理,以确保转录本的清晰和可读性。然后使用定性内容分析方法对定性数据进行了归纳手动编码分析。分组过程涉及阅读和比较单个标签,将相似的标签聚类到类别中,并归纳出主题。

结果

定性分析提取了 61 个不同的语义单元,这些单元被重复。使用分组过程归纳提取了七个类别。这些类别进一步整合,提取了以下四个主题:对个人防护设备(PPE)的恐惧、孤独感、对行为限制和视频通话限制的不满,以及家庭对服务使用的干扰。

讨论

由于 COVID-19 的预防措施,痴呆症患者在大流行期间经常面临精神困扰,而且对这些预防措施的认识和理解不足,加剧了他们的困扰。他们经历了严重的社会隔离和孤独感。研究结果还表明,家庭往往忽视痴呆症患者的需求以及他们对医疗保健服务使用的决策和意见。

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