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我是否有痴呆症状:晚期痴呆症患者的意识和羞耻感的论述研究。

Do I Have Symptoms of Dementia: A Discursive Study of Awareness and Shame Among People With Advanced Dementia.

机构信息

Faculty of Psychology, SWPS University, Wrocław, Poland.

Department of Psychology, Moravian University, Bethlehem, Pennsylvania, USA.

出版信息

Gerontologist. 2024 Aug 1;64(8). doi: 10.1093/geront/gnae067.

Abstract

BACKGROUND AND OBJECTIVES

This study explores the narrated experiences of individuals with advanced stages of late-onset dementia, focusing on their diagnosis awareness. Such framing is motivated by 2 reasons. Firstly, there is a lack of consensus regarding the prevalence of anosognosia among people with dementia. Secondly, research on anosognosia often neglects to address the important issues of shame and stigma associated with receiving a dementia diagnosis.

RESEARCH DESIGN AND METHODS

For this qualitative study, a total of 27 participants ranging in age from 66 to 94 were involved. The data collected were analyzed using textual-oriented discourse analysis.

RESULTS

Our findings indicated that individuals with dementia struggled to comprehend the medical terminology used to describe their experiences within biomedical standards. The interviewees utilized 5 negative discourses on dementia, which shaped their attitudes toward the condition and people diagnosed with it. These discourses depicted dementia as an illness, negative aging, a devaluation, a burden, and a life tragedy. Moreover, study participants did not outright reject the diagnosis but rather negotiated its acceptance within the context of shame associated with dementia.

DISCUSSION AND IMPLICATIONS

The concept of anosognosia can serve as a mechanism of social control and stigmatization of people with dementia within the dominant biomedical discourse.

摘要

背景与目的

本研究探讨了晚期发病的痴呆症患者的个体叙述经验,重点关注他们的诊断意识。这种框架有两个原因。首先,对于痴呆症患者中存在否认症的普遍性,目前尚无共识。其次,关于否认症的研究往往忽略了与接受痴呆症诊断相关的重要问题,如羞耻感和污名化。

研究设计与方法

对于这项定性研究,共有 27 名年龄在 66 岁至 94 岁之间的参与者参与。使用文本导向的话语分析对收集的数据进行分析。

结果

我们的研究结果表明,痴呆症患者难以理解用于描述其在生物医学标准下的经验的医学术语。受访者使用了 5 种关于痴呆症的负面话语,这些话语塑造了他们对该病症和被诊断为该病症的人的态度。这些话语将痴呆症描述为一种疾病、负面的衰老、贬值、负担和生活悲剧。此外,研究参与者并没有完全拒绝诊断,而是在与痴呆症相关的羞耻感背景下,对其进行协商性的接受。

讨论与意义

否认症的概念可以作为一种社会控制机制,在占主导地位的生物医学话语中对痴呆症患者进行污名化。

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