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痴呆患者淡漠现状及其影响因素的系统评价。

The current status of apathy in patients with dementia and its factors: A systematic review.

机构信息

Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.

School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.

出版信息

Geriatr Nurs. 2024 Jul-Aug;58:290-297. doi: 10.1016/j.gerinurse.2024.05.022. Epub 2024 Jun 7.

Abstract

OBJECTIVE

To systematically evaluate the current status of apathy in dementia patients and its associated factors.

METHODS

We searched Chinese and English databases to collect studies on the associated factors of apathy in patients with dementia from inception to March 14, 2023. Two researchers independently screened the literature, evaluated the quality, and extracted the data RESULTS: A total of 20 studies were included, and the incidence of apathy in patients with dementia ranged from 21 % to 90 %. According to the model of apathy proposed by Massimo in 2018, the associated factors were divided into individual factors for dementia patients, caregiver factors, and environmental factors. The individual factors of apathy in patients with dementia mainly include demographic characteristics, the severity of cognitive impairment, a combination of other behavioral and psychological symptoms of dementia, acute medical problems or adverse drug reactions, unmet needs, and malnutrition. Caregiver factors mainly include emotional expressions of hostility or criticism towards dementia patients and caregivers' expectations for a better life in the future. Environmental factors mainly include too high or too low stimulation and a lack of daytime activities CONCLUSIONS: Existing studies have shown that the incidence of apathy in dementia patients is high and is affected by multi-dimensional factors. There are more studies on individual factors in dementia patients and fewer studies on caregivers and environmental factors. In the future, a large number of high-quality studies are needed to demonstrate the mechanism of apathy in dementia patients and to find more related factors.

摘要

目的

系统评价痴呆患者淡漠的现状及其相关因素。

方法

检索中、英文数据库,收集 2023 年 3 月 14 日前关于痴呆患者淡漠相关因素的研究。由 2 位研究者独立筛选文献、评价质量并提取资料。

结果

共纳入 20 项研究,痴呆患者淡漠的发生率为 21%~90%。根据 Massimo 于 2018 年提出的淡漠模型,将相关因素分为痴呆患者的个体因素、照料者因素和环境因素。痴呆患者淡漠的个体因素主要包括人口学特征、认知障碍严重程度、其他行为和心理症状的合并、急性医学问题或药物不良反应、未满足的需求和营养不良。照料者因素主要包括对痴呆患者表现出敌意或批评的情绪表达,以及照料者对未来更好生活的期望。环境因素主要包括刺激过高或过低,以及白天活动缺乏。

结论

现有研究表明,痴呆患者淡漠的发生率较高,受多维度因素影响。目前对痴呆患者个体因素的研究较多,对照料者和环境因素的研究较少。未来需要更多高质量的研究来阐明痴呆患者淡漠的发生机制,并寻找更多相关因素。

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