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亚洲痴呆症患者寻求帮助的促进因素和障碍:一项对非正式照护者的定性研究结果。

Facilitators and barriers of help-seeking for persons with dementia in Asia-findings from a qualitative study of informal caregivers.

机构信息

Research Division, Institute of Mental Health, Singapore, Singapore.

Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore.

出版信息

Front Public Health. 2024 Jul 12;12:1396056. doi: 10.3389/fpubh.2024.1396056. eCollection 2024.

Abstract

BACKGROUND AND AIM

The deterioration in cognition of persons with dementia (PWD) makes their caregivers key players in their help-seeking process. This study aimed to identify the facilitators and barriers of help-seeking for persons with dementia in Asia from the perspective of their informal caregivers.

METHODS

A qualitative methodology was adopted in the current study. Twenty-nine informal caregivers of PWD in Singapore were interviewed between April 2019 and December 2020. All interviews were audio-recorded and transcribed verbatim for the analysis.

RESULTS

The transcripts were analyzed using inductive thematic analysis. The results revealed four major themes with 12 sub-themes, including (1) Barriers to diagnosis-seeking (i.e., lack of knowledge and awareness of dementia, emotional denial, resistance from PWD, and delays in the healthcare system); (2) Facilitators of diagnosis-seeking (i.e., synergy between awareness of dementia and an active diagnosis-seeking intention and incidental diagnosis resulting from seeking treatment for comorbid conditions); (3) Barriers to treatment-seeking (i.e., challenges from PWD and disease, challenges faced by caregivers when seeking treatment for PWD, and challenges imposed by the COVID-19 pandemic); (4) Facilitators of treatment-seeking (i.e., caregivers' capabilities of handling PWD, cooperation/compliance from PWD, and an integrated care plan for PWD).

CONCLUSION

The findings highlight the importance of raising public awareness, enabling health professionals to tailor psychosocial interventions better, and improving community support through dementia awareness and education.

摘要

背景与目的

痴呆症患者(PWD)认知能力的恶化使他们的照护者成为他们寻求帮助过程中的关键角色。本研究旨在从他们的非正式照护者的角度确定亚洲痴呆症患者寻求帮助的促进因素和障碍。

方法

本研究采用定性方法。2019 年 4 月至 2020 年 12 月期间,在新加坡对 29 名 PWD 的非正式照护者进行了访谈。所有访谈均进行了录音,并逐字转录进行分析。

结果

使用归纳主题分析对转录本进行了分析。结果显示了四个主要主题和 12 个子主题,包括:(1)寻求诊断的障碍(即缺乏对痴呆症的知识和认识、情感否认、PWD 的抵制以及医疗保健系统的延误);(2)寻求诊断的促进因素(即对痴呆症的认识与积极寻求诊断的意图之间的协同作用以及因同时治疗共病而偶然诊断);(3)寻求治疗的障碍(即 PWD 和疾病带来的挑战、照护者在为 PWD 寻求治疗时面临的挑战以及 COVID-19 大流行带来的挑战);(4)寻求治疗的促进因素(即照护者照顾 PWD 的能力、PWD 的合作/遵守以及 PWD 的综合护理计划)。

结论

研究结果强调了提高公众意识、使卫生专业人员能够更好地调整心理社会干预措施以及通过痴呆症意识和教育改善社区支持的重要性。

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The effects of the COVID-19 pandemic on people with dementia.新冠疫情对痴呆症患者的影响。
Nat Rev Neurol. 2021 Feb;17(2):69-70. doi: 10.1038/s41582-020-00450-z.
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Diagnosis and Management of Dementia: Review.痴呆的诊断与管理:综述。
JAMA. 2019 Oct 22;322(16):1589-1599. doi: 10.1001/jama.2019.4782.

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