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“只是要让大家知道这件事”:早发性痴呆症患者的自我表露。

"It's just getting the word out there": Self-disclosure by people with young-onset dementia.

机构信息

UCL Unit for Stigma Research, Clinical, Educational and Health Psychology, University College London, London, United Kingdom.

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.

出版信息

PLoS One. 2024 Sep 30;19(9):e0310983. doi: 10.1371/journal.pone.0310983. eCollection 2024.

Abstract

BACKGROUND

Sharing a dementia diagnosis with others is a prerequisite to accessing important support for social, cognitive, and physical activity. However, due to the stigma associated with dementia, individuals may be hesitant to disclose their diagnosis. Despite the importance of this issue, there is limited research on personal experiences with sharing one's diagnosis. This study explored how people with young-onset dementia disclose their diagnosis to other people, also known as self-disclosure, and how time affects self-disclosure.

METHODS

We conducted an exploratory qualitative study, using semi-structured interviews with nine people with young-onset dementia living in the United Kingdom (UK). A narrative approach to analysis was applied, focusing on understanding the core narratives, themes, tone, and imagery of each participant's narratives as well as providing a cross-case analysis to identify patterns across narratives.

RESULTS

Participants openly disclosed their diagnosis, accepting it as an illness that did not define their identity. Several were met with stigmatizing reactions, which affected their levels of openness, and a lack of understanding, which caused shrinking social networks for some. Peer support groups, advocacy activities, and strategic concealment were used to support self-disclosure.

CONCLUSION

This study provides a holistic understanding of people with young-onset dementia's experiences with self-disclosure and how these evolved. Policies should prioritize the creation of dementia-friendly communities, while recommendations for practice include integrating empowerment interventions and peer support into post-diagnostic support. These efforts will support individuals in their self-disclosure journey, promote social engagement and reduce stigma.

摘要

背景

与他人分享痴呆症诊断结果是获得社交、认知和身体活动支持的前提条件。然而,由于痴呆症相关的污名化,个人可能会犹豫是否透露自己的诊断。尽管这个问题很重要,但对于个人分享诊断结果的经验研究却有限。本研究探讨了患有早发性痴呆症的人如何向他人透露自己的诊断,即自我披露,以及时间如何影响自我披露。

方法

我们进行了一项探索性定性研究,使用半结构化访谈对居住在英国的 9 名早发性痴呆症患者进行了访谈。采用叙事方法进行分析,重点理解每位参与者叙事的核心叙事、主题、语气和意象,以及进行跨案例分析以识别叙事中的模式。

结果

参与者公开透露了他们的诊断,将其视为一种不会定义自己身份的疾病。一些人遇到了污名化的反应,这影响了他们的开放程度,还有一些人缺乏理解,导致社交网络缩小。同伴支持小组、宣传活动和策略性隐瞒被用来支持自我披露。

结论

本研究全面了解了早发性痴呆症患者的自我披露经验,以及这些经验的演变。政策应优先考虑创建痴呆症友好社区,而实践建议包括将赋权干预和同伴支持纳入诊断后支持中。这些努力将支持个人的自我披露之旅,促进社交参与并减少污名化。

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Stigma Reduction Interventions of Dementia: A Scoping Review.痴呆症的消除污名干预措施:一项范围综述
Can J Aging. 2022 Jun;41(2):203-213. doi: 10.1017/S0714980821000192. Epub 2021 Jul 13.
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Social Stigma of People with Dementia.痴呆症患者的社会污名
J Alzheimers Dis. 2020;78(4):1339-1343. doi: 10.3233/JAD-201004.
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The involvement of people with dementia in advocacy: a systematic narrative review.痴呆症患者参与倡导活动:系统叙述性综述。
Aging Ment Health. 2021 Sep;25(9):1595-1604. doi: 10.1080/13607863.2020.1783512. Epub 2020 Jun 24.
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Resilience in older people living with dementia - A narrative analysis.老年人痴呆症患者的韧性——叙事分析。
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