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向社交网络披露痴呆症诊断的人群:一项系统综述与元综合分析

People With Dementia Disclosing Their Diagnosis to Social Networks: A Systematic Review and Meta-Synthesis.

作者信息

Kohl Gianna, Molinari Ulate Mauricio, Bhatt Jem, Lynch Jennifer, Scior Katrina, Charlesworth Georgina

机构信息

UCL Unit for Stigma Research, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.

Psycho-Sciences Research Group, Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain.

出版信息

Gerontologist. 2025 Feb 17;65(3). doi: 10.1093/geront/gnae186.

Abstract

BACKGROUND AND OBJECTIVES

Given the stigma of dementia, individuals with the condition may be wary to disclose their diagnosis to other people, both in face-to-face and digital settings. While sharing one's dementia diagnosis with others is essential for accessing valuable support for social, cognitive, and physical well-being, this area of research has largely been neglected. In this meta-synthesis, we aimed to systematically review qualitative research on the factors associated with online and offline self-disclosure in people with dementia.

RESEARCH DESIGN AND METHODS

We conducted a systematic search in 6 electronic databases. Inclusion criteria comprised qualitative and mixed-methods studies describing experiences with self-disclosure in people with any type of dementia. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool. The meta-synthesis was conducted in NVivo using a thematic synthesis approach.

RESULTS

28 studies were included. 3 analytical themes were generated: "Concealment," "Stigma and fear," and "Taking control," the latter 2 with subthemes. Findings from this review were corroborated with people with dementia and family carers as part of Patient and Public Involvement meetings. Our findings reveal that while stigma plays a pivotal role, people with dementia can take control of the meaning of their diagnosis through self-disclosure.

DISCUSSION AND IMPLICATIONS

Self-disclosure is complex and multifaceted. People with dementia, particularly those experiencing stigma, can benefit from post-diagnostic support that encompasses resources and interventions for self-disclosure. Further research is required to investigate people with dementia's disclosure decision-making process.

摘要

背景与目的

鉴于痴呆症带来的污名,患有这种疾病的人可能会在面对面和数字环境中都不愿向他人透露自己的诊断结果。虽然与他人分享自己的痴呆症诊断对于获得社交、认知和身体健康方面的宝贵支持至关重要,但这一研究领域在很大程度上被忽视了。在这项元综合研究中,我们旨在系统地回顾关于痴呆症患者在线和线下自我披露相关因素的定性研究。

研究设计与方法

我们在6个电子数据库中进行了系统检索。纳入标准包括定性和混合方法研究,这些研究描述了任何类型痴呆症患者的自我披露经历。使用混合方法评估工具对纳入研究的质量进行评估。在NVivo中采用主题综合方法进行元综合。

结果

纳入了28项研究。生成了3个分析主题:“隐瞒”、“污名与恐惧”以及“掌控局面”,后两个主题还有子主题。作为患者及公众参与会议的一部分,痴呆症患者和家庭护理人员对本综述的结果进行了证实。我们的研究结果表明,虽然污名起着关键作用,但痴呆症患者可以通过自我披露来掌控其诊断的意义。

讨论与启示

自我披露是复杂且多方面的。痴呆症患者,尤其是那些遭受污名的患者,可以从诊断后支持中受益,这种支持包括自我披露的资源和干预措施。需要进一步研究来调查痴呆症患者的披露决策过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fcb/11833486/54562d4e1cfe/gnae186_fig1.jpg

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