Yamanaka Katsuo, Miyazawa Nana, Oba Hikaru
Institute of Human Sciences, University of Tsukuba, Tsukuba, Japan.
College of Human Sciences, University of Tsukuba, Tsukuba, Japan.
Psychogeriatrics. 2025 Sep;25(5):e70070. doi: 10.1111/psyg.70070.
Dignity is crucial for family members providing care to individuals with dementia, yet its conceptualization may vary based on periods since onset and family relationships. This study employed quantitative text analysis to elucidate family members' concepts of dignity in care, considering both the time elapsed since the dementia diagnosis and the nature of family relationships.
Concepts of dignity were gathered from 120 Japanese family members through an open-ended question. Morphemes extracted from the responses, along with family relationship attributes and periods after diagnosis, were plotted on dimensions of correspondence analysis. Hypotheses about these concepts were formulated based on the plots and content analysis of the responses. Fisher's exact test was used to compare the frequency of morphemes across different attributes.
Three hypotheses of concepts of dignity related to periods after diagnosis and six related to family relationships were established. Significant differences in morpheme frequencies connected with the concepts were observed among attributes such as periods, spouse versus non-spouse, blood relative versus non-blood relative, and sex. For instance, the frequency on 'Do not deny or hurt, and manage symptoms' was more during the short period after the diagnosis than the other periods while the frequencies regarding 'Accept her/him, esteem her/him as an adult or a member of society' was more during the long period than the other periods. While opinions did express challenges in maintaining dignity, these did not show significant variation across attributes.
Different morpheme frequencies of concepts of dignity among the attributes suggest that the conceptualization varies with the periods since the diagnosis and family relationships. Common challenges in practicing dignified care suggest that all family members experience conflicts between ideals and reality. It is essential for professionals to recognise these differing ideals and shared conflicts. Further cross-cultural comparisons of these findings are needed.
尊严对于照顾痴呆症患者的家庭成员至关重要，但其概念可能因发病后的时间以及家庭关系而异。本研究采用定量文本分析方法，以阐明家庭成员在照顾中对尊严的概念，同时考虑痴呆症诊断后的时间以及家庭关系的性质。
通过开放式问题从120名日本家庭成员中收集尊严的概念。从回答中提取的语素，连同家庭关系属性和诊断后的时间，绘制在对应分析维度上。基于这些图和回答的内容分析，对这些概念提出假设。使用Fisher精确检验比较不同属性的语素频率。
确立了与诊断后时间相关的尊严概念的三个假设以及与家庭关系相关的六个假设。在诸如时间、配偶与非配偶、血亲与非血亲以及性别等属性之间，观察到与这些概念相关的语素频率存在显著差异。例如，“不否认或伤害，并管理症状”的频率在诊断后的短时间内高于其他时间段，而“接受她/他，将她/他视为成年人或社会成员并尊重她/他”的频率在长时间内高于其他时间段。虽然意见确实表达了在维护尊严方面的挑战，但这些挑战在不同属性之间并未显示出显著差异。
尊严概念在不同属性之间的语素频率差异表明其概念化因诊断后的时间和家庭关系而异。在实施有尊严的护理方面的共同挑战表明，所有家庭成员都在理想与现实之间经历冲突。专业人员必须认识到这些不同的理想和共同的冲突。需要对这些发现进行进一步的跨文化比较。
