Factors that Affect Quality of Life from the Perspective of People with Dementia: A Metasynthesis
Factors that Affect Quality of Life from the Perspective of People with Dementia: A Metasynthesis
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DOI：
10.1111/jgs.13178
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发表时间：
2015-01-01
影响因子：
6.3
通讯作者：
Jerke, Lauren
中科院分区：
文献类型：
--
作者：
O'Rourke, Hannah M.;Duggleby, Wendy;Jerke, Lauren
目的从痴呆患者的角度全面系统地识别、评价和综合影响生活质量因素的定性研究成果。设计系统综述和综合已发表的灰色文献中的主要定性研究，旨在从痴呆患者的角度确定影响生活质量的因素。在9个电子数据库中应用了专家开发的搜索策略。对检索过程中确定的收录文章和文献综述的参考清单进行了审查。应用结构化纳入标准筛选了5625个标题和摘要，以确定1975年至2012年4月发表的11项定性研究。两位独立评价者对研究质量进行了评估。主要研究招募地点包括英国、美国、加拿大、荷兰、爱尔兰、澳大利亚和日本的长期护理和社区环境。参与者包括345名轻度、中度和重度痴呆患者的联合样本。测量主要研究采用访谈和焦点小组方法。采用分类学分析、恒定比较和引入概念的方法对初步研究的结果进行综合。结果根据痴呆症患者的不同，四个因素和每个因素中的连接或断开的经历影响生活质量。这些因素，以及代表联系和断开联系的术语，分别是关系(在一起与单独)，当今生活中的代理(有目的与无目的)，健康视角(好与病)，以及地方感(定位与未确定)。幸福和悲伤分别是生活质量好和差的关键结果。结论这四个因素确定了潜在的可改变的领域，以提高痴呆症患者的生活质量，即使在认知功能恶化的情况下也是如此。
ObjectivesTo comprehensively and systematically identify, appraise, and synthesize qualitative research findings on factors that affect quality of life from the perspective of people with dementia.DesignSystematic review and metasynthesis of primary qualitative studies in published and gray literature that aimed to identify factors that influence quality of life from the perspective of people with dementia. Expert-developed search strategies were applied in nine electronic databases. Reference lists of included articles and literature reviews identified during the search were reviewed. Structured inclusion criteria were applied to screen 5,625 titles and abstracts to identify 11 qualitative studies published from 1975 to April 2012. Two independent reviewers appraised study quality.SettingPrimary study recruitment sites included long-term care and community-based settings in the United Kingdom, the United States, Canada, the Netherlands, Ireland, Australia, and Japan.ParticipantsA combined sample of 345 people with mild, moderate, and severe dementia.MeasurementsThe primary studies used interview and focus group methods. Findings from primary studies were synthesized using techniques of taxonomic analysis, constant comparison, and importing concepts.ResultsFour factors and the experience of connectedness or disconnectedness within each factor influenced quality of life according to people with dementia. These factors, and the terms that represent connectedness and disconnectedness, were relationships (together vs alone), agency in life today (purposeful vs aimless), wellness perspective (well vs ill), and sense of place (located vs unsettled). Happiness and sadness were key outcomes of good and poor quality of life, respectively.ConclusionThe four factors identified potentially modifiable areas to improve quality of life for people with dementia, even in the context of worsening cognitive function.