Nomenclature Used by Family Caregivers to Describe and Characterize Neuropsychiatric Symptoms
Nomenclature Used by Family Caregivers to Describe and Characterize Neuropsychiatric Symptoms
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DOI：
10.1093/geront/gnz140
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发表时间：
2020-08-01
期刊：
影响因子：
5.7
通讯作者：
Werner, Nicole E.
中科院分区：
文献类型：
--
作者：
Gilmore-Bykovskyi, Andrea;Mullen, Shannon;Werner, Nicole E.
背景和目标：神经精神症状（Neuropsychiatric symptoms，简称CNS）是阿尔茨海默病和相关痴呆的核心特征，其特征在于波动性病程。这些问题很难管理，并导致家庭照顾者负担沉重。临床医生和家庭护理人员之间成功的信息交流对于促进有效管理糖尿病至关重要。然而，由于术语和症状分类不一致，以及对家庭护理人员如何识别和描述症状的了解有限，这种沟通往往具有挑战性。本研究的目的是探讨语言的家庭照顾者的使用来描述和语境化的研究设计和方法：描述性的定性研究，20个家庭照顾者在美国中西部的一个主要城市县，使用半结构式访谈。护理人员的描述的ESTA进行了分析，使用直接的内容和文本分析，检查术语，然后由一个主题分析的方法来检查语境化的ESTA。结果：护理人员采用共享的术语来描述ESTA，从临床术语用于分类症状有很大不同。照顾者经常使用意义制造作为一种解释焦虑的策略。这种意义的形成有助于将行为模式置于情境中，并以解释性、情境性和战略导向性框架为特征，以根据行为的目的和意义来理解行为。照顾者对婴儿的描述反映了个体婴儿之间的广泛重叠（即，焦虑和护理阻力），一般会被认为是临床上独特的symptoms.Discussion和影响：周围的焦虑可能会有很大的不同，家庭照顾者和临床医生，并应与痴呆症患者和他们的照顾者进行评估，以确保支持性干预措施和资源是响应照顾者的解释症状和意义。
Background and Objectives: Neuropsychiatric symptoms (NPS) are a core feature of Alzheimer's disease and related dementias that are characterized by a fluctuating course. NPS are challenging to manage and contribute to high rates of burden among family caregivers. Successful information exchange between clinicians and family caregivers is critical for facilitating effective management of NPS. However, this communication is often challenging due to inconsistent terminology and classification of symptoms and limited understanding of how family caregivers recognize and describe symptoms. The objective of this study was to examine the language family caregivers' use to describe and contextualize NPS.Research Design and Methods: Descriptive qualitative study of 20 family caregivers in a mostly urban county in the Midwestern United States using semistructured interviews. Caregiver descriptions of NPS were analyzed using directed content and text analysis to examine terminology, followed by a thematic analysis approach to examine contextualization of NPS.Results: Caregivers employed shared terminologies to describe NPS that differed substantially from clinical terminology used to classify symptoms. Caregivers frequently engaged sense-making as a strategy to explain NPS. This sense-making served to contextualize patterns in behavior and was characterized by explanatory, situational, and strategy-oriented frameworks for understanding behavior in terms of its purpose and meaning. Caregivers' descriptions of NPS reflected broad overlap between individual NPS (i.e., agitation and care resistance) that would generally be considered clinically distinct symptoms.Discussion and Implications: Nomenclature surrounding NPS may vary considerably between family caregivers and clinicians, and should be evaluated in partnership with people with dementia and their caregivers to ensure supportive interventions and resources are responsive to caregivers' interpretation of symptoms and sense-making.