Does awareness of condition help people with mild-to-moderate dementia to live well? Findings from the IDEAL programme.
Does awareness of condition help people with mild-to-moderate dementia to live well? Findings from the IDEAL programme.
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对病情的认知是否有助于轻度至中度痴呆患者生活得更好？来自IDEAL项目的研究结果。
DOI：
10.1186/s12877-021-02468-4
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发表时间：
2021-09-25
期刊：
影响因子：
4.1
通讯作者：
IDEAL programme research team
中科院分区：
文献类型：
--
作者：
Alexander CM;Martyr A;Gamble LD;Savage SA;Quinn C;Morris RG;Collins R;Clare L;IDEAL programme research team
痴呆患者对自身能力的认知各不相同。我们探究了轻度至中度痴呆患者对自身病情和诊断的认知，以及这种认知与生活质量、幸福感、生活满意度和照顾者压力之间的关系。
本研究是对IDEAL队列数据的横断面探索性分析，该队列从英国29个研究地点招募了在家居住的痴呆患者及其照顾者。我们的研究包括917名轻度至中度痴呆患者和755名照顾者。根据对一项痴呆表征测量的自我报告回答，划分出认知度低和认知度高的两组。采用逻辑回归分析，利用人口统计学、认知、功能和心理测量指标，探究病情和诊断认知的预测因素，以及与生活质量、幸福感和生活满意度（“生活得好”）以及照顾者压力之间的关系。
有83人对自身病情认知度低。其余834人表现出一定认知，其中103人对自身病情和诊断有高度认知。心理社会因素比认知和功能能力更能预测认知度。认知度较高的人报告情绪较低，在生活得好的各项指标上得分较低，乐观度、自我效能感和自尊也较低。80岁及以上以及生活在社会贫困程度较高地区的人更可能认知度低。照顾者压力与患者认知度之间未发现关联。
轻度至中度痴呆患者对病情和诊断的认知各不相同，且与生活得好的能力相关。在以患者为中心的临床护理中应考虑认知度这一因素。
网络版包含补充材料，网址为10.1186/s12877 - 021 - 02468 - 4。
People living with dementia vary in awareness of their abilities. We explored awareness of the condition and diagnosis in people with mild-to-moderate dementia, and how this relates to quality of life, well-being, life satisfaction, and caregiver stress. This study was a cross-sectional exploratory analysis of data from the IDEAL cohort, which recruited people with dementia living at home and available caregivers from 29 research sites in Great Britain. Our study included 917 people with mild-to-moderate dementia and 755 carers. Low and high awareness groups were derived from self-reported responses to a dementia representation measure. Logistic regression was used to explore predictors of awareness of condition and diagnosis using demographic, cognitive, functional and psychological measures, and the relationship with quality of life, well-being and life satisfaction (‘living well’), and caregiver stress. There were 83 people with low awareness of their condition. The remaining 834 people showed some awareness and 103 of these had high awareness of their condition and diagnosis. Psychosocial factors were stronger predictors of awareness than cognitive and functional ability. Those with higher awareness reported lower mood, and lower scores on indices of living well as well as lower optimism, self-efficacy and self-esteem. Low awareness was more likely in those aged 80y and above, and living in more socially deprived areas. No relationship was seen between caregiver stress and awareness. Awareness of the condition and diagnosis varies in people with mild-to-moderate dementia and is relevant to the capability to live well. Awareness should be considered in person-centered clinical care. The online version contains supplementary material available at 10.1186/s12877-021-02468-4.
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