"It's You": Caregiver and Clinician Perspectives on Lucidity in People Living With Dementia.
"It's You": Caregiver and Clinician Perspectives on Lucidity in People Living With Dementia.
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“是你”：护理人员和临床医生对痴呆症患者清醒的看法。
DOI：
10.1093/geront/gnac095
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Shah,MindyJ
中科院分区：
文献类型：
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作者：
Gilmore-Bykovskyi,Andrea;Block,Laura;Benson,Clark;Fehland,Jess;Botsch,Meghan;Mueller,KimberlyD;Werner,Nicole;Shah,MindyJ
背景和目标 清醒期（EL），或者被认为是痴呆症患者丧失的能力的短暂恢复，是一个日益受到关注的领域。这些事件对护理、护理以及我们对潜在病因的理解具有重要意义。对 EL 的研究很大程度上局限于回顾性报告。专业和家庭护理人员对 EL 和研究方法的看法可以为定义和研究清醒度的工作提供信息。本研究调查了家庭护理人员和临终关怀临床医生对痴呆症患者 EL 的经验和看法，以及研究这些事件的观察方法。研究设计和方法这项探索性、描述性定性研究采用半结构化访谈（N = 20 名护理人员，N = 6 名临床医生）。使用主题快速识别和随后对访谈数据的重复审查来分析数据，以增强可信度。结果大多数参与者很容易回忆起他们认为是 EL 的事件，描述他们认为重要和/或有意义的能力的短暂恢复。尽管 EL 通常被概念化为自我的表现，但 EL 的定义特征、解释和感知影响各不相同。护理人员描述了为发现 EL 的模式和支持性社会条件所做的大量努力。参与者支持使用视听观察来研究 EL，并提供有关隐私、工作流程和护理人员参与的建议。讨论和影响对 EL 的解释是多种多样的，对这些事件的认识可能需要对痴呆症患者非常熟悉。参与者认可本研究中的观察方法和护理人员的整合。
Background and ObjectivesEpisodes of lucidity (ELs), or a transient return of abilities believed to be lost in people living with dementia, are a growing area of interest. These events hold important implications for care, caregiving, and our understanding of underlying etiologies. Research on ELs is largely limited to retrospective reports. The perspectives of professional and family caregivers on ELs and research approaches can inform efforts to define and study lucidity. The present study examined family caregiver and hospice clinician experiences with and perspectives on ELs in people living with dementia and observational approaches to studying these events.Research Design and MethodsThis exploratory, descriptive qualitative study employed semistructured interviews (N= 20 caregivers,N= 6 clinicians). Data were analyzed using Rapid Identification of Themes and subsequent duplicate review of interview data to enhance trustworthiness.ResultsMost participants readily recalled events they perceived as ELs, describing a transient return of abilities they felt was significant and/or meaningful. Defining features, interpretations, and the perceived impact of ELs varied, although ELs were commonly conceptualized as a manifestation of self. Caregivers described extensive efforts to detect patterns and supportive social conditions for ELs. Participants supported use of audiovisual observation to study ELs and provided recommendations for privacy, workflow, and caregiver engagement.Discussion and ImplicationsInterpretations of ELs are heterogeneous, and recognition of these events may necessitate close familiarity with the person living with dementia. Participants endorse observational approaches and integration of caregivers in this research.