Living With Ambiguity: A Metasynthesis of Qualitative Research on Mild Cognitive Impairment.
Living With Ambiguity: A Metasynthesis of Qualitative Research on Mild Cognitive Impairment.
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与歧义生活：对轻度认知障碍的定性研究的元合成。
DOI：
10.1093/geront/gnv067
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Hwang A
中科院分区：
文献类型：
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作者：
Gomersall T;Astell A;Nygård L;Sixsmith A;Mihailidis A;Hwang A
轻度认知障碍（MCI）是一种诊断，旨在描述正常认知衰老和痴呆之间的中间状态。 MCI因其概念模糊、与痴呆症的模糊关系以及它在医学和社会学对“正常衰老”的理解之间造成的紧张而受到批评。我们使用荟萃分析作为方法框架，研究了已发表的有关 MCI 诊断和生活经验的定性文献。制定了两个总体概念主题。第一个是 MCI 和“及时的我”，表明 MCI 的诊断可能会深刻影响一个人对自己在世界上的地位的理解。这种影响似乎是由多种因素介导的，包括一个人的社交支持网络（其日常活动受到影响）以及对 MCI 含义的主观解释。第二个主题“生活在模糊之中”描述了人们在理解自己的诊断时所经历的困难。不确定性部分是由于 MCI 患者收到的信息缺乏清晰度和一致性，包括他们是否被告知 MCI 就是诊断结果。我们的结论是，当做出 MCI 诊断时，道德紧张总是在发挥作用。具体来说，诊断提供的早期支持和服务可能会以一个人对未来的焦虑为代价，并且持续不确定如何解决他或她的担忧和需求。
Mild Cognitive Impairment (MCI) is a diagnosis proposed to describe an intermediate state between normal cognitive aging and dementia. MCI has been criticised for its conceptual fuzziness, its ambiguous relationship to dementia, and the tension it creates between medical and sociological understandings of “normal aging”. We examined the published qualitative literature on experiences of being diagnosed and living with MCI using metasynthesis as the methodological framework. Two overarching conceptual themes were developed. The first, MCI and myself-in-time, showed that a diagnosis of MCI could profoundly affect a person’s understanding of their place in the world. This impact appears to be mediated by multiple factors including a person’s social support networks, which daily activities are affected, and subjective interpretations of the meaning of MCI. The second theme, Living with Ambiguity, describes the difficulties people experienced in making sense of their diagnosis. Uncertainty arose, in part, from lack of clarity and consistency in the information received by people with MCI, including whether they are even told MCI is the diagnosis. We conclude by suggesting an ethical tension is always at play when a MCI diagnosis is made. Specifically, earlier support and services afforded by a diagnosis may come at the expense of a person’s anxiety about the future, with continued uncertainty about how his or her concerns and needs can be addressed.