护理学报 ›› 2021, Vol. 28 ›› Issue (23): 28-31.doi: 10.16460/j.issn1008-9969.2021.23.028
昝畅, 周莹, 张琼琼, 汤胜男, 丁梓曦, 王庆妍
摘要: 目的 对国内外痴呆患者就医延迟现状及影响因素进行综述,为今后开展痴呆患者就医相关研究提供参考,为制定促进痴呆患者就医的有效干预措施提供依据。方法 通过检索中国知网、万方、维普、PubMed、Embase、Web of Science等数据库,回顾国内外痴呆患者就医相关文献,对纳入的相关研究内容进行提取与归纳。结果 不同国家和地区的痴呆患者就医延迟的时间均较长,出现症状至就医的时间在1.77~2.40年。就医延迟的影响因素包括:痴呆类型、疾病症状、疾病相关知识及信息、病耻感、就医态度、医疗保健系统的形象、认知相关基层医疗服务资源和跨文化差异。患者年龄、家族史、受教育程度、居住状况、财务状况对就医延迟的影响尚无一致结论。结论 痴呆患者就医延迟现象严重、影响因素繁杂,未来的研究应进一步考虑因素间的相互作用关系,为构建干预方案提供理论基础。
中图分类号:
[1] Claveau JS, Presse N, Kergoat MJ, et al.The Lost Years: Delay Between the Onset of Cognitive Symptoms and Clinical Assessment at a Memory Clinic[J]. Can Geriatr J, 2018,21(2):152-156. [2] Devoy S, Simpson E.Help-seeking Intentions for Early Dementia Diagnosis in a Sample of Irish Adults[J].Aging Ment Health, 2017,21(8):870-878. [3] Xu J, Wang J, Wimo A, et al.The Economic Burden of Dementia in China, 1990-2030: Implications for Health Policy[J]. Bull World Health Organ, 2017,95(1):18-26. [4] 李明士, 邓小岚, 葛兆霞. 164例老年痴呆患者主要照顾者哀伤现状及影响因素分析[J]. 护理学报, 2021,28(2):52-57. [5] Zhao M, Lv X, Tuerxun M, et al.Delayed Help Seeking Behavior in Dementia Care: Preliminary Findings From the Clinical Pathway for Alzheimer’s Disease in China (CPAD) Study[J]. Int Psychogeriatr, 2016,28(2):211-219. [6] Werner P, Goldstein D, Karpas DS, et al.Help-seeking for Dementia: A Systematic Review of the Literature[J]. Alzheimer Dis Assoc Disord, 2014,28(4):299-310. [7] Parker M, Barlow S, Hoe J, et al.Persistent Barriers and Facilitators to Seeking Help for a Dementia Diagnosis: A Systematic Review of 30 Years of the Perspectives of Carers and People with Dementia[J]. Int Psychogeriatr, 2020,32(5):1-24. [8] Feldman L, Wilcock J, Thuné-Boyle I, et al.Explaining the Effects of Symptom Attribution by Carers on Help-seeking for Individuals Living with Dementia[J]. Dementia (London), 2017,16(3):375-387. [9] Chrisp TAC, Thomas BD, Goddard WA, et al.Dementia Timeline: Journeys, Delays and Decisions on the Pathway to an Early Diagnosis[J]. Dementia, 2011,10(4):555-570. [10] Leung KK, Finlay J, Silvius JL, et al.Pathways to Diagnosis: Exploring the Experiences of Problem Recognition and Obtaining a Dementia Diagnosis among Anglo-canadians[J]. Health Soc Care Community, 2011,19(4):372-381. [11] Jia L, Du Y, Chu L, et al.Prevalence, Risk Factors, and Management of Dementia and Mild Cognitive Impairment in Adults Aged 60 Years or Older in China: A Cross-sectional Study[J]. Lancet Public Health, 2020, 5(12):e661-e671. [12] World Health Organization. Dementia[EB/OL]. (2020-09-21)[2020-12-07].https://www.who.int/zh/news-room/fact-sheets/detail/dementia. [13] Mattos MK, Nilsen ML, Lingler JH.Experiences Surrounding an Early-stage Cognitive Diagnosis in Rural-dwelling Older Adults[J]. Res Gerontol Nurs, 2018,11(4):181-189. [14] Hurt CS, Burns A, Brown RG, et al.Why Don’t Older Adults with Subjective Memory Complaints Seek Help?[J]. Int J Geriatr Psychiatry, 2012,27(4):394-400. [15] Begum A, Whitley R, Banerjee S, et al.Help-seeking Response to Subjective Memory Complaints in Older Adults: Toward a Conceptual Model[J]. Gerontologist, 2013,53(3):462-473. [16] Zheng YB, Shi L, Gong YM, et al.Public Awareness and Knowledge of Factors Associated with Dementia in China[J]. BMC Public Health, 2020,20(1):1567. [17] 滕丽新, 黄希庭, 陈本友. 英国老年人心理健康服务体系的现状及启示[J]. 西南大学学报(社会科学版), 2009,35(3):18-23. [18] Sagbakken M, Spilker RS, Nielsen TR.Dementia and Immigrant Groups: A Qualitative Study of Challenges Related to Identifying, Assessing, and Diagnosing Dementia[J]. BMC Health Serv Res, 2018,18(1):910. [19] 陈晓春, 张杰文, 贾建平, 等. 2018中国痴呆与认知障碍诊治指南(一):痴呆及其分类诊断标准[J]. 中华医学杂志, 2018,98(13):965-970. [20] Koehn S, Mccleary L, Garcia L, et al.Understanding Chinese-canadian Pathways to a Diagnosis of Dementia Through a Critical-constructionist Lens[J]. J Aging Stud, 2012,26(1):44-54. [21] Mukadam N, Waugh A, Cooper C, et al.What Would Encourage Help-seeking for Memory Problems among UK-based South Asians? A Qualitative Study[J]. BMJ Open, 2015,5(9):e7990. [22] Lian Y, Xiao LD, Zeng F, et al.The Experiences of People with Dementia and Their Caregivers in Dementia Diagnosis[J]. J Alzheimers Dis, 2017,59(4):1203-1211. [23] Jackson S.Caregivers’ Perceptions of an Early Diagnosis of Alzheimer’s Disease in African Americans[D]. Minneapolis:Walden University, 2016. [24] Rydberg ST, Dahlin-Ivanoff S, Gudmundsson P, et al.‘I Wanted to Talk about It, but I Couldn’t’, an H70 Focus Group Study about Experiencing Depression in Early Late Life[J]. BMC Geriatr, 2020,20(1):528. [25] 郑佳映, 陈雪萍. 老年期痴呆症与抑郁相关性[J]. 中国老年学杂志, 2018,38:2039-2041. [26] Gove D, Downs M, Vernooij-Dassen M, et al.Stigma and GPs’ Perceptions of Dementia[J]. Aging Ment Health, 2016,20(4):391-400. [27] Chrisp TA, Tabberer S, Thomas BD, et al.Dementia Early Diagnosis: Triggers, Supports and Constraints Affecting the Decision to Engage with the Health Care System[J]. Aging Ment Health, 2012,16(5):559-565. [28] McCleary L, Persaud M, Hum S, et al. Pathways to Dementia Diagnosis among South Asian Canadians[J]. Dementia (London), 2013,12(6):769-789. [29] Mukadam N, Cooper C, Basit B, et al.Why Do Ethnic Elders Present Later to UK Dementia Services? A Qualitative Study[J]. Int Psychogeriatr, 2011,23(7):1070-1077. [30] 王伟, 谭淑慧, 张斌, 等. 加强基层医务工作者对痴呆的识别与诊治是中国痴呆防控的关键[J]. 中国全科医学, 2021,24(6):637-642. [31] Ortiz F, Fitten LJ.Barriers to Healthcare Access for Cognitively Impaired Older Hispanics[J]. Alzheimer Dis Assoc Disord, 2000,14(3):141-150. [32] Sayegh P, Knight BG.Cross-cultural Differences in Dementia: The Sociocultural Health Belief Model[J]. Int Psychogeriatr, 2013,25(4):517-530. |
[1] | 谢敏娟, 肖康娇, 杨腊梅, 王瑞, 李静芝, 梁云芳. 社区失能老人家庭照顾者主观幸福感现状及影响因素分析[J]. 护理学报, 2022, 29(9): 5-10. |
[2] | 罗爽, 尹华英, 雷莉, 王海梅. 父亲抑郁情绪和家庭功能在早产儿母亲抑郁情绪与母婴情感联结间的中介效应[J]. 护理学报, 2022, 29(9): 58-63. |
[3] | 张杰兰, 赖先婷, 余兆兰, 柯艾均, 徐铁飞, 鞠梅. 维持性血液透析患者配偶恐惧疾病进展的现状及影响因素分析[J]. 护理学报, 2022, 29(7): 17-22. |
[4] | 孙彩云, 林征, 周美景, 顾子君, 王咪, 顾珺怡, 朱展慧. 炎症性肠病患者疾病获益感现状及影响因素分析[J]. 护理学报, 2022, 29(6): 1-6. |
[5] | 陈羽双, 杨斯钰, 张叶霞. 2010-2019年基于PubMed数据库家庭参与式护理研究热点的共词聚类分析[J]. 护理学报, 2021, 28(9): 14-18. |
[6] | 李洁, 张斯秀, 徐翠荣. 以家庭为中心的护理对ICU患者家属满意度影响的研究进展[J]. 护理学报, 2021, 28(9): 19-21. |
[7] | 梁韵仪, 殷文君, 申乔乔, 周静静, 彭勇良, 高钰琳. 老化态度在老年人家庭功能与生命意义感的中介效应分析[J]. 护理学报, 2021, 28(8): 39-43. |
[8] | 刘鑫, 江锦芳, 覃彦珠, 周帅, 施洁, 刘彦君. 215例结直肠癌造口患者家庭主要照顾者照顾能力现状及影响因素分析[J]. 护理学报, 2021, 28(7): 53-58. |
[9] | 肖萍, 宋洁, 吴淑琳, 姜倩倩, 陈海雯, 刘霖. 护生接受痴呆教育干预的研究进展[J]. 护理学报, 2021, 28(7): 26-29. |
[10] | 欧阳雅琦, 谢鑑辉, 梅海波, 刘昆, 刘尧喜, 黄源. 364例先天性胫骨假关节患儿照顾者家庭抗逆力现状及影响因素分析[J]. 护理学报, 2021, 28(5): 1-5. |
[11] | 朱玮玮, 许阳子, 霍婉君, 陈慈玉, 李远添, 凌冬兰. 老年痴呆患者疼痛评估及管理最佳证据总结[J]. 护理学报, 2021, 28(5): 32-37. |
[12] | 施赵维, 张扬, 官常荣, 郑晓佳, 陈敏华. 2型糖尿病患者营养干预联合家庭主要成员烹饪实践教育[J]. 护理学报, 2021, 28(4): 73-76. |
[13] | 张珊珊, 李惠萍, 宋江艳, 周梦珂, 高杰, 李嘉欣. 乳腺癌患者家庭韧性评估量表的汉化及信效度研究[J]. 护理学报, 2021, 28(24): 1-5. |
[14] | 李博, 张倩倩, 李锋, 唐乃夫, 张利, 臧格, 贾慜, 娄小平. 425名急诊科护士工作投入现状及影响因素分析[J]. 护理学报, 2021, 28(23): 62-66. |
[15] | 滕慧艳, 成华艳. 创造性故事疗法在老年痴呆患者的应用研究进展[J]. 护理学报, 2021, 28(2): 28-30. |
|