" I'm not a risk taker " : Risk Perceptions of Nursing Home Residents With Dementia.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY Alzheimer Disease & Associated Disorders Pub Date : 2024-04-01 Epub Date: 2024-04-23 DOI:10.1097/WAD.0000000000000616

Liza L Behrens, Hannah L Anderson, Kaléi H Kowalchik, Jacqueline Mogle, Joanne Roman Jones, Kimberly Van Haitsma, Nancy Hodgson, Marie Boltz

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Abstract

Background: Persons living with Alzheimer disease and related dementia (ADRD) in nursing homes (NH) are often excluded from conversations about their health/safety. These omissions impinge on personhood and the rights to have care preferences heard and honored. While persons with ADRD maintain the ability to communicate their preferences long after their decision-making abilities are affected, little is known about how persons with ADRD understand the risks associated with their preferences.

Methods: As part of a larger focused ethnography, in-depth interviews and an adapted risk propensity questionnaire explored the risk perceptions of NH residents with ADRD (N=7) associated with their preferences for care and activities of daily living.

Results: Residents generally self-identified as risk avoiders ( M =3.2±1.84) on the risk propensity scale and were able to rate risk associated with preferences described within 5 thematic categories: 1) participation in decision-making, 2) risk awareness, 3) paying attention to safety, 4) reliance on nursing home staff and family, and 5) impacts on quality of life and quality of care.

Discussion: Results suggest NH residents with ADRD can express risk surrounding their preferences and should be encouraged to participate in discussions about their health and safety.

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"我不喜欢冒险"：养老院痴呆症患者的风险意识。

背景：养老院（NH）中的阿尔茨海默氏症及相关痴呆症（ADRD）患者常常被排除在有关其健康/安全的对话之外。这些疏忽影响了他们的人格，也影响了他们倾听和尊重护理偏好的权利。虽然 ADRD 患者在其决策能力受到影响后仍能长期保持表达其偏好的能力，但人们对 ADRD 患者如何理解与其偏好相关的风险却知之甚少：作为大型重点人种学研究的一部分，深入访谈和改编的风险倾向问卷调查了患有 ADRD 的 NH 居民（N=7）对与其护理和日常生活活动偏好相关的风险认知：结果：在风险倾向量表上，居民普遍自我认同为风险规避者（M=3.2±1.84），并能对与 5 个主题类别中描述的偏好相关的风险进行评级：1) 参与决策；2) 风险意识；3) 注意安全；4) 依赖养老院工作人员和家人；5) 对生活质量和护理质量的影响：讨论：研究结果表明，患有 ADRD 的 NH 院友可以表达围绕其偏好的风险，应鼓励他们参与有关其健康和安全的讨论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer Disease & Associated Disorders 医学-病理学

CiteScore

3.10

自引率

4.80%

发文量

期刊介绍： Alzheimer Disease & Associated Disorders is a peer-reviewed, multidisciplinary journal directed to an audience of clinicians and researchers, with primary emphasis on Alzheimer disease and associated disorders. The journal publishes original articles emphasizing research in humans including epidemiologic studies, clinical trials and experimental studies, studies of diagnosis and biomarkers, as well as research on the health of persons with dementia and their caregivers. The scientific portion of the journal is augmented by reviews of the current literature, concepts, conjectures, and hypotheses in dementia, brief reports, and letters to the editor.