了解路易体痴呆症患者认知波动和睡眠障碍的性质和影响:护理人员定性研究。

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL SAGE Open Medicine Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.1177/20503121241271827
Ellie Matterson, Gemma Wilson-Menzfeld, Kirsty Olsen, John-Paul Taylor, Greg J Elder
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引用次数: 0

摘要

目的:路易体痴呆的特点是注意力快速波动,即所谓的 "认知波动"。尽管认知波动被认为是路易体痴呆症的核心症状,但使用现有的定量主观测量工具很难对其进行定义和测量,这些工具通常由护理人员完成。认知波动还可能受到睡眠各方面的影响,但这一点尚未得到探讨。这项定性研究的主要目的是通过了解照护者的经验,调查路易体痴呆症患者认知波动的现象学:七位路易体痴呆症患者的照顾者通过电话完成了一对一的半结构化访谈。我们要求照顾者描述路易体痴呆症患者认知波动的性质、频率、持续时间和潜在诱因。护理人员还被问及路易体痴呆症患者的主观睡眠体验以及他们自己的睡眠体验。对访谈进行了录音、逐字记录并使用主题分析法进行了分析:护理人员报告说,认知波动的频率、持续时间和严重程度存在很大的个体差异。患者的睡眠障碍,包括白天过度嗜睡、夜间觉醒、双腿不宁和睡眠呼吸暂停,也很常见。然而,据报告,睡眠改变或睡眠经历对波动的影响并不明显。护理人员还报告说,他们自己的睡眠也受到了负面影响,这可能是由于积极倾听夜间事件和行为造成的:定性分析显示,照护者认为路易体痴呆症患者的认知波动在频率、持续时间和严重程度上存在很大的个体差异,但从主观上看,睡眠可能不会持续影响这一症状。要保持路易体痴呆症照护者良好的睡眠健康,有必要采取以照护者为中心的具体干预措施。
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Understanding the nature and impact of cognitive fluctuations and sleep disturbances in dementia with Lewy bodies: A qualitative caregiver study.

Objectives: Dementia with Lewy bodies is characterised by rapid fluctuations in attention, which are known as "cognitive fluctuations." Despite the fact that cognitive fluctuations are considered to be a core dementia with Lewy bodies symptom, they are very difficult to define and measure using existing quantitative subjective measurement tools, which are typically completed by caregivers. Cognitive fluctuations are also likely to be influenced by various aspects of sleep, but this is as yet unexplored. The primary aim of this qualitative study was to investigate the phenomenology of cognitive fluctuations in dementia with Lewy bodies by understanding caregiver experiences.

Methods: Seven caregivers of people with dementia with Lewy bodies completed one-to-one semistructured interviews, which were conducted by telephone. Caregivers were asked to describe the nature, frequency, duration and potential triggers of cognitive fluctuations that were experienced by the individual with dementia with Lewy bodies. Caregivers were also asked about the subjective sleep experience of the individual with dementia with Lewy bodies, and about their own sleep experiences. Interviews were audio recorded, transcribed verbatim and analysed using Thematic Analysis.

Results: Caregivers reported that there was a great deal of individual variation in the frequency, duration and severity of cognitive fluctuations. Patient sleep disturbances, including excessive daytime sleepiness, nocturnal awakenings, restless legs and sleep apnoea, were common. However, the impact of sleep alterations or experiences upon the fluctuations was reported to be less clear. Caregivers also reported that their own sleep was negatively affected, potentially due to actively listening for overnight events and behaviours.

Conclusions: Qualitatively, caregivers report that dementia with Lewy bodies cognitive fluctuations show large individual variations in terms of their frequency, duration and severity, but that subjectively, sleep may not consistently influence this symptom. Specific, caregiver-focussed interventions are likely to be necessary to maintain good sleep health in dementia with Lewy bodies caregivers.

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来源期刊
SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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