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Vignolo J, Jacus JP, Darnaud T, Cuervo-Lombard CV. [Conscience des déficits dans le cadre de la maladie d'Alzheimer : représentations et vécu des professionnels soignants]. Can J Aging 2024:1-8. [PMID: 38449386 DOI: 10.1017/s0714980824000096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
La qualité des soins apportés aux personnes vivant avec la maladie d'Alzheimer (MA) dépend en partie de la capacité des professionnels à déterminer le degré de conscience de la maladie chez les patients. La présente recherche s'est intéressée aux représentations des soignants concernant la conscience des troubles chez les résidents d'établissements de soins de longue durée présentant un diagnostic de MA. Le pouvoir prédicteur de l'anosognosie sur le fardeau soignant a également été examiné. L'anosognosie des troubles de la construction (r = 0,40, p = 0,0164) et de l'initiation (r = 0,32, p = 0,052) était corrélée au fardeau soignant. Les professionnels se représentaient les résidents comme ayant une conscience altérée de leurs capacités, même en l'absence d'anosognosie. Les scores réels d'anosognosie ne prédisaient pas les estimations soignantes, hormis le score global sous forme de tendance (χ2 = 3,38, p = 0,066). Les soignants surestimaient pourtant les performances cognitives des résidents, telles que mesurées au moyen du protocole Misawareness (prédictions aidants/performances réelles : DC = 12,32, p < 0,0001).
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Affiliation(s)
- Julie Vignolo
- Master 2 en Psychologie Clinique et Gérontologie. LCPI : Laboratoire Cliniques Psychopathologique et Interculturelle EA4591, Université Toulouse 2 Jean-Jaurès, 5 Allée Antonio Machado, 31058, Toulouse, France
| | - Jean-Pierre Jacus
- Doctorat. LCPI : Laboratoire Cliniques Psychopathologique et Interculturelle EA4591, Université Toulouse 2 Jean-Jaurès, 5 Allée Antonio Machado, 31058, Toulouse, France
| | - Thierry Darnaud
- HDR. LCPI : Laboratoire Cliniques Psychopathologique et Interculturelle EA4591, Université Toulouse 2 Jean-Jaurès, 5 Allée Antonio Machado, 31058, Toulouse, France
| | - Christine Vanessa Cuervo-Lombard
- HDR. CERPPS : Centre d'Études et de Recherche en Psychopathologie et Psychologie de la Santé EA7411, Université Toulouse 2 Jean-Jaurès, Allée Antonio Machado, 31058, Toulouse, France
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2
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Gurtmann S, Schwahn C, Krüger M, Janowitz D, Pilz K, Biffar R, Grabe HJ, Söhnel A. Proposing a communication module to enhance dental students' attitudes towards people with dementia: Phase 1 of a curriculum revision study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:251-258. [PMID: 37550952 DOI: 10.1111/eje.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/17/2023] [Accepted: 07/08/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION The number of mentally altered patients a dentist meets in practice is increasing and interaction with them can be very challenging. As a baseline for an interventional study, we want to assess the attitude of dental students and identify areas of improvement in patient communication. This work compares the attitude of dental students towards people suffering from dementia to the attitudes of trained medical caregivers and the general population. Our aim is to use the results to assess the need for training in communicating with mentally altered patients. MATERIALS AND METHODS Fourth-year dental students attended two lectures on dementia given by a psychiatrist as part of the geriatric dentistry lecture and were questioned afterwards using the Dementia Attitude Scale. In 2016 and 2017, 73 students at the University of Greifswald were interviewed. The response rate was 84%. Using a factor analysis, the Dementia Attitude Scale's validated questions were interpreted and compared with data from nursing staff from Switzerland and the USA. RESULTS The factor analysis of the data showed the same two-factor loadings as the comparative groups, and that dental students' attitude is more comparable to the general population than to medically trained nursing staff. CONCLUSION Given the results, we conclude that the implementation of a communication module can serve in improving the attitude of dental students towards patients with dementia.
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Affiliation(s)
- Sonja Gurtmann
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Markus Krüger
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Kristin Pilz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Reiner Biffar
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Hans-J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Andreas Söhnel
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
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Ross JP, Post SG, Scheinfeld L. Lucidity in the Deeply Forgetful: A Scoping Review. J Alzheimers Dis 2024; 98:3-11. [PMID: 38339937 DOI: 10.3233/jad-231396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Background Even in severe states of Alzheimer's disease and related dementias (ADRD), accounts of an unexpected or paradoxical return of awareness and lucidity have been reported in some patients, documented formally, and studied. Objective A scoping review was undertaken to survey the literature on the topic. Methods Five databases were searched using pertinent search terms. Results were deduplicated and subsequently screened by title and abstract for relevance. Remaining reports were read and included or excluded using specific inclusion criteria. 30 results consisted of a mix of perspective papers, case reports, qualitative surveys of caregivers, law journal comments, and mechanistic speculation. Results An equal mix of primary and secondary research was identified. Conclusions The papers collected in this review provide a valuable methodological outline for researching the topic of lucid episodes in ADRD. The verified legitimacy and simultaneous inexplicability of these events promote philosophical discussion, mechanistic investigations, and sorely needed research in the field of ADRD.
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Affiliation(s)
- John Paul Ross
- Department of Family, Population and Preventive Medicine, Center for Medical Humanities, Compassionate Care and Bioethics, Renaissance School of Medicine at SUNY Stony Brook, Stony Brook, NY, USA
| | - Stephen G Post
- Department of Family, Population and Preventive Medicine, Center for Medical Humanities, Compassionate Care and Bioethics, Renaissance School of Medicine at SUNY Stony Brook, Stony Brook, NY, USA
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White LW, Dawson N, Saale BP, Lemley T. Physical Therapists' and Physical Therapist Students' Experiences and Views on the Provision of Physical Therapy Services to People With Dementia: A Scoping Review. J Geriatr Phys Ther 2022:00139143-990000000-00002. [PMID: 35420572 DOI: 10.1519/jpt.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Physical therapists (PTs) require specialized education and training to increase the capacity and competence of the dementia care workforce. Four areas of critical dementia workforce education and training gaps that apply to the physical therapy profession have been identified, including recruitment/retention, financing and cost of training, interprofessional education, and translation/implementation of effective dementia care. A critical step in developing effective training programs and educational curricula is to understand PTs' and PT students' experiences and views on working with people with dementia (PwD). Therefore, the purpose of this scoping review was to examine the extent and types of evidence that explore the experiences and views of PTs and PT students on the provision of physical therapy services to PwD. METHODS The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, ERIC, PEDro, Web of Science, and Medline databases and sources of gray literature were searched for sources of evidence that met the inclusion criteria of the review protocol. The literature was mapped according to author, participant role, setting, publication type, study design, study aim, key findings, and dementia workforce training gaps addressed. RESULTS AND DISCUSSION A total of 552 sources of evidence were screened for eligibility, and 16 studies were selected for inclusion. Twelve studies included PTs as participants, and 5 included PT students. Included sources explored PTs' experiences, behaviors, knowledge, attitudes, and confidence in working with PwD and the influence of educational, organizational, and other factors on these domains. Challenges to and strategies for delivering effective care to PwD were examined in multiple sources. The 4 areas of critical dementia workforce education and training gaps were each addressed by at least 1 of the included studies. CONCLUSIONS The current body of literature identifies several gaps in both research and education that need to be addressed before our profession is truly prepared to effectively manage this challenging population of patients with specialized needs.
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Affiliation(s)
- Laura W White
- Department of Physical Therapy, University of South Alabama, Mobile
| | - Nicole Dawson
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando
| | - Blair P Saale
- Department of Physical Therapy, University of South Alabama, Mobile
| | - Trey Lemley
- Biomedical Library, University of South Alabama, Mobile
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Wang J, Cui J, Tu S, Yang R, Zhao L. Resilience and caregiving ability among caregivers of people with stroke: The mediating role of uncertainty in illness. Front Psychiatry 2022; 13:788737. [PMID: 36483138 PMCID: PMC9723154 DOI: 10.3389/fpsyt.2022.788737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In China, stroke survivors are usually cared for by their family members. However, the caregiving ability of these informal caregivers remain inadequate during the hospitalization of their family members following a sudden onset of a stroke, and this sudden need for care overwhelms caregivers even after the hospital discharge. Therefore, research is required to identify predictors of caregiving ability that could be targeted in future interventions aimed at improving caregiving skills and reducing the burden on caregivers who care for stroke survivors. MATERIALS AND METHODS From August 2019 to February 2020, stroke survivors were hospitalized for the first time, and their family caregivers were registered via convenience sampling. Caregiver demographic information, resilience status, uncertainty in illness, caregiving ability, and patients' severity of stroke were measured using standardized questionnaires. Structural equation modeling was used to test the proposed model, where caregiver resilience and stroke severity predicted caregiving ability directly, and uncertainty in illness mediated the association between caregiver resilience and caregiving ability. RESULTS A total of 306 dyads were included in the study. The tested model fit the data well (χ2 = 118.2, df = 64, RMSEA = 0.053, CFI = 0.946, TLI = 0.923). Statistically significant pathways linked caregivers' resilience status to uncertainty in illness (β = -0.558, S.E. = 0.022, P < 0.01), caregivers' resilience to the status of caregiving ability (β = -0.269, S.E. = 0.013, P < 0.01) and caregivers' uncertainty about the illness to caregiving ability (β = 0.687, S.E. = 0.051, P < 0.01). We also found that caregivers' uncertainty in illness mediated the association between caregivers' resilience and caregiving ability (β = -0.384, S.E. = 0.061, P < 0.01). CONCLUSIONS Our structural equation modeling result identified resilience and uncertainty about the illness as predictors of the caregiving ability of informal family caregivers who suffered from care burdens. Supporting family caregivers to build their resilience and reduce illness uncertainty may improve caregiving for stroke survivors.
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Affiliation(s)
- Jinyao Wang
- West China School of Nursing, Sichuan University, Chengdu, China.,Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Cui
- West China Hospital, Sichuan University, Chengdu, China
| | - Shuangyan Tu
- West China School of Nursing, Sichuan University, Chengdu, China.,Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Yang
- West China Hospital, Sichuan University, Chengdu, China
| | - Lihong Zhao
- West China School of Nursing, Sichuan University, Chengdu, China.,Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Tan LF, Ho Wei Fen S. Comment on: Referral criteria to specialist palliative care for patients with dementia: A systematic review. J Am Geriatr Soc 2021; 69:2037-2038. [PMID: 33939834 DOI: 10.1111/jgs.17197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 01/06/2023]
Affiliation(s)
- Li Feng Tan
- Division of Healthy Ageing, Alexandra Hospital, Singapore
| | - Sara Ho Wei Fen
- Department of Medicine, National University Hospital, Singapore
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Morris P, Bulman D. Reply: The Importance of Conceptualizing and Defining Episodes of Lucidity. J Gerontol Nurs 2021; 47:6. [PMID: 34038254 DOI: 10.3928/00989134-20210309-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Patricia Morris
- Department of Nursing and Health Sciences University of New Brunswick, RN Horizon Health Network, Ridgewood Veterans Hospital Saint John, New Brunswick, Canada
| | - Donna Bulman
- University of New Brunswick Fredericton, New Brunswick, Canada
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Montiel-Aponte MC, Bertolucci PHF. Do you look for information about dementia? Knowledge of cognitive impairment in older people among their relatives. Dement Neuropsychol 2021; 15:248-255. [PMID: 34345367 PMCID: PMC8283879 DOI: 10.1590/1980-57642021dn15-020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/09/2021] [Indexed: 11/24/2022] Open
Abstract
Relatives and caregivers receive little information and have poor knowledge about cognitive impairment and dementia.
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Affiliation(s)
- Mariel Carolina Montiel-Aponte
- Postgraduate Program in Neurology and Neurosciences, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo, SP, Brazil
| | - Paulo Henrique Ferreira Bertolucci
- Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo, SP, Brazil.,Behavioral Neurology Outpatient Clinic, Hospital São Paulo - São Paulo, SP, Brazil
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Huntley JD, Fleming SM, Mograbi DC, Bor D, Naci L, Owen AM, Howard R. Understanding Alzheimer's disease as a disorder of consciousness. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12203. [PMID: 34877398 PMCID: PMC8630359 DOI: 10.1002/trc2.12203] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/28/2021] [Accepted: 07/28/2021] [Indexed: 11/07/2022]
Abstract
People with Alzheimer's disease (AD) demonstrate a range of alterations in consciousness. Changes in awareness of cognitive deficit, self-awareness, and introspection are seen early in AD, and dysfunction of awareness and arousal progresses with increasing disease severity. However, heterogeneity of deficits between individuals and a lack of empirical studies in people with severe dementia highlight the importance of identifying and applying biomarkers of awareness in AD. Impairments of awareness in AD are associated with neuropathology in regions that overlap with proposed neural correlates of consciousness. Recent developments in consciousness science provide theoretical frameworks and experimental approaches to help further understand the conscious experience of people with AD. Recognition of AD as a disorder of consciousness is overdue, and important to both understand the lived experience of people with AD and to improve care.
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Affiliation(s)
- Jonathan D. Huntley
- Division of PsychiatryUniversity College LondonLondonUK
- Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUK
| | - Stephen M. Fleming
- Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUK
- Department of Experimental PsychologyUniversity College LondonLondonUK
- Max Planck‐UCL Centre for Computational Psychiatry and Ageing ResearchUniversity College LondonLondonUK
| | - Daniel C. Mograbi
- Department of PsychologyPontifical Catholic University of Rio de JaneiroRio de JaneiroBrazil
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Daniel Bor
- Department of PsychologyUniversity of CambridgeCambridgeUK
| | - Lorina Naci
- School of PsychologyGlobal Brain Health InstituteTrinity College DublinDublinIreland
| | - Adrian M. Owen
- Brain and Mind InstituteDepartment of Physiology and Pharmacology and Department of PsychologyUniversity of Western OntarioLondonOntarioCanada
| | - Robert Howard
- Division of PsychiatryUniversity College LondonLondonUK
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Ho HC, Fong KNK, Chan TC, Shi Y. The associations between social, built and geophysical environment and age-specific dementia mortality among older adults in a high-density Asian city. Int J Health Geogr 2020; 19:53. [PMID: 33276778 PMCID: PMC7716506 DOI: 10.1186/s12942-020-00252-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/25/2020] [Indexed: 12/26/2022] Open
Abstract
Background Although socio-environmental factors which may affect dementia have widely been studied, the mortality of dementia and socio-environmental relationships among older adults have seldom been discussed. Method A retrospective, observational study based on territory-wide register-based data was conducted to evaluate the relationships of four individual-level social measures, two community-level social measures, six short-term (temporally varying) environmental measures, and four long-term (spatially varying) environmental measures with dementia mortality among older adults in a high-density Asian city (Hong Kong), for the following decedents: (1) all deaths: age >= 65, (2) “old-old”: age > = 85, (3) “mid-old”: aged 75–84, and (4) “young-old”: aged 65–74. Results This study identified 5438 deaths (3771 old-old; 1439 mid-old; 228 young-old) from dementia out of 228,600 all-cause deaths among older adults in Hong Kong between 2007 and 2014. Generally, regional air pollution, being unmarried or female, older age, and daily O3 were associated with higher dementia mortality, while more urban compactness and greenness were linked to lower dementia mortality among older adults. Specifically, being unmarried and the age effect were associated with higher dementia mortality among the “old-old”, “mid-old” and “young-old”. Regional air pollution was linked to increased dementia mortality, while urban compactness and greenness were associated with lower dementia mortality among the “old-old” and “mid-old”. Higher daily O3 had higher dementia mortality, while districts with a greater percentage of residents whose native language is not Cantonese were linked to lower dementia mortality among the “old-old”. Economic inactivity was associated with increased dementia mortality among the “young-old”. Gender effect varied by age. Conclusion The difference in strengths of association of various factors with dementia mortality among different age groups implies the need for a comprehensive framework for community health planning. In particular, strategies for air quality control, usage of greenspace and social space, and activity engagement to reduce vulnerability at all ages are warranted.
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Affiliation(s)
- Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China.
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.
| | - Yuan Shi
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China
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Morris P, Bulman D. Lucidity in the Context of Advanced Neurodegenerative Disorders: A Concept Analysis. J Gerontol Nurs 2020; 46:42-50. [DOI: 10.3928/00989134-20201106-06] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022]
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Mayelle A, El Haj M, Antoine P. Awareness of Self and Disease Assessment: Development and Validation of a Subjective Measure in People with Alzheimer’s Disease. J Alzheimers Dis 2019; 71:841-850. [DOI: 10.3233/jad-190371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Amandine Mayelle
- Univ. Lille, CNRS, CHU Lille, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Mohamad El Haj
- Univ. Nantes, EA 4638 – LPPL – Laboratoire de Psychologie des Pays de la Loire, Nantes, France
- Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France
- Institut Universitaire de France, Paris, France
| | - Pascal Antoine
- Univ. Lille, CNRS, CHU Lille, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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