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Hughes M, Hanna K, Wiles A, Taylor E, Giebel C. The experiences of caring for someone with dementia and a learning disability: A qualitative systematic review. DEMENTIA 2024; 23:817-849. [PMID: 38172089 PMCID: PMC11163849 DOI: 10.1177/14713012231225797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND The life expectancy of people with a learning disability is increasing and with this comes a greater risk of developing dementia. Dementia poses new challenges for both family and formal learning disability carers as they try to support dementia's progressive nature and quality of life for their care recipient. This qualitative systematic review explores the evidence base of family and formal carers' experiences and needs of caring for someone with both a learning disability and dementia. METHODS Six electronic databases (PubMed, PsycINFO, Cochrane Library, Prospero, Scopus, CINAHL), were searched in May 2022, utilising a predefined search strategy. Thirteen papers fulfilled inclusion criteria and were included in in the review. RESULTS Thematic synthesis was used to explore and synthesise the qualitative findings of the studies. Four conceptual themes were identified following analysis: Knowledge and skills, Accessing support, Repercussions of dementia for carers, Influences of continuity of caring role. CONCLUSION There are significant training and educational needs for all carers who support the dual diagnosis of dementia and learning disability. Differences between family and formal carers relate to the organisational support and process available to formal carers. Parity across services combined with sufficiently trained carers may support dementia diagnosis and improve quality of care provided. Further research is needed to address environmental, and economic barriers carers face to facilitate ageing in place for their care recipients.
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Affiliation(s)
- Michelle Hughes
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | - Kerry Hanna
- School of Health Sciences, University of Liverpool, UK
| | - Akpevwoghene Wiles
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | | | - Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, UK; NIHR Applied Research Collaboration North West Coast, UK
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Couples with intellectual disability where one partner has dementia – a scoping review exploring relationships in the context of dementia and intellectual disability. AGEING & SOCIETY 2023. [DOI: 10.1017/s0144686x22001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Abstract
Relationships and marriages between couples with intellectual disability are to be celebrated, as is the longer life expectancy now enjoyed by many with intellectual disability. However, dementia disproportionately affects people with intellectual disability, especially people with Down's syndrome. Research into experiences of couples without intellectual disability who are affected by dementia suggests that a relational perspective provides health and social care professionals with information to support the wellbeing of both partners. This dyadic perspective is missing for couples with an intellectual disability where one partner has dementia. There is currently no evidence base informing how each partner may best be supported. This scoping review, with three separate searches, aims to address this gap. The first search sought to establish if any studies had explored the experiences of couples with intellectual disability where one partner has dementia. After determining that no studies have been published to date, the review explores what is known about relationships in the context of dementia (N = 8) and in the context of intellectual disability (N = 10), in second and third searches. Different ways to approach care and support in relationships among partners, staff and other family members were identified and it was evident that support could act as a facilitator as well as a barrier to people and their relationships. While the lives of couples affected by dementia appeared to remain largely private, couples with intellectual disability had a high involvement of staff and family members in their life. Potential implications for future research with couples with intellectual disability affected by dementia are discussed, highlighting the importance of exploring how couples navigate emotional complexities and changes in their relationship, while understanding that the context in which the lives of people with intellectual disability take place and relationships happen is different.
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Nakanishi M, Yamasaki S, Ando S, Endo K, Richards M, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Neighborhood Social Cohesion and Dementia-Related Stigma Among Mothers of Adolescents in the Pre- and Current COVID-19 Period: An Observational Study Using Population-Based Cohort Data. J Alzheimers Dis 2022; 88:493-502. [DOI: 10.3233/jad-220043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Middle-aged adults may be the ideal target group for dementia-related stigma reduction interventions to encourage the utilization of services among those who may become family caregivers. Neighborhood social cohesion may diminish dementia-related stigma, particularly in terms of perceived public attitudes. The COVID-19 pandemic can further negatively impact perceived public stigma. Objective: To investigate the association between neighborhood social cohesion and dementia-related stigma during the pre- and current COVID-19 period. Methods: We employed a cross-sectional design using data from a large population-based cohort, the Tokyo Teen Cohort, in Japan. Overall, 2,469 mothers of 16-year-old adolescents self-completed a questionnaire comprising nine dementia-related stigma questions evaluating perceived public and personal attitudes. Neighborhood social cohesion was assessed using a five-item instrument. The participants were divided into two groups according to the time of assessment: prior to the pandemic’s onset (February 2019–March 2020) and during the pandemic (April 2020–July 2021). A multiple regression analysis of stigma was performed using neighborhood social cohesion as an independent variable, and caring experience, age, educational level, and working status as covariates. Results: Personal and perceived public stigma were significantly lower in participants who perceived greater neighborhood social cohesion. However, level of personal and perceived public stigma did not differ between pre- and during the pandemic period. Conclusion: Neighborhood social cohesion may be a modifiable factor for dementia-related stigma. A localized intervention to enhance social cohesion in the neighborhood community would promote the utilization of services among those who may become family caregivers.
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Affiliation(s)
- Miharu Nakanishi
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai-shi, Miyagi, Japan
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Syudo Yamasaki
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kaori Endo
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Hayama-machi, Kanagawa, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Atsushi Nishida
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
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Abstract
Despite its global importance and the recognition of dementia as an international public health priority, interventions to reduce stigma of dementia are a relatively new and emerging field. The purpose of this review was to synthesize the existing literature and identify key components of interventions to reduce stigma of dementia. We followed Arksey and O'Malley's scoping review process to examine peer-reviewed literature of interventions to reduce dementia-related stigma. A stigma-reduction framework was used for classifying the interventions: education (dispel myths with facts), contact (interact with people with dementia), mixed (education and contact), and protest (challenge negative attitudes). From the initial 732 references, 21 studies were identified for inclusion. We found a variety of education, contact, and mixed interventions ranging from culturally tailored films to intergenerational choirs. Findings from our review can inform the development of interventions to support policies, programs, and practices to reduce stigma and improve the quality of life for people with dementia.
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Frausing KP, Stamp AS. Making a difference: Students' experiences with a dementia care program. GERONTOLOGY & GERIATRICS EDUCATION 2021; 42:126-139. [PMID: 31442104 DOI: 10.1080/02701960.2019.1659256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
As the number of elderly citizens in general and the number of persons with dementia in particular rises, the importance of educating geriatric health care professionals increases. Recruitment is, however, impaired by negative stereotypes and insecurity. Previous research has shown that contact with the field of dementia care is important for students' motivation for choosing this career path. This paper presents an extracurricular psychomotor intervention program in which students through eight visits to elderly persons with dementia carry out an intervention involving direct individual contact. Eight psychomotor therapy students participated in follow-up focus group interviews. The purpose was to explore the motivational dynamics that make these experiences meaningful to students. Qualitative analysis of the students' self-assessed outcomes revealed three themes: The relational encounter, Discovering the person, and Making a difference. In combination these themes show important nuances to existing literature on student career dreams by pointing to the benefits of attending to the moment to moment changes in the care situation.
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Affiliation(s)
- Kristian Park Frausing
- VIA Psychomotor Therapy, Faculty of Health Sciences, VIA University College, Randers, Denmark
- VIA Ageing & Dementia, Center for research, Faculty of Health Sciences, VIA University College, Holstebro, Denmark
| | - Anne Schinkel Stamp
- VIA Psychomotor Therapy, Faculty of Health Sciences, VIA University College, Randers, Denmark
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Lion KM, Szcześniak D, Bulińska K, Mazurek J, Evans SB, Evans SC, Saibene FL, d'Arma A, Scorolli C, Farina E, Brooker D, Chattat R, Meiland FJM, Dröes RM, Rymaszewska J. Does the Meeting Centre Support Programme decrease the experience of stigmatisation among people with cognitive deficits? Aging Ment Health 2021; 25:160-169. [PMID: 31694389 DOI: 10.1080/13607863.2019.1683815] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This is the first study to focus on the role and impact of a psychosocial intervention, the Meeting Centre Support Programme (MCSP), for people living with dementia and mild cognitive impairment (MCI) on the experience of stigmatisation across three different European countries. METHOD A pre/post-test control group study design compared outcomes for 114 people with dementia (n=74) and MCI (n=40) in Italy, Poland and the UK who received either the MCSP or usual care (UC). The 'Stigma Impact Scale, neurological disease' (SIS) was administered at two points in time, 6 months apart. The Global Deterioration Scale (GDS) was used to assess the level of cognitive impairment. RESULTS Although statistical analysis did not show any significant differences between MCSP and UC at pre/post-test for the 3 countries combined, there were significant results for individual countries. In Italy, the level of SIS was significantly lower (p=0.02) in the MCSP group following the intervention. The level of Social Isolation increased significantly (p=0.05) in the UC group at follow-up in Poland. The level of Social Rejection was significantly higher (p=0.03) over time for UK participants receiving MCSP compared to UC. CONCLUSION The experience of stigma by people living with dementia and MCI is complex and there may be different country specific contexts and mechanisms. The results do not enable us to confirm or disconfirm the impact of a social support programme, such as MCSP, on this experience. Difficulties in directly measuring the level of stigma in this group also requires further research.
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Affiliation(s)
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Bulińska
- Department of Rehabilitation in Internal Diseases, Wroclaw University School of Physical Education, Wroclaw, Poland
| | - Justyna Mazurek
- Department and Division of Medical Rehabilitation, Wroclaw Medical University, Wrocław, Poland
| | - Shirley B Evans
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, UK
| | - Simon C Evans
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, UK
| | | | | | - Claudia Scorolli
- Department of Philosophy and Communication Studies, University of Bologna, Bologna, Italy
| | | | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, UK
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Franka J M Meiland
- Deptartment of Psychiatry, Amsterdam University Medical Centers, location VU University medical center, GGZ inGeest, Department of Research and Innovation, Amsterdam, the Netherlands
| | - Rose-Marie Dröes
- Deptartment of Psychiatry, Amsterdam University Medical Centers, location VU University medical center, GGZ inGeest, Department of Research and Innovation, Amsterdam, the Netherlands
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Pelegrini LNDC, Hall A, Hooper E, Oliveira D, Guerra F, Casemiro FG, Bonfadini J, Yong K, Pereira N, Costa R, Barbosa MT, Mioshi E. Challenges in public perception: highlights from the United Kingdom-Brazil Dementia Workshop. Dement Neuropsychol 2020; 14:209-215. [PMID: 32973974 PMCID: PMC7500815 DOI: 10.1590/1980-57642020dn14-030002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In July 2019, Belo Horizonte hosted an international workshop for 27 junior
researchers, whose participants were from Brazil and the United Kingdom. This
three-day meeting organized by the Universidade Federal de Minas Gerais and the
University of East Anglia addressed challenges in cognitive impairment and
dementia, with particular interest in public perceptions, diagnosis and care
management. The purpose of this report is to highlight the outcomes of the
above-mentioned workshop regarding the topic of public perceptions (part I).
Discussions focused on differences and similarities between countries, as well
as on identifying main issues that required collaborative and creative
solutions. After these group discussions, four core themes emerged: I) cognitive
impairment; II) dementia - beyond Alzheimer’s disease; III) prevention; and IV)
stigma. National and international initiatives to deal with public
misperceptions about cognitive impairment and dementia were discussed.
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Affiliation(s)
| | | | | | | | | | | | | | - Keir Yong
- University College London, United Kingdom
| | - Natalie Pereira
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
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Plunger P, Heimerl K, Tatzer VC, Zepke G, Finsterwald M, Pichler B, Reitinger E. Developing dementia-friendly pharmacies in Austria: a health promotion approach. Health Promot Int 2020; 35:702-713. [PMID: 31292603 DOI: 10.1093/heapro/daz063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The need for integrated, accessible and person-centred care for people with dementia to foster quality of life and facilitate life in the community has been voiced by health policy. Pharmacies have the potential to provide easily accessible information and support for people with dementia, caregivers and the public. The 'Dementia-friendly Pharmacy' programme aimed at re-orienting community pharmacy in Austria, focusing on stronger inclusion of professional counselling into core services. It followed principles of health promotion and person-centred care, aiming at empowering all actors involved, and at fostering quality of life. Methodologically, the programme was based on participatory health research, thus involving all relevant actors and consolidating their perspectives on issues related to dementia care. In the course of the programme, a workshop series covering topics relevant for dementia care in community pharmacy, as well as prototypes for small-scale projects were developed, and measures were taken for securing sustainability. Findings related to programme development and implementation encompass pharmacy staff's motivation to participate in the programme, counselling knowledge and skills development, experience with building community partnerships and cross-organizational development and sustainability. Furthermore, effectiveness of the programme has been established. These findings are discussed against the background of re-orienting pharmacies.
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Affiliation(s)
- Petra Plunger
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
| | - Katharina Heimerl
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
| | - Verena C Tatzer
- Department of Occupational Therapy, University of Applied Sciences Wiener Neustadt, Austria
| | | | | | - Barbara Pichler
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
| | - Elisabeth Reitinger
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
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Lion KM, Szcześniak D, Bulińska K, Evans SB, Evans SC, Saibene FL, d'Arma A, Farina E, Brooker DJ, Chattat R, Meiland FJM, Dröes RM, Rymaszewska J. Do people with dementia and mild cognitive impairments experience stigma? A cross-cultural investigation between Italy, Poland and the UK. Aging Ment Health 2020; 24:947-955. [PMID: 30789028 DOI: 10.1080/13607863.2019.1577799] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Until now little research has been done to answer the question of whether people with dementia experience stigma. No previous studies investigated possible differences between countries and cultures. Therefore, the aims of this study were to compare the experience of stigma (with social isolation, social rejection and internalised shame as components) among people with dementia and mild cognitive impairment (MCI) (n = 180) in Italy (n = 79), Poland (n = 47) and the United Kingdom (UK) (n = 54); and to investigate possible relationships with demographical and clinical outcomes.Methods: A one group multinational cross-sectional design was used. Stigma was measured with the Stigma Impact Scale (SIS), quality of life aspects with Dementia Quality of Life scale (DQOL) and Quality of Life Alzheimer's Disease scale (QOL-AD), social support with Duke Social Support Index (DSSI), cognitive functioning with Global Deterioration Scale (GDS).Results: The level of stigmatisation (SIS) among study participants varied from 2 to 65 (median = 33.5; Q1 = 27; Q3 = 41). People with dementia in the UK experienced a higher level of stigmatisation than people in Italy and Poland. The experienced stigmatisation negatively correlated with social support (DSSI; rho = -0.42, p = 0.000) and quality of life (QOL-AD; rho = -0.39, p = 0.000). People who experienced a higher level of stigmatisation scored higher in negative mood DQOL subscale (rho = 0.28, p = 0.0002).Conclusion: There is a strong need for research into the individual experience of people with dementia across the world. This could help in providing support and care services that match their experience, needs, preferences; and in designing well informed awareness campaigns based on their voice.
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Affiliation(s)
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Bulińska
- Department of Rehabilitation in Internal Diseases, Wroclaw University School of Physical Education, Wroclaw, Poland
| | | | - Simon C Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | | | | | | | - Dawn June Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Franka J M Meiland
- Department of Psychiatry, VU University Medical Center & Department of Research and Innovation, GGZ inGeest, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University Medical Center & Department of Research and Innovation, GGZ inGeest, Amsterdam, The Netherlands
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Dupin CM, Borglin G. Usability and application of a data integration technique (following the thread) for multi- and mixed methods research: A systematic review. Int J Nurs Stud 2020; 108:103608. [PMID: 32454297 DOI: 10.1016/j.ijnurstu.2020.103608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 04/08/2020] [Accepted: 04/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The scope of methodological development and innovation in multi- and mixed methods design is endless and, at times, challenging. The latter is especially true with regards to the integration of data generated through different methods. About a decade ago, Professor Jo Moran-Ellis and her colleagues at the University of Sussex suggested a framework for analytical integration known as "following a thread." Despite an increased focus within health services research on different perspectives and approaches to successful data integration, the framework's usability and application have not yet been well described. OBJECTIVES This systematic review aims to integrate and synthesise published accounts of the framework and its applications. DESIGN AND DATA SOURCES Seven electronic databases were utilised. Included were peer-reviewed scientific papers published in English from 2006 - 2018. The authors independently screened eligible publications by title and abstract. RESULTS Thirteen studies were included in our systematic review. One notable finding is that in almost half of the cases (n = 6), the framework had been applied as an analytical integration framework in single studies using multiple qualitative methods. Overall, the descriptions and accounts of the framework were sparse and lacked transparency. Accounts of the analytical integration framework could be said to fall within three overarching areas: (1) applications of the framework, (2) justifications for analytical integration, and (3) benefits and shortfalls of the framework. CONCLUSION Data integration is often one of the major method steps in multi- and mixed methods designs. To further the future development of methodologically sound frameworks for analytical integration, it is essential that they are sufficiently described so as to ensure validation of the framework's usability and replicability. "Following a thread" appears to be an promising analytical integration framework, particularly in that it can be applied with the same datatypes as well as between different types of data.
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Affiliation(s)
- C M Dupin
- Faculty of Medicine and Nursing Science, Aix Marseille Universite, Marseille, F-13000, France; Centre d'Études et de Recherche sur les Services de Santé et la Qualité de Vie, La Timone Medical Campus.
| | - G Borglin
- Department of Nursing Education, Lovisenberg Diaconal University College, 0456 Oslo, Norway
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Psychometric Properties of the Family Stigma in Alzheimer's Disease Scale in Greek Professional Caregivers. J Nurs Meas 2020; 28:259-282. [DOI: 10.1891/jnm-d-18-00113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and PurposesThe present study was undertaken in order to evaluate the validity and reliability of the Family Stigma in Alzheimer's Disease Scale (FS-ADS) in the Greek population.MethodsThe Greek version of the FS-ADS as well as the Maslach Burnout Inventory (MBI) was administered to 171 healthcare professional caring for people with dementia. Exploratory factor analysis was performed to examine the factor structure of the FS-ADS. Test–retest reliability was measured by administration of the FS-ADS in 20 individuals.ResultsPrincipal component analysis revealed 5, 8 and 3 factors (subscales) for each dimension of the original questionnaire, respectively, similar to other previously reported results in the literature. The overall Cronbach's α was .899, yielding a high internal consistency. Test–retest reliability was very high (r= 0.903,p< .001). Statistically significant relationships were found between most of the FS-ADS dimensions and Maslach subscales.ConclusionThe findings favor the use of FS-ADS in nurses and professional caregivers in general, for measuring stigma in dementia in Greece.
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Mantzorou M, Economou M, Kalokerinou A, Sourtzi P, Zyga S, Politis A, Koukia E. Exploration of the relationship between stigma and burnout among Greek nurses in dementia care. J Nurs Manag 2020; 28:615-624. [DOI: 10.1111/jonm.12964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Marina Economou
- Medical School National and Kapodistrian University of Athens Athens Greece
| | - Athena Kalokerinou
- Nursing Department National and Kapodistrian University of Athens Athens Greece
| | - Panayota Sourtzi
- Nursing Department National and Kapodistrian University of Athens Athens Greece
| | - Sofia Zyga
- Nursing Department University of Peloponnese Tripoli Greece
| | - Antonis Politis
- Medical School National and Kapodistrian University of Athens Athens Greece
| | - Evmorfia Koukia
- Nursing Department National and Kapodistrian University of Athens Athens Greece
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Abstract
Although community inclusion brings a number of advantages for vulnerable individuals, it can also entail a range of challenges, and draws in issues of safety and security. This qualitative psychological study, therefore, aimed to explore the challenges being faced by two groups of vulnerable individuals: those with intellectual disabilities and dementia, and how these could be addressed in order to establish a community that is safe and welcoming for all. Interviews and focus groups were conducted with a range of community stakeholders—for instance, local businesses, residents, and individuals with intellectual disabilities, dementia and their carers—and data was thematically analysed to explore the issue of inclusion and participation particularly in relation to stigma and prejudice, self-worth, social isolation and feeling safe. As well as highlighting practical issues regarding inclusion and support, the work emphasised the psychological dimension, linking to a multi-faceted conception of community participation. While significant work is already addressing issues of risk and safety for vulnerable populations (such as “Keep Safe” schemes), the work described here leads to an alternative conceptualization, tied to notions of kindness in communities with a view to crafting communities capable of safely welcoming a wider variety of marginalized groups.
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Abstract
The destigmatisation of dementia through awareness raising campaigns and associated activities has become a key pillar of dementia studies and related activism. This anti-stigma agenda is undermined by a poor evidence base and inadequate operationalisations of stigma. Scambler's distinction between felt stigma and enacted stigma provides a conceptual basis for improvement. Felt stigma encompasses negative self-appraisals and fears regarding the reactions of others, while enacted stigma describes active discriminatory behaviours. Awareness campaigns based around high-profile spokespeople and pathology-based models of dementia may effectively tackle enacted stigma, but they may also unintentionally exacerbate felt stigma. Distinguishing people with dementia as an exceptional group to elicit public sympathies promotes benevolent othering, unwittingly implying their negative otherness. This is problematic because felt stigma is typically more prevalent and deleterious to wellbeing than enacted stigma.
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Abstract
BACKGROUND Dementia in the elderly constitutes a growing challenge in healthcare worldwide, including Hungary. There is no previous report on the role of general practitioners in the management of dementia. AIM The purpose of the present study was to investigate the Hungarian general practitioners' attitude toward their patients living with dementia as well as dementia care. Our goal was also to assess their willingness and habits in assessing dementia. Additionally we wanted to explore the role of education about dementia, and its impact on their attitude in dementia management. METHODS As part of a large survey, a self-administered questionnaire was filled out voluntarily by 402 of general practitioners. According to our preset criteria, 277 surveys were selected for evaluation. Descriptive statistical analysis and Likert-scale analysis were performed. FINDINGS Half of the doctors (49.8%) indicated that they conducted a test to assess cognitive functions in case of suspicion. Among the respondents who did not assess, 50.0% of physicians cited lack of time as the main reason for not doing so and 14.4% of them had not proper knowledge of testing methods. The respondents most often mentioned feelings toward their patients with dementia, were regret (Likert-scale mean: 3.33), helplessness (3.28) and sadness (3.07). The majority of physicians thought the treatment of dementia was difficult (4.46). Most of the respondents (81.2%) indicated that in the past 2 years they had not participated in any training about dementia. Those practitioners who had participated in some form of education were less likely to feel helpless facing a patient with dementia, and education also determined their approach to dementia care.
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Young JA, Lind C, Orange J, Savundranayagam MY. Expanding current understandings of epistemic injustice and dementia: Learning from stigma theory. J Aging Stud 2019; 48:76-84. [DOI: 10.1016/j.jaging.2019.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/17/2019] [Accepted: 01/19/2019] [Indexed: 11/30/2022]
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Heap CJ, Wolverson E. Intensive Interaction and discourses of personhood: A focus group study with dementia caregivers. DEMENTIA 2018; 19:2018-2037. [PMID: 30514117 DOI: 10.1177/1471301218814389] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Societal discourses of dementia are medicalised and dehumanising. This leads to a social problem: the loss of personhood in dementia care. The communication technique Intensive Interaction, however, honours personhood. The current study aimed to explore how paid caregivers of people with dementia enact societal discourses of dementia, with and without the context of Intensive Interaction. This was to explore ways to address the loss of personhood in dementia care. METHOD Paid caregivers from two residential care homes attended an Intensive Interaction training day. Caregivers participated in focus groups before and after training. Transcripts of the focus groups were analysed with Critical Discourse Analysis, an approach which relates discourse to social power. RESULTS Before Intensive Interaction training, carers accessed medical discourses of loss, non-communication and lack of personhood. 'Being with' people with dementia was framed as separate to paid work. After training, caregivers accessed discourses of communication and personhood. Intensive Interaction reframed 'being with' people with dementia as part of 'doing work'. Family caregivers were largely absent from discourses. Care home hierarchies and the industrialisation of care were barriers towards honouring personhood. CONCLUSIONS Medical discourses of dementia reinforce a status quo whereby interpersonal interactions are devalued in dementia care, and professional 'knowledge' (thereby professional power) is privileged over relationships. Intensive Interaction may enable paid caregivers to access person-centred discourses and related practices. However, this requires support from management, organisational structures, and wider society. More research is needed to identify ways to involve families in residential care and to explore the effects of using Intensive Interaction in practice.
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Affiliation(s)
- Cheyann J Heap
- Harrogate and District Community Team for Learning Disabilities, Knaresborough, UK
| | - Emma Wolverson
- School of Health and Social Work, University of Hull, Hull, UK
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19
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Do mentalization skills affect the perception of stigma in patients with epilepsy? Epilepsy Behav 2018; 88:49-53. [PMID: 30241053 DOI: 10.1016/j.yebeh.2018.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE We aimed to study the relationship between the mentalizing ability and stigma in patients with epilepsy. METHODS Patients with epilepsy were administered the following battery of tests: Mini-International Neuropsychiatric Interview (MINI) form, Reading the Mind in the Eyes Test (Eyes Test), Stigma Scale of Epilepsy (SSE), Internalized Stigma of Mental Illness (ISMI) Scale, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS Assessment of an association between the Eyes Test score, ISMI Scale total score, and subscale scores revealed a negative significant correlation of Eyes Test scores with approval of stereotypes, perceived discrimination, stigma resistance, and total score. Eyes Test score and BDI scores appears to be significant predictor of internalized stigma among the clinical variables that were studied. A positive significant correlation was detected between BDI score and alienation, perceived discrimination, and total score. CONCLUSION The presence of a correlation between the mentalization and stigma perception in our study demonstrates that these two concepts are connected and that this connection needs further study. In particular, mentalization-based therapy can have an effect on the reduction of the stigma perceptions and in this way can improve the course of the disease, potentially improving the patients' quality of life.
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Dementia at the End of Life and Family Partners: A Symbolic Interactionist Perspective on Communication. Behav Sci (Basel) 2017; 7:bs7030042. [PMID: 28698488 PMCID: PMC5618050 DOI: 10.3390/bs7030042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 11/30/2022] Open
Abstract
People with dementia are not dying; they are experiencing changes in the brain. This paper utilizes a symbolic interaction theoretical perspective to outline communicative alternatives to polypharmacy. There is a growing interest in sociological interventions to untangle the “disordered discourses” associated with dementia. Such practices challenge common stigmas attached to dementia as an “ongoing funeral” or “death certificate.” Changing the expectations, attitudes and communication patterns of family care partners can positively impact them and the person living with dementia at the end of life. This paper delineates multiple non-verbal communication interventions (e.g., the trip back in time, dementia citizenship and sensory engagement modalities) to explore techniques to engage persons with advanced dementia.
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21
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de Witt L, Fortune D. Relationship-Centered Dementia Care: Insights from a Community-Based Culture Change Coalition. DEMENTIA 2017; 18:1146-1165. [DOI: 10.1177/1471301217708814] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Darla Fortune
- Department of Applied Human Sciences, Concordia University, Canada
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22
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Apostolova I, Lange C, Roberts A, Igel HJ, Mäurer A, Liese S, Estrella M, Prasad V, Stechl E, Lämmler G, Steinhagen-Thiessen E, Buchert R. Challenges in Screening and Recruitment for a Neuroimaging Study in Cognitively Impaired Geriatric Inpatients. J Alzheimers Dis 2017; 56:197-204. [PMID: 27911313 DOI: 10.3233/jad-160797] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ivayla Apostolova
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Catharina Lange
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Roberts
- Evangelisches Geriatriezentrum Berlin, Berlin, Germany
| | | | - Anja Mäurer
- Evangelisches Geriatriezentrum Berlin, Berlin, Germany
| | | | - Melanie Estrella
- Geriatric Research Group, Department of Geriatric Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Vikas Prasad
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | - Ralph Buchert
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Gerritsen DL, Oyebode J, Gove D. Ethical implications of the perception and portrayal of dementia. DEMENTIA 2016; 17:596-608. [PMID: 27288459 DOI: 10.1177/1471301216654036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The way we perceive and portray dementia has implications for how we act towards people with dementia and how we address the issue of dementia within society. As a multi-disciplinary working group, established within the framework of the European Dementia Ethics Network of Alzheimer Europe, we aimed to describe the different ways that people with dementia are perceived and portrayed within society and to consider the moral implications of this. In the current paper, we address perceptions of dementia as reflected in explanatory models of its cause and nature, descriptions of characteristics of people with dementia, the use of language, media portrayals and the views of people living with dementia. Academics and professionals could use this exploration to reflect on their behaviour and their use of language regarding people with dementia.
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Affiliation(s)
- Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Centre Nijmegen; Radboudumc Alzheimer Centre; Joachim en Anna, centre for specialized geriatric care, Nijmegen, the Netherlands
| | - Jan Oyebode
- School of Dementia Studies, University of Bradford, Bradford, BD7 1DP, UK
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