Characteristics and Underlying Meaning of Hoarding Behavior in Elders with Alzheimer's Dementia: Caregivers' Perspective

從照顧者角度探討阿茲海默氏症失智老人的藏匿行為之構成要素與背後意義

10.1097/JNR.0b013e3182656132

王靜枝(Jing-Jy Wang)；Karen Feldt；張文芸(Wen-Yun Cheng)

阿茲海默氏症 ； 失智 ； 藏匿／囤積行為 ； 安全感需求 ； Alzheimer's disease ； dementia ； hoarding behavior ； security needs ； elders ； caregivers

The Journal of Nursing Research

20卷3期（2012 / 09 / 01）

189 - 196

英文

背景　失智症及其相關問題行為一直以來困擾著家庭照顧者與專業照顧者。探討患者干擾行為的構成要素與背後代表意義，可為提供以患者為中心照護的第一步。雖然藏匿／囤積行為看似不具立即傷害性，若忽略之，過度的藏匿／囤積對患者本身與照護者的健康與安全仍是有威脅的。目的　本研究的目的是從家屬照顧者的角度，探討阿茲海默型失智老人藏匿／囤積行為的構成要素與背後代表意義。方法　本研究採質性探索性研究設計，以立意取樣方式，深度訪談12位阿茲海默型失智老人的家庭照顧者，並以內容分析法分析資料。結果　資料分析出三項影響藏匿／囤積行為的構成要素概念，含過去與現在症狀的影響、內在個性習慣的再現、過去經濟危機感的重現。這些概念代表除患者目前生活情境外，其過去社會與家庭背景也強烈影響該行為。而藏匿／囤積行為的背後意義代表著患者對安全感的企求。討論　本研究結果可提供家庭或專業照顧者對失智相關問題行為之瞭解，提升照顧者對患者行為的瞭解能增進其彼此的互動與溝通。如此一來，照顧者較能找到滿足患者需求之門路。

Background: Dementia and its associated problem behaviors remain bothersome to family and professional caregivers. Exploring characteristics and the underlying meaning of disruptive behaviors in elders with Alzheimer's dementia can be a first step to pursuing patient-centered care. Although hoarding is relatively harmless, unattended excessive hoarding can create health and safety issues for both patients and caregivers.Purpose: This study examined the characteristics and underlying meaning of hoarding behavior among Taiwanese elders with Alzheimer's dementia from the perspective of family caregivers.Methods: We used an exploratory research design and purposive sampling. A total of 12 family caregivers of elders with Alzheimer's dementia received qualitative interview. We used one-on-one in-depth interviews to collect data and content analysis to analyze data.Results: Three main characteristics related to hoarding behavior emerged from the data were ”influence of former and current symptoms,” ”recurrence of the original personal characteristics and habits,” and ”re-experiencing past economic crises.” These three characteristics reflected patients' past social and family background and the current life situation. We elicited ”a desire for security'' as the underlying meaning of hoarding behavior.Conclusion: Findings of this study provide a reference for family and professional care providers to understand dementia-related problem behaviors. Improved caregiver understanding of dementia patient behaviors may help improve caregiver-patient interaction and communication and help caregivers better meet patient needs.

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