ABSTRACT

Cognitive rehabilitation for people living with early-stage dementia improves functional ability in areas targeted in the therapy, but little is known about how participants experience this intervention. This qualitative paper investigates participants’ views about a cognitive rehabilitation intervention in a randomized controlled trial (the GREAT trial) and aims to help explain and interpret the findings and to inform further intervention development. Using in-depth thematic analysis, 43 semi-structured interviews (35 individual and 8 dyadic) were conducted with 25 people living with dementia and 26 family carers from three sites. The person-centred, individualized approach was valued. Some participants’ views about dementia were questioned as a consequence of taking part in the therapy; they considered the effectiveness of the intervention in the context of the progressive nature of the condition. Certain participants continued to be doubtful, focussing on the inevitability of decline, rather than the possibility of reablement. Such views may have influenced engagement. The therapeutic relationship played a vital role as it was how personalized care was provided and participants’ views had changed positively. Therapists engendered greater confidence and reduced anxiety and social isolation. Positive responses support personalized rehabilitative care to address the specific needs of people living with dementia.

摘要

早期痴呆症患者的认知康复提高了治疗目标区域的功能能力，但人们对参与者如何体验这种干预知之甚少。这篇定性论文调查了参与者对随机对照试验（GREAT 试验）中认知康复干预的看法，旨在帮助解释和解释研究结果，并为进一步的干预发展提供信息。使用深入的主题分析，对来自三个地点的 25 名痴呆症患者和 26 名家庭照顾者进行了 43 次半结构化访谈（35 个人和 8 对偶）。以人为本的个性化方法受到重视。由于参与治疗，一些参与者对痴呆症的看法受到质疑；他们在病情进展性的背景下考虑了干预的有效性。某些参与者仍然持怀疑态度，他们关注的是衰退的必然性，而不是重新回归的可能性。这些观点可能影响了参与度。治疗关系发挥了至关重要的作用，因为它是如何提供个性化护理并且参与者的观点发生了积极变化。治疗师产生了更大的信心，减少了焦虑和社会孤立。积极响应支持个性化康复护理，以满足痴呆症患者的特定需求。这些观点可能影响了参与度。治疗关系发挥了至关重要的作用，因为它是如何提供个性化护理并且参与者的观点发生了积极变化。治疗师产生了更大的信心，减少了焦虑和社会孤立。积极响应支持个性化康复护理，以满足痴呆症患者的特定需求。这些观点可能影响了参与度。治疗关系发挥了至关重要的作用，因为它是如何提供个性化护理并且参与者的观点发生了积极变化。治疗师产生了更大的信心，减少了焦虑和社会孤立。积极响应支持个性化康复护理，以满足痴呆症患者的特定需求。