痴呆患者抗拒护理行为的概念分析

doi:10.3761/j.issn.0254-1769.2025.15.004

摘要/Abstract

摘要：

目的分析并阐明痴呆患者抗拒护理行为的概念内涵，为临床痴呆患者抗拒护理行为的评估与实践提供参考。方法系统检索PubMed、Scopus、Web of Science、Cochrane Library、Embase、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中痴呆患者抗拒护理行为的相关文献，检索时限为建库至2024年12月。采用Walker和Avant经典概念分析法对文献进行分析。结果痴呆患者抗拒护理行为包括护理背景、感知威胁、需求未满、缺乏理解、多维表现5个概念属性；其前置因素包含患者、照护者、环境以及组织4个方面；后置影响包含对患者及照护者的影响。结论该研究通过概念分析，明确了痴呆患者抗拒护理行为的概念属性、前置因素和后置影响。未来，应结合痴呆患者抗拒护理行为的内涵，开发本土化痴呆患者抗拒护理行为评估工具，构建针对性的干预方案，进而提升护理人员的护理质量，改善痴呆患者的护理体验。

关键词: 痴呆, 抗拒护理行为, 概念分析, 老年人护理

Abstract:

Objective To analyze and clarify the concept and connotation of care-resistant behavior in dementia patients，so as to provide references for the evaluation and practice of care-resistant behavior in clinical dementia patients. Methods PubMed，Scopus，Web of Science，Cochrane Library，Embase，CINAHL，CNKI，VIP，Wanfang database and Chinese Biomedical Literature Database were systematically searched for the literature on care-resistant behavior in dementia patients. The search time limit was from the establishment of the database to December 2024. Walker and Avant’s classical concept analysis method was used to analyze the literature. Results The care-resistant behavior in dementia patients included 5 conceptual attributes，including nursing background，perceived threat，unmet needs，lack of understanding and multi-dimensional performance. The antecedent factors include patient factors，caregiver factors，environmental factors and organizational factors. Post-impact includes the impact on patients and the impact on caregivers. Conclusion This study clarified the conceptual attributes，antecedents and post-effects of care-resistant behavior in dementia patients through concept analysis. In the future，researchers should combine the connotation of dementia patients’ care-resistant behavior，develop localized assessment tools for dementia patients’ care-resistant behavior，and construct targeted intervention programs，so as to improve the quality of nursing staff and enhance the care experience of dementia patients.

Key words: Dementia, Care-Resistant Behavior, Concept Analysis, Geriatric Nursing

李含, 黄颖琪, 杜菲, 张秋实, 梅永霞, 徐晖. 痴呆患者抗拒护理行为的概念分析[J]. 中华护理杂志, 2025, 60(15): 1818-1823.

LI Han, HUANG Yingqi, DU Fei, ZHANG Qiushi, MEI Yongxia, XU Hui. Concept analysis of care-resistant behavior in dementia patients[J]. Chinese Journal of Nursing, 2025, 60(15): 1818-1823.

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