Abstract:

Objective To explore the experiences of family caregivers in dealing with the care-resistance behaviors in elderly patients with dementia，to improve the quality of care for elderly patients with dementia，and to enhance the ability of family caregivers to cope with resistance behaviors. Methods Utilizing purposeful sampling，we conducted in-depth interviews with 16 family caregivers of elderly patients with dementia between February 2024 and May 2024. The participants were recruited from a tertiary-grade hospital and the surrounding community in Zhengzhou，Henan Province. The interview data were subjected to thematic analysis using the Colaizzi 7-step method. Results A total of 19 interviews were conducted in this study，with each caregiver being interviewed for 30-44 minutes. The total transcription was about 82，000 words，and 4 themes and 11 sub-themes were identified：the considerable physical and psychological burden（persistent negative emotions，gradually increasing physical burden），realization of self-worth（sense of filial responsibility，care benefit feeling），subjective adjustment of coping strategies（actively seeking external support，resorting to restrictions and protection，passively coping out of helplessness），and facing multiple coping challenges（difficulty in establishing effective communication，poor sleep quality，lack of caregiving skills，unmet diverse support needs）. Conclusion Family caregivers experience a heavier burden of care and develop various negative emotions when dealing with resistance behaviors. Different caregivers gradually adapt and develop different coping strategies in the care process. However，there are still some coping dilemmas that need to be resolved. Healthcare professionals should pay timely attention to caregivers’ experiences in dealing with resistance behaviors，correct their attitudes towards care-resistance behaviors，strengthen health education on managing care-resistance behaviors，and improve their ability to cope with care-resistance behaviors.

Key words: Aged, Dementia, Family Caregiver, Care Resistant Behavior, Qualitative Research, Nursing Care

摘要：

目的 探索家庭照顾者对老年失智患者照护抗拒行为的应对体验，为改善老年失智患者的照护质量、提高家庭照顾者应对照护抗拒行为的能力提供参考。方法 采用目的抽样法，于2024年2月—5月，对郑州市某三级甲等医院和社区16名老年失智患者的家庭照顾者进行深入访谈，采用Colaizzi 7步分析法对访谈资料进行分析。结果 共进行19次访谈，每名家庭照顾者访谈时间为30~44 min，共转录约8.2万字，提取4个主题和11个亚主题，包括身心负担沉重（受到负性情绪持续困扰、身体负担逐渐加重）、领悟自我价值（孝道责任感、照护获益感）、主观调整应对策略（主动寻求外界支持、被迫采取限制与保护、无奈选择消极应对）和面临多重应对困境（有效沟通机制难以建立、睡眠质量难以保证、自身照护技能尚缺、多元支持需求难以满足）。结论 家庭照顾者在应对老年失智患者照护抗拒行为时照护负担较重，产生多种负性情绪。不同家庭照顾者在照护老年失智患者过程中逐渐适应并采取不同应对策略，然而仍存在一些应对困境亟待解决。医护人员应及时关注家庭照顾者对老年失智患者照护抗拒行为应对体验，协助家庭照顾者端正照护抗拒行为的应对态度，提高自身应对照护抗拒行为的能力。

关键词: 老年人, 失智症, 家庭照顾者, 照护抗拒行为, 质性研究, 护理