失智症者之迷路──範域文獻回顧

Getting Lost in People With Dementia: A Scoping Review

"背景 許多失智症者因伴隨迷路問題，不僅衝擊失智症者本身的日常生活，也影響其身旁的照顧者和社會大眾，而目前文獻上對於迷路相關概念與研究狀況不甚清楚。 目的 藉由範域文獻查證深入了解失智症者迷路的整體現象，有助於提供照顧者更完整資訊，並啟迪我國失智症迷路相關研究與實務。 方法 本研究採系統性文獻回顧法，收錄發表於PubMed、Embase、華藝線上圖書館、Cochrane Library及相關之灰色文獻，設立關鍵字與同義字為失智症（dementia）、迷路（getting lost）等，發行年限為2011–2021年，共搜尋出10,523篇文獻，經篩選、刪除重複及評讀後，納入64篇符合主題之文章進行分析，並依據Arksey和O’Malley提出之範域文獻回顧六步驟，歸類和統整所有文獻。 結果 從文獻歸納出以下結果：（一）失智症的迷路概念多元且與遊走密不可分。（二）失智症者相關的迷路評估工具，超過一半都含有遊走。（三）影響失智症者迷路的相關因素包含個人特質、疾病因素、照顧因素及環境因素。（四）失智症者迷路會負向地影響自身、身旁照顧者和社會大眾。（五）大部分文獻來自西方且多為量性研究。 結論／ 實務應用 透過此範域查證，能全方位的了解失智症者迷路概念，與其前因後果，並找出缺失之處，可作為未來政策上發展失智症者迷路相關預防措施和照護計畫之參考，亦可為學術研究的依據與導航。"

"Backgrounds: Many people with dementia suffer from getting lost, which not only impacts their daily lives but also affects their caregivers and the general public. The concept of getting lost in dementia has not been clarified in the literature. Purpose: This scoping review was designed to provide a deeper understanding of the overall phenomenon of getting lost in people with dementia, with the results intended to provide caregivers with more complete information and enlightening research and practice related to dementia getting lost. Methods: A systematic review method was used, and articles were retrieved from electronic databases including PubMed, Embase, Airiti Library, Cochrane Library, and Gray literature. Specific keywords, MeSH terms, and Emtree terms were used to search for articles on dementia and getting lost. A total of 10,523 articles published from 2011- 2020 that matched the search criteria were extracted. After screening the topics and deleting repetitions, 64 articles were selected for further analysis. These articles were classified and integrated based on the six-step literature review method proposed by Arksey and O’Malley. Results: The key findings of the review included: (1) The concept of getting lost in dementia is diverse and inseparable from wandering; (2) More than half of the assessment tools related to getting lost in dementia include the concept of wandering; (3) The factors identified as affecting getting lost in dementia include the patient’s personal traits, disease factors, care factors, and environmental factors; (4) Getting lost in dementia negatively affects patients as well as their caregivers and the general public; (5) Most of the articles in this review were quantitative studies and were conducted in Western countries. Conclusions/Implications for Practice: The scoping review approach may assist care providers to fully understand the phenomenon of getting lost in dementia, clarify its causes and consequences, and identify the limitations in the literature. The findings may be referenced in the creation of healthcare policies promoting related preventive measures and care plans as well as used to guide future academic research."