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P3‐400: Therapeutic Nursing Interview for the Purpose of Early Diagnosis and Care of Alzheimer's Disease in an Outpatient Department: Part II
Author(s) -
Nakano Masako
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.2066
Subject(s) - outpatient clinic , metacognition , cognition , medicine , dementia , emergency department , disease , psychology , clinical psychology , nursing , psychiatry , pathology
Background: In 2011, we reported a trial of preliminary therapeutic examinations of their daily living performed by nurses prior to the examination by a specialized doctor at an outpatient department. Here, we report the metacognitive monitoring of patients’ own cognitive processes from their language reports. Metacognition is cognition about cognition and is higher concept than the normal cognition required to grasp the essence of a problem and choose a solution. The purpose of this research was to rearrange patients’ daily problems and clarify their need for efficient preventive help. Methods:The subjects of the study were elderly people with MCI and early-stage AD, all of whom participated voluntarily. The study was conducted in the “department of forgetfulness” section of the outpatient department from July 2013 to March 2014. Data were collected through semi-structured interviews, and these subjective data were assessed together with objective data collected by the nurses. Finally, a care plan was drawn up for each patient, and the information was collated as the patient’s medical history in an electronic chart. All data concerning metacognition were qualitatively analyzed by the qualitative synthesis method. Results: The participants were 8 old men and 17 old women (mean age 75.54 6 SD 5.5 years). The mean of the score of Mini Mental State Examination was 21.6, range: 28–11. There were 5 MCI, 10 AD, and 10 other dementia patients. The patients’ own monitoring of and solutions to their problems resulted in action through their own metacognitive activity. We had categorized their problems as “coping with a failure of memory,” “the restoration of the changed relationship with their families,” “the maintenance of the dignity of self,” and “coping with the jitters.” Conclusions:Metacognition is possible for an elderly person and enables the self-monitoring of cognitive functional decline, which promotes the individual to take action to find a solution to the problem. All elderly people who received specialized outpatient treatment retained this ability, and it was demonstrated to be effective.