二元视角下轻度认知障碍患者及其照顾者健康生活方式体验的质性研究及对策 [中文引用][英文引用]

目的 探讨二元视角下轻度认知障碍患者及其家庭照顾者健康生活方式体验，为构建患者 - 照顾者二元健康生活方式干预方案提供依据。方法 基于二元疾病管理理论，采用目的抽样法，选取 2024 年 12 月至 2025 年 1 月就诊于北京市某三级甲等综合医院的 11 对轻度认知障碍患者及其家庭照顾者进行半结构式访谈，运用定向内容分析法对访谈资料进行分析。结果 共提炼出 3 个主题和 10 个亚主题，分别为二元评价的认知差异（疾病威胁的感知差异、健康生活的认知差异）；二元健康管理的协同实践（多维度开展痴呆预防实践、基于角色分工的协同应对）；多重因素共同塑造健康生活方式（平衡优先性事项、回避应对策略、照顾关系质量、家庭与群体支持、医疗服务可及性、疾病污名困境）。结论 轻度认知障碍患者及其家庭照顾者对健康生活方式的二元评价和二元管理行为存在差异性，并受多重因素影响，需重视家庭照顾者在患者健康生活方式管理中的关键作用，构建患者 - 照顾者二元健康生活方式干预方案，以提升其健康生活方式水平。

Objective To explore the healthy lifestyle experiences of the patients with mild cognitive impairment（MCI）and their family caregivers based on the theory of dyadic illness management（TDIM），thereby to provide references for developing the patient-caregiver dyadic interventions. Methods Guided by TDIM，purposive sampling was employed to select 11 MCI patientcaregiver dyads from a Tier-IIIA hospital in Beijing，China，between December 2024 and January 2025. Semi-structured interviews were conducted，and data were analysed using directed content analysis. Results Three themes and ten sub-themes were emerged：cognitive differences in dyadic evaluation（perceived discrepancies in disease threat，divergent cognitions on healthy living）；collaborative practice of dyadic health management（multidimensional practice of dementia prevention，collaborative coping based on role division）；and common factors shaping a healthy lifestyle together（balancing priority task，avoidance coping strategies，quality of caregiver-relationship， familial/community support，healthcare accessibility，and stigma associated with dementia）. Conclusion There is a disparity in dyadic appraisal and management regarding healthy lifestyles between MCI patients and their caregivers and it is influenced by multiple interrelated factors. Interventions should be prioritised to the critical role of caregivers in health management and develop tailored dyadic strategies to improve healthy lifestyles for both the patients and caregivers.