McIntosh I B, Swanson V, Power K G, Rae C A
Dementia Services Development Centre, University of Stirling, Stirling FK9 4LA.
Health Bull (Edinb). 1999 Jan;57(1):35-43.
GPs and nurses play a major role in dementia care. Negative attitudes and uncertainties may be common sources of stress in both professions. Specific anxieties related to dementia management in primary care need to be identified.
To assess whether dementia care is a stress-provoking experience and examine perceived roles, attitudes, and anxieties for GPs and nurses working with people with dementia and their informal family carers.
A structured self-report questionnaire administered opportunistically to GPs and nurses attending dementia education seminars.
298 doctors and 487 nurses participated (response rate 98%). Over half dealing with people with dementia and their carers stressful. GPs reported more negative attitudes to dementia care than nurses (p < 0.001), and felt that professionally they could offer less to people with dementia (p < 0.001) and carers (p < 0.05) than nurses, reporting more difficulties with aspects of dementia care. For GPs and nurses, factors outwith their own profession's 'traditional' role were more stressful, e.g. responding to patients' behavioural (p < 0.001) and social problems (p < 0.001) were stressful for a greater proportion of GPs than nurses. Responding to patients' psychiatric problems was more stressful for nurses than GPs (p < 0.05). More GPs than in previous studies reported routinely administering tests of memory (70%) and depression (58%) in diagnosis.
Negative attitudes towards dementia care are associated with increased stress for GPs and nurses. Difficulties and uncertainties in these professional roles should be addressed by education in dementia management and improved awareness of available services and resources for people with dementia and their carers.
全科医生和护士在痴呆症护理中发挥着重要作用。消极态度和不确定性可能是这两个职业中压力的常见来源。需要确定与初级保健中痴呆症管理相关的具体焦虑。
评估痴呆症护理是否是一种引发压力的经历,并检查与痴呆症患者及其非正式家庭护理人员打交道的全科医生和护士所感知的角色、态度和焦虑。
对参加痴呆症教育研讨会的全科医生和护士进行机会性管理的结构化自我报告问卷。
298名医生和487名护士参与(回复率98%)。超过一半的人认为与痴呆症患者及其护理人员打交道有压力。全科医生对痴呆症护理的消极态度比护士更多(p<0.001),并且认为在专业上他们能为痴呆症患者(p<0.001)和护理人员(p<0.05)提供的比护士少,报告在痴呆症护理方面有更多困难。对于全科医生和护士来说,超出其自身职业“传统”角色的因素压力更大,例如,对全科医生而言,应对患者的行为问题(p<0.001)和社会问题(p<0.001)比护士更具压力。对护士来说,应对患者的精神问题比全科医生更具压力(p<0.05)。与之前的研究相比,更多的全科医生报告在诊断中常规进行记忆测试(70%)和抑郁测试(58%)。
对痴呆症护理的消极态度与全科医生和护士的压力增加有关。这些专业角色中的困难和不确定性应通过痴呆症管理教育以及提高对痴呆症患者及其护理人员可用服务和资源的认识来解决。