Centre for Health Services Research, University of Newcastle upon Tyne, 21 Claremont Place Newcastle upon Tyne, UK.
Implement Sci. 2006 Mar 31;1:7. doi: 10.1186/1748-5908-1-7.
For people with dementia, care should include an explanation of the diagnosis to individuals and their carers, and information about the likely prognosis and possible packages of care. However, this is neither routine nor inevitable, and there is wide variation in the practice of disclosure. The aim of this study is to develop a tailored theory-based intervention to promote appropriate disclosure of diagnosis of dementia.
There are three objectives. Objective 1 is to define and develop an appropriate model of disclosure; this will be addressed using a multidisciplinary consensus development process. Objective 2 is to identify factors that influence disclosure of diagnosis; a questionnaire based upon theoretical constructs from a range of behavioural theories will be developed and members of old age mental health teams will be surveyed. The analysis will identify those factors that best predict intention to disclose a diagnosis to a person with dementia. Objective 3 is to develop and pilot test a theory-based intervention to promote disclosure of diagnosis that targets attitudes, beliefs and actions most amenable to change. Objective 3 will use the results of Objectives 1&2 to design and pilot test an intervention to improve the process of and increase the proportion of individuals receiving a diagnosis of dementia, for members of old age mental health teams. This work will lead to a proposal for a randomised controlled trial of the intervention.
对于痴呆症患者,护理应包括向个人及其照顾者解释诊断、提供有关可能的预后和护理方案的信息。然而,这既不是常规的,也不是不可避免的,披露的实践存在很大差异。本研究的目的是开发一种基于理论的量身定制的干预措施,以促进对痴呆症诊断的适当披露。
有三个目标。目标 1 是定义和开发适当的披露模型;这将通过多学科共识开发过程来解决。目标 2 是确定影响诊断披露的因素;将根据一系列行为理论的理论结构开发一份基于问卷的调查问卷,并对老年心理健康团队的成员进行调查。分析将确定那些最能预测向痴呆症患者披露诊断的意图的因素。目标 3 是开发和试点测试一种基于理论的干预措施,以促进诊断披露,该干预措施针对最容易改变的态度、信念和行为。目标 3 将利用目标 1 和 2 的结果,为老年心理健康团队成员设计和试点测试一项干预措施,以改善诊断过程并增加接受痴呆症诊断的个人比例。这项工作将导致对该干预措施进行随机对照试验的提案。