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[痴呆症护理中的耻辱感与禁忌——全科医生和护士的继续教育是否有助于消除耻辱感]

[Stigma and taboo in dementia care - does continuing education for GPs and nurses contribute to destigmatisation].

作者信息

Kaduszkiewicz H, Röntgen I, Mossakowski K, van den Bussche H

机构信息

Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin, Hamburg, Germany.

出版信息

Z Gerontol Geriatr. 2009 Apr;42(2):155-62. doi: 10.1007/s00391-008-0569-0. Epub 2008 Sep 8.

Abstract

One of the main reasons for deficits in the care of patients with dementia is the taboo on the disease and the stigma of the people suffering from the disease, also from the side of the professional caregivers. The aim of the project was to find out whether a continuing education program for GPs and for nurses in ambulatory care was able to increase the skills of professionals to better communicate with patients and relatives on the taboo topic of dementia. The program was developed with a multi-professional team and tested with 53 GPs and 54 nurses in ambulatory care. The evaluation was performed with a 39-item questionnaire administered before and after the training. Also, to test the stability of the outcomes, the same questionnaire was administered to the GPs after one year and after two months for the nurses. The process quality of the training was evaluated very positively in both groups. Outcome quality was also very positive. Many attitudes of the GPs changed in a positive way and this change was still present after one year. This was the case for their general attitude towards caring for people with dementia, their view on therapeutic possibilities, their willingness to support relatives, to refer them to the Alzheimer Society and to suggest to them participation in a self-help group. Results for the nurses pointed in the same direction. However, with regard to diagnosis disclosure and informing the patient, no effect of the training could be shown in the GP sample.

摘要

痴呆症患者护理存在缺陷的主要原因之一是该疾病存在禁忌以及患病者遭受污名化,专业护理人员方面亦是如此。该项目的目的是了解针对全科医生和门诊护理护士的继续教育项目是否能够提高专业人员在痴呆症这个禁忌话题上与患者及亲属进行更好沟通的技能。该项目由一个多专业团队开发,并在53名全科医生和54名门诊护理护士中进行了测试。通过在培训前后发放一份包含39个条目的问卷进行评估。此外,为了测试结果的稳定性,一年后对全科医生以及两个月后对护士再次发放相同问卷。两组对培训过程质量的评价都非常积极。结果质量也非常积极。许多全科医生的态度发生了积极变化,且这种变化在一年后仍然存在。这体现在他们对护理痴呆症患者的总体态度、对治疗可能性的看法、支持亲属的意愿、将亲属转介至阿尔茨海默病协会以及建议他们参加自助小组等方面。护士的结果也指向相同方向。然而,在全科医生样本中,未显示出培训在诊断披露和告知患者方面有效果。

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