School of Nursing & Midwifery, University of Tasmania, Hobart, Tasmania, Australia.
Health Soc Care Community. 2009 Mar;17(2):141-50. doi: 10.1111/j.1365-2524.2008.00808.x. Epub 2008 Sep 17.
The rising prevalence of dementia and concomitant demands upon dementia services are global issues. In Australia, dementia has attained national health priority status and governments at all levels have implemented service strategies to help manage the complex lives of people with dementia. Despite recognition that information is pivotal to effective dementia service delivery, little is known about the information needs of individual providers and the processes used to transfer information between providers. This qualitative study scoped information issues for key service providers for people with dementia living in the community in southern Tasmania, Australia, including information needs, availability, and transfer. Eleven focus groups were held with general practitioners, residential aged care facility staff, home carers, community health nurses, and aged care-assessment team members. Findings revealed that provider groups shared common, albeit unbeknown to them, information needs (e.g. diagnosis, behaviours, and services) and information concerns (e.g. untrustworthy information and poor information transfer) leading to poor service coordination. General practitioners emerged as a stand-out group with markedly fewer needs and concerns than other providers, a finding of special interest given their pivotal role in dementia diagnosis and referral. Participants were adamant in their view that electronic data bases and single points of entry to dementia services would improve service provision and should be developed. The research highlights complexities and associated frustrations of information transferability, accessibility, and trustworthiness for dementia service providers in the community. Increased understanding of providers' diverse yet interdependent roles could, we believe, play an important part in breaking the cycle of frustration experienced by all participants and thus contribute to system reform.
痴呆症的患病率不断上升，以及由此对痴呆症服务的需求，是全球性问题。在澳大利亚，痴呆症已被列为国家卫生重点，各级政府已实施服务策略，以帮助管理痴呆症患者的复杂生活。尽管人们认识到信息对于有效提供痴呆症服务至关重要，但对于个体提供者的信息需求以及提供者之间信息传递的过程知之甚少。这项定性研究旨在了解澳大利亚塔斯马尼亚州南部社区中痴呆症患者的主要服务提供者的信息问题，包括信息需求、可用性和传递。共进行了 11 次焦点小组讨论，参与者包括全科医生、养老院工作人员、家庭护理员、社区护士和老年护理评估团队成员。研究结果表明，提供者群体存在共同的信息需求（如诊断、行为和服务）和信息关注点（如不可靠的信息和信息传递不畅），这导致了服务协调不良。全科医生是一个特别的群体，与其他提供者相比，他们的需求和关注点明显较少，这一发现特别有趣，因为他们在痴呆症诊断和转介方面发挥着关键作用。参与者强烈认为，电子数据库和痴呆症服务的单一入口将改善服务提供，应该开发这些资源。该研究强调了社区痴呆症服务提供者在信息可传递性、可及性和可信度方面的复杂性和相关挑战。我们相信，增加对提供者多样化但相互依存角色的理解，可以在打破所有参与者所经历的挫折循环方面发挥重要作用，从而有助于系统改革。
