Schoenmakers Birgitte, Buntinx Frank, Delepeleire Jan
Catholic University Leuven, Academic Centre of General Practice, Kapucijnenvoer 33, Leuven, Belgium.
Scand J Prim Health Care. 2009;27(1):31-40. doi: 10.1080/02813430802588907.
To identify the attitudes and perspectives of the family physician towards the caregivers of demented relatives and to describe the caregivers' satisfaction.
Systematic review.
The studied population consisted of dementia family and their general practitioners.
Outcome measures were the generic tasks and skills of the general practitioner to improve home care from the perspective of the family caregiver. Caregivers were assessed on satisfaction regarding the care provided by their general practitioner.
The general practitioner is aware of his/her skills and limits in all aspects of dementia care and his/her role towards the family caregiver. They also acknowledged the importance of an adequate diagnostic process, but they felt uncomfortable disclosing the diagnosis to both the patient and the caregiver. They reported having more confidence in treatment matters than in diagnostic stages. Caregivers' reports on the attitude of their general practitioner in the diagnostic process were rated from helpful to poorly empathized. General practitioners found themselves to be highly involved in dementia home care, but caregivers rated their involvement to be insufficient. The lack of appropriate communication skills of general practitioners was also not appreciated by the caregivers. A lack of time and reward was considered by the general practitioner to be a major obstacle in dementia care.
The key role of general practitioners as care providers and care planners is consolidated by the family caregivers' confidence in their skills. Clear guidelines from early diagnosis to adequate referrals should improve the ability of the general practitioner to support these time and energy-consuming home-care situations. Intervention studies addressing the gaps in the skills of the general practitioners in dementia home care management could be helpful in supporting the family caregiver.
确定家庭医生对痴呆症患者亲属照料者的态度和观点，并描述照料者的满意度。
系统评价。
研究人群包括痴呆症患者家属及其全科医生。
观察指标为全科医生从家庭照料者角度改善居家护理的一般任务和技能。对照料者对其全科医生提供的护理的满意度进行评估。
全科医生了解自己在痴呆症护理各方面的技能和局限性以及对家庭照料者的角色。他们也认识到充分诊断过程的重要性，但向患者和照料者透露诊断结果时会感到不自在。他们表示对治疗方面比对诊断阶段更有信心。照料者对其全科医生在诊断过程中态度的评价从有帮助到缺乏同理心不等。全科医生认为自己高度参与痴呆症居家护理，但照料者认为他们的参与不足。照料者也不认可全科医生缺乏适当的沟通技巧。全科医生认为时间不足和缺乏回报是痴呆症护理的主要障碍。
家庭照料者对全科医生技能的信任巩固了全科医生作为护理提供者和护理规划者的关键作用。从早期诊断到适当转诊的明确指南应能提高全科医生支持这些耗时耗力的居家护理情况的能力。针对全科医生在痴呆症居家护理管理方面技能差距的干预研究可能有助于支持家庭照料者。
