National Audit Office, Health VFM, London.
Br J Gen Pract. 2010 Sep;60(578):e360-5. doi: 10.3399/bjgp10X515386.
In primary care, the diagnosis of dementia is often delayed and the 2007 National Audit Office Report concluded action was needed to improve patient care and value for money.
To investigate the attitudes, awareness, and practice of GPs in England regarding early diagnosis and management of patients with dementia, and perceptions of local specialist services, to identify training or support needs.
Secondary analysis of survey data that capture the above attitudes, awareness, and practice.
Online survey, targeting GP members of medeConnect.
Survey data were obtained using an anonymised online self-completion questionnaire, and then analysed using standard data-analysis software.
A total of 1011 GPs across the eight English regions responded. Older GPs were more confident in diagnosing and giving advice about dementia, but less likely to feel that early diagnosis was beneficial, and more likely to feel that patients with dementia can be a drain on resources with little positive outcome. Younger GPs were more positive and felt that much could be done to improve quality of life. Attitudes had no correlation with sex. GPs in general felt they had not had sufficient basic and post-qualifying training in dementia, and overall knowledge about dementia was low.
Much could be done to improve GPs' knowledge of dementia, and the confidence of older GPs could be an educational resource. However, greater experience may create scepticism about early diagnosis because of the perceived poor quality of specialist services.
在初级保健中,痴呆症的诊断常常被延误,2007 年国家审计署的报告得出结论,需要采取行动改善患者的护理和物有所值。
调查英格兰全科医生(GP)对痴呆症患者早期诊断和管理的态度、意识和实践,以及对当地专科服务的看法,以确定培训或支持需求。
对调查数据的二次分析,这些数据捕捉了上述态度、意识和实践。
medeConnect 面向 GP 成员的在线调查。
使用匿名在线自我完成问卷获得调查数据,然后使用标准数据分析软件进行分析。
来自英格兰八个地区的共 1011 名全科医生做出了回应。年长的全科医生在诊断和提供痴呆症建议方面更有信心,但他们认为早期诊断有益的可能性较小,认为痴呆症患者可能会消耗资源而几乎没有积极的结果的可能性较大。年轻的全科医生更积极,认为可以做很多事情来提高生活质量。态度与性别无关。全科医生普遍认为他们在痴呆症方面的基础和资格后培训不足,整体上对痴呆症的了解也很低。
可以做很多工作来提高全科医生对痴呆症的认识,并且年长全科医生的信心可能是一种教育资源。然而,更多的经验可能会对早期诊断产生怀疑,因为专科服务的质量较差。