Greenway-Crombie Angela, Snow Pamela, Disler Peter, Davis Sam, Pond Dimity
Monash University School of Rural Health, Collaborative Health Education and Research Centre, Bendigo, Australia.
Aust J Prim Health. 2012;18(3):178-84. doi: 10.1071/PY12008.
This article reviews the literature concerning barriers in making a diagnosis of dementia in general practice and examines these from a rural perspective. It is proposed that the increasing prevalence of dementia in coming years in Australia will be felt most keenly in rural communities where there are already shortages of GPs and dementia-specific services to manage growing demand. Evidence suggests that dementia is often not specifically diagnosed by GPs and that this is a global issue. There are many barriers to the diagnosis of dementia in general practice, including time constraints, diagnostic uncertainty, denial of symptoms by patients and families, and stigma. This review examines these barriers and their impact on making a dementia diagnosis from a rural general practice perspective. Identification of these practice issues and their influence on service delivery is essential to inform relevant policy decisions and to improve dementia management in rural general practice.
本文回顾了有关全科医疗中痴呆症诊断障碍的文献,并从农村视角对这些障碍进行了审视。预计未来几年澳大利亚痴呆症患病率的上升在农村社区将最为明显,因为这些地区已经面临全科医生短缺以及痴呆症专项服务难以满足不断增长需求的问题。有证据表明,全科医生常常无法明确诊断出痴呆症,这是一个全球性问题。在全科医疗中,痴呆症诊断存在诸多障碍,包括时间限制、诊断不确定性、患者及其家属对症状的否认以及污名化。本综述从农村全科医疗的角度审视了这些障碍及其对痴呆症诊断的影响。识别这些实际问题及其对服务提供的影响,对于为相关政策决策提供依据以及改善农村全科医疗中的痴呆症管理至关重要。