Thyrian Jochen René, Hoffmann Wolfgang
Germany Center for Neurodegenerative Diseases Rostock/Greifswald, Germany.
Cent Eur J Public Health. 2012 Dec;20(4):270-5. doi: 10.21101/cejph.a3751.
General physicians (GP) play a key role in providing appropriate care for people with dementia. It is important to understand their workload and opinions regarding areas for improvement.
A group of 1,109 GPs working in Mecklenburg-Western Pomerania, Gemany (1.633 million inhabitants), were identified, contacted and asked to participate in a written survey. The survey addressed five main topics: (a) the GP, (b) the GP's practice, (c) the treatment of dementia, (d) personal views, attitudes and specific competences regarding dementia and (e) the GP's recommendations for improving dementia-related health care.
The survey response rate was 31%. In total, the responding GPs estimated that they provided care to 12,587 patients with dementia every quarter year. The GPs also reported their opinions about screening instruments, treatment and recommendations for better care of dementia patients. Only 10% of them do not use screening instruments, one third felt competent in their care for patients with dementia and 54% opt for transfer of patients to a specialist for further neuropsychological testing.
Four conclusions from this study are the following: (a) dementia care is a relevant and prevalent topic for GPs, (b) systematic screening instruments are widely used, but treatment is guided, mostly by clinical experience, (c) attitudes towards caring for people with dementia are positive, and (d) GPs recommend spending a lot more time with patients and caregivers and provision of better support in social participation. A majority of GPs recommend abolishing "Budgetierung", a healthcare budgeting system in the statutory health insurance programmes.
全科医生在为痴呆症患者提供适当护理方面发挥着关键作用。了解他们的工作量以及对改进领域的看法非常重要。
确定了一组在德国梅克伦堡-前波美拉尼亚工作的1109名全科医生（该地区有163.3万居民），与他们取得联系并邀请他们参与一项书面调查。该调查涉及五个主要主题：（a）全科医生，（b）全科医生的诊所，（c）痴呆症的治疗，（d）对痴呆症的个人观点、态度和特定能力，以及（e）全科医生对改善痴呆症相关医疗保健的建议。
调查回复率为31%。总体而言，回复的全科医生估计他们每季度为12587名痴呆症患者提供护理。全科医生还报告了他们对筛查工具、治疗以及改善痴呆症患者护理建议的看法。他们中只有10%不使用筛查工具，三分之一的人认为自己有能力护理痴呆症患者，54%的人选择将患者转介给专科医生进行进一步的神经心理测试。
本研究得出的四个结论如下：（a）痴呆症护理是全科医生相关且普遍关注的话题，（b）系统的筛查工具被广泛使用，但治疗主要以临床经验为指导，（c）对护理痴呆症患者的态度是积极的，（d）全科医生建议花更多时间与患者及护理人员在一起，并在社会参与方面提供更好的支持。大多数全科医生建议废除法定医疗保险计划中的“预算编制”这一医疗保健预算系统。
