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全科医生对痴呆症的诊断、披露和药物治疗管理实践——一项全国性调查。

Practices in diagnosis, disclosure and pharmacotherapeutic management of dementia by general practitioners--a national survey.

机构信息

a Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery , University of Malta , Msida , Malta.

出版信息

Aging Ment Health. 2014 Mar;18(2):179-86. doi: 10.1080/13607863.2013.819833. Epub 2013 Jul 22.

Abstract

OBJECTIVES

To explore the practice patterns of general practitioners (GPs) for the diagnosis, disclosure and pharmacological management of individuals with dementia. We also investigated whether the number of years working in general practice is a determinant factor associated with the responses obtained.

METHOD

A national survey was sent to all registered GPs in the Maltese islands. The return rate was 54.2% with the majority of respondents having 15 years or more working experience in general practice. Chi-square analysis of variance was used to determine any relationship effects.

RESULTS

Although the majority of GPs indicated lack of competence in diagnosing dementia, only a small percentage showed a preference towards specialist referral. Lack of training was mostly envisaged by physicians with the least number of years in general practice. Significant differences in pharmacotherapeutic prescribing were noted depending on the stage of disease progression and the number of years working as a GP. Disease disclosure was not routinely carried out even though GPs were aware of the fact that disclosure may help individuals with dementia and their caregivers or relatives with future planning.

CONCLUSION

The findings show notable shortcomings in various aspects of dementia management by GPs. This highlights the need of providing continued educational support and training opportunities to enhance not only GPs' clinical competence, but also their role as key players in providing quality support to individuals with dementia in the primary care setting.

摘要

目的

探讨全科医生(GP)在痴呆患者的诊断、披露和药物管理方面的实践模式。我们还调查了在全科医学领域工作的年限是否是与所获得的反应相关的决定因素。

方法

对马耳他群岛的所有注册全科医生进行了一项全国性调查。回复率为 54.2%,大多数受访者在全科医学领域有 15 年或更长的工作经验。卡方方差分析用于确定任何关系效应。

结果

尽管大多数全科医生表示缺乏诊断痴呆的能力,但只有一小部分人倾向于向专家转诊。缺乏培训主要是由在全科医学领域工作年限最少的医生所设想的。根据疾病进展的阶段和作为全科医生工作的年限,在药物治疗处方方面存在显著差异。尽管医生们知道披露可能有助于痴呆症患者及其护理人员或亲属进行未来规划,但他们并没有例行进行疾病披露。

结论

研究结果表明,全科医生在痴呆症管理的各个方面都存在明显的不足。这凸显了提供持续教育支持和培训机会的必要性,不仅要提高全科医生的临床能力,还要提高他们在初级保健环境中为痴呆症患者提供优质支持的角色。

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