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一项促进初级保健中以患者为中心的痴呆症应对措施的教育干预措施的开发与评估。

The development and evaluation of an educational intervention for primary care promoting person-centred responses to dementia.

作者信息

Edwards Rachel, Voss Sarah E, Iliffe Steve

机构信息

Avon and Wiltshire Mental Health Partnership NHS Trust, UK

Faculty of Health and Life Sciences, University of the West of England, Bristol, UK.

出版信息

Dementia (London). 2015 Jul;14(4):468-82. doi: 10.1177/1471301213499768. Epub 2013 Aug 27.

Abstract

BACKGROUND

Early diagnosis of dementia within primary care is important to allow access to support. However, dementia remains under-detected in general practice.

AIM

This work aimed to develop and evaluate an educational intervention for primary care promoting person-centred responses to people experiencing cognitive decline.

METHOD

A prototype educational intervention was pilot tested and refined; the final version of the educational intervention was then evaluated in four volunteer practices. A questionnaire was administered pre- and post-training to 94 practice staff to assess knowledge and attitudes to dementia. The responses of general practitioners (who make diagnostic, referral and treatment decisions) were compared with those from other staff who do not have such roles.

FINDINGS

Post-training, there were statistically significant improvements in understanding of person-centred care for people with dementia; attitudes to early diagnosis; awareness of non-cognitive dementia symptoms; and awareness of the role that non-clinical staff may have in recognising dementia.

CONCLUSIONS

A dementia education intervention for primary care which fosters person-centred attitudes can involve all members of a primary care team. Further research is needed to ascertain if improvements in knowledge and attitudes translate into improved practice.

摘要

背景

在初级医疗保健中尽早诊断痴呆症对于获得支持至关重要。然而,痴呆症在全科医疗中仍未得到充分检测。

目的

这项工作旨在开发并评估一项针对初级医疗保健的教育干预措施,以促进对认知能力下降者采取以人为本的应对方式。

方法

对一个教育干预原型进行了试点测试并加以完善;然后在四个志愿医疗机构对教育干预的最终版本进行了评估。在培训前后向94名医疗机构工作人员发放问卷,以评估他们对痴呆症的知识和态度。将做出诊断、转诊和治疗决策的全科医生的回答与其他不承担此类职责的工作人员的回答进行比较。

结果

培训后,在对痴呆症患者以人为本的护理理解、对早期诊断的态度、对非认知性痴呆症状的认识以及对非临床工作人员在识别痴呆症中可能发挥的作用的认识方面,均有统计学上的显著改善。

结论

一项促进以人为本态度的针对初级医疗保健的痴呆症教育干预措施可涉及初级医疗保健团队的所有成员。需要进一步研究以确定知识和态度的改善是否转化为实践的改进。

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