“我们肯定不在舒适区”：对全科医生痴呆症护理教育需求的定性研究
"We're certainly not in our comfort zone": a qualitative study of GPs' dementia-care educational needs.
作者信息
Foley Tony, Boyle Siobhán, Jennings Aisling, Smithson W Henry
机构信息
Department of General Practice, Western Gateway Building, University College Cork, Cork, Ireland.
出版信息
BMC Fam Pract. 2017 May 22;18(1):66. doi: 10.1186/s12875-017-0639-8.
BACKGROUND
Rising dementia prevalence rates rise combined with the policy objective of enabling people with dementia to remain living at home, means that there will be a growing demand for dementia care in the community setting. However, GPs are challenged by dementia care and have identified it as an area in which further training is needed. Previous studies of GPs dementia care educational needs have explored the views of GPs alone, without taking the perspectives of people with dementia and family carers into account. The aim of the study was to explore GPs' dementia care educational needs, as viewed from multiple perspectives, in order to inform the design and delivery of an educational programme for GPs.
METHODS
A qualitative study of GPs, people with dementia and family carers in a community setting was undertaken. Face-to-face interviews were performed with GPs, people with dementia and with family carers. Interviews were audio-recorded, transcribed verbatim and thematically analysed.
RESULTS
Thirty-one people were interviewed, consisting of fourteen GPs, twelve family carers and five people with dementia. GPs expressed a wish for further education, preferentially through small group workshops. Five distinct educational needs emerged from the interviews, namely, diagnosis, disclosure, signposting of local services, counselling and the management of behavioural and psychological symptoms (BPSD). While GPs focused on diagnosis, disclosure and BPSD in particular, people with dementia and family carers emphasised the need for GPs to engage in counselling and signposting of local services.
CONCLUSIONS
The triangulation of data from multiple relevant sources revealed a broader range of GPs' educational needs, incorporating both medical and social aspects of dementia care. The findings of this study will inform the content and delivery of a dementia educational programme for GPs that is practice-relevant, by ensuring that the curriculum meets the needs of GPs, patients and their families.
背景
痴呆症患病率不断上升，再加上让痴呆症患者能够居家生活的政策目标，这意味着社区环境中对痴呆症护理的需求将不断增加。然而，全科医生在痴呆症护理方面面临挑战，并将其确定为需要进一步培训的领域。以往关于全科医生痴呆症护理教育需求的研究仅探讨了全科医生的观点，而没有考虑痴呆症患者及其家庭护理人员的观点。本研究的目的是从多个角度探讨全科医生的痴呆症护理教育需求，以便为全科医生教育项目的设计和实施提供参考。
方法
在社区环境中对全科医生、痴呆症患者及其家庭护理人员进行了定性研究。对全科医生、痴呆症患者及其家庭护理人员进行了面对面访谈。访谈进行了录音，逐字转录并进行了主题分析。
结果
共访谈了31人，其中包括14名全科医生、12名家庭护理人员和5名痴呆症患者。全科医生表示希望接受进一步教育，优先通过小组研讨会的形式。访谈中出现了五个不同的教育需求，即诊断、告知、当地服务的指引、咨询以及行为和心理症状（BPSD）的管理。虽然全科医生特别关注诊断、告知和BPSD，但痴呆症患者及其家庭护理人员强调全科医生需要提供咨询服务并指引当地服务。
结论
来自多个相关来源的数据三角测量揭示了全科医生更广泛的教育需求，涵盖了痴呆症护理的医学和社会方面。本研究的结果将为针对全科医生的痴呆症教育项目的内容和实施提供参考，确保课程满足全科医生、患者及其家庭的需求，从而与实践相关。
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