Kunneman Marleen, Smets Ellen M A, Bouwman Femke H, Schoonenboom Niki S M, Zwan Marissa D, Pel-Littel Ruth, van der Flier Wiesje M
Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
Alzheimer Center and Department of Neurology, VU University Medical Center and Amsterdam Neuroscience, Amsterdam, The Netherlands.
Alzheimers Dement (N Y). 2017 May 10;3(3):305-313. doi: 10.1016/j.trci.2017.03.009. eCollection 2017 Sep.
This study explores clinicians' views on and experiences with when, how, and by whom decisions about diagnostic testing for Alzheimer's disease are made and how test results are discussed with patients.
Following a preparatory focus group with 13 neurologists and geriatricians, we disseminated an online questionnaire among 200 memory clinic clinicians.
Respondents were 95 neurologists and geriatricians (response rate 47.5%). Clinicians (74%) indicated that decisions about testing are made before the first encounter, yet they favored a shared decision-making approach. Patient involvement seems limited to receiving information. Clinicians with less tolerance for uncertainty preferred a bigger say in decisions ( < .05). Clinicians indicated to always communicate the diagnosis (94%), results of different tests (88%-96%), and risk of developing dementia (66%).
Clinicians favor patient involvement in deciding about diagnostic testing, but conversations about decisions and test results can be improved and supported.
本研究探讨临床医生对于何时、如何以及由谁做出阿尔茨海默病诊断检测决策，以及如何与患者讨论检测结果的看法和经验。
在与13名神经科医生和老年科医生进行预备性焦点小组讨论之后，我们在200名记忆门诊临床医生中发放了一份在线问卷。
95名神经科医生和老年科医生回复了问卷（回复率47.5%）。临床医生（74%）表示检测决策在首次就诊前就已做出，但他们倾向于采用共同决策的方法。患者的参与似乎仅限于接收信息。对不确定性容忍度较低的临床医生在决策中希望有更大的话语权（P<0.05）。临床医生表示总是会告知患者诊断结果（94%）、不同检测的结果（88%-96%）以及患痴呆症的风险（66%）。
临床医生支持患者参与诊断检测的决策，但关于决策和检测结果的沟通可以得到改善和支持。
