Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Bonn, Germany.
Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
BMC Fam Pract. 2019 Feb 25;20(1):34. doi: 10.1186/s12875-019-0920-0.
Diagnosing dementia, a syndrome affecting 35.6 million people worldwide, can be challenging, especially in patients with a migrant background. Language barriers and language-based diagnostic tools, cultural differences in the perception of the syndrome as well as restricted access to healthcare can influence medical care. For the first time in Germany, this study investigates whether German general practitioners (GPs) feel prepared to meet the diagnostic needs of these patient groups and whether there are challenges and support needs.
A cross-sectional study among a random sample of 982 general practitioners in Germany was conducted from October 2017 to January 2018 (response rate: 34.5%). A self-developed, written, standardised questionnaire was used. Descriptive statistics as well as multiple logistic regression analyses were performed using data of 326 GPs.
Ninety-six percent of GPs reported having experienced barriers at least once. Uncertainties in diagnosing dementia in patients with a migrant background were indicated by 70.9%. There was no significant association between uncertainties in diagnosing dementia and GPs' sociodemographic characteristics. The most frequently reported barriers were language barriers that affected or prevented diagnostics (89.3%) and information deficits in patients with a migrant background (59.2%). Shameful interaction or lack of acceptance of the syndrome was also common (55.5%). A demand for more information about the topic was expressed by 70.6% of GPs.
Public health measures supporting GPs in their interaction with patients with a migrant background as well as information and services for dementia patients are needed. Efforts to facilitate access to interpreting services and to focus on people with a migrant background in healthcare are necessary.
German Clinical Trials Register: DRKS00012503 , date of registration: 05/09/2017 (German Institute of Medical Documentation and Information. German Clinical Trials Register (DRKS) 2017). Clinical register of the study coordination office of the University hospital of Bonn: ID530, date of registration: 05/09/2017 (Universitätsklinikum Bonn. Studienzentrum. UKB-Studienregister 2017).
痴呆症是一种影响全球 3560 万人的综合征，诊断具有挑战性，尤其是对于移民背景的患者。语言障碍和基于语言的诊断工具、对该综合征的认知方面的文化差异以及获得医疗保健的机会有限，都会影响医疗服务。德国首次进行了这项研究，以调查德国全科医生（GP）是否有能力满足这些患者群体的诊断需求，以及他们是否存在挑战和支持需求。
2017 年 10 月至 2018 年 1 月，对德国的 982 名全科医生进行了一项横断面研究（回应率：34.5%）。使用自行开发的书面标准化问卷进行调查。对 326 名全科医生的数据进行描述性统计和多项逻辑回归分析。
96%的全科医生报告至少遇到过一次障碍。70.9%的全科医生表示，在移民背景的患者中诊断痴呆症存在不确定性。全科医生的社会人口学特征与诊断痴呆症的不确定性之间没有显著关联。报告最多的障碍是影响或妨碍诊断的语言障碍（89.3%）和移民背景患者的信息不足（59.2%）。尴尬的互动或对该综合征的不接受也很常见（55.5%）。70.6%的全科医生表示需要更多关于该主题的信息。
需要采取公共卫生措施来支持全科医生与移民背景患者互动，并为痴呆症患者提供信息和服务。需要努力为口译服务提供便利，并将重点放在医疗保健中的移民背景人群上。
德国临床试验注册处：DRKS00012503，注册日期：2017 年 9 月 5 日（德国医学文献和信息研究所。德国临床试验注册处（DRKS）2017 年）。波恩大学医院研究协调办公室的临床登记册：ID530，注册日期：2017 年 9 月 5 日（波恩大学医院。研究中心。UKB-Studienregister 2017 年）。
