Cations Monica, Radisic Gorjana, de la Perrelle Lenore, Laver Kate E
College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Cognitive Decline Partnership Centre, The University of Sydney, Camperdown, NSW, Australia.
BMC Res Notes. 2019 Sep 4;12(1):559. doi: 10.1186/s13104-019-4588-2.
The Clinical Practice Guidelines for Dementia in Australia provide evidence-based recommendations for the assessment, diagnosis, and care of people with dementia and their informal carers. The extent to which current Australian post-diagnosis care reflects these recommendations is not well understood. This brief report provides a snapshot of current practice related to three key recommendations from the Guidelines: occupational therapy, exercise, and informal carer support.
Nursing (n = 3) and allied health clinicians (n = 29) provided data about 1114 consultations with people with dementia and/or informal carers over a 9-month study period. Results showed that delivery of evidence-based dementia care remains a significant challenge in Australia. Clinicians found it difficult to tailor exercise interventions to overcome cognitive and organisational barriers to adherence during and between consultations. Occupational therapists primarily focussed on functional assessment rather than on delivering evidence-based interventions. Clinicians also found it difficult to identify and address the array of needs reported by informal carers, especially when the person with dementia is present during the consultation. Though these results are reported by a selected sample, they emphasise the need for innovative knowledge translation strategies to facilitate widespread quality improvement in post-diagnosis dementia care. Trial registration Registered with the Australian New Zealand Clinical Trials Registry 21 February 2018 (ACTRN12618000268246).
澳大利亚痴呆症临床实践指南为痴呆症患者及其非正式护理人员的评估、诊断和护理提供了循证建议。目前澳大利亚诊断后护理在多大程度上反映了这些建议尚不清楚。本简要报告概述了与指南中的三项关键建议相关的当前实践情况：职业治疗、运动和非正式护理人员支持。
在为期9个月的研究期间，护士（n = 3）和专职医疗临床医生（n = 29）提供了1114次与痴呆症患者和/或非正式护理人员会诊的数据。结果显示，在澳大利亚，提供循证痴呆症护理仍然是一项重大挑战。临床医生发现，很难调整运动干预措施，以克服会诊期间及会诊之间依从性方面的认知和组织障碍。职业治疗师主要关注功能评估，而非提供循证干预措施。临床医生还发现，很难识别和满足非正式护理人员报告的一系列需求，尤其是在会诊时有痴呆症患者在场的情况下。尽管这些结果是由一个选定样本报告的，但它们强调需要创新的知识转化策略，以促进诊断后痴呆症护理的广泛质量改进。试验注册于2018年2月21日在澳大利亚新西兰临床试验注册中心注册（ACTRN12618000268246）。
