痴呆老年人：卫生单位医生的知识和态度。
Older adults with dementia: knowledge and attitudes of physicians in health units.
机构信息
Universidade Federal de São Paulo. Escola Paulista de Medicina. Programa de Pós-Graduação em Psiquiatria e Psicologia Médica. São Paulo, SP, Brasil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina. São Paulo, SP, Brasil.
出版信息
Rev Saude Publica. 2020 Dec 14;54:137. doi: 10.11606/s1518-8787.2020054002451. eCollection 2020.
OBJECTIVE
To describe the knowledge and attitudes of general practitioners of the basic health network of the city of São Paulo in relation to patients with dementia and identify patterns of attitudes.
METHODS
A total of 10% of the basic health units in the city of São Paulo (n = 45) were randomly distributed into six regional health coordination centers. Up to two general practitioners were interviewed in each unit, with a total of 81 physicians interviewed. They answered the translated and cross-culturally adapted version for Brazil of two British questionnaires, the knowledge quiz (knowledge about dementias) and the attitude quiz (attitude towards the patient afflicted with dementia), as well as a sociodemographic and occupational questionnaire to understand the profile of general practitioners working in primary care. Descriptive data analysis, factor analysis of the main components of the attitude quiz and study of association between attitudes and knowledge were performed, in addition to the multiple linear regression test to determine the relationship between occupational profile and knowledge about attitude patterns in dementia.
RESULTS
The physicians interviewed had a median of five-year graduation time; 35.8% worked exclusively with primary care, and less than 40% had completed, or were attending, medical residency or specialization. Physicians showed a lower knowledge about the diagnosis of dementia than about the epidemiology of the disease and its therapeutic management. Their attitudes towards patients afflicted with dementia resulted in four factors: proactive optimism, delegated optimism, implicit dismay, and explicit dismay. The regression study showed that the attitude of explicit dismay decreases the longer the weekly working hours of the physician in the units, and that the delegated optimistic attitude of the physician decreases in the same situation.
CONCLUSION
Investment in training is essential to improve physicians' performance in the field of dementia in primary care.
目的
描述圣保罗市基本卫生网络的全科医生对痴呆患者的知识和态度，并确定态度模式。
方法
随机分配圣保罗市（n=45）10%的基本卫生单位到六个区域卫生协调中心。每个单位最多采访两名全科医生，共采访了 81 名医生。他们回答了两个英国问卷的翻译和跨文化适应巴西版本，知识测验（关于痴呆症的知识）和态度测验（对患有痴呆症的患者的态度），以及一个社会人口学和职业问卷，以了解在初级保健中工作的全科医生的概况。进行了描述性数据分析、态度测验的主要成分的因子分析以及态度与知识之间的关联研究，此外还进行了多元线性回归测试，以确定职业概况与痴呆症态度模式知识之间的关系。
结果
接受采访的医生毕业时间中位数为五年；35.8%的医生专门从事初级保健工作，不到 40%的医生完成或正在参加医学住院医师或专科培训。医生对痴呆症的诊断知识比对疾病的流行病学及其治疗管理的知识要低。他们对患有痴呆症的患者的态度导致了四个因素：积极主动的乐观主义、委托的乐观主义、隐含的沮丧和明确的沮丧。回归研究表明，医生在单位每周工作时间越长，明显沮丧的态度就越低，而医生的委托乐观态度也会在同样的情况下下降。
结论
在培训方面的投资对于提高医生在初级保健领域的痴呆症方面的表现至关重要。
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