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影响全科医生对痴呆症诊断和护理认知及态度的因素——德国初级保健医生调查结果。

Factors influencing general practitioners' perception of and attitude towards dementia diagnostics and care-results of a survey among primary care physicians in Germany.

机构信息

Centre for General Medicine and Geriatrics, Universitätsmedizin Mainz, Am Pulverturm 13, 55131, Mainz, Germany.

出版信息

Wien Med Wochenschr. 2021 May;171(7-8):165-173. doi: 10.1007/s10354-020-00803-9. Epub 2021 Jan 14.

Abstract

Studies have shown that primary care is not always effective when it comes to caring for people with dementia. In addition, general practitioners do not always use diagnostic instruments consistently. The aim of the study was to identify relevant factors that influence general practitioners' attitudes and willingness with respect to consistent diagnosis and care. For this purpose, resources, viewpoints, and behavioral patterns of general practitioners with regard to dementia diagnostics as well as common challenges in everyday practice were recorded. In the course of a survey, a total of 2266 general practitioners in Hesse and Baden-Württemberg were interviewed between January and March 2020. In addition to the descriptive analysis, a t-test was used to determine significant differences between two groups. A univariate linear regression analysis was carried out to identify possible influencing factors. 81% of the respondents do provide dementia diagnostics; 51% are involved in the treatment. Most of them see the diagnostic work-up (77%), communication and compliance problems (73%), as well as the therapeutic support (71%) as common challenges. In addition, there are interface problems regarding the interdisciplinary cooperation. Some of the respondents express doubts about the value of early detection (41%). The general practitioners' attitude with respect to dementia diagnostics and care is determined by influencing factors that relate to geriatric competencies, expectations of self-efficacy, the integration of practice staff, as well as the knowledge of and cooperation with counseling and care services. It seems advisable to strengthen the geriatric competence of general practitioners. Moreover, it appears essential to educate general practitioners more about support structures in the field of dementia care and to integrate them accordingly. In addition, practice staff should be more systematically involved in the identification and care of dementia patients.

摘要

研究表明,初级保健在照顾痴呆症患者方面并不总是有效。此外,全科医生并不总是始终如一地使用诊断工具。该研究的目的是确定影响全科医生对一致性诊断和护理的态度和意愿的相关因素。为此,记录了全科医生在痴呆症诊断方面的资源、观点和行为模式,以及日常实践中的常见挑战。在一项调查中,2020 年 1 月至 3 月期间,对黑森州和巴登-符腾堡州的 2266 名全科医生进行了采访。除了描述性分析外,还使用 t 检验来确定两组之间的显著差异。进行了单变量线性回归分析,以确定可能的影响因素。81%的受访者确实提供痴呆症诊断;51%的人参与治疗。他们大多数人认为诊断工作(77%)、沟通和依从性问题(73%)以及治疗支持(71%)是常见的挑战。此外,在跨学科合作方面还存在接口问题。一些受访者对早期发现的价值表示怀疑(41%)。全科医生对痴呆症诊断和护理的态度取决于与老年医学能力、自我效能期望、实践人员的整合以及咨询和护理服务的知识和合作相关的影响因素。加强全科医生的老年医学能力似乎是明智的。此外,有必要对全科医生进行更多关于痴呆症护理领域支持结构的教育,并相应地进行整合。此外,应更系统地让实践人员参与痴呆症患者的识别和护理。

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