Faculty of Health, University of Plymouth, Plymouth, UK.
Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
Int J Geriatr Psychiatry. 2021 Jul;36(7):1011-1019. doi: 10.1002/gps.5532. Epub 2021 Mar 28.
Traditional healthcare education typically focuses on short block clinical placements based on acute care, investigations and technical aspects of diagnosis and treatment. It may therefore fail to build the understanding, compassion and person-centred empathy needed to help those with long-term conditions, like dementia. Time for Dementia was developed to address this.
Parallel group comparison of two cohorts of UK medical students from universities, one participating in Time for Dementia (intervention group) and one not (control group). In Time for Dementia students visit a person with dementia and their family in pairs for 2 hours three times a year for 2 years, the control group received their normal curriculum.
In an adjusted multilevel model (intervention group n = 274, control n = 112), there was strong evidence supporting improvements for Time for Dementia participants in: total Approaches to Dementia Questionnaire score (coefficient: 2.19, p = 0.003) and its person-centredness subscale (1.32, p = 0.006) and weaker evidence in its hopefulness subscale (0.78, p = 0.070). There was also strong evidence of improvement in the Dementia Knowledge Questionnaire (1.63, p < 0.001) and Dementia Attitudes Scale (total score: 6.55, p < 0.001; social comfort subscale: 4.15, p < 0.001; dementia knowledge subscale: 3.38, p = 0.001) scores. No differences were observed on the Alzheimer's Disease Knowledge Scale, the Medical Condition Regard Scale or the Jefferson Scale of Empathy.
Time for Dementia may help improve the attitudes of medical students towards dementia promoting a person-centred approach and increasing social comfort. Such patient-focused programmes may be a useful complement to traditional medical education.
传统的医疗保健教育通常侧重于基于急性护理、调查和诊断与治疗技术方面的短期临床实习。因此,它可能无法建立理解、同情和以患者为中心的同理心,而这些同理心是帮助那些患有长期疾病(如痴呆症)的人所必需的。“为痴呆症腾出时间”(Time for Dementia)就是为了解决这个问题而开发的。
对来自两所英国大学的两组医学生进行平行组比较,一组参加“为痴呆症腾出时间”(干预组),另一组不参加(对照组)。在“为痴呆症腾出时间”项目中,学生每学年两次、每次 2 小时、共 3 次与一名痴呆症患者及其家人配对访问,对照组则接受他们的正常课程。
在调整后的多层次模型中(干预组 n=274,对照组 n=112),有强有力的证据支持“为痴呆症腾出时间”项目对参与者的以下方面产生积极影响:对痴呆症的总体方法问卷评分(系数:2.19,p=0.003)及其以患者为中心的子量表(1.32,p=0.006),以及在其希望子量表方面的证据较弱(0.78,p=0.070)。痴呆症知识问卷(1.63,p<0.001)和痴呆症态度量表(总分:6.55,p<0.001;社会舒适度子量表:4.15,p<0.001;痴呆症知识子量表:3.38,p=0.001)的评分也有明显改善。在阿尔茨海默病知识量表、医疗状况量表或杰斐逊同理心量表上没有观察到差异。
“为痴呆症腾出时间”项目可能有助于改善医学生对痴呆症的态度,促进以患者为中心的方法,并提高社会舒适度。这种以患者为中心的项目可能是传统医学教育的有益补充。