Department of Health Services, Policy, and Practice and Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island, USA.
Departments of Psychiatry and Neurology, Duke University School of Medicine, Durham, North Carolina, USA.
J Am Geriatr Soc. 2022 Oct;70(10):2938-2947. doi: 10.1111/jgs.17937. Epub 2022 Jul 14.
The primary objective of this paper was to examine perspectives and experiences of individuals with cognitive impairment who received an amyloid PET scan and their care partners, with regard to the process, logistics, and decision-making associated with receiving an amyloid PET scan and its results.
Structured telephone interviews were conducted with 200 randomly sampled scan recipient/care partner dyads from the CARE IDEAS study. The audio-recorded, transcribed responses were analyzed using an inductive qualitative content analytic approach.
Participating individuals and care partners described their experiences in seeking a diagnosis for memory issues, including decision-making and logistics involved with receiving an amyloid PET scan. Participants discussed the factors contributing to their decision to seek a diagnosis for their memory issues and their hopes and expectations in completing the scan. Participants also described the trajectory of this process, and although some described relatively straightforward trajectories, others described problems associated with identifying appropriate providers and coordinating care across numerous providers to obtain a diagnosis for their memory issues. Participants described an additional challenge of physicians attributing cognitive decline to normal aging, rather than signs of a neurodegenerative disorder.
Findings shed light on the barriers and delays that individuals and care partners experience in connecting with physicians and obtaining a comprehensive evaluation for cognitive problems. Results from this study have implications for physicians who provide care to older adults, and specifically highlight the need for greater care coordination and clearer communication with and systems of referral for patients.
本文的主要目的是研究认知障碍个体及其护理伙伴在接受淀粉样 PET 扫描及其结果相关的过程、后勤和决策方面的观点和经验。
从 CARE IDEAS 研究中随机抽取 200 对扫描接受者/护理伙伴进行了结构化电话访谈。使用归纳定性内容分析方法对录音转录的回复进行了分析。
参与的个体和护理伙伴描述了他们在寻求记忆问题诊断方面的经验，包括接受淀粉样 PET 扫描所涉及的决策和后勤工作。参与者讨论了促使他们决定为记忆问题寻求诊断的因素，以及他们在完成扫描时的希望和期望。参与者还描述了这个过程的轨迹，尽管有些人描述了相对简单的轨迹，但也有些人描述了在识别合适的提供者和协调多个提供者的护理以获得记忆问题诊断方面存在的问题。参与者描述了医生将认知能力下降归因于正常衰老而不是神经退行性疾病迹象的另一个挑战。
研究结果揭示了个体和护理伙伴在与医生联系并为认知问题进行全面评估方面所面临的障碍和延迟。本研究的结果对为老年人提供护理的医生具有启示意义，特别强调了需要更好的护理协调以及与患者更清晰的沟通和转诊系统。
