Wollney Easton N, Armstrong Melissa J, Bedenfield Noheli, Rosselli Monica, Curiel-Cid Rosie E, Kitaigorodsky Marcela, Levy Ximena, Bylund Carma L
Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA.
Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA.
Health Serv Insights. 2022 Dec 5;15:11786329221141829. doi: 10.1177/11786329221141829. eCollection 2022.
The vast majority of individuals with dementia want to receive a diagnosis. Research suggests, however, that only a fraction of individuals with dementia receive a diagnosis and patients and families often feel the information is poorly explained. We thus aimed to assess clinician-reported barriers to dementia disclosure and recommendations for giving a dementia diagnosis. To accomplish this, we performed telephone interviews with 15 clinicians from different specialties using a semi-structured interview guide. Transcripts were analyzed thematically. Clinician-reported barriers fit 3 categories: patient and caregiver-related barriers, clinician-related barriers, and barriers related to the triadic interaction. Patient and caregiver-related barriers included , and Clinician barriers included , and Triadic interaction barriers included c and Recommendations for best practice included for clinicians to foster relationships, educate patients and family, and take a family-centered approach. Clinicians described recommendations for fostering relationships such as using and . Educating patients and families included , , and . Family approaches included to delivering the diagnosis and in the discussion. Findings may inform updated recommendations for best practices when communicating a dementia diagnosis.
绝大多数痴呆症患者希望得到诊断。然而,研究表明,只有一小部分痴呆症患者得到了诊断,而且患者及其家属常常觉得所提供的信息解释得不够清楚。因此,我们旨在评估临床医生报告的痴呆症诊断披露障碍以及关于做出痴呆症诊断的建议。为实现这一目标,我们使用半结构化访谈指南对15名来自不同专业的临床医生进行了电话访谈。对访谈记录进行了主题分析。临床医生报告的障碍分为三类:与患者和照顾者相关的障碍、与临床医生相关的障碍以及与三方互动相关的障碍。与患者和照顾者相关的障碍包括……以及……临床医生相关的障碍包括……以及……三方互动障碍包括c和……最佳实践建议包括临床医生要建立良好关系、对患者和家属进行教育,并采取以家庭为中心的方法。临床医生描述了建立良好关系的建议,比如使用……和……对患者和家属进行教育包括……、……和……以家庭为中心的方法包括诊断传达方式以及讨论中的……研究结果可能为痴呆症诊断沟通时最佳实践的更新建议提供参考。