Visser Leonie N C, Fruijtier Agnetha, Kunneman Marleen, Bouwman Femke H, Schoonenboom Niki, Staekenborg Salka S, Wind Hilje A, Hempenius Liesbeth, de Beer Marlijn H, Roks Gerwin, Boelaarts Leo, Kleijer Mariska, Smets Ellen M A, van der Flier Wiesje M
Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands; Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.
Patient Educ Couns. 2023 Jun;111:107693. doi: 10.1016/j.pec.2023.107693. Epub 2023 Mar 3.
We investigated motivations of patients and care partners for their memory clinic visit, and whether these are expressed in consultations.
We included data from 115 patients (age 71 ± 11, 49% Female) and their care partners (N = 93), who completed questionnaires after their first consultation with a clinician. Audio-recordings of these consultations were available from 105 patients. Motivations for visiting the clinic were content-coded as reported by patients in the questionnaire, and expressed by patients and care partners in consultations.
Most patients reported seeking a cause for symptoms (61%) or to confirm/exclude a (dementia) diagnosis (16%), yet 19% reported another motivation: (more) information, care access, or treatment/advice. In the first consultation, about half of patients (52%) and care partners (62%) did not express their motivation(s). When both expressed a motivation, these differed in about half of dyads. A quarter of patients (23%) expressed a different/complementary motivation in the consultation, then reported in the questionnaire.
Motivations for visiting a memory clinic can be specific and multifaceted, yet are often not addressed during consultations.
We should encourage clinicians, patients, and care partners to talk about motivations for visiting the memory clinic, as a starting point to personalize (diagnostic) care.
我们调查了患者及其护理伙伴前往记忆门诊就诊的动机，以及这些动机在会诊中是否有所体现。
我们纳入了115名患者（年龄71±11岁，49%为女性）及其护理伙伴（N = 93）的数据，他们在首次与临床医生会诊后完成了问卷调查。其中105名患者的这些会诊有音频记录。就诊动机根据患者在问卷中报告的内容进行编码，并由患者及其护理伙伴在会诊中表达。
大多数患者表示就诊目的是寻找症状的原因（61%）或确认/排除（痴呆症）诊断（16%），但19%的患者表示有其他动机：（获取更多）信息、获得护理或寻求治疗/建议。在首次会诊中，约一半的患者（52%）和护理伙伴（62%）未表达其动机。当双方都表达了动机时，约一半的二元组中动机有所不同。四分之一的患者（23%）在会诊中表达了与问卷中不同/互补的动机。
前往记忆门诊就诊的动机可能是具体且多方面的，但在会诊中往往未得到讨论。
我们应鼓励临床医生、患者及其护理伙伴讨论前往记忆门诊就诊的动机，以此作为个性化（诊断）护理的起点。
