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痴呆症预防与全科医生的角色:一项定性访谈研究。

Dementia prevention and the GP's role: a qualitative interview study.

机构信息

Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford.

GP with an extended role in older people, associate clinical director frailty/dementia and LD, Bradford District and Craven Health and Care Partnership, Bradford; medical director, Westcliffe Health Innovations, Bradford; clinical lead, Yorkshire and the Humber Clinical Network (Dementia and Older Peoples Mental Health); honorary visiting professor, Faculty of Health Studies, University of Bradford, Bradford.

出版信息

Br J Gen Pract. 2024 Mar 27;74(741):e242-e249. doi: 10.3399/BJGP.2023.0103. Print 2024 Apr.

Abstract

BACKGROUND

GPs play an increasingly important role in proactively preventing dementia. Dementia in 40% of patients could be prevented or delayed by targeting 12 modifiable risk factors throughout life. However, little is known about how GPs perceive their role in dementia prevention and the associated barriers.

AIM

To explore the role of GPs in dementia prevention.

DESIGN AND SETTING

Qualitative study among UK GPs.

METHOD

Semi-structured online interviews were conducted with 11 UK GPs exploring their views regarding their role in dementia prevention. Data were analysed using thematic analysis.

RESULTS

GPs reported that they never explicitly discuss dementia risk with patients, even when patients are presenting with risk factors, but acknowledge that dementia prevention should be part of their role. They advocate for adopting a whole team approach to primary care preventive practice, using long-term condition/medication reviews or NHS health checks as a platform to enable dementia risk communication targeting already at-risk individuals. Barriers included a lack of time and an absence of knowledge and education about the modifiable dementia risk factors, as well as a reluctance to use 'dementia' as a term within the appointment for fear of causing health anxiety. 'Brain health' was perceived as offering a more encouraging discursive tool for primary care practitioners, supporting communication and behaviour change.

CONCLUSION

There needs to be a whole-systems shift towards prioritising brain health and supporting primary care professionals in their preventive role. Education is key to underpinning this role in dementia prevention.

摘要

背景

全科医生在积极预防痴呆症方面发挥着越来越重要的作用。通过针对一生中的 12 个可改变的风险因素,40%的痴呆症患者可以得到预防或延缓。然而,对于全科医生如何看待自己在预防痴呆症方面的作用以及相关障碍,人们知之甚少。

目的

探讨全科医生在预防痴呆症中的作用。

设计和环境

英国全科医生的定性研究。

方法

对 11 名英国全科医生进行了半结构化在线访谈,探讨他们对自己在预防痴呆症方面的角色的看法。使用主题分析对数据进行分析。

结果

全科医生报告说,他们从未与患者明确讨论过痴呆症风险,即使患者出现风险因素,他们也承认预防痴呆症应该是他们角色的一部分。他们倡导采用全科医疗预防实践的全团队方法,利用长期疾病/药物审查或 NHS 健康检查作为平台,针对已经处于风险中的个体进行痴呆症风险沟通。障碍包括缺乏时间以及对可改变的痴呆症风险因素缺乏知识和教育,并且由于担心引起健康焦虑,不愿意在预约中使用“痴呆症”一词。“大脑健康”被认为是为初级保健从业者提供了一种更具鼓励性的论述工具,支持沟通和行为改变。

结论

需要从整个系统层面转变为优先关注大脑健康,并支持初级保健专业人员发挥其预防作用。教育是在预防痴呆症中发挥这一作用的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56a5/10962504/6692923ef781/bjgpapr-2024-74-741-e242-1.jpg

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