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痴呆症专业护理临床医生对其在痴呆症诊断过程和诊断披露中的角色的看法。

Dementia Specialty Care Clinicians' Perspectives on Their Role in the Dementia Diagnostic Process and Diagnostic Disclosure.

作者信息

Sideman Alissa B, Harrison Krista L, Garrett Sarah B, Paladino Joanna, Naasan Georges, Ritchie Christine S

机构信息

Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.

Global Brain Health Institute, University of California, San Francisco, CA, USA.

出版信息

J Geriatr Psychiatry Neurol. 2025 Jan;38(1):3-12. doi: 10.1177/08919887241254468. Epub 2024 Jul 24.

Abstract

BACKGROUND

Delivering a diagnosis of Alzheimer's disease and related dementias (ADRD) can be challenging not just for patients and families, but also for clinicians. Our objective was to understand dementia specialty care clinicians' perspectives on their role in diagnosis and diagnostic disclosure in dementia.

METHODS

Qualitative interviews with clinicians from a specialty tertiary dementia care center focused on practices, challenges, and opportunities addressing patient and caregiver needs in dementia. Data was analyzed by an interdisciplinary team using thematic analysis.

RESULTS

The 16 participants included behavioral neurologists, social workers, neuropsychologists, and nurses. Themes included the value of providing an accurate diagnosis, the timing and challenges of delivering a diagnosis, the central focus on diagnosis alongside the need for more education on care management, and the role of the interdisciplinary team.

DISCUSSION

We identified areas for improvement and strengths that can be built upon or adapted to other settings, including providing clinicians in specialty and primary care settings more guidance and support when diagnostic challenges arise, strengthening interdisciplinary teamwork, and making dementia diagnosis and care more accessible.

摘要

背景

向患者及其家属传达阿尔茨海默病及相关痴呆症(ADRD)的诊断结果颇具挑战,临床医生也不例外。我们的目的是了解痴呆症专科护理临床医生在诊断和诊断披露方面的角色。

方法

对一家专科三级痴呆症护理中心的临床医生进行了定性访谈,重点关注实践、挑战以及满足痴呆症患者及其照护者需求的机会。一个跨学科团队采用主题分析对数据进行了分析。

结果

16 名参与者包括行为神经科医生、社会工作者、神经心理学家和护士。主题包括提供准确诊断的价值、诊断的时机和挑战、以诊断为中心,同时需要更多关于护理管理的教育,以及跨学科团队的作用。

讨论

我们确定了可以改进和加强的领域,这些领域可以在其他环境中进行借鉴或改编,包括为专科和初级保健环境中的临床医生提供更多指导和支持,以应对诊断挑战,加强跨学科团队合作,并使痴呆症的诊断和护理更加普及。

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