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唐氏综合征患者的阿尔茨海默病性痴呆:关于诊断和治疗中医疗保健缺陷及解决方法的指南辅助专家访谈结果

[Alzheimer's dementia in people with Down syndrome : Results of guideline-assisted expert interviews on healthcare deficits in the diagnostics and treatment as well as solution approaches].

作者信息

Hüer Theresa, Weitzel Milena, Giebel Godwin Denk, Raszke Pascal, Wasem Jürgen, Levin Johannes, Nübling Georg, Wagemann Olivia, Wlasich Elisabeth, Pantel Johannes, Tesky Valentina, Schall Arthur, Walendzik Anke

机构信息

Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Deutschland.

Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Deutschland.

出版信息

Z Gerontol Geriatr. 2025 Aug;58(5):397-404. doi: 10.1007/s00391-024-02371-8. Epub 2024 Oct 9.

DOI:10.1007/s00391-024-02371-8
PMID:39384617
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12321907/
Abstract

BACKGROUND

People with Down syndrome have a genetically increased risk of developing early onset Alzheimer's dementia. An interview study with healthcare providers, patient representatives and employees in residential and work facilities was conducted to identify deficits in the healthcare process and approaches to overcoming them.

METHOD

In this study 14 semi-structured interviews were conducted and analyzed using qualitative content analysis.

RESULTS

A lack of knowledge and experience on the part of medical service providers in dealing with and providing medical care for people with Down syndrome was identified as a key challenge. In addition, the diagnosis of dementia in people with Down syndrome is difficult for various reasons (including lack of appropriate diagnostic tools in standard care and lack of time or financial resources). Doubts were expressed about the efficacy of antidementia medications and the reasons for the increased use of sedatives were discussed. Attentive observation of behavior and involvement of caregivers, regular review and reduction of polypharmacy and the use of alternative behavior modification techniques were mentioned as possible solutions.

CONCLUSION

The identified deficits in the medical care of the target population and the approaches to solving them will be incorporated into the development of health policy recommendations in order to optimize the care situation of those affected in the long term.

摘要

背景

唐氏综合征患者患早发性阿尔茨海默病痴呆症的遗传风险增加。开展了一项针对医疗服务提供者、患者代表以及住宿和工作机构员工的访谈研究,以确定医疗过程中的不足及克服这些不足的方法。

方法

本研究进行了14次半结构化访谈,并采用定性内容分析法进行分析。

结果

医疗服务提供者在应对唐氏综合征患者并为其提供医疗护理方面缺乏知识和经验被确定为一项关键挑战。此外,由于各种原因(包括标准护理中缺乏合适的诊断工具以及缺乏时间或资金资源),唐氏综合征患者的痴呆症诊断存在困难。人们对抗痴呆药物的疗效表示怀疑,并讨论了使用镇静剂增多的原因。有人提到,对行为进行细心观察、护理人员参与、定期审查并减少多种药物联用以及使用替代性行为矫正技术可能是解决办法。

结论

在目标人群医疗护理方面所确定的不足及其解决方法将被纳入卫生政策建议的制定过程,以便从长远角度优化受影响者的护理状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1f/12321907/49bdaa6877e4/391_2024_2371_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1f/12321907/ebfa1d1bb555/391_2024_2371_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1f/12321907/af725c1ee479/391_2024_2371_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1f/12321907/49bdaa6877e4/391_2024_2371_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1f/12321907/ebfa1d1bb555/391_2024_2371_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1f/12321907/af725c1ee479/391_2024_2371_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c1f/12321907/49bdaa6877e4/391_2024_2371_Fig3_HTML.jpg

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