Neugebauer Till, Brzoska Patrick, Özcebe Hilal, Yilmaz-Aslan Yüce
Faculty of Health, Health Services Research, School of Medicine, Witten/Herdecke University, Witten, Germany.
Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Int J Geriatr Psychiatry. 2025 Mar;40(3):e70068. doi: 10.1002/gps.70068.
Facilitating and challenging aspects of a non-linear diagnostic process of dementia were explored in interviews with physicians from outpatient clinics of a major hospital in Turkey.
Semi-structured interviews were conducted with 15 physicians between March and April 2023. Purposive sampling was used to identify clinics that perform dementia diagnostics, including neurology, geriatrics, and psychiatry outpatient clinics. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis.
Facilitating and challenging aspects were perceived on three levels: (1) diagnostic procedures and methods, which focus on the assessment of dementia and the aspects that arise in the process; (2) communication, which describes the verbal and nonverbal relationships between health care professionals, patients, and their caregivers, as well as their communication styles; (3) care environment, which describes the various environmental influences on patients, both on a sociocultural and institutional level.
The diagnostic process for dementia involves several interrelated aspects, making a flexible, holistic approach essential. In this study, the social and cultural context of the patients and the involvement of the family emerged as crucial elements. By integrating these aspects, along with a mix of informal and formal communication between healthcare providers and families, the diagnostic process can become more patient-centered and effective. To further improve outcomes, raising awareness and providing education about dementia could reduce stigma and encourage earlier recognition and better management of the condition during the diagnostic process.
通过对土耳其一家大型医院门诊医生的访谈，探讨痴呆非线性诊断过程中的促进因素和挑战因素。
2023年3月至4月间，对15名医生进行了半结构化访谈。采用目的抽样法确定进行痴呆诊断的科室，包括神经内科、老年医学科和精神科门诊。访谈进行了录音、转录，并采用定性内容分析法进行分析。
促进因素和挑战因素体现在三个层面：（1）诊断程序和方法，重点是痴呆评估及过程中出现的方面；（2）沟通，描述医疗保健专业人员、患者及其照顾者之间的言语和非言语关系，以及他们的沟通方式；（3）护理环境，描述社会文化和机构层面上对患者的各种环境影响。
痴呆的诊断过程涉及几个相互关联的方面，因此灵活、全面的方法至关重要。在本研究中，患者的社会文化背景和家庭的参与成为关键因素。通过整合这些方面，以及医疗保健提供者与家庭之间非正式和正式沟通的结合，诊断过程可以变得更加以患者为中心且有效。为了进一步改善结果，提高对痴呆的认识并提供相关教育可以减少污名化，并鼓励在诊断过程中更早地识别和更好地管理该疾病。
