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痴呆症护理中的挑战与需求:瑞典初级保健中痴呆症患者及家庭护理人员从诊断到随访的经历:一项定性研究

Challenges and needs in dementia care: people with dementia and family caregivers' experiences from diagnosis to follow-up in Swedish primary care: a qualitative study.

作者信息

Bergqvist Monica, Bastholm-Rahmner Pia, Modig Karin, Schmidt-Mende Katharina

机构信息

Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden.

Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.

出版信息

Scand J Prim Health Care. 2025 Jul 12:1-14. doi: 10.1080/02813432.2025.2529414.

Abstract

OBJECTIVE

Primary care plays a central role in diagnosing dementia and coordinating and providing care. This study explores how older people with dementia and their family caregivers experience the process from diagnosis to follow-up in primary care, what support is needed, what works well and what could be improved.

DESIGN

Semi-structured interviews were conducted with four people with dementia and 11 family caregivers in Stockholm, Sweden. Data were analyzed with inductive thematic analysis.

RESULTS

Four themes were identified: , describes the transition from primary care to memory clinics, where empathy and professionalism are crucial to prevent feelings of failure. , highlights a communication gap between memory clinics and primary care that leaves informants feeling abandoned and causes emotional distress and isolation. , underscores the importance of having 'a single point of entry' for coordinated support and a primary care provider with expertise in dementia. , emphasizes the need for guidance from a dedicated dementia team to manage progression.

CONCLUSION

People with dementia and their caregivers felt that primary care often failed to meet their needs due to limited accessibility, poor coordination, and a lack of dementia-specific expertise. Strengthening the role of general practitioners, introducing liaison nurses, and enhancing collaboration with municipal services could improve continuity, navigation, and support. These findings underscore the need for Swedish health care policy to promote sustainable, person-centered dementia care models within primary care.

摘要

目的

初级保健在痴呆症诊断以及协调和提供护理方面发挥着核心作用。本研究探讨了患有痴呆症的老年人及其家庭护理人员在初级保健中从诊断到随访的过程体验、需要何种支持、哪些方面运作良好以及哪些方面可以改进。

设计

对瑞典斯德哥尔摩的4名痴呆症患者和11名家庭护理人员进行了半结构化访谈。采用归纳主题分析法对数据进行分析。

结果

确定了四个主题:,描述了从初级保健向记忆诊所的过渡,其中同理心和专业精神对于防止失败感至关重要。,突出了记忆诊所与初级保健之间的沟通差距,这使受访者感到被遗弃,并导致情绪困扰和孤立感。,强调了拥有“单一入口点”以获得协调支持以及具备痴呆症专业知识初级保健提供者的重要性。,强调了需要由专门的痴呆症团队提供指导以管理病情进展。

结论

痴呆症患者及其护理人员认为,由于可及性有限、协调不善以及缺乏痴呆症特定专业知识,初级保健往往无法满足他们的需求。加强全科医生的作用、引入联络护士以及加强与市政服务的合作可以改善连续性、引导和支持。这些发现强调了瑞典医疗保健政策需要在初级保健中推广可持续的、以患者为中心的痴呆症护理模式。

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