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医生中与痴呆症相关的污名化:减少污名化干预措施的范围综述

Dementia-related stigma in physicians: a scoping review of stigma-reduction interventions.

作者信息

Warren Alison, Wynia Zan

机构信息

The Department of Clinical Research and Leadership, School of Medicine and Health Sciences, George Washington University, Washington, DC, United States.

The Frame-Corr Laboratory, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.

出版信息

Front Dement. 2025 Jul 22;4:1601462. doi: 10.3389/frdem.2025.1601462. eCollection 2025.

DOI:10.3389/frdem.2025.1601462
PMID:40766949
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12321845/
Abstract

INTRODUCTION

Despite progress in dementia diagnosis and treatment, physician-held stigma remains a significant barrier to early recognition and effective care. Stigmatizing attitudes among healthcare professionals can negatively impact diagnosis rates, clinical interactions, and care quality for people living with dementia.

METHODS

This scoping review was conducted following Arksey and O'Malley's framework. Peer-reviewed literature from 2014 to 2024 was systematically reviewed to identify and evaluate interventions aimed at reducing dementia-related stigma among physicians. A total of 14 studies met inclusion criteria, examining educational, skill-building, and person-centered approaches.

RESULTS

Interventions included brief workshops, online modular training, and interdisciplinary methods integrating person-centered frameworks and behavior management tools. Validated outcome measures used in the studies included the Alzheimer's Disease Knowledge Scale (ADKS), the Dementia Negative Stereotype Scale (DNS), and the General Practitioners Confidence and Attitude Scale for Dementia (GPACS-D). Across studies, interventions were found to improve clinical confidence, reduce negative stereotypes, and enhance care quality.

DISCUSSION

Findings highlight the importance of culturally sensitive and interdisciplinary interventions to address stigma, improve clinical confidence, and enhance care quality, particularly in low-resource settings. Notable gaps remain in understanding the long-term impact and scalability of such interventions. This review aims to contribute a deeper understanding of the barriers and facilitators to implementing dementia care practices, offering a conceptualization for enhanced physician education and improved health outcomes for persons with dementia. We offer recommendations for future research to develop tailored strategies that support stigma reduction and improve care delivery.

摘要

引言

尽管在痴呆症诊断和治疗方面取得了进展,但医生的污名化观念仍然是早期识别和有效护理的重大障碍。医疗保健专业人员的污名化态度会对痴呆症患者的诊断率、临床互动和护理质量产生负面影响。

方法

本范围综述是按照阿克西和奥马利的框架进行的。系统回顾了2014年至2024年的同行评审文献,以识别和评估旨在减少医生中与痴呆症相关污名的干预措施。共有14项研究符合纳入标准,研究了教育、技能培养和以人为本的方法。

结果

干预措施包括简短的研讨会、在线模块化培训以及整合以人为本框架和行为管理工具的跨学科方法。研究中使用的经过验证的结果指标包括阿尔茨海默病知识量表(ADKS)、痴呆症负面刻板印象量表(DNS)和全科医生对痴呆症的信心和态度量表(GPACS-D)。在各项研究中,发现干预措施可提高临床信心、减少负面刻板印象并提高护理质量。

讨论

研究结果强调了文化敏感和跨学科干预措施对于消除污名、提高临床信心和改善护理质量的重要性,尤其是在资源匮乏的环境中。在理解此类干预措施的长期影响和可扩展性方面仍存在显著差距。本综述旨在更深入地理解实施痴呆症护理实践的障碍和促进因素,为加强医生教育和改善痴呆症患者的健康结果提供一个概念框架。我们为未来的研究提供建议,以制定支持减少污名和改善护理提供的量身定制策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/12321845/4f4618793795/frdem-04-1601462-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/12321845/4f4618793795/frdem-04-1601462-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc95/12321845/4f4618793795/frdem-04-1601462-g001.jpg

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