Cheok A S, Cohen C A, Zucchero C A
Department of Psychiatry, University of Toronto.
Can Fam Physician. 1997 Mar;43:477-82.
To examine the practice patterns of family physicians in diagnosing and managing patients with dementia.
In-depth structured interviews.
Metropolitan Toronto family practices.
Twenty family physicians who referred patients to a specialized community psychiatry service for the elderly in the previous year.
Two vignettes focusing on diagnosis and management issues were developed for the study. Physicians were asked how they would handle the clinical problems presented in the vignettes. Their responses were compared to standardized diagnostic and management protocols.
Participants were more comfortable with diagnosing dementia than with ongoing management issues, and most physicians were not using standardized cognitive screening protocols. Physicians were more oriented to immediate medical and psychiatric problems than to long-term psychosocial issues.
More attention should be paid to the ongoing educational needs of family physicians with respect to this patient population.
研究家庭医生诊断和管理痴呆患者的实践模式。
深入结构化访谈。
大多伦多地区的家庭诊所。
前一年将患者转诊至专门的老年社区精神病服务机构的20名家庭医生。
为该研究设计了两个聚焦于诊断和管理问题的病例。询问医生他们将如何处理病例中呈现的临床问题。将他们的回答与标准化诊断和管理方案进行比较。
参与者对痴呆的诊断比对持续管理问题更得心应手，且大多数医生未使用标准化认知筛查方案。医生更关注即时的医疗和精神问题，而非长期的社会心理问题。
应更加关注针对这一患者群体的家庭医生持续教育需求。
