加强澳大利亚记忆诊所的诊断后护理:医疗专业人员对当前做法、障碍和促进因素以及理想支持的见解。

Dementia (London, England) Pub Date : 2024-01-01 Epub Date: 2023-11-24 DOI:10.1177/14713012231213419
Slađana Pavković, Lynette Ruth Goldberg, Maree Farrow, Jane Alty, Melissa Abela, Sharon Naismith, Perminder Sachdev, Lee-Fay Low
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引用次数: 0

摘要

导言:在诊断出痴呆症后,为个人和家庭提供以证据为基础的综合支持,对于优化他们的生活质量和帮助他们健康生活至关重要。记忆诊所提供多学科服务,专门对痴呆症患者进行评估和诊断后治疗。本研究旨在确定目前提供诊断后支持的做法、障碍和促进因素,并了解医疗专业人员对澳大利亚记忆诊所应提供的理想诊断后支持的看法:这是一项横断面定性探索性研究。通过两次专家小组会议(22 人),从熟悉诊断过程和诊断后支持的医疗专业人员那里收集数据。此外,还进行了 5 次焦点小组讨论(22 人),包括受雇于澳大利亚记忆诊所的医疗专业人员。数据收集时间为 2020 年 10 月至 2021 年 11 月。对数据进行了反思性主题分析:在三个主题下确定了七个主题和三个次主题:结果:在三个主题下确定了七个主题和三个次主题:当前做法、障碍和促进因素以及理想的支持。与当前做法有关的主题有关于诊断的有针对性的沟通和反馈;药物处方和随访;转诊到医疗和社区服务机构。与障碍和促进因素有关的主题包括当前系统的结构;缺乏资金;缺乏资源;呼吁政府投资。与理想支持有关的主题有关键/单一支持点;认知干预;咨询和教育:澳大利亚记忆诊所的诊断后支持主要集中在确保患者了解其诊断结果、提供诊断后支持信息以及开具痴呆症药物处方。与地区相比,大都市的做法存在明显差异。一个主要问题是需要增加资金,特别是用于支持建立单一联络点,以促进护理的连续性。
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Enhancing post-diagnostic care in Australian memory clinics: Health professionals' insights into current practices, barriers and facilitators, and desirable support.

Introduction: Providing integrated and evidence-based support to individuals and families following a diagnosis of dementia is essential in order to optimise their quality of life and assist them to live well. Memory clinics provide multidisciplinary services specialising in the assessment and post-diagnostic treatment of people with dementia. This study sought to identify current practices, barriers and facilitators to provision of postdiagnostic support and to obtain health professionals' opinion of ideal post-diagnostic support to be offered in Australian memory clinics.

Methodology: This was a cross-sectional qualitative exploratory study. Data was collected from health professionals familiar with the process of diagnosis and post-diagnostic support through two expert panel meetings (n = 22). In addition, 5 focus groups (n = 22) were conducted including health professionals who are employed in Australian memory clinics. Data was collected between October 2020 and November 2021. Reflexive thematic analysis was undertaken.

Results: Seven themes and three subthemes were identified under the three topics: Current Practices, Barriers and Facilitators, and Desirable Support. Themes relating to Current Practices were: Tailored Communication and feedback about diagnosis; Prescription of medications and follow-up; and Referrals to health and community services. Themes relating to Barriers and Facilitators were: The structure of the current system; Lack of funding; Lack of resources; Call for government investment. Themes relating to Desirable support were: A key/single point of support; Cognitive interventions; and Counselling and education.

Conclusion: Post-diagnostic support in Australian memory clinics focused primarily on ensuring people understood their diagnosis, information about postdiagnostic support was provided, and dementia medications were prescribed. There were notable differences in practices in metropolitan compared to regional areas. A key concern was the need for increased funding, particularly to support the establishment of a single point of contact to facilitate continuity of care.

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