The Role of Referrals in Diagnosing Dementia at the Primary Care Level
The Role of Referrals in Diagnosing Dementia at the Primary Care Level
复制标题
转诊在初级保健层面诊断痴呆症中的作用
DOI：
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发表时间：
1999
影响因子：
7
通讯作者：
Matthias C. Angermeyer
中科院分区：
文献类型：
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作者：
S. Riedel;A. Schork;Herbert Matschinger;Matthias C. Angermeyer
背景：人口结构的变化表明人口普遍老龄化，这表明全科医生(GP)在痴呆的诊断和治疗中的关键作用变得更加突出。鼓励全科医生与专家合作是支持全科医生履行与诊断和管理痴呆症相关的各种职能的一个机会。方法：我们使用问卷调查了转诊在初级保健水平诊断痴呆症中的作用以及可能影响德国全科医生转诊行为的变量(n=563)。结果：只有31%的全科医生表示，痴呆症的诊断主要是在转诊给专家的情况下做出的。那些与自助团体、心理学家或“阿尔茨海默氏症协会”/“脑联盟”保持广泛合作关系的全科医生(优势比[OR]1.74)，以及那些感觉到患者亲属非常愿意接受转介的全科医生(OR 2.29)以及注意到专科医生非常愿意接受患者诊断痴呆症的全科医生(OR 2.55)，转诊的机会增加了。通过进一步的培训和科学文献形成治疗方向的全科医生更有可能参考(OR 3.54)。讨论：通过提高全科医生的老年心理能力以及与非医疗服务的联系来加强全科医生和专科医生之间的联系。
Background: Demographic changes indicating a general aging of the population suggest that the key role of general practitioners (GPs) in the diagnosis and management of dementia becomes more salient. The encouragement of GPs to collaborate with specialists is one chance to support GPs in performing a variety of functions associated with the diagnosis and management of dementia. Method: We used a questionnaire to investigate the role of referrals in diagnosing dementia at the primary care level and variables potentially influencing the referral behavior of German GPs (n = 563). Results: Only 31% of the GPs stated that the diagnosis of dementia was made predominantly in the context of referral to a specialist. The chance that referrals were made was increased for those GPs who entertained extensive cooperative relationships with self-help groups, psychologists, or the “Alzheimer Society”/“Brain League” (odds ratio [OR] 1.74) and for those GPs who perceived a great preparedness on the part of the relatives of the patient to comply with a referral (OR 2.29) as well as who noticed a great readiness among specialists to accept patients for the diagnosis of dementia (OR 2.55). GPs whose therapeutic orientation was shaped by further training and scientific literature were more likely to refer (OR 3.54). Discussion: Enhancing the liaison between GPs and specialist physicians by improving the psychogeriatric competence of GPs as well as the connection to nonmedical services is discussed.