Diagnosis and management of dementia in primary care at an early stage: the need for a new concept and an adapted procedure
Diagnosis and management of dementia in primary care at an early stage: the need for a new concept and an adapted procedure
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初级保健中痴呆症的早期诊断和管理：需要新概念和适应程序
DOI：
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发表时间：
1999
影响因子：
1.4
通讯作者：
J. Heyrman
中科院分区：
文献类型：
--
作者：
J. de Lepeleire;J. Heyrman
在初级保健中诊断痴呆症既困难又重要。几位作者的建议，以提高诊断痴呆症的全科医生是重要的，但不够的。有人认为，也许疾病的概念本身就是临床医生混淆的原因。初级保健医生需要一个适应的程序，逐步导致痴呆症的最终诊断。它必须是一个逐步的标签策略，在开始时使用全球描述和非疾病特异性标签，最终以明确的疾病标准结束。在这个过程中，有一个循环：以前的诊断必须记住，因为症状和体征可能会在疾病进展过程中逐渐改变，导致重新考虑以前删除的选项。为了正确地构建这一框架，初级保健医生需要采用一个广泛的“体弱老人”的老年概念。这一概念的实施不仅有助于诊断过程，而且还刺激了对痴呆患者及其护理人员的护理。初级保健医生的早期诊断参与的相关参数可以提出的条件下，一个新的概念，适应的程序和适应的工具被使用。
Diagnosis of dementia in primary care is both difficult and important. The recommendations by several authors to improve the diagnosis of dementia by general practitioners are important, but insufficient. It is argued that perhaps the disease concept in itself is a cause of confusion for clinicians. Primary care physicians need an adapted procedure, gradually leading to the final diagnosis of dementia. It has to be a stepwise labelling strategy, using global descriptions and non-disease specific labels in the beginning, ending up with well-defined disease criteria. In this process, there is circularity: previous diagnoses have to be kept in mind because symptoms and signs may gradually change during the progression of the disease, leading to reconsideration of previous deleted options. To frame this properly, the primary care physician needs to adopt a broad “frail elderly” geriatric concept. Implementation of this concept not only helps the diagnostic process, but also stimulates the care for dementing patients and their caregivers. Relevant arguments for early diagnostic involvement of primary care physicians can be put forward on condition that a new concept, adapted procedures and adapted instruments are used.
老年人认知障碍的筛查：对当前方法的严格审查。
影响因子：
7.2
作者：
Ritchie,K
通讯作者：
Ritchie,K
DOI：
10.1001/jama.1996.03540210033030
发表时间：
1996-12-04
影响因子：
120.7
作者：
Mittelman, MS;Ferris, SH;Levin, B
通讯作者：
Levin, B
初级保健医生对抑郁症患者使用认知行为技术。
DOI：
--
发表时间：
1995
期刊：
The Journal of family practice
影响因子：
--
作者：
Robinson,P;Bush,T;VonKorff,M;Katon,W;Lin,E;Simon,GE;Walker,E
通讯作者：
Walker,E