Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care.
Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care.
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DOI：
10.1001/jamanetworkopen.2023.36030
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发表时间：
2023-09-05
影响因子：
13.8
通讯作者：
Borson, Soo
中科院分区：
文献类型：
--
作者：
Sideman, Alissa Bernstein;Ma, Melissa;de Jesus, Alma Hernandez;Alagappan, Cecilia;Razon, Na'amah;Dohan, Daniel;Chodos, Anna;Al-Rousan, Tala;Alving, Loren I.;Segal-Gidan, Freddi;Rosen, Howie;Rankin, Katherine P.;Possin, Katherine L.;Borson, Soo
这项定性研究评估了初级保健从业人员对他们在痴呆症诊断和护理中的作用的看法。初级保健医生（PCP）对他们在痴呆症诊断和护理中的作用有什么看法？在这项定性访谈研究中，39名来自加州的PCP，6个主题与他们的观点，他们在痴呆症护理中的作用进行了鉴定。这些主题集中在他们在诊断检查中的作用;与患者建立长期信任关系的重要性;了解患者生活环境的价值;他们教育家庭的工作;他们协调痴呆症护理的活动;以及他们面临的系统级限制。这些研究结果表明，PCP认为他们在提供痴呆症护理方面发挥着重要作用，而他们工作的医疗保健系统并不总是促进这种护理。虽然在初级保健痴呆症护理的障碍是很好的特点，初级保健医生（PCP）的观点可以用来支持设计的价值取向的痴呆症护理途径，加强初级保健的作用。描述PCP在痴呆症诊断和护理中的作用。在这项定性研究中，于2020年3月至2022年11月期间对加州的39名PCP（医生、执业护士和骨科医生）进行了访谈。结果进行了分析，采用专题分析。与PCP在痴呆症护理中的作用相关的全面主题。对39名PCP进行了访谈（25名[64.1%]为女性; 16名[41%]为亚洲人）。大多数（36名PCP [92.3%]）报告称，他们一半以上的患者通过MediCal投保，MediCal是加州医疗补助计划，为低收入个人提供服务。确定了六个主题，传达PCP的观点，他们在痴呆症护理中的作用。这些主题集中在（1）他们作为第一接触点和诊断检查的作用;（2）与患者建立长期信任关系的重要性;（3）了解患者生活背景的价值;（4）他们参与和教育家庭的工作;（5）他们围绕协调痴呆症护理的活动;（6）他们的工作。以及（6）他们想要提供的护理可能受到系统级约束的限制。在这一定性研究的PCP的观点，他们在痴呆症护理的作用，有对齐之间的PCP的初级保健的核心价值观和他们的工作诊断和为痴呆症患者提供护理的观点。该研究还确定了这些价值观与其实践环境中痴呆症护理的卫生系统基础设施之间的不匹配。
This qualitative study evaluates primary care pracitioner perspectives on their role in dementia diagnosis and care. What are primary care practitioner (PCP) perspectives on their role in dementia diagnosis and care? In this qualitative interview study with 39 PCPs from across California, 6 themes associated with their perspectives on their role in dementia care were identified. These themes focused on their role in the diagnostic workup; the importance of long-term, trusting relationships with patients; the value of understanding patients’ life contexts; their work to educate families; their activities around coordinating dementia care; and the systems-level constraints they face. These findings suggest PCPs believe they have an important role in providing dementia care that is not always facilitated by the health care systems in which they work. Although the barriers to dementia care in primary care are well characterized, primary care practitioner (PCP) perspectives could be used to support the design of values-aligned dementia care pathways that strengthen the role of primary care. To describe PCP perspectives on their role in dementia diagnosis and care. In this qualitative study, interviews were conducted with 39 PCPs (medical doctors, nurse practitioners, and doctors of osteopathic medicine) in California between March 2020 and November 2022. Results were analyzed using thematic analysis. Overarching themes associated with PCP roles in dementia care. Interviews were conducted with 39 PCPs (25 [64.1%] were female; 16 [41%] were Asian). The majority (36 PCPs [92.3%]) reported that more than half of their patients were insured via MediCal, the California Medicaid program serving low-income individuals. Six themes were identified that convey PCPs’ perspectives on their role in dementia care. These themes focused on (1) their role as first point of contact and in the diagnostic workup; (2) the importance of long-term, trusting relationships with patients; (3) the value of understanding patients’ life contexts; (4) their work to involve and educate families; (5) their activities around coordinating dementia care; and (6) how the care they want to provide may be limited by systems-level constraints. In this qualitative study of PCP perspectives on their role in dementia care, there was alignment between PCP perspectives about the core values of primary care and their work diagnosing and providing care for people living with dementia. The study also identified a mismatch between these values and the health systems infrastructure for dementia care in their practice environment.
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影响因子：
2.1
作者：
Bradford A;Kunik ME;Schulz P;Williams SP;Singh H
通讯作者：
Singh H
影响因子：
14
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影响因子：
14
作者：
Cordell, Cyndy B.;Borson, Soo;Fried, Leslie B.
通讯作者：
Fried, Leslie B.
影响因子：
14
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--
影响因子：
2.9
作者：
Gibson C;Goeman D;Hutchinson A;Yates M;Pond D
通讯作者：
Pond D