Journal articles on the topic 'GP confidence and attitudes to Dementia'
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Mason, Ron, Kathleen Doherty, Claire Eccleston, Margaret Winbolt, Marita Long, and Andrew Robinson. "Effect of a dementia education intervention on the confidence and attitudes of general practitioners in Australia: a pretest post-test study." BMJ Open 10, no. 1 (January 2020): e033218. http://dx.doi.org/10.1136/bmjopen-2019-033218.
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ObjectivesThis study assessed the impact of a Dementia Education Workshop on the confidence and attitudes of general practitioner (GP) registrars (GPR) and GP supervisors (GPS) in relation to the early diagnosis and management of dementia.DesignPretest post-test research design.SettingContinuing medical education in Australia.Participants332 GPR and 114 GPS.InterventionsRegistrars participated in a 3-hour face-to-face workshop while supervisors participated in a 2-hour-modified version designed to assist with the education and supervision of registrars.Main outcome measuresThe General Practitioners Confidence and Attitude Scale for Dementia was used to assess overall confidence, attitude to care and engagement. A t-test for paired samples was used to identify differences from preworkshop (T1) to postworkshop (T2) for each GP group. A t-test for independent samples was undertaken to ascertain differences between each workshop group. A Cohen’s d was calculated to measure the effect size of any difference between T1 and T2 scores.ResultsSignificant increases in scores were recorded forConfidence in Clinical Abilities,Attitude to CareandEngagementbetween pretest and post-test periods. GPR exhibited the greatest increase in scores forConfidence in Clinical AbilitiesandEngagement.ConclusionsTargeted educational interventions can improve attitude, increase confidence and reduce negative attitudes towards engagement of participating GPs.
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Subramaniam, Mythily, Hui Lin Ong, Edimansyah Abdin, Boon Yiang Chua, Saleha Shafie, Fiona Devi Siva Kumar, Sophia Foo, et al. "General Practitioner’s Attitudes and Confidence in Managing Patients with Dementia in Singapore." Annals of the Academy of Medicine, Singapore 47, no. 3 (March 15, 2018): 108–18. http://dx.doi.org/10.47102/annals-acadmedsg.v47n3p108.
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The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs’ attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the “GP Attitudes and Competencies Towards Dementia” questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n = 296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed or agreed that early recognition of dementia served the welfare of the patients (n = 385; 96%) and their relatives (n = 387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of the questionnaire revealed 4 factors representing “benefits of early diagnosis and treatment of patients with dementia”, “confidence in dealing with patients and caregiver of dementia", “negative perceptions towards dementia care” and “training needs”. GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical first step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs’ knowledge, confidence and comfort in managing patients with dementia. Key words: Communication, Diagnosis, Management
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Tang, Eugene Yee Hing, Ratika Birdi, and Louise Robinson. "Attitudes to diagnosis and management in dementia care: views of future general practitioners." International Psychogeriatrics 30, no. 3 (August 9, 2016): 425–30. http://dx.doi.org/10.1017/s1041610216001204.
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ABSTRACTConsiderable international governmental support is focused on the timely diagnosis of dementia and post-diagnostic care of people with dementia. Identifying those at high risk of dementia is one approach to timely diagnosis. General practitioners (GPs) are well-placed clinicians in the community to provide both pre- and post-diagnostic dementia care. However, GPs have in the past consistently demonstrated low confidence in both diagnosing dementia and providing care for these complex patients particularly for patients in the post-diagnostic phase. It is currently unclear how future GPs view dementia care. We aimed to evaluate the current attitudes and experiences of future GPs in dementia care and their views on targeting high risk groups. All (n = 513) GP trainees were approached by email to participate in a cross-sectional web and paper-based survey in the North of England. A further reminder was sent out two months after the initial invitation. We received 153 responses (29.8% response rate, 66.7% female, average age 31 (range 25–55 years old). The main difficulties encountered included coordinating supporting services for carers and the person with dementia and responding to co-existing behavioral and psychiatric symptoms. Further education in dementia management was considered to be important by respondents. GP trainees were generally very positive about their future role in caring for people with dementia, particularly in the area of earlier diagnosis via identification of high-risk individuals. Future GPs in one area of England are very positive about their key role in dementia care. In order to facilitate the delivery of high quality, community-based care, work is required to establish core post-diagnostic dementia support services. Further research is needed to identify effective systems to enable accurate assessment and to ensure earlier diagnosis in high-risk groups.
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Milne, Alisoun J., Kate Hamilton-West, and Eleni Hatzidimitriadou. "GP attitudes to early diagnosis of dementia: Evidence of improvement." Aging & Mental Health 9, no. 5 (September 2005): 449–55. http://dx.doi.org/10.1080/13607860500142762.
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Burke, Sarah, Athanasios Hassoulas, and Andrew Forrester. "An Investigation Into the Impact of Dementia Knowledge and Attitudes on Individuals’ Confidence in Practice: A Survey of Non-Healthcare Staff Inside the Prison Estate in England and Wales." BJPsych Open 8, S1 (June 2022): S129. http://dx.doi.org/10.1192/bjo.2022.380.
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AimsWhilst the majority of age groups are seeing a decline in numbers in prison custody, the older male population continues to rise year on year. This unexpected trend has led researchers to investigate the needs of this particular cohort in more detail and start to question if the prison estate is able to care for the specific needs of the ageing population. This primary research specifically, looks to investigate what relationship, if any knowledge and attitudes to dementia have on how the confidence in practice levels of non-healthcare prison staffMethodsThis research, in a specific, applied context considers the relationship between attitudes toward the prison estate alongside knowledge and attitudes toward dementia in general and the potential relationship these may have on confidence levels. To do this, the research scored individuals’ responses against the dementia knowledge assessment scale, attitudes to the prison estate and general attitudes toward dementia. These three independent variables were measured both overall and individually against individual confidence in practices scores. 50 individuals participated with differing roles and length of service in the prison estateResultsThe results of the study found that the overall model was significant. Of the three independent variables, it was found that positive attitudes to dementia were the most influential predictor of confidence. Knowledge of the condition and attitudes to the prison estate, the second and third independent variable however were not significant predictors of confidence in practice levels. Overall, the results indicate that there is a relationship between knowledge, attitudes, and confidence in delivery of dementia care in the prison estate as an overall model.ConclusionThe main objective of this study was to determine the knowledge and attitudes to dementia of non-healthcare prison staff and if that knowledge and those attitudes had an impact on confidence in practice levels. It could be argued that this research has fulfilled its primary aim, reporting that knowledge about and attitudes toward dementia scores are a significant predictor of knowledge of the condition in non-healthcare-based staff.
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Schneider, Catherine E., Alycia A. Bristol, Ariel Ford, Shih-Yin Lin, and Abraham A. Brody. "THE IMPACT OF ALIVIADO DEMENTIA CARE HOSPICE EDITION TRAINING PROGRAM ON HOSPICE STAFF’S DEMENTIA SYMPTOM KNOWLEDGE." Innovation in Aging 3, Supplement_1 (November 2019): S851. http://dx.doi.org/10.1093/geroni/igz038.3130.
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Abstract A lack of high quality dementia training for healthcare workers is a key barrier to effective care for persons with dementia (PWD), a vulnerable and increasing population across the care continuum. Hospice agencies in particular are underprepared to care for this population, although annually about 17% of hospice patients have a primary diagnosis of dementia and an additional 28% as a comorbidity. Aliviado Dementia Care-Hospice Edition is an interdisciplinary, evidence-based quality improvement program developed to assist hospice interdisciplinary teams in caring for PWD and their caregivers. Interdisciplinary hospice team members in two agencies were enrolled in online training modules, which addressed multiple areas including pain, behavioral and psychological symptoms of dementia (BPSD), and working with caregivers. They were also provided a toolkit to integrate training in daily practice. Changes in knowledge, confidence and attitudes were tested before and after training and paired t-tests were utilized to evaluate the program’s effect. Thirty-five individuals completed the program and pre/post tests. Paired t-tests showed clinically and statistically significant increases in knowledge, attitudes and confidence in five of 10 domains including depression knowledge and confidence and BPSD knowledge, confidence and interventions. The greatest increase was in using BPSD interventions (18.5% increase, p-value: 0.0002), depression confidence (15.9% increase, p-value: 0.006) and BPSD confidence (12.6% increase, p-value: 0.02). Aliviado is an evidence-based, systems-level intervention shown to improve clinical knowledge, attitudes and confidence in treating pain and BPSD in PWD. This training could be used to produce systems-level practice change for hospice interdisciplinary team members serving PWD.
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Veneziani, Federica, Francesco Panza, Vincenzo Solfrizzi, Rosa Capozzo, Maria Rosaria Barulli, Antonio Leo, Madia Lozupone, et al. "Examination of level of knowledge in Italian general practitioners attending an education session on diagnosis and management of the early stage of Alzheimer's disease: pass or fail?" International Psychogeriatrics 28, no. 7 (January 28, 2016): 1111–24. http://dx.doi.org/10.1017/s1041610216000041.
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ABSTRACTBackground:We detected the general level of knowledge about the early diagnosis of Alzheimer's disease (AD) and subsequent care in general practitioners (GPs) from Southern Italy. We explored also the GP perception about their knowledge and training on diagnosis and management of AD.Methods:On a sample of 131 GPs, we administered two questionnaires: the GP-Knowledge, evaluating GPs’ expertise about AD epidemiology, differential diagnosis, and available treatments, and the GP-QUestionnaire on Awareness of Dementia (GP-QUAD), assessing the GPs’ attitudes, awareness, and practice regarding early diagnosis of dementia.Results:Specific screening tests or protocols to diagnose and manage dementia were not used by 53% of our GPs. The training on the recognition of early AD signs and symptoms was considered inadequate by 55% of the participants. Females were more likely to consider their training insufficient (58%) compared to males (53%). Female GPs were less likely to prescribe antipsychotic drugs to control neuropsychiatric symptoms (NPS) and suggest specialist advice in late stage of cognitive impairment. Multiple Correspondence Analysis (MCA) performed only on GP-QUAD suggested two dimensions explaining 26.1% (“GP attitude”) and 20.1% (“GP knowledge”) of the inertia for a total of 46.2%,Conclusion:In our survey on GP clinical practice, several problems in properly recognizing early AD symptoms and subsequently screening patients to be referred to secondary/tertiary care centers for diagnosis confirmation have emerged. In the future, specific training programs and educational projects for GPs should be implemented also in Italy to improve detection rates and management of dementia in primary care.
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Bentley, Michael W., Rohan Kerr, Margaret Ginger, and Jacob Karagoz. "Behavioural change in primary care professionals undertaking online education in dementia care in general practice." Australian Journal of Primary Health 25, no. 3 (2019): 244. http://dx.doi.org/10.1071/py18079.
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A challenge facing general practice is improving the diagnosis, management and care of people with dementia. Training and education for primary care professionals about knowledge and attitudes about dementia is needed. Online resources can provide educational opportunities for health professionals with limited access to dementia training. An online educational resource (four modules over 3 h) was designed to assist primary care practitioners to develop a systematic framework to identify, diagnose and manage patients with dementia within their practice. Interviews and questionnaires (knowledge, attitudes, confidence and behavioural intentions), with practice nurses and international medical graduates working in general practices, were used to evaluate the resource. Participants’ knowledge, confidence and attitudes about dementia increased after completing the modules. Participants had strong intentions to apply a systematic framework to identify and manage dementia. In post-module interviews, participants reported increased awareness, knowledge and confidence in assessing and managing people with dementia, corroborating the questionnaire results. This project has demonstrated some early changes in clinical behaviour around dementia care in general practice. Promoting the value of applying a systematic framework with colleagues and co-workers could increase awareness of, and participation in, dementia assessment by other primary care professionals within general practices.
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Herrick, Tamara, and Michelle Ward. "Physician Attitudes and Confidence Toward Dementia Capability: Screening, Diagnoses, and Referrals." Innovation in Aging 4, Supplement_1 (December 1, 2020): 202. http://dx.doi.org/10.1093/geroni/igaa057.654.
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Abstract The MaineHealth Alzheimer’s Disease Partnership is working to improve integration between the healthcare system and community partners through training and a referral network. Primary care providers are often the first to assess cognitively impaired patients, so it is important to understand their attitudes and confidence in dealing with dementia. The objective of this study is to determine barriers to care and evaluate healthcare providers’ attitudes towards their dementia capability, which includes screening for cognitive impairment, disclosing diagnoses, and making referrals to community-based organizations or specialists. A 27-item survey was developed and sent to 474 providers from MaineHealth practices via email. Fifty-three providers responded to the survey. Five healthcare professionals also took part in a focus group; looking more specifically at challenges encountered throughout the dementia care system. This poster will present the findings from the survey and focus group. There was strong agreement that much can be done to improve the quality of life for patients with dementia (86% agreed/strongly agreed) and that screening all patients over age 65 is important (85% agreed/strongly agreed). Confidence levels in ability to diagnose dementia, provide memory loss information, and refer patients to specialists were significantly associated with training (p<.05). The majority of providers identified barriers to cognitive screening and referring patients to community-based organizations, showing that improvements are needed at the system level to remove these barriers. Overall, the results suggest that dementia specific training can improve confidence in care and allow physicians to provide more information about memory loss to patients.
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Gkioka, Mara, Birgit Teichmann, Despina Moraitou, Sotirios Papagiannopoulos, and Magda Tsolaki. "Effects of a Person Centered Dementia Training Program in Greek Hospital Staff—Implementation and Evaluation." Brain Sciences 10, no. 12 (December 12, 2020): 976. http://dx.doi.org/10.3390/brainsci10120976.
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People with Dementia (PwD) are frequently admitted in general hospitals. However, health care professionals have lack of dementia knowledge, negative attitudes toward dementia, and lack of confidence in caring those patients. The aim of this study is to develop, implement and evaluate a dementia staff training program in Greek general hospitals. It was a repeated-measures research design. Fourteen (14) two-day workshops were conducted, consisting of six targeted and interactive modules. Staff members (N = 242) attended the program and were assessed according to (1) individual performance: questionnaires about attitudes towards dementia, confidence in care, knowledge about dementia and anxiety before, immediately after the training and three months later, (2) an overall training evaluation immediately after the training and (3) an evaluation of training implementation three months later. Positive attitudes towards dementia, improvement of confidence in care and decrease of feeling of anxiety as a trait, were sustained over time. Knowledge about dementia also increased after the training and sustained, with, however, a slight decrease over time. A well applied training program seems to provide the basis of a better care in PwD during hospitalization. However, changes in the organizational level and a transformation of care culture are necessary for training sustainability over time.
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Allison, Rosalie L., Ellie J. Ricketts, Thomas Hartney, Anthony Nardone, Katy Town, Claire Rugman, Kate Folkard, J. Kevin Dunbar, and Cliodna AM McNulty. "Qualitative impact assessment of an educational workshop on primary care practitioner attitudes to NICE HIV testing guidelines." BJGP Open 2, no. 1 (March 6, 2018): bjgpopen18X101433. http://dx.doi.org/10.3399/bjgpopen18x101433.
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BackgroundIn 2013, Public Health England piloted the ‘3Cs (chlamydia, contraception, condoms) and HIV (human immunodeficiency virus)’ educational intervention in 460 GP surgeries. The educational HIV workshop aimed to improve the ability and confidence of staff to offer HIV testing in line with national guidelines.AimTo qualitatively assess the impact of an educational workshop on GP staff’s attitudes to NICE HIV testing guidelines.Design & settingQualitative interviews with GP staff across England before and after an educational HIV workshop.MethodThirty-two GP staff (15 before and 17 after educational HIV workshop) participated in interviews exploring their views and current practice of HIV testing. Interview transcripts were thematically analysed and examined, using the components of the theory of planned behaviour (TPB) and normalisation process theory (NPT) as a framework.ResultsGPs reported that the educational HIV workshop resulted in increased knowledge of, and confidence to offer, HIV tests based on indicator conditions. However, overall participants felt they needed additional HIV training around clinical care pathways for offering tests, giving positive HIV results, and current treatments and outcomes. Participants did not see a place for point-of-care testing in general practice.ConclusionImplementation of national HIV guidelines will require multiple educational sessions, especially to implement testing guidelines for indicator conditions in areas of low HIV prevalence. Additional role-play or discussions around scripts suggesting how to offer an HIV test may improve participants’ confidence and facilitate increased testing. Healthcare assistants (HCAs) may need specific training to ensure that they are skilled in offering HIV testing within new patient checks.
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Wangler, Julian, and Michael Jansky. "Dementia diagnostics in general practitioner care." Wiener Medizinische Wochenschrift 170, no. 9-10 (December 6, 2019): 230–37. http://dx.doi.org/10.1007/s10354-019-00722-4.
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SummaryGeneral practitioner (GP) treatment of dementia is often criticized as being ineffective and not implemented consistently enough. The causes and specific standpoints of GPs have not previously been thoroughly investigated. This paper focuses on the reasons and the criticisms levelled at GPs with regard to diagnosing dementia, and identifies approaches to enable optimization. The analysis is based on 41 semi-structured interviews with GPs in Hesse, Germany, in 2018. During the course of a content analysis, the interviewees’ attitudes and behavioral patterns towards dementia diagnostics were to be analyzed. The results of the study show various challenges and problems of primary care in this field. The majority of the sample showed skepticism and reluctance with regard to the diagnosis of dementia. Six key problem areas were extracted from the interviews, which can be seen as root causes for the distance kept by GPs: 1) early delegation of patients due to role understanding, 2) attitude of pessimism towards dementia, 3) differential diagnosis perceived as an obstacle, 4) insufficient remuneration, 5) fear of patient stigmatization, and 6) lack of application. Some GPs demonstrated personal initiative with the aim of optimizing dementia diagnostics. Three approaches can be derived which could be used to improve the GP-based care of dementia: 1) self-efficacy, 2) differential diagnostics and treatment pathways, and 3) physician–patient communication.
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Leung, Cheuk Wing, Tai Pong Lam, Kwai Wing Wong, and Vai Kiong David Chao. "Early detection of dementia: The knowledge and attitudes of primary care physicians in Hong Kong." Dementia 19, no. 3 (July 19, 2018): 830–46. http://dx.doi.org/10.1177/1471301218788133.
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BackgroundDementia affects people worldwide and its prevalence is growing. Early detection of dementia by primary care physicians can be beneficial; thus, their knowledge and attitudes about this issue are important.ObjectiveTo assess primary care physicians’ knowledge and attitudes about the early detection of dementia in Hong Kong.MethodsThis was a mixed methods (qualitative and quantitative) study. Four focus groups with a purposive sample of 31 primary care physicians were interviewed, and a questionnaire-survey was completed and returned by 437 primary care physicians.ResultsParticipants all agreed that the early detection of dementia would benefit patients and primary care physicians should be capable of making such diagnoses. Confidence in making an early diagnosis varied; physicians tended to overlook symptoms in the early stages. All agreed that more training is needed at the post-graduate level of medical education.ConclusionsParticipants had positive attitudes towards early detection of dementia; however, their confidence and ability to make an early diagnosis varied.
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Pentzek, Michael, Michael Wagner, Heinz-Harald Abholz, Horst Bickel, Hanna Kaduszkiewicz, Birgitt Wiese, Siegfried Weyerer, et al. "The value of the GP’s clinical judgement in predicting dementia: a multicentre prospective cohort study among patients in general practice." British Journal of General Practice 69, no. 688 (October 8, 2019): e786-e793. http://dx.doi.org/10.3399/bjgp19x706037.
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BackgroundClinical judgement is intrinsic to diagnostic strategies in general practice; however, empirical evidence for its validity is sparse.AimTo ascertain whether a GP’s global clinical judgement of future cognitive status has an added value for predicting a patient’s likelihood of experiencing dementia.Design and settingMulticentre prospective cohort study among patients in German general practice that took place from January 2003 to October 2016.MethodPatients without baseline dementia were assessed with neuropsychological interviews over 12 years; 138 GPs rated the future cognitive decline of their participating patients. Associations of baseline predictors with follow-up incident dementia were analysed with mixed-effects logistic and Cox regression.ResultsA total of 3201 patients were analysed over the study period (mean age = 79.6 years, 65.3% females, 6.7% incident dementia in 3 years, 22.1% incident dementia in 12 years). Descriptive analyses and comparison with other cohorts identified the participants as having frequent and long-lasting doctor–patient relationships and being well known to their GPs. The GP baseline rating of future cognitive decline had significant value for 3-year dementia prediction, independent of cognitive test scores and patient’s memory complaints (GP ratings of very mild (odds ratio [OR] 1.97, 95% confidence intervals [95% CI] = 1.28 to 3.04); mild (OR 3.00, 95% CI = 1.90 to 4.76); and moderate/severe decline (OR 5.66, 95% CI = 3.29 to 9.73)). GPs’ baseline judgements were significantly associated with patients’ 12-year dementia-free survival rates (Mantel–Cox log rank test P<0.001).ConclusionIn this sample of patients in familiar doctor–patient relationships, the GP’s clinical judgement holds additional value for predicting dementia, complementing test performance and patients’ self-reports. Existing and emerging primary care-based dementia risk models should consider the GP’s judgement as one predictor. Results underline the importance of the GP-patient relationship.
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Gkioka, Mara, Magdalini Tsolaki, Sotirios Papagianopoulos, Birgit Teichmann, and Despina Moraitou. "Psychometric properties of dementia attitudes scale, dementia knowledge assessment tool 2 and confidence in dementia scale in a Greek sample." Nursing Open 7, no. 5 (July 3, 2020): 1623–33. http://dx.doi.org/10.1002/nop2.546.
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Jacinto, Alessandro Ferrari, Paulo José Fortes Villas Boas, Vânia Ferreira de Sá Mayoral, and Vanessa de Albuquerque Citero. "Knowledge and attitudes towards dementia in a sample of medical residents from a university-hospital in São Paulo, Brazil." Dementia & Neuropsychologia 10, no. 1 (March 2016): 37–41. http://dx.doi.org/10.1590/s1980-57642016dn10100007.
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An estimated 61% of the 24.3 million people diagnosed with dementia worldwide live in underdeveloped countries, including Brazil, where a public healthcare system covers the majority of the population. This care is usually provided by General Practitioners (GP) and in Brazil many doctors recently graduated from medical school and residents of different medical specialties practice as GPs. Objective : The aim of this study was to describe the knowledge and attitudes about dementia in a sample of Brazilian medical residents from a university-hospital in São Paulo, Brazil. Methods : A total of 152 Brazilian medical residents participated in the study. Participants answered a "Knowledge Quiz" (KQ) and "Attitude Quiz" (AQ) about dementia issues, transculturally adapted for use in Brazilian physicians. A descriptive analysis of the correct answers on knowledge and of the attitude aspects was performed. Results : The medical residents showed poor knowledge (<50%) about dementia prevalence and incidence and a good knowledge on disease management and diagnosis. Participants tended to be optimistic about caring for demented patients. Conclusion : In this study, it is likely that the physicians' good knowledge about dementia issues is the reason for their optimism dealing with demented patients.
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Pentzek, Michael, Heinz-Harald Abholz, Martin Ostapczuk, Attila Altiner, Anja Wollny, and Angela Fuchs. "Dementia knowledge among general practitioners: first results and psychometric properties of a new instrument." International Psychogeriatrics 21, no. 6 (July 15, 2009): 1105–15. http://dx.doi.org/10.1017/s1041610209990500.
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ABSTRACTBackground: General practitioners (GPs) play an important role in dementia care. Sufficient knowledge is one of the prerequisites for adequate dementia management, and educational activities do include knowledge transfer. There is no up-to-date measure of GPs' knowledge of dementia, resulting in the use of unreliable ad hoc questionnaires in recent studies, thus increasing the risk of biased results.Methods: In a cross-sectional, observational questionnaire study, 292 German GPs answered 37 questions regarding factual dementia knowledge. For the purpose of cross-validation, the psychometric properties of the test and its associations with GP characteristics were analyzed in independent samples with item and regression analyses.Results: Twenty questions constituted a reliable questionnaire (Cohen's α = 0.733) with a normal distribution of test scores. Linear regression analysis revealed significant associations of the knowledge test score with the GPs' age and their attitudes towards dementia.Conclusions: The newly developed dementia-knowledge test for GPs can be used in observational studies, in which a rough and easy to use instrument is required.
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Berenbaum, Rakel, Julian Dresner, Bracha Erlich, Shlomo Vinker, and Chariklia Tziraki. "Survey of the Knowledge, Attitudes and Practices of Primary Care Physician's Towards Dementia Care in Israel." Eurasian Journal of Family Medicine 9, no. 2 (June 26, 2020): 70–80. http://dx.doi.org/10.33880/ejfm.2020090202.
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Aim: Primary care physicians have an important role in the early diagnosis and management of dementia as a common first point of contact for patients dealing with cognitive decline. Our aim was to explore primary care physicians knowledge, attitudes, and practices regarding care of people with dementia and their families. Methods: A cross sectional study among primary care physicians, attending their annual conference. The self-complete questionnaire included questions measured with a five point Likert scale as well as open-ended questions. Multivariable linear regression models were used to evaluate primary care physicians confidence in their dementia diagnosis and their level of knowledge and training. Results: Questionnaires were returned by 95 primary care physicians, a 24% response rate. The majority of primary care physicians feel it is their role to diagnose dementia (87%), unfortunately, 80% do not feel confident in making this diagnosis and 66% feel they are lacking knowledge or training to do so. They report they need more training on non-pharmacological interventions (86%), pharmacological treatments (92%), and community services (92%). Regression analysis revealed that lack of easily accessible screening tools plays an important role in confidence in dementia diagnosis. Conclusion: Our results may help policy makers plan interventions to meet training and system needs of primary care physicians and translate the national dementia policy guidelines into practice at the local level. Keywords: physicians, primary care, dementia, early diagnosis, adult day care centers
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Turner, Stephen, Steve Iliffe, Murna Downs, Jane Wilcock, Michelle Bryans, Enid Levin, John Keady, and Ronan O'Carroll. "General practitioners' knowledge, confidence and attitudes in the diagnosis and management of dementia." Age and Ageing 33, no. 5 (July 22, 2004): 461–67. http://dx.doi.org/10.1093/ageing/afh140.
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Mughal, Faraz, Ahmed Rashid, and Mohammed Jawad. "Tobacco and electronic cigarette products: awareness, cessation attitudes, and behaviours among general practitioners." Primary Health Care Research & Development 19, no. 6 (June 8, 2018): 605–9. http://dx.doi.org/10.1017/s1463423618000166.
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AbstractBackgroundLittle is known around how general practitioners (GP) approach tobacco products beyond traditional cigarettes.AimTo examine GP perceptions of tobacco and electronic cigarette (EC) products, and their attitudes and behaviours towards product cessation.MethodA 13-item self-completed anonymous questionnaire measured awareness of waterpipe tobacco smoking (WTS) and smokeless tobacco (ST). Cessation advice provision, referral to cessation services, and the harm perception of these products were asked using five-point Likert scales that were dichotomised on analysis. Correlates of cessation advice were analysed using regression models.FindingsWe analysed 312 responses, of whom 63% were aware of WTS and between 5–32% were aware of ST products. WTS and ST were considered less harmful than cigarettes by 82 and 68% of GPs, respectively. WTS, ST, and EC users were less advised (P<0.001) and referred (P<0.001) to cessation services compared to cigarette users. Ethnic minority and senior GPs were more likely to provide cessation advice for WTS and ST users compared to younger white GPs. GPs who were recent tobacco users were less likely to give cessation advice to cigarette users (adjusted odds ratios 0.17, 95% confidence interval 0.03–0.99, P<0.049).Conclusions (implications for practice and research)GPs had lower harm perception, gave less cessation advice, and made less referrals for WTS and ST users compared to cigarettes. Our findings highlight the need for targeted tobacco education in general practice. More research is needed to explore GP perceptions in depth as well as patient perspectives.
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Bhanu, Cini, Mary Elizabeth Jones, Kate Walters, Irene Petersen, Jill Manthorpe, Rosalind Raine, Naaheed Mukadam, and Claudia Cooper. "Physical health monitoring in dementia and associations with ethnicity: a descriptive study using electronic health records." BJGP Open 4, no. 4 (September 23, 2020): bjgpopen20X101080. http://dx.doi.org/10.3399/bjgpopen20x101080.
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BackgroundGood physical health monitoring can increase quality of life for people with dementia, but the monitoring may vary and ethnic inequalities may exist.AimTo investigate UK primary care routine physical health monitoring for people with dementia by: (a) ethnic groups, and (b) comorbidity status.Design & settingA retrospective cohort study was undertaken using electronic primary care records in the UK.MethodPhysical health monitoring was compared in people with dementia from white, black, and Asian ethnic groups and compared those with ≥1 comorbidity versus no comorbidity, from 1 April 2015 to 31 March 2016. Using the Dementia:Good Care Planning framework and expert consensus, good care was defined as receiving, within 1 year: a dementia review; a blood pressure (BP) check (at least one); a GP consultation (at least one); a weight and/or body mass index (BMI) recording (at least one); and an influenza vaccination.ResultsOf 20 821 people with dementia, 68% received a dementia review, 80% at least one BP recording, 97% at least one GP contact, 48% a weight and/or BMI recording, and 81% an influenza vaccination in 1 year. Compared with white people, black people were 23% less likely and Asian people 16% less likely to have weight recorded (adjusted incidence rate ratio [IRR] = 0.77, 95% confidence interval [CI] = 0.60 to 0.98/0.84, 0.71 to 1.00). People without comorbidities were less likely to have weight recorded (adjusted IRR = 0.74, 95% CI = 0.69 to 0.79) and BP monitored (adjusted IRR = 0.71, 95% CI = 0.68 to 0.75).ConclusionEthnic group was not associated with differences in physical health monitoring, other than weight monitoring. Comorbidity status was associated with weight and BP monitoring. Physical health monitoring in dementia, in particular nutrition, requires improvement.
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Moehl, Keelin, Rollin M. Wright, Joseph Shega, Monica Malec, G. Kelley Fitzgerald, Gregg Robbins-Welty, Kimberly Zoberi, et al. "How to Teach Medical Students About Pain and Dementia: E-Learning, Experiential Learning, or Both?" Pain Medicine 21, no. 10 (August 8, 2020): 2117–22. http://dx.doi.org/10.1093/pm/pnaa187.
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Abstract Objective Pain management in persons with mild to moderate dementia poses unique challenges because of altered pain modulation and the tendency of some individuals to perseverate. We aimed to test the impact of an e-learning module about pain in communicative people with dementia on third-year medical students who had or had not completed an experiential geriatrics course. Design Analysis of pre- to postlearning changes and comparison of the same across the student group. Setting University of Pittsburgh School of Medicine and Saint Louis University School of Medicine. Subjects One hundred four University of Pittsburgh and 57 Saint Louis University medical students. Methods University of Pittsburgh students were randomized to view either the pain and dementia module or a control module on pain during a five-day geriatrics course. Saint Louis University students were asked to complete either of the two modules without the context of a geriatrics course. A 10-item multiple choice knowledge test and three-item attitudes and confidence questionnaires were administered before viewing the module and up to seven days later. Results Knowledge increase was significantly greater among students who viewed the dementia module while participating in the geriatrics course than among students who viewed the module without engaging in the course (P < 0.001). The modules did not improve attitudes in any group, while student confidence improved in all groups. Conclusions Medical students exposed to e-learning or experiential learning demonstrated improved confidence in evaluating and managing pain in patients with dementia. Those exposed to both educational methods also significantly improved their knowledge.
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Schneider, Julia, Anton Schönstein, Winfried Teschauer, Andreas Kruse, and Birgit Teichmann. "Hospital Staff’s Attitudes Toward and Knowledge About Dementia Before and After a Two-Day Dementia Training Program." Journal of Alzheimer's Disease 77, no. 1 (September 1, 2020): 355–65. http://dx.doi.org/10.3233/jad-200268.
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Background: The outcomes of hospitalized People with Dementia (PwD) are likely to be negative due to, among other key causes, negative staff attitudes and limited staff knowledge regarding dementia. Targeted interventions have been shown to positively change the attitudes of the hospital staff while also increasing their overall knowledge of dementia. However, training effects are often short-lived and frequently long-term effects are not examined in studies. Objective: To examine whether attending a dementia training program changes the attitudes of hospital staff toward PwD and/or increases their knowledge levels about dementia, and whether or not these changes are stable. Methods: The training program lasted two days and N = 60 attending hospital staff members agreed to participate in the study. Data were assessed with questionnaires prior to the training, 3 months, and 6 months after the training. German versions of the Dementia Attitude Scale (DAS-D) and the Knowledge in Dementia (KIDE) scale were used. Additionally, data about perception of PwD and confidence in dealing with challenging behavior were collected and analyzed. Results: After the training program, participants showed a significantly better attitude toward PwD as measured by DAS-D. These time-effects occurred in both DAS-D subscales (“dementia knowledge” and “social comfort”). Although a positive trend could be seen in the KIDE scale, no statistically significant increase occurred over time. Conclusion: Specialist training programs seem to be promising in positively changing attitudes toward and increasing knowledge about PwD with long-term effects. Further research should address the effects of attitude change in patient care.
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Parveen, Sahdia, Sarah Jane Smith, Cara Sass, Jan R. Oyebode, Andrea Capstick, Alison Dennison, and Claire A. Surr. "Impact of dementia education and training on health and social care staff knowledge, attitudes and confidence: a cross-sectional study." BMJ Open 11, no. 1 (January 2021): e039939. http://dx.doi.org/10.1136/bmjopen-2020-039939.
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ObjectivesThe aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training.DesignCross-sectional survey study. Data collection occurred in 2017.SettingsHealth and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes.ParticipantsAll health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%).OutcomesKnowledge, attitude and confidence of health and social care staff.ResultsHierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01).ConclusionThe results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence.
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Greenstone, Harriet, and Amy Burlingham. "Where’s that stethoscope? A survey of psychiatrists’ attitudes to their role in managing physical health." Journal of Mental Health Training, Education and Practice 15, no. 3 (February 12, 2020): 141–55. http://dx.doi.org/10.1108/jmhtep-10-2019-0056.
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Purpose This study aims to explore current attitudes among doctors working in psychiatry, with regard to their perceived role and their confidence in managing their patients’ physical health problems. Design/methodology/approach A 20-item electronic questionnaire was distributed to doctors working in psychiatry within two large UK mental health trusts in 2018. Quantitative analysis was conducted, alongside qualitative analysis of free-text comments made by participants. Findings Many participants perceived their physical examination skills to have deteriorated since working in psychiatry (78 per cent). Participants were questioned on which professional group should hold responsibility for managing the physical health of patients under psychiatric services. A minority felt it should be psychiatrist-led (5 per cent), followed by general practitioner (GP)-led (42 per cent) and then shared responsibility (47 per cent). The majority felt there should be more focused training on physical health in the Core (72 per cent) and Advanced (63 per cent) psychiatry training. Key themes from a framework analysis of qualitative data included potential barriers to shared care, psychiatrists’ concerns regarding their experience and confidence in managing physical health, reasons in favour of shared responsibility, ideas for training and suggestions for improving the current situation. Originality/value Psychiatric patients may engage less well with health services, yet psychiatric medication often impacts significantly on physical health. In this context, there is often a blurring of role boundaries between a psychiatrist and a GP, and there is considerable variation between individual teams. There is a consistent call for more physical health training opportunities for psychiatrists and for mental health services to more proactively promote the physical health of their patients.
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Punwasi, Rani, L. de Kleijn, J. B. M. Rijkels-Otters, M. Veen, Alessandro Chiarotto, and Bart Koes. "General practitioners’ attitudes towards opioids for non-cancer pain: a qualitative systematic review." BMJ Open 12, no. 2 (February 2022): e054945. http://dx.doi.org/10.1136/bmjopen-2021-054945.
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ObjectivesWorldwide the use of opioids, both doctor-prescribed and illicit, has increased. In most countries, opioids are first prescribed by general practitioners (GPs). Identifying factors that influence GPs’ opioid prescription decision-making may help reduce opioid misuse and overuse. We performed a systematic review to gain insight into GP attitudes towards opioid prescription and to identify possible solutions to promote changes in the field of primary care.Design and settingSystematic review of qualitative studies reporting GPs’ attitudes towards opioid use in non-cancer pain management.MethodsWe searched Embase, Medline, Web of Science Core Collection, Cochrane, PsychInfo, Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Google Scholar. Two independent reviewers selected studies based on prespecified eligibility criteria. Study quality was evaluated with the Critical Appraisal Skills Programme checklist, and their results were analysed using thematic analysis. Quality of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation—Confidence in the Evidence from Reviews of Qualitative research approach.ResultsWe included 14 studies. Four themes were established using thematic analyses: (1) GPs caught in the middle of ‘the opioid crisis’; (2) Are opioids always bad? (3) GPs’ weighing scale, taking patient-related and therapeutic relationship-related factors into account; and (4) GPs’ sense of powerlessness—lack of alternatives, support by specialists and lack of time in justifying non-prescriptions.ConclusionGP attitudes towards opioid prescribing for non-cancer pain are subject to several GP-related, patient-related and therapeutic relationship-related factors. Raising GP and patient awareness on the inefficacy of opioids in chronic non-cancer pain management and providing non-opioid alternatives to treat chronic pain might help to promote opioid reduction in primary care. More research is needed to develop practical guidelines on appropriate opioid prescribing, tapering off opioid use and adopting effective communication strategies.PROSPERO registration numberCRD42020194561.Cite Now
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Roydhouse, Jessica A., Smita Shah, Brett G. Toelle, Susan M. Sawyer, Craig M. Mellis, Tim P. Usherwood, Peter Edwards, and Christine R. Jenkins. "A snapshot of general practitioner attitudes, levels of confidence and self-reported paediatric asthma management practice." Australian Journal of Primary Health 17, no. 3 (2011): 288. http://dx.doi.org/10.1071/py11009.
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The prevalence of asthma in Australia is high. Previous findings have suggested that asthma management, particularly in primary care, remains suboptimal and recent government initiatives to improve asthma management and encourage the use of written asthma action plans (WAAPs) in general practice have been implemented. We aimed to assess the attitudes, confidence and self-reported paediatric asthma management practices of a convenience sample of Australian general practitioners (GPs). A baseline questionnaire was administered to GPs as part of a randomised controlled trial. General practitioners (GPs) were recruited from two areas of greater metropolitan Sydney, NSW between 2006 and 2008. Invitations were sent to an estimated 1200 potentially eligible GPs. Of 150 (12.5%) GPs that enrolled, 122 (10.2%) completed the baseline questionnaire. Though 89% were aware of the Australian National Asthma Guidelines, less than 40% were familiar with guideline recommendations. While 85.2% had positive attitudes towards WAAPs, only 45.1% reported providing them frequently. For children with frequent symptoms, 90% agreed they should prescribe daily, inhaled corticosteroids (ICS), and 83% reported currently prescribing ICS to such patients. These findings indicate gaps between GP attitudes and behaviours and highlights opportunities for interventions to improve paediatric asthma management.
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Delgado, João, Philip H. Evans, Denis Pereira Gray, Kate Sidaway-Lee, Louise Allan, Linda Clare, Clive Ballard, Jane Masoli, Jose M. Valderas, and David Melzer. "Continuity of GP care for patients with dementia: impact on prescribing and the health of patients." British Journal of General Practice 72, no. 715 (January 24, 2022): e91-e98. http://dx.doi.org/10.3399/bjgp.2021.0413.
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BackgroundHigher continuity of GP care (CGPC), that is, consulting the same doctor consistently, can improve doctor–patient relationships and increase quality of care; however, its effects on patients with dementia are mostly unknown.AimTo estimate the associations between CGPC and potentially inappropriate prescribing (PIP), and with the incidence of adverse health outcomes (AHOs) in patients with dementia.Design and settingA retrospective cohort study with 1 year of follow-up anonymised medical records from 9324 patients with dementia, aged ≥65 years living in England in 2016.MethodCGPC measures include the Usual Provider of Care (UPC), Bice–Boxerman Continuity of Care (BB), and Sequential Continuity (SECON) indices. Regression models estimated associations with PIPs and survival analysis with incidence of AHOs during the follow-up adjusted for age, sex, deprivation level, 14 comorbidities, and frailty.ResultsThe highest quartile (HQ) of UPC (highest continuity) had 34.8% less risk of delirium (odds ratio [OR] 0.65, 95% confidence interval [CI] = 0.51 to 0.84), 57.9% less risk of incontinence (OR 0.42, 95% CI = 0.31 to 0.58), and 9.7% less risk of emergency admissions to hospital (OR 0.90, 95% CI = 0.82 to 0.99) compared with the lowest quartile. Polypharmacy and PIP were identified in 81.6% (n = 7612) and 75.4% (n = 7027) of patients, respectively. The HQ had fewer prescribed medications (HQ: mean 8.5, lowest quartile (LQ): mean 9.7, P<0.01) and had fewer PIPs (HQ: mean 2.1, LQ: mean 2.5, P<0.01), including fewer loop diuretics in patients with incontinence, drugs that can cause constipation, and benzodiazepines with high fall risk. The BB and SECON measures produced similar findings.ConclusionHigher CGPC for patients with dementia was associated with safer prescribing and lower rates of major adverse events. Increasing continuity of care for patients with dementia may help improve treatment and outcomes.
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Tropea, Joanne, Dina LoGiudice, Danny Liew, Carol Roberts, and Caroline Brand. "Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care." International Psychogeriatrics 29, no. 3 (November 23, 2016): 467–74. http://dx.doi.org/10.1017/s104161021600185x.
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ABSTRACTBackground:Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care.Methods:A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents’ current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care.Results:A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low.Conclusion:The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.
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Rutherford, Emer Forde, Jacqueline Priego-Hernandez, Aurelia Butcher, and Clare Wedderburn. "Using photography to enhance GP trainees’ reflective practice and professional development." Medical Humanities 44, no. 3 (February 8, 2018): 158–64. http://dx.doi.org/10.1136/medhum-2017-011203.
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The capacity and the commitment to reflect are integral to the practice of medicine and are core components of most general practitioners (GP) training programmes. Teaching through the humanities is a growing area within medical education, but one which is often considered a voluntary ‘add-on’ for the interested doctor. This article describes an evaluation of a highly innovative pedagogical project which used photography as a means to enhance GP trainees’ reflective capacity, self-awareness and professional development. Photography was used as a tool to develop GP trainees’ skills in recognising and articulating the attitudes, feelings and values that might impact on their clinical work and to enhance their confidence in their ability to deal with these concerns/issues. We submit that photography is uniquely well suited for facilitating insight and self-reflection because it provides the ability to record ‘at the touch of a button’ those scenes and images to which our attention is intuitively drawn without the need for—or the interference of—conscious decisions. This allows us the opportunity to reflect later on the reasons for our intuitive attraction to these scenes. These photography workshops were a compulsory part of the GP training programme and, despite the participants’ traditional scientific backgrounds, the results clearly demonstrate the willingness of participants to accept—even embrace—the use of art as a tool for learning. The GP trainees who took part in this project acknowledged it to be beneficial for both their personal and professional development.
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Brodribb, Wendy, Anthony Fallon, Claire Jackson, and Desley Hegney. "The relationship between personal breastfeeding experience and the breastfeeding attitudes, knowledge, confidence and effectiveness of Australian GP registrars." Maternal & Child Nutrition 4, no. 4 (October 2008): 264–74. http://dx.doi.org/10.1111/j.1740-8709.2008.00141.x.
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Low, Lee-Fay, Margaret McGrath, Kate Swaffer, and Henry Brodaty. "Communicating a diagnosis of dementia: A systematic mixed studies review of attitudes and practices of health practitioners." Dementia 18, no. 7-8 (March 15, 2018): 2856–905. http://dx.doi.org/10.1177/1471301218761911.
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The aim of this study is to systematically review practitioners’ practices and attitudes in regards to communicating a diagnosis of dementia. A systematic search was conducted of Scopus, Web of Science and PubMed for English language original empirical papers. A sequential explanatory mixed studies analysis approach was used. Twenty-five quantitative descriptive, two intervention, six mixed methods descriptive and 21 qualitative studies were included. Pooled analysis showed that 34% of GPs and 48% of specialists usually/routinely tell the person with dementia their diagnosis, and 89% of GPs and 97% specialists usually/routinely tell the family the diagnosis. Euphemistic terms such as ‘memory problems’ are more often used to describe dementia than medical terms. Practitioners’ decision to diagnose and communicate the diagnosis of dementia are influenced by (a) their own beliefs regarding dementia and treatment efficacy and their confidence in diagnosis and communication; (b) patient circumstances including level of awareness, level of severity and family support; (c) the health and social care system including access to specialist and diagnostic services, reimbursement for diagnosis/management and availability of services and (d) cultural norms in relation to dementia including stigma, labels, and common clinical practice. The diagnosis and communication of diagnosis of dementia are intertwined processes and should be concurrently addressed in interventions. Multicomponent approaches to address these practices could include guideline development, practitioner education, anti-stigma public health campaigns, offering post-diagnosis treatments and support and sufficient reimbursement for practitioners for time spent managing dementia.
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Petrazzuoli, Ferdinando, Shlomo Vinker, Tuomas H. Koskela, Thomas Frese, Nicola Buono, Jean Karl Soler, Jette Ahrensberg, et al. "Exploring dementia management attitudes in primary care: a key informant survey to primary care physicians in 25 European countries." International Psychogeriatrics 29, no. 9 (April 18, 2017): 1413–23. http://dx.doi.org/10.1017/s1041610217000552.
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ABSTRACTBackground:Strategies for the involvement of primary care in the management of patients with presumed or diagnosed dementia are heterogeneous across Europe. We wanted to explore attitudes of primary care physicians (PCPs) when managing dementia: (i) the most popular cognitive tests, (ii) who had the right to initiate or continue cholinesterase inhibitor or memantine treatment, and (iii) the relationship between the permissiveness of these rules/guidelines and PCP's approach in the dementia investigations and assessment.Methods:Key informant survey. Setting: Primary care practices across 25 European countries. Subjects: Four hundred forty-five PCPs responded to a self-administered questionnaire. Two-step cluster analysis was performed using characteristics of the informants and the responses to the survey. Main outcome measures: Two by two contingency tables with odds ratios and 95% confidence intervals were used to assess the association between categorical variables. A multinomial logistic regression model was used to assess the association of multiple variables (age class, gender, and perceived prescription rules) with the PCPs’ attitude of “trying to establish a diagnosis of dementia on their own.”Results:Discrepancies between rules/guidelines and attitudes to dementia management was found in many countries. There was a strong association between the authorization to prescribe dementia drugs and pursuing dementia diagnostic work-up (odds ratio, 3.45; 95% CI 2.28–5.23).Conclusions:Differing regulations about who does what in dementia management seemed to affect PCP's engagement in dementia investigations and assessment. PCPs who were allowed to prescribe dementia drugs also claimed higher engagement in dementia work-up than PCPs who were not allowed to prescribe.
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O’Regan, N. A., M. M. Mohamad, and D. J. Meagher. "Impact of an educational workshop upon psychiatrists’ attitudes towards delirium care." Irish Journal of Psychological Medicine 36, no. 2 (March 21, 2017): 89–98. http://dx.doi.org/10.1017/ipm.2016.47.
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ObjectivesImproving knowledge about delirium care is a key target for health care. We describe the implementation of a four-part workshop focusing upon key aspects of delirium care.MethodsAttitudes towards and understanding of delirium diagnosis and management amongst psychiatrists were surveyed before and immediately after an educational workshop.ResultsThere were 62 participants. Pre-workshop, delirium was rated highly relevant to psychiatry. Overall level of confidence in diagnosis was modest, with the behavioural and psychological symptoms of dementia considered the most challenging differential diagnosis. Only nine participants (15%) correctly identified DSM-5 delirium criteria. Preferred assessment of attention varied with six different approaches endorsed. Confidence was higher for managing hyperactive compared with hypoactive delirium (p<0.001). Pharmacotherapy was more frequently endorsed for hyperactive compared with hypoactive presentations, with haloperidol the most popular agent (p<0.001). A total of 41 (66%) participants completed post-workshop assessments. Post-workshop, there were significant increases to the perceived relevance of delirium (p = 0.003), confidence in overall diagnosis (p<0.001) accuracy of awareness of DSM-5 criteria (p<0.001), and confidence in treating different presentations (p<0.001). The Months Backward Test was the preferred bedside test of attention (38/40 respondents).ConclusionsThis interactive educational intervention impacted positively upon knowledge and attitudes amongst psychiatrists towards key aspects of delirium care. Further investigation can examine the impact upon longer term knowledge and behaviour.
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Grace, Lydia, Anna Sandfield, and William J. McGeown. "P2-106: Dementia diagnosis in primary care: A qualitative study of GP attitudes and practices in the east of england." Alzheimer's & Dementia 11, no. 7S_Part_11 (July 2015): P524. http://dx.doi.org/10.1016/j.jalz.2015.06.644.
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Wilcox, Christopher R., Paul Little, and Christine E. Jones. "Current practice and attitudes towards vaccination during pregnancy: a survey of GPs across England." British Journal of General Practice 70, no. 692 (January 27, 2020): e179-e185. http://dx.doi.org/10.3399/bjgp20x708113.
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BackgroundAntenatal vaccines are commonly delivered in primary care, yet the views of GPs regarding these programmes have been neglected in research to date.AimTo establish the attitudes and current practice of GPs towards antenatal vaccination and their views on the optimal location for delivery of this service.Design and settingA multicentre online survey questionnaire.MethodA questionnaire was sent to GPs across England between December 2018 and January 2019.ResultsThe majority of 1586 responders considered antenatal vaccination safe (96% for influenza, 89% pertussis). GPs were significantly less confident in their knowledge of pertussis compared with influenza vaccination (64% versus 80% were confident, P<0.001), and many desired further education (59% versus 48%, P<0.001). Few (37%) discussed vaccination with pregnant women regularly, but most (80%) felt their recommendation would influence decision making. Those with greater confidence in their knowledge of pertussis and influenza vaccination, and who were >2 years since qualifying, discussed vaccination significantly more often (odds ratio [OR] 3.52, P<0.001; OR 2.34, P = 0.001; OR 1.76, P = 0.003, respectively), regardless of whether they routinely saw pregnant women. Most (83%) reported that antenatal vaccination was GP led in their region, yet only 26% thought it should be primarily GP based. GPs expressed disconnect from antenatal care, and many suggested that midwives and/or secondary care should take greater responsibility for the delivery of antenatal vaccination.ConclusionThere is support among GPs to embed vaccination programmes within routine antenatal care. Further educational resources, specifically designed for the needs of GPs, are needed to facilitate opportunistic discussion with pregnant women about vaccination.
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Cotter, Valerie T., Maryam M. Hasan, Jheesoo Ahn, Chakra Budhathoki, and Esther Oh. "A Practice Improvement Project to Increase Advance Care Planning in a Dementia Specialty Practice." American Journal of Hospice and Palliative Medicine® 36, no. 9 (April 4, 2019): 831–35. http://dx.doi.org/10.1177/1049909119841544.
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This study was conducted to enhance the rate of advance care planning (ACP) conversations and documentation in a dementia specialty practice by increasing physician knowledge, attitudes, and skills. We used a pre- and postintervention paired design for physicians and 2 independent groups for patients. The ACP dementia educational program encompassed 3 objectives: (1) to understand the relevance of ACP to the dementia specialty practice, (2) to provide a framework to discuss ACP with patients and caregivers, and (3) to discuss ways to improve ACP documentation and billing in the electronic medical record. A 10-item survey was utilized pre- and posteducational intervention to assess knowledge, attitudes, and skill. The prevalence of ACP documentation was assessed through chart review 3 months pre- and postintervention. The educational intervention was associated with increased confidence in ability to discuss ACP ( P = .033), belief that ACP improves outcomes in dementia ( P = .035), knowledge about ACP Medicare billing codes and requirements ( P = .002), and belief that they have support from other personnel to implement ACP ( P = .017). In 2 independent groups of patients with dementia, documentation rates of an advance directive increased from 13.6% to 19.7% ( P = .045) and the Medical Order for Life-Sustaining Treatment (MOLST) increased from 11.0% to 19.0% ( P = .006). The MOLST documentation in 2 independent groups of patients with nondementia increased from 7.3% to 10.7% ( P = .046). Continuing efforts to initiate educational interventions are warranted to increase the effectiveness ACP documentation and future care of persons with dementia.
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Seston, Elizabeth M., Chiamaka Julia Anoliefo, Jinghua Guo, Joanne Lane, Chikwado Okoro Aroh, Samantha White, and Ellen I. Schafheutle. "Community Pharmacist Consultation Service: A Survey Exploring Factors Facilitating or Hindering Community Pharmacists’ Ability to Apply Learnt Skills in Practice." Pharmacy 10, no. 5 (September 21, 2022): 117. http://dx.doi.org/10.3390/pharmacy10050117.
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Background: The NHS Community Pharmacist Consultation Service (CPCS) offers patients requiring urgent care a consultation with a community pharmacist, following referral from general practice or urgent care. The study explored the impact of undertaking a Centre for Pharmacy Postgraduate Education (CPPE) CPCS learning programme, and barriers and enablers to CPCS delivery. Methods: CPPE distributed an online survey to those who had undertaken their CPCS learning. The survey explored participants’ knowledge, confidence and application of taught skills/tools, including clinical history-taking, clinical assessment, record keeping, transfer of care, and Calgary-Cambridge, L(ICE)F and SBARD communication tools. Details on barriers and enablers to CPCS delivery were also included. Results: One-hundred-and-fifty-nine responses were received (response rate 5.6%). Knowledge of, and confidence in, taught skills were high and respondents reported applying skills in CPCS consultations and wider practice. Barriers to CPCS included a lack of general practice referrals, staffing levels, workload, and GP attitudes. Enablers included a clear understanding of what was expected, minimal concerns over indemnity cover and privacy, and positive patient attitudes towards pharmacy. Conclusion: This study demonstrates that community pharmacists can extend their practice and contribute to the enhanced provision of urgent care in England. This study identified barriers, both interpersonal and infrastructural, that may hinder service implementation.
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DOWRICK, C., L. GASK, R. PERRY, C. DIXON, and T. USHERWOOD. "Do general practitioners' attitudes towards depression predict their clinical behaviour?" Psychological Medicine 30, no. 2 (March 2000): 413–19. http://dx.doi.org/10.1017/s0033291799001531.
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Background. GPs' attitudes towards depression vary, as do their abilities to detect and manage it effectively. Associations between attitudes and clinical behaviour have not yet been demonstrated directly. We tested two hypotheses: (1) that questionnaire measures of GPs' confidence in identifying depression predict their ability to identify depression in their patients; and (2) that GPs who prefer antidepressants prescribe more than those who prefer psychotherapy.Methods. Forty GPs in Liverpool and Manchester completed the Depression Attitude Questionnaire (DAQ) and were asked for prescribing (PACT) information. Attender surveys using the General Health Questionnaire (GHQ-12), in combination with GP ratings of patients' psychological status, generated indices for GPs' case identification, bias and accuracy. We tested associations between these indices and the four DAQ components, in particular GPs' confidence in diagnosis, across a total of 1436 patients. We also compared the DAQ component on attitudes to treatment with relevant PACT data.Results. The DAQ assessment of GPs' ability to identify cases of depression bore no relationship to their observed ability, as measured by accuracy, bias, or identification indices. However, there were significant associations between observed diagnostic ability and: preference for psychotherapy; ease in managing depression; and, belief in successful treatment. PACT data were available for 26 (65%) GPs. There was an association between preference for antidepressants and prescription of SSRIs (rs 0·3981, P < 0·044), but not for overall antidepressant or tricyclic prescribing, or for dose of dothiepin.Conclusions. The DAQ measure of ease of identification is not valid when compared to actual clinical practice. The ability of GPs to identify depression may not be an independent variable, but may rather reflect other beliefs, attitudes and skills. This has considerable implications for educational interventions in primary care.
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Schafheutle, E., E. M. Seston, C. J. Anoliefo, H. Asrat, J. Guo, J. Lane, C. Okoro Aroh, and S. White. "Community pharmacist consultation service: survey insights into impact of learning on practice, and barriers and enablers to service implementation." International Journal of Pharmacy Practice 30, Supplement_2 (November 30, 2022): ii47—ii48. http://dx.doi.org/10.1093/ijpp/riac089.056.
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Abstract Introduction Some patients attend NHS services with ‘clinically divertible’ urgent low acuity conditions. The NHS Community Pharmacist Consultation Service (CPCS) enables the referral of such patients and subsequent consultation with a community pharmacist. The Centre for Pharmacy Postgraduate Education (CPPE) offered a learning programme to prepare pharmacists for a more clinical and person-centred approach when delivering the CPCS. Aim To investigate the impact of the CPPE CPCS learning programme on learnt skills and their application in practice, and barriers and enablers to CPCS delivery. Methods A survey was designed to explored participants’ knowledge, confidence and application of taught skills/tools, including clinical history-taking, clinical assessment, record-keeping, Calgary-Cambridge, L(ICE)F (lifestyle, ideas, concerns, expectations, feelings) and SBARD (situation, background, assessment, recommendation, decision) communication tools. Statements on barriers and enablers to CPCS delivery were included. In November/December 2021, CPPE emailed an online survey (one reminder) to CPCS learners who had agreed to be contacted (n=2836). The University of Manchester’s Research Ethics Committee decision tool confirmed that ethics committee approval was not required for this study. Results One-hundred and fifty-nine pharmacists responded (5.6%). Sixty percent were female, all ages were represented, the most populous groups being 55-64 (33.3%) and 45-54 years (27.7%). Ethnicity was broadly representative of community pharmacists: 49.0% white, 38.9% Asian, 8.2% black, and 1.9% Arab. Sixty-eight (43%) of respondents were working in a large multiple community pharmacy, 33.3% (n=53) in an independent pharmacy, and 17.0% (n=27) in a small to medium pharmacy multiple. Knowledge of, and confidence in, taught skills were high and respondents reported applying skills in CPCS consultations and wider practice. There was strong positive correlation between the perceived levels of competence and confidence when delivering CPCS (r=0.966, p=<0.001). The level of competence (r=0.259, p=0.003) and confidence increased (r=0.264, p=0.002) with an increasing number of NHS111 referrals. With regards to specific skills learnt, the highest levels of knowledge were recorded for ‘taking a clinical history’ (86% agreement), ‘clinically assessing a patient’ (84%), ‘using L(ICE)F’ (84%), and ‘completing an accurate and concise clinical record’ (81%). Seventy-three percent of respondents agreed they knew how to use the Calgary Cambridge, whilst only 49% knew how to use SBARD. Barriers to CPCS included lack of GP referrals, staffing levels, workload, and GP attitudes. Enablers included a clear understanding of what was expected, minimal concerns over indemnity cover and privacy, and positive patient attitudes towards pharmacy. Those working in independent pharmacies were more likely than those in multiple pharmacies to report that they were receiving GP referrals (68.5% vs. 49.0%, X2=5.249, p=0.022), that they had enough staff to provide the CPCS (45.3% vs. 26.3%, X2=5.526, p=0.019), and that the local GP considers community pharmacy to be an integral part of the primary healthcare team (54.7% vs. 37.2%, X2=4.214, p=0.040). Employed pharmacists were more likely than locums to report that they had a good relationship with their local general practice (57.5% vs. 37.5%, X2=5.436, p=0.020). Discussion/Conclusion This study demonstrates that CPPE learning contributed to community pharmacists’ extended knowledge and skills in CPCS delivery, which contributes to enhanced provision of urgent care in England. This study identified barriers, both interpersonal and infrastructural, that may hinder service implementation.
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Grivell, N., E. Hoon, C. Chai-Coetzer, J. Fuller, and R. McEvoy. "P049 Barriers and facilitators to the delivery of insomnia management by general practice nurses: a qualitative analysis of patient perspectives." SLEEP Advances 3, Supplement_1 (October 1, 2022): A47. http://dx.doi.org/10.1093/sleepadvances/zpac029.122.
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Abstract Introduction With insufficient providers of insomnia care, alternative approaches to the delivery of insomnia treatments are being explored. Research has demonstrated that insomnia can be successfully managed by primary care nurses but patient attitudes towards this care are largely unknown. This study explored patient perspectives towards barriers and facilitators to practice nurse-delivered care to inform the development of patient-centred models of care for insomnia. Methods A qualitative sub-study within a process evaluation of sleep health care delivered in a pilot study in one general practice in metropolitan Adelaide. Semi-structured telephone interviews were conducted with patients with insomnia offered nurse-delivered or nurse-supported insomnia management. Thematic Analysis was used to identify themes within the data. Results Eleven patients participated (6 males; age mean [range] 59 years [29-72]; time at practice 14.3 years [4-21]; Sleep Condition Indicator 9.5 [3-14]). Two major themes were identified: 1. Patients are supportive of nurses providing care for uncomplicated insomnia; 2. Trust in practice nurse-delivered insomnia care is influenced by relationships with the GP, the practice, and the nurse. Participants reported confidence in practice nurses providing insomnia management provided that they had sufficient knowledge. Established relationships with the GP and the practice, along with previous appointments with the nurse, increased patient confidence in nurse-delivered insomnia care. Discussion Patient acceptance of practice nurse-delivered insomnia care supports further research into developing a role for practice nurses within insomnia management. The findings of this work will be tested and explored further within a large implementation study conducted in multiple general practices.
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Peri, Kathryn, Ngaire Kerse, Simon Moyes, Shane Scahill, Charlotte Chen, Jae Beom Hong, and Carmel M. Hughes. "Is psychotropic medication use related to organisational and treatment culture in residential care." Journal of Health Organization and Management 29, no. 7 (November 16, 2015): 1065–79. http://dx.doi.org/10.1108/jhom-10-2013-0236.
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Purpose – The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care. Design/methodology/approach – Cross-sectional analyses of staff and resident’s record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers). Findings – In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants’ assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98). Originality/value – Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture may be another avenue to improve prescribing in residential aged care.
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Spencer, Karen, Pippa E. R. Foster, Kathy H. Whittamore, Sarah E. Goldberg, and Rowan H. Harwood. "Staff confidence, morale and attitudes in a specialist unit for general hospital patients with dementia and delirium-a qualitative study." International Journal of Geriatric Psychiatry 29, no. 12 (November 13, 2014): 1315–17. http://dx.doi.org/10.1002/gps.4178.
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Lee, Linda, Loretta M. Hillier, Jason Locklin, Jennifer Lee, and Karen Slonim. "Advanced Care Planning for Persons With Dementia in Primary Care: Attitudes and Barriers Among Health-Care Professionals." Journal of Palliative Care 34, no. 4 (November 22, 2018): 248–54. http://dx.doi.org/10.1177/0825859718812463.
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Background: Advance care planning (ACP) provides clarity on goals and preferences for future health-care decisions, the timeliness of which is critical for persons with dementia. Aim: This study assessed Primary Care Collaborative Memory Clinic (PCCMC) health-care practitioners’ desire for more education on ACP, capacity for and attitudes toward ACP, and current ACP practices in their regular family practice and in their PCCMC. Methods: Primary Care Collaborative Memory Clinic health-care professionals completed a questionnaire in which they rated their interest in learning various ACP-related topics (5-point scale: not at all to very much so), attitudes toward ACP, and the importance of and perceived degree of responsibility for ACP (5-point scale: not at all to extremely). Respondents estimated ACP completion in regular family practice and PCCMC. Results: Two hundred and sixty one surveys were completed. Mean knowledge ratings were moderate (M = 3.0) and mean ratings of interest in ACP topics were all high (median ≥ 4). Despite the perception that ACP is very important (M = 4.9) and the responsibility of PCCMCs (M = 3.7), the majority of respondents estimated that 40% or fewer patients have had ACP. Ratings of willingness to conduct ACP (M = 3.7) and comfort level (M = 3.4) were moderate but significantly exceeded ratings of ability (M = 2.9), comfort (M = 3.5), and confidence (M = 2.8). Conclusion: There was a striking disconnect between perceptions of the importance of completing ACP for persons with dementia and actual ACP completion rates. Primary Care Collaborative Memory Clinics may be in an ideal position to support ACP discussions; however, there is a need to improve health-care professionals’ knowledge and attitudes toward ACP.
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Scerri, Anthony, and Charles Scerri. "Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme." Aging & Mental Health 23, no. 8 (November 8, 2017): 919–28. http://dx.doi.org/10.1080/13607863.2017.1399342.
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von Wagner, Christian, Sandro Stoffel, Madeleine Freeman, Helga Laszlo, Brian D. Nicholson, Jessican Sheringham, Dorothy Szinay, and Yasemin Hirst. "Attitudes towards faecal immunochemical testing in patients at increased risk of colorectal cancer: an online survey of GPs in England." British Journal of General Practice 68, no. 676 (October 8, 2018): e757-e764. http://dx.doi.org/10.3399/bjgp18x699413.
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BackgroundThere is increasing interest in using a quantitative faecal immunochemical test (FIT) to rule out colorectal cancer (CRC) in patients with high-risk symptoms in primary care.AimThis study aimed to investigate GPs’ attitudes and willingness to use a FIT over an urgent 2-week wait (2WW) referral.Design and settingA cross-sectional online survey involving 1024 GPs working across England.MethodLogistic regression models were used to explore the likelihood of GPs using a FIT instead of a 2WW referral, and reported using odds ratios (ORs) and 95% confidence intervals (95% CIs).ResultsJust over one-third of GPs (n = 365) preferred to use a FIT as a rule-out test over a 2WW referral. GPs were more willing if they were: aged 36–45 years (OR 1.59 [95% CI = 1.04 to 2.44]); 46–55 years (OR 1.99 [95% CI = 1.14 to 3.47]); thought a FIT was highly accurate (OR 1.63 [95% CI = 1.16 to 2.29]); thought patients would benefit compared with having a colonoscopy (OR 2.02 [95% CI = 1.46 to 2.79]); and were highly confident about discussing the benefits of a FIT (OR 2.14 [95% CI = 1.46 to 3.16]). GPs were less willing if they had had >10 urgent referrals in the past year (OR 0.62 [95% CI = 0.40 to 0.94]) and thought that longer consultations would be needed (OR 0.61 [95% CI = 0.44 to 0.83]).ConclusionThe study findings suggest that the acceptability of using a FIT as a rule-out test in primary care is currently low, with less than half of GPs who perceived the test to be accurate preferring it over colonoscopy. Any potential guideline changes recommending a FIT in patients with high-risk symptoms, instead of urgent referral to rule out CRC, are likely to require intensive supporting educational outreach to increase GP confidence in the accuracy and application of a FIT in this context.
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Michail, Maria, Lynda Tait, and Dick Churchill. "General practitioners’ clinical expertise in managing suicidal young people: implications for continued education." Primary Health Care Research & Development 18, no. 05 (May 24, 2017): 419–28. http://dx.doi.org/10.1017/s1463423617000299.
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Aim To examine general practitioners’ (GPs) clinical expertise in assessing, communicating with, and managing suicidal young people aged 14–25 to inform the development of an educational intervention for GPs on youth suicide prevention. Background Suicide is the second leading cause of death for young people worldwide. GPs are ideally suited to facilitate early identification and assessment of suicide risk. However, GPs’ levels of competence, knowledge, and attitudes towards suicidal young people have not yet been explored. Methods A cross-sectional survey on GPs’ levels of confidence in assessing and managing young people at risk of suicide; knowledge of risk factors and warning signs of suicide in young people; attitudes towards young suicidal people; and training preferences on managing suicide risk. Findings Seventy GPs completed the survey (30 males). The majority of GPs reported high levels of confidence in assessing and managing suicidality in young people. Experienced GPs demonstrated high levels of knowledge of suicide risk factors in young people but low levels of knowledge of warning signs that might indicate heightened risk. Although 48% of GPs disagreed that maintaining compassionate care is difficult with those who deliberately self-harm, GPs perceived communication with young people to be difficult, with one-third reporting frustration in managing those at risk of suicide. A total of 75% of GPs said they would be interested in receiving further training on assessing and managing young people at risk of suicide. The study has important implications for providing specialist training to support GPs in assessing and managing youth suicide risk and facilitating attitudinal change. GP education on youth suicide risk assessment and management should promote a holistic understanding and assessment of risk and its individual, social and contextual influences in line with clinical recommendations to facilitate therapeutic engagement and communication with young people.
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Basedow, Martin, William B. Runciman, Wendy Lipworth, and Adrian Esterman. "Australian general practitioner attitudes to clinical practice guidelines and some implications for translating osteoarthritis care into practice." Australian Journal of Primary Health 22, no. 5 (2016): 403. http://dx.doi.org/10.1071/py15079.
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Clinical practice guidelines (CPGs) have been shown to improve processes of care and health outcomes, but there is often a discrepancy between recommendations for care and clinical practice. This study sought to explore general practitioner (GP) attitudes towards CPGs, in general and specifically for osteoarthritis (OA), with the implications for translating OA care into practice. A self-administered questionnaire was conducted in January 2013 with a sample of 228 GPs in New South Wales and South Australia. Seventy-nine GPs returned questionnaires (response rate 35%). Nearly all GPs considered that CPGs support decision-making in practice (94%) and medical education (92%). Very few respondents regarded CPGs as a threat to clinical autonomy, and most recognised that individual patient circumstances must be taken into account. Shorter CPG formats were preferred over longer and more comprehensive formats, with preferences being evenly divided among respondents for short, 2–3-page summaries, flowcharts or algorithms and single page checklists. GPs considered accessibility to CPGs to be important, and electronic formats were popular. Familiarity and use of The Royal Australian College of General Practitioners OA Guideline was poor, with most respondents either not aware of it (30%; 95% confidence interval (CI) 27 – 41%), had never used it (19%; 95% CI 12 – 29%) or rarely used it (34%; 95% CI 25–45%). If CPGs are to assist with the translation of evidence into practice, they must be easily accessible and in a format that encourages use.
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Gkioka, Mara, Julia Schneider, Andreas Kruse, Magda Tsolaki, Despina Moraitou, and Birgit Teichmann. "Evaluation and Effectiveness of Dementia Staff Training Programs in General Hospital Settings: A Narrative Synthesis with Holton’s Three-Level Model Applied." Journal of Alzheimer's Disease 78, no. 3 (November 24, 2020): 1089–108. http://dx.doi.org/10.3233/jad-200741.
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Background: People with Dementia (PwD) are frequently admitted to hospital settings. The lack of proper dementia knowledge, poor communication skills, negative attitudes toward dementia, and lack of confidence affects the quality of care, thus development of dementia trainings has increased. Nevertheless, literature regarding the effectiveness of training implementation is limited. Objective: The aim of this narrative synthesis is to 1) identify the characteristics of training programs and 2) explore the effectiveness of these training programs in everyday clinical practice. Methods: A systematic search in PubMed, PsycINFO, CINAHL, and Cochrane was conducted, including qualitative and quantitative peer-reviewed studies. Holton’s evaluation model with its three outcome levels (learning, individual performance, and organizational results) was adopted. 14 studies were included. Results: The synthesis of the results was divided into two parts: 1) to describe the characteristics and content of trainings 2) to evaluate the effectiveness of training programs according to the three outcome levels of Holton’s model, taking into consideration its construct domains: ability, motivation, and environment. Learning outcomes were assessed in all selected studies: 13 studies observed changes in individual performance, four studies reported changes within the organizational level, and only five showed sustainable changes over time. Conclusion: Person-centered care (PCC) approaches, interactive and varied teaching methods, supporting conditions like champions, action plans, and setting care policies, are all characteristics of effective trainings. Successful programs should be sustainable over time, demonstrating positive outcomes across the organization. Based on current findings, there is a lack of adequate evaluation with regard to training programs on the organizational level.
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Barrett, Tina, Edel McEntee, Richard Drew, Fiona O’Reilly, Austin O’Carroll, Aisling O’Shea, and Brian Cleary. "Influenza vaccination in pregnancy: vaccine uptake, maternal and healthcare providers’ knowledge and attitudes. A quantitative study." BJGP Open 2, no. 3 (August 7, 2018): bjgpopen18X101599. http://dx.doi.org/10.3399/bjgpopen18x101599.
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BackgroundInfluenza during pregnancy is a potentially life threatening illness. There are limited data on influenza vaccination uptake and determinants of uptake in Irish obstetric populations.AimTo determine the uptake of influenza vaccination during pregnancy; determinants of vaccination uptake; knowledge, attitudes, and concerns of postnatal women; and knowledge and attitudes of healthcare professionals (HCPs) surrounding vaccination.Design & settingA quantitative study of postnatal women attending the Rotunda Hospital, a tertiary referral maternity hospital in Dublin, Ireland. A separate quantitative study conducted by the North Dublin City GP Training Programme surveyed GPs, pharmacists, and Rotunda Hospital clinical staff.MethodA paper-based survey was distributed to postnatal women. HCPs completed the survey via the online tool Survey Monkey.Results330 patient surveys were disseminated, with a 60.0% response rate. Of 198 responders, 109 (55.1%) were vaccinated against influenza. Non-professionals were less likely to be vaccinated (adjusted odds ratio [aOR] 0.29, 95% confidence interval [CI] = 0.09 to 0.89). Vaccination in previous pregnancy (aOR 5.2, 95% CI = 1.69 to 15.62) and information from an HCP were strongly associated with vaccination (aOR 12.8, 95% CI = 2.65 to 62.5). There was a 20.2% (n = 1180) response rate among HCPs. More GPs felt that it was their role to discuss vaccination (92.9%; n = 676), and offer to vaccinate women (91.7%; n = 666) than any other HCP.ConclusionProvision of information about the importance of vaccination against influenza and pertussis during pregnancy by HCPs and their consistent recommendations in support of vaccination were key determinants of vaccine uptake during pregnancy. The sociodemographic determinants of a woman’s vaccination status should be addressed in health promotion campaigns. Education of HCPs may address knowledge gaps surrounding vaccination.