Dementia Diagnosis and Care – a Challenge for Family Medicine.
DOI: 10.3238/zfa.2018.0012-0016german translation / full article
Background: Only a few studies have investigated why dementia is usually diagnosed at an advanced stage in primary care. It can be assumed that the causes are complex and depend on a series of interacting influencing factors.Methods: The study is based on 35 qualitative individual interviews with family practitioners in Rhineland-Palatinate which were conducted between February and May 2017 (duration: 35 to 90 minutes). With the help of an indicator-based typification various behavioral patterns should be identified with respect to the recognition and care of dementia.Results: Five types could be extracted which differ as to the self-conception of the doctor and his interaction with dementia patients. The largest part of the sample was characterized by a skeptical and reserved attitude towards the topic of dementia. A third of the physicians surveyed showed a high degree of commitment and initiative in order to improve the early detection in their own FP surgery. Various good practice examples can be shown.Conclusions: With the help of the extracted types, four starting points can be identified to further optimize the FP dementia diagnoses and care: 1) self-efficacy, 2) differential diagnosis and care pathways, 3) doctor-patient communication, 4) remuneration and incentives.