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Options about Dementia Managment of Family Physicians

Year 2016, Volume: 18 Issue: 3, 95 - 98, 01.12.2016

Abstract

Objective: Dementia is poised to become a major public health problem and it is addictive,disabled leaving chronic disease. It requires interdisciplinary approach. In this study it is aimedto evaluate the opinions of family physicians working at Family Health Centers, about themanagement of the patients diagnosed with dementia and having cognitive problems. Material and Method: Twenty two family physicians working in Antalya participated to thestudy. A 26 question survey consisting of three parts was administered. Opinions were evaluatedwith style five-point Likert response scale. The data are analyzed with descriptive statistics.Results: The options of family physicians participating in the study are as follows. (M: Medyan)“I feel myself adequate to diagnose cognitive problems” (M=3) “I regulate the treatment ofdementia” (M=4), “I manage the dementia behavior problems” (M=3) “I cooperated with branchexpertise on the management of dementia” (M=2) ,“I direct bedridden dementia patients to takehome health care”(M=2), “I care with relatives of dementia patients” (M=2), “family physicianshave important contributions in the early diagnosis ” (M=2), and “family physicians haveconstributions in management ” (M=2). They directed the patients with preliminary diagnosisof cognitive problems to neurologist 8 patients (36.4%), to psychiatrists 1 (4.5%) and otherexperts 13 (59.1%). Health problems among caregivers of patients with dementia, depression11 (50%), anxiety disorders 7 (31.8%) and chronic fatigue 1 (4.5%) have reported.Conclusion: This preliminary study suggests that the participants do not feel themselvesadequate in the regulation of the diagnosis and treatment of dementia

References

  • Ihl R, Bunevicius R, Frölich L, Winblad B, Schneider LS, Dubois B, Burns A,Thibaut F, Kasper S, Möller HJ; WFSBP Task Force on Mental Disorders in Primary Care; WFSBP Task Force on Dementia. World Federation of Societies of Biological Psychiatry guidelines for the pharmacological treatment of dementias in primary care. Int J Psychiatry Clin Pract. 10.3109/13651501.2014.961931. Epub 2014 Oct 18.
  • Yaman A, Yaman H. Dementia Subtypes in Antalya, Turkey: A Retrospective Study. Postgraduate Medicine 2014; 125(5):109-112.
  • Robinson L, Tang E, Taylor JP. Dementia: timely diagnosis and early intervention. BMJ. 2015 Jun 16;350:h3029. doi:10.1136/bmj.h3029.
  • van den Dungen P, Moll van Charante EP, van de Ven PM, Foppes G, van Campen JP, van Marwijk HW, van der Horst HE, van Hout HP. Dutch family physicians' awareness of cognitive impairment among the elderly. BMC Geriatr. 2015 Aug 27;15:105. doi: 10.1186/s12877-015-0105-1.
  • Parmar J, Dobbs B, McKay R, Kirwan C, Cooper T, Marin A, Gupta N. Diagnosis and management of dementia in primary care: exploratory study. Can Fam Physician. 2014 May;60(5):457-65.
  • Lathren CR, Sloane PD, Hoyle JD, Zimmerman S, Kaufer DI. Improving dementia diagnosis and management in primary care: a cohort study of the impact of a training and support program on physician competency, practice patterns, and community linkages. BMC Geriatr. 2013 Dec 10;13:134. doi: 10.1186/1471-2318-13-134.
  • Yaman H. Geriatrik Hasta Yönetimi: Kognitif Problemler- Demans Demansın Toplum İçindeki Yönetimi: Aile Hekimliğinin Yeri 13. Ulusal Kongresi, Antalya, 23-27 Nisan 2014.
  • Yaman H. Yaşlı Dostu Sağlık ve Bakım Uygulamaları: Yaşlı Dostu Döşemealtı Örneği. Yaşlı Dostu Kentler Sempozyumu. 26-27 Kasım 2015 / Bursa
  • Wilcock J, Iliffe S, Griffin M, Jain P, Thuné-Boyle I, Lefford F, Rapp D. Tailored educational intervention for primary care to improve the management of dementia: the EVIDEM-ED cluster randomized controlled trial. Trials 2013, 14:397.http://www.trialsjournal.com/content/14/1/397
  • Geldmacher DS, Kerwin DR. Practical Diagnosis and Management of Dementia Due to Alzheimer’s Disease in the Primary Care Setting: An Eviden. ce-Based Approach Prim Care Companion CNS Disord. 2013; 15(4): PCC.12r01474. Published online 2013 Aug 29. doi: 10.4088/PCC.12r01474
  • Fortinsky RH: How linked are physicians to community support services for their patients with dementia? J Appl Gerontol 1998;17(4):480-498.
  • Stewart TV, Loskutova N, Galliher JM, Warshaw GA, Coombs LJ, Staton EW, Huff JM, Pace WD. Practice patterns, beliefs, and perceived barriers to care regarding dementia: a report from the American Academy of Family Physicians (AAFP) national research network. J Am Board Fam Med. 2014 10.3122/jabfm.2014.02.120284. doi
  • Hum S, Cohen C, Persaud M, Lee J, Drummond N, Dalziel W, Pimlott N. Role expectations in dementia care among family physicians and specialists. Can Geriatr J. 2014 Sep 5;17(3):95-102. doi: 10.5770/cgj.17.110. eCollection 2014.
  • Knapp M, Iemmi V, Romeo R. Dementia care costs and outcomes: a systematic review. Int J Geriatr Psychiatry 2013;28:551-61.
  • Greenwood N1, Smith R2. Barriers and facilitators for male carers in accessing formal and informal support: A systematic review. 10.1016/j.maturitas.2015.07.013. Epub 2015 Jul 19.
  • Dening KH1, Jones L, Sampson EL. Advance care planning for people with dementia: a review. Int Psychogeriatr. 2011 Dec;23(10):1535-51. doi: 10.1017/S1041610211001608. Epub 2011 Aug 26.
  • Mukadam N, Cooper C, Kherani N, Livingston G. A systematic review of interventions to detect dementia or cognitive impairment. Int J Geriatr Psychiatry. 2015 Jan;30(1):32-45. doi: 10.1002/gps.4184. Epub 2014 Aug 3.

AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ

Year 2016, Volume: 18 Issue: 3, 95 - 98, 01.12.2016

Abstract

Amaç: Demans önemli bir halk sağlığı sorunu olmaya aday, bağımlılık yapan ve engelli bırakankronik bir hastalıktır. Konu interdisipliner yaklaşım gerektirmektedir. Bu çalışmada aile sağlığımerkezlerinde (ASM) görev yapan aile hekimlerinin bilişsel sorunu olan ve demans tanısı iletakip edilen hastaların yönetimleri ile ilgili görüşlerinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışmaya Antalya'da görev yapan 22 aile hekimi katılmış, Üç bölümdenoluşan 26 soruluk anket uygulanmıştır. Veriler tanımlayıcı istatistik ile değerlendirilmiştir. Bulgular: Çalışmaya katılan aile hekimlerinin görüşleri şu şekildedir: (M=medyan)“bilişsel sorunlara tanı koymada kendimi yeterli hissederim” (M=3),“demansın tedavisinidüzenlerim” (M=4), “demansın davranış sorunlarını yönetirim” (M=3), “demansın yönetimindeilgili branş uzmanları ile işbirliği yaparım” (M=2), “demansın farmakolojik olmayan yönetiminisağlarım” (M=2,5), “demansa yönelik tıp dışı hizmetlere hastaları yönlendiririm” (M=3), “ileritalimatlar konusunda yönlendiririm” (M=2) “yatağa bağımlı demanslı hastaları evde sağlıkhizmeti almaları için yönlendiririm” (M=2), “demans hastasına bakan yakınları ile ilgilenirim”(M=2),“aile hekimlerinin demansın erken tanısında önemli katkıları bulunur” (M=2) ve “ailehekimlerinin demans yönetiminde önemli katkıları bulunur” (M=2). Bilişsel sorun ön tanısıkoydukları hastaları nörolog 8 (%36.4), psikiyatrist 1 (%4.5) ve uzmanlara 13 (%59.1)yönlendirmişlerdir. Evde bakım, grup etkinlikleri ve aile desteği 3 (%13.5) gibi demansa yöneliktıp dışı faaliyetlerden haberdardırlar. Demanslı hastalara bakımverenlerin sağlık sorunlarıarasında depresyon 11 (%50), anksiyete bozuklukları 7 ( %31.8) ve kronik yorgunluğun 1 (%4.5)görüldüğünü bildirmişlerdir.Sonuç: Bu ön çalışmada katılımcıların kendilerini demansın tanısını koymada, tedavisinindüzenlenmesinde ve yönetiminde yeterli hissetmedikleri anlaşılmıştır

References

  • Ihl R, Bunevicius R, Frölich L, Winblad B, Schneider LS, Dubois B, Burns A,Thibaut F, Kasper S, Möller HJ; WFSBP Task Force on Mental Disorders in Primary Care; WFSBP Task Force on Dementia. World Federation of Societies of Biological Psychiatry guidelines for the pharmacological treatment of dementias in primary care. Int J Psychiatry Clin Pract. 10.3109/13651501.2014.961931. Epub 2014 Oct 18.
  • Yaman A, Yaman H. Dementia Subtypes in Antalya, Turkey: A Retrospective Study. Postgraduate Medicine 2014; 125(5):109-112.
  • Robinson L, Tang E, Taylor JP. Dementia: timely diagnosis and early intervention. BMJ. 2015 Jun 16;350:h3029. doi:10.1136/bmj.h3029.
  • van den Dungen P, Moll van Charante EP, van de Ven PM, Foppes G, van Campen JP, van Marwijk HW, van der Horst HE, van Hout HP. Dutch family physicians' awareness of cognitive impairment among the elderly. BMC Geriatr. 2015 Aug 27;15:105. doi: 10.1186/s12877-015-0105-1.
  • Parmar J, Dobbs B, McKay R, Kirwan C, Cooper T, Marin A, Gupta N. Diagnosis and management of dementia in primary care: exploratory study. Can Fam Physician. 2014 May;60(5):457-65.
  • Lathren CR, Sloane PD, Hoyle JD, Zimmerman S, Kaufer DI. Improving dementia diagnosis and management in primary care: a cohort study of the impact of a training and support program on physician competency, practice patterns, and community linkages. BMC Geriatr. 2013 Dec 10;13:134. doi: 10.1186/1471-2318-13-134.
  • Yaman H. Geriatrik Hasta Yönetimi: Kognitif Problemler- Demans Demansın Toplum İçindeki Yönetimi: Aile Hekimliğinin Yeri 13. Ulusal Kongresi, Antalya, 23-27 Nisan 2014.
  • Yaman H. Yaşlı Dostu Sağlık ve Bakım Uygulamaları: Yaşlı Dostu Döşemealtı Örneği. Yaşlı Dostu Kentler Sempozyumu. 26-27 Kasım 2015 / Bursa
  • Wilcock J, Iliffe S, Griffin M, Jain P, Thuné-Boyle I, Lefford F, Rapp D. Tailored educational intervention for primary care to improve the management of dementia: the EVIDEM-ED cluster randomized controlled trial. Trials 2013, 14:397.http://www.trialsjournal.com/content/14/1/397
  • Geldmacher DS, Kerwin DR. Practical Diagnosis and Management of Dementia Due to Alzheimer’s Disease in the Primary Care Setting: An Eviden. ce-Based Approach Prim Care Companion CNS Disord. 2013; 15(4): PCC.12r01474. Published online 2013 Aug 29. doi: 10.4088/PCC.12r01474
  • Fortinsky RH: How linked are physicians to community support services for their patients with dementia? J Appl Gerontol 1998;17(4):480-498.
  • Stewart TV, Loskutova N, Galliher JM, Warshaw GA, Coombs LJ, Staton EW, Huff JM, Pace WD. Practice patterns, beliefs, and perceived barriers to care regarding dementia: a report from the American Academy of Family Physicians (AAFP) national research network. J Am Board Fam Med. 2014 10.3122/jabfm.2014.02.120284. doi
  • Hum S, Cohen C, Persaud M, Lee J, Drummond N, Dalziel W, Pimlott N. Role expectations in dementia care among family physicians and specialists. Can Geriatr J. 2014 Sep 5;17(3):95-102. doi: 10.5770/cgj.17.110. eCollection 2014.
  • Knapp M, Iemmi V, Romeo R. Dementia care costs and outcomes: a systematic review. Int J Geriatr Psychiatry 2013;28:551-61.
  • Greenwood N1, Smith R2. Barriers and facilitators for male carers in accessing formal and informal support: A systematic review. 10.1016/j.maturitas.2015.07.013. Epub 2015 Jul 19.
  • Dening KH1, Jones L, Sampson EL. Advance care planning for people with dementia: a review. Int Psychogeriatr. 2011 Dec;23(10):1535-51. doi: 10.1017/S1041610211001608. Epub 2011 Aug 26.
  • Mukadam N, Cooper C, Kherani N, Livingston G. A systematic review of interventions to detect dementia or cognitive impairment. Int J Geriatr Psychiatry. 2015 Jan;30(1):32-45. doi: 10.1002/gps.4184. Epub 2014 Aug 3.
There are 17 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Ramazan Vural This is me

Aylin Yaman This is me

Hakan Yaman This is me

Publication Date December 1, 2016
Published in Issue Year 2016 Volume: 18 Issue: 3

Cite

APA Vural, R., Yaman, A., & Yaman, H. (2016). AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ. Duzce Medical Journal, 18(3), 95-98. https://doi.org/10.3109/13651501.2014.961931. Epub 2014 Oct 18.
AMA Vural R, Yaman A, Yaman H. AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ. Duzce Med J. December 2016;18(3):95-98. doi:10.3109/13651501.2014.961931. Epub 2014 Oct 18.
Chicago Vural, Ramazan, Aylin Yaman, and Hakan Yaman. “AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ”. Duzce Medical Journal 18, no. 3 (December 2016): 95-98. https://doi.org/10.3109/13651501.2014.961931. Epub 2014 Oct 18.
EndNote Vural R, Yaman A, Yaman H (December 1, 2016) AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ. Duzce Medical Journal 18 3 95–98.
IEEE R. Vural, A. Yaman, and H. Yaman, “AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ”, Duzce Med J, vol. 18, no. 3, pp. 95–98, 2016, doi: 10.3109/13651501.2014.961931. Epub 2014 Oct 18.
ISNAD Vural, Ramazan et al. “AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ”. Duzce Medical Journal 18/3 (December 2016), 95-98. https://doi.org/10.3109/13651501.2014.961931. Epub 2014 Oct 18.
JAMA Vural R, Yaman A, Yaman H. AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ. Duzce Med J. 2016;18:95–98.
MLA Vural, Ramazan et al. “AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ”. Duzce Medical Journal, vol. 18, no. 3, 2016, pp. 95-98, doi:10.3109/13651501.2014.961931. Epub 2014 Oct 18.
Vancouver Vural R, Yaman A, Yaman H. AİLE HEKİMLERİNİN DEMANS YÖNETİMİ İLE İLGİLİ GÖRÜŞLERİ. Duzce Med J. 2016;18(3):95-8.