Dementia-Related Knowledge, Attitudes, and Practices among Family Medicine Residents

Abstract

Dementia-Related Knowledge, Attitudes, and Practices among Family Medicine Residents

Abstract

Purpose: Primary care physicians (PCPs) are often the first to encounter dementia patients, highlighting the importance of their role in early detection and management. This study evaluates the knowledge, attitudes, and practices of family medicine residents (FMRs) in Turkey regarding dementia. Material and Methods: A cross-sectional study was conducted from March to April 2022 using an online questionnaire distributed to family medicine clinics across Turkey. The questionnaire, comprising three sections on demographics, the Dementia Knowledge Assessment Scale (DKAS), and the Dementia Attitude Scale (DAS), was distributed using Google Forms. Results: A total of 393 FMRs participated, with a mean age of 28.9±3.0 years; 71.2% were female. DKAS scores averaged 18.33±5.11, while DAS scores averaged 93.48±12.29. Higher knowledge levels were associated with postgraduate training, experience in dementia care, and willingness to screen for dementia. Positive attitudes were linked to more years in residency, family history of dementia, and prior dementia-related education. Conclusion: FMRs demonstrated limited knowledge but positive attitudes toward dementia. The study underscores the need for enhanced dementia training in residency programs to improve early detection and management skills among PCPs. Addressing gaps in knowledge and confidence can lead to better patient outcomes and more effective dementia care.

Keywords

• Alzheimer
• Attitude
• Dementia
• Family Medicine
• Knowledge

References

1. World Health Organization. Towards a dementia plan: A WHO guide. 2018.
2. Patterson C. World Alzheimer Report 2018 The state of the art of dementia research: New frontiers [Report]: Alzheimer's Disease International; 2018.
3. Mansfield E, Noble N, Sanson-Fisher R, Mazza D, Bryant J. Primary care physicians' perceived barriers to optimal dementia care: A systematic review. Gerontologist 2019;59(6):e697-e708.
4. Wangler J, Jansky M. Factors influencing general practitioners' perception of and attitude towards dementia diagnostics and care-results of a survey among primary care physicians in Germany. Wien Med Wochenschr 2021;171(7-8):165-73.
5. Galvin JE, Sadowsky CH. Practical guidelines for the recognition and diagnosis of dementia. Journal of the American Board of Family Medicine 2012;25(3):367-82.
6. British Columbia Ministry of Health. Cognitive impairment- recognition, diagnosis and management in primary care 2016.
7. Lo IL, Zeng W, Lei CI, Lam C, Lou HL. Knowledge, attitude and preventive practice on dementia care among primary health professionals in Macao. J Prev Alzheimers Dis 2020;7(2):83-6.
8. Wang M, Xu X, Huang Y, Shao S, Chen X, Li J, et al. Knowledge, attitudes and skills of dementia care in general practice: A cross-sectional study in primary health settings in Beijing, China. BMC Fam Pract 2020;21(1):89.

9. Zhao W, Moyle W, Wu MW, Petsky H. Hospital healthcare professionals' knowledge of dementia and attitudes towards dementia care: A cross-sectional study. J Clin Nurs 2022;31(13-14):1786-99.
10. Jennings AA, Foley T, Walsh KA, Coffey A, Browne JP, Bradley CP. General practitioners' knowledge, attitudes and experiences of managing behavioural and psychological symptoms of dementia: protocol of a mixed methods systematic review and meta-ethnography. Syst Rev 2018;7(1):62.
11. Tang EYH, Birdi R, Robinson L. Attitudes to diagnosis and management in dementia care: views of future general practitioners. Int Psychogeriatr 2018;30(3):425-30.
12. Kalin L, Kinder N, Eckstrom E. Dementia & Delirium. 2019 [cited 2022/06/07]. In: Behavioral medicine: A guide for clinical practice, 5ed [Internet]. New York, NY: McGraw-Hill Education, [cited 2022/06/07]. Erişim Adresi: https://accessmedicine.mhmedical.com/content.aspx?bookid=2747§ionid=230251761.
13. Heim S, Busa C, Pozsgai E, Csikos A, Papp E, Pakaski M, et al. Hungarian general practitioners' attitude and the role of education in dementia care. Prim Health Care Res Dev 2019;20:e92.
14. Helm L, Balzer K, Behncke A, Eisemann N, Kopke S. Patients with dementia in acute care hospitals: A cross-sectional study of physicians' experiences and attitudes. Z Gerontol Geriatr 2018;51(5):501-8.
15. Annear MJ, Toye CM, Eccleston CE, McInerney FJ, Elliott KE, Tranter BK, et al. Dementia knowledge assessment scale: Development and Preliminary psychometric properties. J Am Geriatr Soc 2015;63(11):2375-81.
16. Akyol MA, Gonen Senturk S, Akpinar Soylemez B, Kucukguclu O. Assessment of dementia knowledge scale for the nursing profession and the general population: Cross-cultural adaptation and psychometric validation. Dement Geriatr Cogn Disord 2021;50(2):170-7.
17. O'Connor ML, McFadden SH. Development and psychometric validation of the dementia attitudes scale. International Journal of Alzheimer's Disease 2010;2010:1-10.
18. Cetinkaya A, Elb IH, Altan S, Rahman S, AydemIr O. Adaptation of the dementia attitudes scale into Turkish. Noro Psikiyatr Ars 2020;57(4):325-32.
19. Prorok JC, Stolee P, Cooke M, McAiney CA, Lee L. Evaluation of a dementia education program for family medicine residents. Can Geriatr J 2015;18(2):57-64.
20. Somme D, Gautier A, Pin S, Corvol A. General practitioner's clinical practices, difficulties and educational needs to manage Alzheimer's disease in France: Analysis of national telephone-inquiry data. BMC Fam Pract 2013;14(1):81.
21. Wang Y, Xiao LD, Luo Y, Xiao SY, Whitehead C, Davies O. Community health professionals' dementia knowledge, attitudes and care approach: A cross-sectional survey in Changsha, China. BMC Geriatr 2018;18(1):122.
22. Lerner BS, Kalish V, Ledford CJW. Exploring residents' skills in diagnosing dementia: The unexpected dissonance between ability and confidence. Fam Med 2017;49(6):460-3.
23. Leung CW, Lam TP, Wong KW, Chao VKD. Early detection of dementia: The knowledge and attitudes of primary care physicians in Hong Kong. Dementia (London) 2020;19(3):830-46.
24. Subramaniam M, Ong HL, Abdin E, Chua BY, Shafie S, Siva Kumar FD, et al. General practitioner's attitudes and confidence in managing patients with dementia in Singapore. Ann Acad Med Singap 2018;47(3):108-18.
25. Lee L, Weston WW, Hillier LM. Education to improve dementia care: Impact of a structured clinical reasoning approach. Fam Med 2018;50(3):195-203.
26. Sannemann L, Muller T, Waterink L, Zwan M, Wimo A, Stomrud E, et al. General practitioners' attitude toward early and pre-dementia diagnosis of AD in five European countries-A MOPEAD project survey. Alzheimers Dement (Amst) 2021;13(1):e12130.
27. Petrazzuoli F, Vinker S, Koskela TH, Frese T, Buono N, Soler JK, et al. Exploring dementia management attitudes in primary care: a key informant survey to primary care physicians in 25 European countries. Int Psychogeriatr 2017;29(9):1413-23.
28. Bernstein A, Rogers KM, Possin KL, Steele NZR, Ritchie CS, Kramer JH, et al. Dementia assessment and management in primary care settings: a survey of current provider practices in the United States. BMC Health Serv Res 2019;19(1):919.
29. Thyrian JR, Hoffmann W. Dementia care and general physicians--a survey on prevalence, means, attitudes and recommendations. Cent Eur J Public Health 2012;20(4):270-5.
30. Strom BS, Engedal K, Andreassen L. Nursing staff's knowledge and attitudes toward dementia: A pilot study from an Indian perspective. Dement Geriatr Cogn Dis Extra 2019;9(3):352-61.
31. Murphy K, O'Connor DA, Browning CJ, French SD, Michie S, Francis JJ, et al. Understanding diagnosis and management of dementia and guideline implementation in general practice: A qualitative study using the theoretical domains framework. Implement Sci 2014;9(1):31.
32. Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020;396(10248):413-46.
33. Keogh B, Ting To W, Daly L, Hynes G, Kennelly S, Lawlor B, et al. Acute hospital staff's attitudes towards dementia and perceived dementia knowledge: a cross-sectional survey in Ireland. BMC Geriatr 2020;20(1):376.
34. Tufan F, Yuruyen M, Kizilarslanoglu MC, Akpinar T, Emiksiye S, Yesil Y, et al. Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study. Arch Gerontol Geriatr 2015;60(2):307-10.