Literature DB >> 19439708

Family physicians and dementia in Canada: Part 2. Understanding the challenges of dementia care.

Nicholas J G Pimlott1, Malini Persaud, Neil Drummond, Carole A Cohen, James L Silvius, Karen Seigel, Gary R Hollingworth, William B Dalziel.   

Abstract

OBJECTIVE: To explore the challenges Canadian family physicians face in providing dementia care.
DESIGN: Qualitative study using focus groups.
SETTING: Academic family practice clinics in Calgary, Alta, Ottawa, Ont, and Toronto, Ont. PARTICIPANTS: Eighteen family physicians.
METHODS: We conducted 4 qualitative focus groups of 4 to 6 family physicians whose practices we had audited in a previous study. Focus group transcripts were analyzed using the principles of thematic analysis. MAIN
FINDINGS: Five major themes related to the provision of dementia care by family physicians emerged: 1) diagnostic uncertainty; 2) the complexity of dementia; 3) time as a paradox in the provision of dementia care; 4) the importance of patients' families; 5) and familiarity with patients. Participants expressed uncertainty about diagnosing dementia and a strong need for expert verification of diagnoses owing to the complexity of dementia. Time, patients' family members, and familiarity with patients were seen as both barriers and enablers in the provision of dementia care.
CONCLUSION: Family physicians face many challenges in providing dementia care. The results of this study and the views of family physicians should be considered in the development and dissemination of future dementia guidelines, as well as by specialist colleagues, policy makers, and those involved in developing continuing physician education about dementia.

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Mesh:

Year:  2009        PMID: 19439708      PMCID: PMC2682312     

Source DB:  PubMed          Journal:  Can Fam Physician        ISSN: 0008-350X            Impact factor:   3.275


  28 in total

1.  The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial.

Authors:  Barbara G Vickrey; Brian S Mittman; Karen I Connor; Marjorie L Pearson; Richard D Della Penna; Theodore G Ganiats; Robert W Demonte; Joshua Chodosh; Xinping Cui; Stefanie Vassar; Naihua Duan; Martin Lee
Journal:  Ann Intern Med       Date:  2006-11-21       Impact factor: 25.391

Review 2.  Effects of interventions aimed at changing the length of primary care physicians' consultation.

Authors:  A D Wilson; S Childs
Journal:  Cochrane Database Syst Rev       Date:  2006-01-25

3.  Management of dementia by family physicians in academic settings.

Authors:  Nicholas J G Pimlott; Karen Siegel; Malini Persaud; Susan Slaughter; Carole Cohen; Gary Hollingworth; Sandy Cummings; Neil Drummond; William Dalziel; James Sylvius; Dorothy Pringle; Tex Eliasziw
Journal:  Can Fam Physician       Date:  2006-09       Impact factor: 3.275

4.  Use of guidelines in primary care--practitioners' perspectives.

Authors:  C Langley; A Faulkner; C Watkins; S Gray; I Harvey
Journal:  Fam Pract       Date:  1998-04       Impact factor: 2.267

5.  Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma.

Authors:  Myrra J F J Vernooij-Dassen; Esme D Moniz-Cook; Robert T Woods; Jan De Lepeleire; Antonio Leuschner; Orazio Zanetti; Joycelyn de Rotrou; Geraldine Kenny; Manuel Franco; Vincent Peters; Steve Iliffe
Journal:  Int J Geriatr Psychiatry       Date:  2005-04       Impact factor: 3.485

6.  The effect of different diagnostic criteria on the prevalence of dementia.

Authors:  T Erkinjuntti; T Ostbye; R Steenhuis; V Hachinski
Journal:  N Engl J Med       Date:  1997-12-04       Impact factor: 91.245

7.  Implementing a screening and diagnosis program for dementia in primary care.

Authors:  Malaz Boustani; Christopher M Callahan; Frederick W Unverzagt; Mary G Austrom; Anthony J Perkins; Bridget A Fultz; Siu L Hui; Hugh C Hendrie
Journal:  J Gen Intern Med       Date:  2005-07       Impact factor: 5.128

8.  Primary care physician specialty referral decision making: patient, physician, and health care system determinants.

Authors:  Christopher B Forrest; Paul A Nutting; Sarah von Schrader; Charles Rohde; Barbara Starfield
Journal:  Med Decis Making       Date:  2006 Jan-Feb       Impact factor: 2.583

Review 9.  Do longer consultations improve the management of psychological problems in general practice? A systematic literature review.

Authors:  Catherine Hutton; Jane Gunn
Journal:  BMC Health Serv Res       Date:  2007-05-17       Impact factor: 2.655

10.  Understanding the work of general practitioners: a social science perspective on the context of medical decision making in primary care.

Authors:  Robert Geneau; Pascale Lehoux; Raynald Pineault; Paul Lamarche
Journal:  BMC Fam Pract       Date:  2008-02-19       Impact factor: 2.497

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  36 in total

1.  Prevalence and management of dementia in primary care practices with electronic medical records: a report from the Canadian Primary Care Sentinel Surveillance Network.

Authors:  Neil Drummond; Richard Birtwhistle; Tyler Williamson; Shahriar Khan; Stephanie Garies; Frank Molnar
Journal:  CMAJ Open       Date:  2016-04-28

2.  Is pre-existing dementia an independent predictor of outcome after stroke? A propensity score-matched analysis.

Authors:  Gustavo Saposnik; Moira K Kapral; Robert Cote; Paula A Rochon; Julie Wang; Stavroula Raptis; Muhammad Mamdani; Sandra E Black
Journal:  J Neurol       Date:  2012-04-25       Impact factor: 4.849

Review 3.  Building capacity for dementia care: training program to develop primary care memory clinics.

Authors:  Linda Lee; M Janet Kasperski; W Wayne Weston
Journal:  Can Fam Physician       Date:  2011-07       Impact factor: 3.275

Review 4.  Health care experiences of people with dementia and their caregivers: a meta-ethnographic analysis of qualitative studies.

Authors:  Jeanette C Prorok; Salinda Horgan; Dallas P Seitz
Journal:  CMAJ       Date:  2013-09-03       Impact factor: 8.262

Review 5. 

Authors:  Linda Lee; Tejal Patel; Frank Molnar; Dallas Seitz
Journal:  Can Fam Physician       Date:  2018-09       Impact factor: 3.275

Review 6.  Optimizing medications in older adults with cognitive impairment: Considerations for primary care clinicians.

Authors:  Linda Lee; Tejal Patel; Frank Molnar; Dallas Seitz
Journal:  Can Fam Physician       Date:  2018-09       Impact factor: 3.275

7.  Ecology of family physicians' research engagement.

Authors:  Nicholas Pimlott; Alan Katz
Journal:  Can Fam Physician       Date:  2016-05       Impact factor: 3.275

8.  [L'écologie de l'engagement des médecins de famille dans la recherche].

Authors:  Nicholas Pimlott; Alan Katz
Journal:  Can Fam Physician       Date:  2016-05-12       Impact factor: 3.275

9.  Community-dwelling older adults with memory loss: needs assessment.

Authors:  Karen Parsons; Aimee Surprenant; Anne-Marie Tracey; Marshall Godwin
Journal:  Can Fam Physician       Date:  2013-03       Impact factor: 3.275

10.  Structured approach to patients with memory difficulties in family practice.

Authors:  Linda Lee; W Wayne Weston; George Heckman; Micheline Gagnon; F Joseph Lee; Scott Sloka
Journal:  Can Fam Physician       Date:  2013-03       Impact factor: 3.275

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