Abstract
AimsTo assess how patients with dementia present to services and reasons for delayed presentation among patients with dementia in Sri Lanka.MethodA descriptive cross-sectional study was conducted among 83 newly diagnosed patients with dementia and their caregivers at the University Psychiatry Unit, National Hospital of Sri Lanka. They were interviewed using a semi-structured pre-tested questionnaire. Statistical Package for the Social Sciences (SPSS) was utilized for data analysis.ResultThe mean age of the patients was 71.53(SD = 7.595)years. The commonest type of dementia in the cohort was Alzheimer's disease(N = 49, 59%). The mean untreated duration before the first presentation was 16.33(SD = 16.13) months. A family member or the care-giver had initiated help-seeking in many (N = 65,78.3%). 84.33% of patients had behavioural and Psychological Symptoms of Dementia (BPSD) at first presentation. BPSD was the main reason for help-seeking in 40(48.2%) cases. Among them, psychosis(n = 18,45%), depression(n = 9,22.5%), disinhibition(n = 4,10%) and wandering(n = 3,7.5%) were common.Lack of awareness on dementia (n = 70,93.3% and n = 68,86.1%) and considering cognitive impairment as a normal part of ageing (n = 39,52% and n = 43,54.4%)were the commonest reasons for delayed presentation reported by patients and care-givers respectively. Twelve patients misattributed the symptoms to their existing medical or psychiatric conditions. The mean untreated duration was significantly higher in the patient group with a family history of dementia (30.5 months) compared to those without a family history (12.8 months)(t = 3.818;p = 0.000). Similarly, the mean untreated duration was significantly higher when there is a family history of dementia among the care-givers (25.53months) compared to the group of care-givers without a family history (13.85 months)(t = 2.532;p = 0.013). Age, sex, education, occupation, income, knowledge on dementia of the patients and the caregivers, illness-related characteristics (type, severity, and presence of BPSD) or being in contact with medical services were not significantly associated with the timing of the first presentation.ConclusionThere is a delay of more than one year for patients with dementia to present to services in Sri Lanka. The commonest reason for the presentation is BPSD. Lack of prior awareness of dementia and considering the cognitive impairment as a part of normal ageing by both patients and carers were the main reasons for delayed presentation. Patients with a family history of dementia present late than those without a family history. There is no significant association between the timing of presentation and the socio-demographic factors of the patients and care-givers, the presence of prior knowledge on dementia, illness-related characteristics, or contact with medical services.
Highlights
We aimed to take a snapshot of the effect virtual Balint sessions have had and analyse the themes that members of virtual Balint groups have been identifying about their online group experience at this challenging time for healthcare workers. We hope this will inform both leaders and participants of future online groups of the benefits and pitfalls found by these members reflecting on their first experiences of virtual Balint
Seven members of virtual Balint groups across the UK were randomly selected for interview from a pool of volunteers facilitated by the UK Balint Society after the first 6 months of their first virtual Balint experience
Interviews were conducted by two academic foundation doctors who were not members of the Balint groups
Summary
Nikhita Handa1*, Romy Garbutt[1] and Sylvia Chudley2 1East Lancashire Hospitals NHS Trust and 2The Balint Society *Corresponding author. From the outset of the COVID-19 global pandemic and the lockdown that subsequently ensued, a challenge was posed to reshape previously face-to-face meetings in all walks of life. One area that rose to this, with quick introduction of online sessions, was the Balint Group.
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