Knowledge, attitudes and practices of mental health professionals regarding the management of major cognitive disorders in the Republic of Moldova

Abstract

Major cognitive impairment is a significant public health problem despite advances in patient management. The purpose of the research was to analyze the knowledge, attitudes, and practices of mental health specialists regarding the management of major cognitive disorders in the Republic of Moldova. Material and method: The research were descriptive online survey type. A structured questionnaire with self-completion questions was used. The questionnaires were pre-tested and validated prior to conducting the research. Results: Barriers identified: 50.0% lack of social support services, 34.4% lack of a national guide/program, 46.9% lack of interdisciplinary collaboration, 43.8% problems in communicating with the patient, 25, 0% difficulties in establishing the diagnosis and developing the treatment plan, 31.3% in communication with relatives/caregiver, and 40.6% in the diagnosis and treatment of concomitant diseases. During consultations, 75.0% of those interviewed quantify the degree of impairment of cognitive function, 71.9% know national and international guidelines/protocols, 90.6% consider training in social and cultural activities useful, 75.0% – performing exercises physical therapy, 65.6% physical therapy, 56.3% cognitive-behavioral therapy, 53.1% speech therapy sessions, 46.9% psychotherapy, and 28.1% state that all options are useful. Positive attitudes 96.9% believe that the patient with cognitive disorders must benefit from access to medical services according to individual needs and that the patient has the right to live with dignity, without suffering, 81.3% are of the opinion that patients must be included in social and cultural activities, 62.5% support that people with cognitive disorders should benefit from institutionalization for palliative care. Negative attitudes 50.0% believe that patients consume time, emotions, and resources, and 25.0% mention that they are a burden on the healthcare system. Conclusion: The most frequent difficulties in the approach and management of patients with cognitive disorders are cited as the lack of social support services for patients or families, interdisciplinary collaboration/difficulty referring to other specialists and a national guide/program for cognitive disorders.