Abstract
BackgroundCaring for patients with dementia is a demanding task. Little is known as to whether physicians feel competent enough to perform this task or whether a lack of self-perceived competence influences attitudes and professional approach. Even less is known with respect to potential differences between general practitioners (GPs) and specialists. The purpose of this study was to investigate the interrelationship between the self-perceived competence, attitude and professional approach of physicians in ambulatory care in Germany. A further aim was to compare GPs and specialists with regard to differences in these areas.MethodsA standardised postal survey was sent to 389 GPs and 239 neurologists and psychiatrists in six metropolitan areas in Germany. The 49-item questionnaire consisted of attitudinal statements to be rated on a Likert-type scale. Return rates were 54 percent for GPs and 40 percent for specialists. Statistical methods used to analyze data included correlation analysis, cluster analysis and ordinal regression analysis.ResultsNo differences were found between GPs and specialists with regard to their general attitude towards caring for patients with dementia. Approximately 15 percent of both disciplines showed a clearly negative attitude. Self-reported competence was strongly associated with general attitude. In particular among GPs, and less so among specialists, a strong positive association was found between self-reported competence, general attitude and professional approach (e.g. early detection, active case finding and cooperation with caregivers). Differences between GPs and specialists were smaller than expected and appear to predominantly reflect task differences within the German health care system.ConclusionTraining opportunities which enable in particular GPs to enhance not only their competence but also their general attitude towards dementia care would appear to be beneficial and might carry positive consequences for patients and their caregivers.
Highlights
Caring for patients with dementia is a demanding task
Do they feel competent enough to perform this task? does a lack of self-perceived competence influence professional attitude or approach in caring for patients with dementia? Several studies from the United Kingdom reveal that general practitioners (GPs) consider themselves to be insufficiently qualified in dealing with dementia and see the need for improved training
The median number of working years in ambulatory care was 13 for GPs and 7 for specialists. 38 percent of the specialists failed to reply to this question
Summary
Caring for patients with dementia is a demanding task. Little is known as to whether physicians feel competent enough to perform this task or whether a lack of self-perceived competence influences attitudes and professional approach. Introduction In most industrialized countries, GPs are responsible for providing care for the majority of patients suffering from dementia, whether in the community or in nursing homes Do they feel competent enough to perform this task? In a recent survey carried out in London and Scotland, one-third of the GPs expressed limited confidence in their diagnostic skills and two-thirds lacked confidence in managing behavioural problems in dementia patients [2]. In an earlier test conducted in Australia in 1992, three-quarters of GPs were able to cite a maximum of only two dementia symptoms [4] Another early study conducted in Alabama revealed knowledge differences between GPs and experts in the care of Alzheimer's disease (AD) patients [5]. More recent studies have lead to more favourable test results: in the London-Scotland study cited above, GPs' knowledge test results were good [2], as was the case in the aforementioned Swedish study [3]
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