Practices and perspectives of primary care physicians in Japan and the United States about diagnosing dementia: a qualitative study.

Autor: Abe M; Department of Family and Community Medicine, Hamamatsu University School of Medicine, Shizuoka, Hamamatsu, Japan., Tsunawaki S; Omaezaki Family Medicine Center, Shizuoka, Omaezaki, Japan.; Shizuoka Family Medicine Program, Shizuoka, Hamamatsu, Japan., Dejonckheere M; Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104, USA., Cigolle CT; Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104, USA.; Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.; VA Ann Arbor Healthcare System (VAAHS) Geriatric Research Education and Clinical Center (GRECC), Ann Arbor, MI, USA., Phillips K; VA Ann Arbor Healthcare System (VAAHS) Geriatric Research Education and Clinical Center (GRECC), Ann Arbor, MI, USA., Rubinstein EB; Department of Sociology and Anthropology, North Dakota State University, Fargo, North Dakota, USA., Matsuda M; Shizuoka Family Medicine Program, Shizuoka, Hamamatsu, Japan.; Kikugawa Family Medicine Center, Shizuoka, Kikugawa, Japan., Fetters MD; Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104, USA. mfetters@med.umich.edu.; The School of Health Humanities, Peking University Health Science Center, Beijing, China. mfetters@med.umich.edu., Inoue M; Department of Family and Community Medicine, Hamamatsu University School of Medicine, Shizuoka, Hamamatsu, Japan.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2021 Oct 11; Vol. 21 (1), pp. 540. Date of Electronic Publication: 2021 Oct 11.
DOI: 10.1186/s12877-021-02457-7
Abstrakt: Background: While dementia is a common problem in Japan and the US, primary care physicians' practices and perspectives about diagnosing dementia in these different healthcare systems are unknown.
Methods: Qualitative research was conducted in an ethnographic tradition using semi-structured interviews and thematic analysis in primary care settings across Japan and in the Midwest State of Michigan, US. Participants were a total of 48 primary care physicians, 24 each from Japan and the US participated. Both groups contained a mixture of geographic areas (rural/urban), gender, age, and years of experience as primary care physicians.
Results: Participants in Japan and the US voiced similar practices for making the diagnosis of dementia and held similar views about the desired benefits of diagnosing dementia. Differences were found in attitudes about the appropriate timing of formally diagnosing dementia. Japanese physicians tended to make a formal diagnosis when problems that would benefit from long-term care services emerged for family members. US physicians were more proactive in diagnosing dementia in the early stages by screening for dementia in health check-ups and promoting advance directives when the patients were still capable of decision-making. Views about appropriate timing of diagnostic testing for dementia in the two systems reflect what medical or nursing care services physicians can use to support dementia patients and caregivers.
Conclusions: Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US. Testing to establish an early diagnosis of dementia by primary care physicians only partly relates to testing and treatment options available. Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US.
(© 2021. The Author(s).)
Databáze: MEDLINE
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