Consultations on driving in people with cognitive impairment in primary care: A scoping review of the evidence

Autor: Tony Foley, Justin Forsyth, Linda Horgan, Colin P Bradley, Kathleen McLoughlin, Carol Sinnott
Přispěvatelé: Sinnott, Carol [0000-0002-8620-7461], Apollo - University of Cambridge Repository
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Medical Doctors
Health Care Providers
lcsh:Medicine
Alzheimer's Disease
Database and Informatics Methods
0302 clinical medicine
Medicine and Health Sciences
Medical Personnel
030212 general & internal medicine
Database Searching
lcsh:Science
Referral and Consultation
media_common
Cognitive Impairment
Multidisciplinary
Cognitive Neurology
Neurodegenerative Diseases
Professions
Cognitive impairment
Neurology
Feeling
Frontotemporal Dementia
Psychology
Inclusion (education)
Research Article
Clinical psychology
Driving
Automobile Driving
Patients
Cognitive Neuroscience
media_common.quotation_subject
MEDLINE
Behavioural sciences
Context (language use)
CINAHL
Research and Analysis Methods
Physicians
Primary Care
03 medical and health sciences
Quality of life (healthcare)
Primary care practice
Physicians
Mental Health and Psychiatry
medicine
Dementia
Humans
Cognitive Dysfunction
Primary Care
Physician-Patient Relations
Primary Health Care
lcsh:R
Biology and Life Sciences
medicine.disease
Health Care
People and Places
Cognitive Science
lcsh:Q
Population Groupings
030217 neurology & neurosurgery
Neuroscience
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 10, p e0205580 (2018)
Popis: Objectives To review the empirical evidence on approaches used by Primary Care Physicians (PCPs) in fitness to drive (FtD) consultations with people living with cognitive impairment. Design Scoping review of empirical literature focused on primary studies of any design. Setting Primary care practice. Participants PCPs or their equivalent and/ or individuals with cognitive impairment across the spectrum of mild cognitive impairment to dementia. Measurements Systematic search of Medline, Cinahl, PsychINFO, Academic Search Complete, Psychological and Behavioural Sciences Collection, SocIndex and Social Sciences FT were conducted. Records screened by two reviewers against agreed inclusion criteria. Mixed studies (qualitative and quantitative) were synthesized within overarching themes. Results Eighteen studies met our inclusion criteria. Synthesized data showed PCPs have mixed feelings on the appropriateness of their role in FtD assessments, with many feeling particularly uncomfortable and lacking confidence in the context of possible cognitive impairment. Reasons include lack of familiarity with legal requirements and local resources; fear of damaging the doctor-patient relationship; and impact on the patient’s quality of life. Patients voiced their desire to maintain agency in planning their driving cessation. Studies evaluating pragmatic educational programmes suggest these can improve physician confidence in FtD consultations. Conclusion The increasing number of older people affected by cognitive impairment, for whom driving may be a concern, has implications for primary care practice. Addressing the reasons for PCPs lack of comfort in dealing with this issue is essential in order for them to better engage in, collaborative discussion with patients on plans and preferences for driving cessation.
Databáze: OpenAIRE
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