'Working away in that Grey Area...' A qualitative exploration of the challenges general practitioners experience when managing behavioural and psychological symptoms of dementia.

Background: general practitioners (GPs) have identified the management of behavioural and psychological symptoms of dementia (BPSD) as a particularly challenging aspect of dementia care. However, there is a paucity of research on why GPs find BPSD challenging and how this influences the care they of...

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Publicado en:Age & Ageing Vol. 47; no. 2; pp. 295 - 304
Autores principales: Jennings, Aisling A, Foley, Tony, McHugh, Sheena, Browne, John P, Bradley, Colin P
Formato: Artículo
Publicado: Oxford University Press / USA Mar2018
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2018
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      pub: Oxford University Press / USA
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        10.1093/ageing/afx175
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        atl: 'Working away in that Grey Area...' A qualitative exploration of the challenges general practitioners experience when managing behavioural and psychological symptoms of dementia.
      aug:
        au:
          Jennings, Aisling A
          Foley, Tony
          McHugh, Sheena
          Browne, John P
          Bradley, Colin P
        affil:
          Dept. of General Practice , University College Cork, Cork, Ireland
          Dept. of Epidemiology and Public Health , University College Cork, Cork, Ireland
      su:
        Ireland
        Behavior disorders
        Caregivers
        Community health services
        Interviewing
        Nursing care facilities
        Qualitative research
        Therapeutics
        Psychology
        Treatment of dementia
        Research methodology
        General practitioners
        Decision making in clinical medicine
        Thematic analysis
      sug:
        subj:
          Behavior disorders
          Caregivers
          Community health services
          Interviewing
          Nursing care facilities
          Qualitative research
          Therapeutics
          Psychology
          Ireland
          All Other Outpatient Care Centers
          Residential Mental Health and Substance Abuse Facilities
          Community health centres
          Other Individual and Family Services
          Other local, municipal and regional public administration
          Nursing Care Facilities (Skilled Nursing Facilities)
          Community care facilities for the elderly
          Treatment of dementia
          Research methodology
          General practitioners
          Decision making in clinical medicine
          Thematic analysis
      keyword:
        behavioural and psychologicalsymptoms (BPSD)
        dementia
        general practitioners (GPs)
        neuropsychiatric symptoms
        qualitative
        behavioural and psychologicalsymptoms (BPSD)
        dementia
        general practitioners (GPs)
        neuropsychiatric symptoms
        qualitative
      ab: Background: general practitioners (GPs) have identified the management of behavioural and psychological symptoms of dementia (BPSD) as a particularly challenging aspect of dementia care. However, there is a paucity of research on why GPs find BPSD challenging and how this influences the care they offer to their patients with dementia. Objectives: to establish the challenges GPs experience when managing BPSD; to explore how these challenges influence GPs' management decisions; and to identify strategies for overcoming these challenges. Design: qualitative study of GPs experiences of managing BPSD. Methods: semi-structured interviews were conducted with 16 GPs in the Republic of Ireland. GPs were purposively recruited to include participants with differing levels of experience caring for people with BPSD in nursing homes and in community settings to provide maximum diversity of views. Interviews were analysed thematically. Results: three main challenges of managing BPSD were identified; lack of clinical guidance, stretched resources and difficulties managing expectations. The lack of relevant clinical guidance available affected GPs' confidence when managing BPSD. In the absence of appropriate resources GPs felt reliant upon sedative medications. GPs believed their advocacy role was further compromised by the difficulties they experienced managing expectations of family caregivers and nursing home staff. Conclusions: this study helps to explain the apparent discrepancy between best practice recommendations in BPSD and reallife practice. It will be used to inform the design of an intervention to support the management of BPSD in general practice.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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