社区全科医生对开展痴呆筛查认知的质性研究

doi:10.12114/j.issn.1007-9572.2022.0168

摘要/Abstract

摘要： 背景随着我国人口老龄化程度不断加深和人均预期寿命的延长，痴呆患者日益增多，而对痴呆患者而言早期诊断极其重要。目的探究社区全科医生对痴呆筛查的态度和看法，旨在为社区开展痴呆筛查工作提供参考与借鉴。方法于2021年7月，采用目的抽样法，选取甘肃省兰州市社区卫生服务中心（站）的全科医生为研究对象，对其进行"一对一"的半结构化深度访谈，了解社区全科医生对痴呆筛查的态度和看法。应用描述现象学分析法对资料进行分析，并提炼访谈主题。结果共纳入来自5家社区卫生服务中心和5家社区卫生服务站的10例社区全科医生。其中男5例，女5例；年龄35~57岁，平均年龄（46.6±6.5）岁；7例学历为本科；4例职称为主治医师；从事社区全科医生工作的年限为5~26年，平均年限（14.90±8.46）年。共提炼出3个主题和9个亚主题，3个主题分别为社区痴呆筛查的基础条件不足、痴呆筛查较为困难、提高社区全科医生痴呆筛查能力。结论社区全科医生痴呆筛查能力不足，但对痴呆筛查持支持态度。提高社区全科医生的痴呆筛查能力，通过加强痴呆相关知识的宣传和普及减少社会对痴呆患者的歧视，深化家庭医生签约服务可能是推动社区痴呆早期筛查和干预工作的有力举措。

关键词: 全科医生, 社区卫生服务, 痴呆, 筛查, 认知, 质性研究

Abstract:

Background

China is seeing an increasing number of people suffering from dementia as aging advances and life expectancy prolongs. Early diagnosis is extremely important for dementia.

Objective

To understand the attitudes and views of community general practitioners (GPs) regarding dementia screening, providing suggestions for the development of dementia screening in the community.

Methods

In July 2021, by use of purposive sampling, GPs were recruited from community health centers (stations) in Lanzhou, Gansu, and invited to attend a semi-structured, in-depth, face-to-face individual interview for understanding their attitudes and views toward dementia screening. The interview results were analyzed using phenomenological analysis and thematic analysis.

Results

Ten GPs from five community health centers and five community health stations were finally enrolled, including five males and five females, with an average age of (46.6±6.5) years〔range (35, 57) 〕, an average years of (14.90±8.46) working as a GP〔range (5, 26) 〕; seven with a bachelor degree; four with a title of attending physician. Three themes were extracted: insufficient basic conditions for carrying out community-based dementia screening, difficulties in carrying out community-based dementia screening, and improvement of community GPs' abilities to participate in dementia screening. Nine subthemes were also extracted.

Conclusion

Community GPs supported community-based dementia screening, but had insufficient capacities to carry out the screening. The following may be effective measures for promoting early screening and intervening dementia: improving the ability of community GPs to screen dementia, strengthening the publicity and popularization of dementia-related knowledge to reduce social discrimination against dementia, and deepening the development of contracted family doctor services.

Key words: General practitioners, Community health services, Dementia, Screening, Cognition, Qualitative research

杨娟,李守琴,张昭昕,等. 社区全科医生对开展痴呆筛查认知的质性研究[J]. 中国全科医学, 2022, 25(16): 1978-1983. DOI: 10.12114/j.issn.1007-9572.2022.0168.
Juan YANG,Shouqin LI,Zhaoxin ZHANG, et al. A Qualitative Study on Community General Practitioners' Perception of Dementia Screening[J]. Chinese General Practice, 2022, 25(16): 1978-1983. DOI: 10.12114/j.issn.1007-9572.2022.0168.

图/表 1

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