scholarly journals 431 - DEMENTIA IN PRIMARY CARE AND DOCTOR-PATIENT-CARER INTERACTIONS: PRELIMINARY FINDINGS

2020 ◽  
Vol 32 (S1) ◽  
pp. 147-147
Author(s):  
Conceição Balsinha ◽  
Steve Iliffe ◽  
Sónia Dias ◽  
Manuel Gonçalves-Pereira
Keyword(s):  
Primary Care ◽  
Family Carer ◽  
Family Carers ◽  
Medical Encounter ◽  
Triadic Interactions ◽  
Patient Interactions ◽  
The Family ◽  
Different Types ◽  
Third Person ◽  
Ongoing Project

INTRODUCTION: Primary care visits of persons with dementia involve different types of communication, bringing together the patient, the family carer and the general practitioner (GP). A particular challenge is the necessary involvement of a third person (the carer) in patient-doctor encounters (or the patient in carer-doctor encounters, as dementia advances). These triad dynamics should be better understood, as health outcomes are expected to result from or be mediated by them.OBJECTIVE: Our aim is to explore triadic dynamics in Portuguese primary care consultations with persons with dementia, their family carers and GPs.METHODS: This is the first part of an ongoing project (Dementia in Primary Care: the Patient, the Carer and the Doctor in the Medical Encounter - Bayer Investigation Grant | NOVAsaúde Ageing 2018). Consultations with persons with dementia, their carers and GPs (purposive sampling) are audio-recorded, transcribed verbatim and thematically analysed. We report the analysis of interactions of the first six consultations, using NVIVO® software.RESULTS: The most frequent type of interaction was between GPs and carers, followed by interactions involving the whole triad. The patients who had more recent relationships with their GPs tended to participate less, irrespective of the stage of dementia. Carers were the ones most often initiating triadic interactions, and GPs the ones most often terminating them by directly addressing the patients. Doctor-carers interactions were very sparse in some consultations.DISCUSSION AND CONCLUSION: These preliminary findings suggest that doctor-patient interactions may be limited in a number of GPs’ consultations, seemingly compromising patient-centred approaches. Nevertheless, even when GPs were involved in triadic interactions they often tried to address the patient directly. We are looking forward to complete this part of the project: to our knowledge, there is practically no evidence from live-recorded primary care consultations about these triadic dynamics.

Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia

2012 ◽  
Vol 24 (6) ◽  
pp. 856-870 ◽  
Author(s):  
Claudia Cooper ◽  
Naaheed Mukadam ◽  
Cornelius Katona ◽  
Constantine G. Lyketsos ◽  
David Ames ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coping Strategy ◽  
Cognitive Stimulation ◽  
Care Homes ◽  
Improve Quality ◽  
Family Carer ◽  
Pharmacological Interventions ◽  
People With Dementia ◽  
At Home

ABSTRACTBackground: People with dementia report lower quality of life, but we know little about what interventions might improve it.Methods: We systematically reviewed 20 randomized controlled trials reporting the effectiveness of non-pharmacological interventions in improving quality of life or well-being of people with dementia meeting predetermined criteria. We rated study validity with a checklist. We contacted authors for additional data. We calculated standardized mean differences (SMD) and, for studies reporting similar interventions, pooled standardized effect sizes (SES).Results: Pooled analyses found that family carer coping strategy-based interventions (four studies, which did not individually achieve significance; n = 420; SES 0.24 (range 0.03–0.45)) and combined patient activity and family carer coping interventions (two studies, not individually significant; n = 191; SES 0.84 (range 0.54–1.14)) might improve quality of life. In one high-quality study, a care management system improved quality of life of people with dementia living at home. Group Cognitive Stimulation Therapy (GCST) improved quality of life of people with dementia in care homes.Conclusion: Preliminary evidence indicated that coping strategy-based family carer therapy with or without a patient activity intervention improved quality of life of people with dementia living at home. GCST was the only effective intervention in a higher quality trial for those in care homes, but we did not find such evidence in the community. Few studies explored whether effects continued after the intervention stopped. Future research should explore the longer-term impact of interventions on, and devise strategies to increase, life quality of people with dementia living in care homes or at home without a family carer.

Validation of the “Quality of Life in Life-Threatening Illness—Family Carer Version” (QOLLTI-F) in German-speaking carers of advanced cancer patients

2014 ◽  
Vol 22 (10) ◽  
pp. 2783-2791 ◽  
Author(s):  
Sophie Schur ◽  
Alexandra Ebert-Vogel ◽  
Michaela Amering ◽  
Eva Katharina Masel ◽  
Marie Neubauer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Family Carer ◽  
Advanced Cancer Patients ◽  
Life Threatening Illness ◽  
German Speaking ◽  
Life Threatening

scholarly journals Just Like Any Other Family? Everyday Life Experiences of Mothers of Adults with Severe Mental Illness in Sweden

2020 ◽  
Vol 56 (6) ◽  
pp. 1023-1032 ◽  
Author(s):  
Katarina Piuva ◽  
Helene Brodin
Keyword(s):  
Mental Illness ◽  
Life Span ◽  
Severe Mental Illness ◽  
Everyday Life ◽  
Life Experiences ◽  
Family Carer ◽  
Negative Attitudes ◽  
The Relationship ◽  
Care Support ◽  
Mothers Experiences

AbstractThis study explores experiences of mothers in Sweden who care for their adult children suffering from severe mental illness. Using 15 interviews with mothers from 40 to 80 years old, the article examines how predominant professional knowledge and sanism constructs the mothers and their children as deviant and what counterstrategies the mothers develop as a response to these experiences of discrimination. The findings show that the mothers’ experiences are characterized by endless confrontations with negative attitudes and comments that have forced them to go through painful and prolonged processes of self-accusations for not having given enough love, care, support and help in different stages of their children's life. But the mothers’ experiences also reveal important aspects of changes over the life span. As the mothers are ageing, the relationship between them and their children becomes more reciprocal and the ill child may even take the role as family carer.

A Systematic Review and Synthesis of Trauma-Informed Care Within Outpatient and Counseling Health Settings for Young People

2020 ◽  
pp. 107755952092746
Author(s):  
Sarah Bendall ◽  
Oliver Eastwood ◽  
Georgina Cox ◽  
Anna Farrelly-Rosch ◽  
Helen Nicoll ◽  
...  
Keyword(s):  
Young People ◽  
Therapeutic Interventions ◽  
System Level ◽  
Family Carer ◽  
Clinical Practices ◽  
Provider Training ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
And Gender ◽  
Definition Of

There is growing consensus that outpatient health services for young people (aged 12–25 years) need to deliver trauma-informed care to ameliorate the effects of trauma, offer safe treatments, and avoid retraumatization. Trauma-informed care has become a familiar term for many professionals; however, its operating definition lacks clarity. MEDLINE, Embase, and PsycINFO were systematically searched to clarify what trauma-informed care is, and what it should achieve in these settings. We reviewed 3,381 unique records, of which 13 met criteria for inclusion. Content analysis identified 10 components of trauma-informed care as it has been operationalized in practice: seven of these occurred at the system-level (interagency collaboration; service provider training; safety; leadership, governance and agency processes; youth and family/carer choice in care; cultural and gender sensitivity; youth and family/carer participation), and three involved trauma-specific clinical practices (screening and assessment; psychoeducation; therapeutic interventions). There is a need for greater consensus regarding an operating definition of trauma-informed care and further research into outcomes for young people and their families/carers.

Sign in / Sign up

Export Citation Format

Share Document