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Self-reported competence, attitude and approach of physicians towards patients with dementia in ambulatory care: results of a postal survey.

Kaduszkiewicz H, Wiese B, van den Bussche H - BMC Health Serv Res (2008)

Bottom Line: Self-reported competence was strongly associated with general attitude.In particular among GPs, and less so among specialists, a strong positive association was found between self-reported competence, general attitude and professional approach (e.g. early detection, active case finding and cooperation with caregivers).Differences between GPs and specialists were smaller than expected and appear to predominantly reflect task differences within the German health care system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. kaduszki@uke.uni-hamburg.de

ABSTRACT

Background: Caring for patients with dementia is a demanding task. Little is known as to whether physicians feel competent enough to perform this task or whether a lack of self-perceived competence influences attitudes and professional approach. Even less is known with respect to potential differences between general practitioners (GPs) and specialists. The purpose of this study was to investigate the interrelationship between the self-perceived competence, attitude and professional approach of physicians in ambulatory care in Germany. A further aim was to compare GPs and specialists with regard to differences in these areas.

Methods: A standardised postal survey was sent to 389 GPs and 239 neurologists and psychiatrists in six metropolitan areas in Germany. The 49-item questionnaire consisted of attitudinal statements to be rated on a Likert-type scale. Return rates were 54 percent for GPs and 40 percent for specialists. Statistical methods used to analyze data included correlation analysis, cluster analysis and ordinal regression analysis.

Results: No differences were found between GPs and specialists with regard to their general attitude towards caring for patients with dementia. Approximately 15 percent of both disciplines showed a clearly negative attitude. Self-reported competence was strongly associated with general attitude. In particular among GPs, and less so among specialists, a strong positive association was found between self-reported competence, general attitude and professional approach (e.g. early detection, active case finding and cooperation with caregivers). Differences between GPs and specialists were smaller than expected and appear to predominantly reflect task differences within the German health care system.

Conclusion: Training opportunities which enable in particular GPs to enhance not only their competence but also their general attitude towards dementia care would appear to be beneficial and might carry positive consequences for patients and their caregivers.

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Histograms of subjective qualification regarding diagnosis (left) and therapy (right) of dementia by profession. 1 = poor, 6 = very good.
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Figure 2: Histograms of subjective qualification regarding diagnosis (left) and therapy (right) of dementia by profession. 1 = poor, 6 = very good.

Mentions: Participants were questioned regarding the extent to which they felt competent in diagnosing and treating dementia patients. Both professions reported feeling competent with regard to both diagnosis and therapy: on a six point Likert-type scale, the mean score for diagnostic competence was 4.31, and 4.38 for therapeutic competence for GPs (medians 5), and 4.95 for diagnostic competence and 5.03 for therapeutic competence for specialists (medians 6). Differences between specialists and GPs were statistically significant (p < 0.001, MWU). The correlation between diagnostic and therapeutic competence estimates was high in both professional groups, though especially so in the GP sample (Kendall's τ for GPs = 0.589, p < 0.001; for specialists = 0.493, p < 0.001). Distributions for both samples are shown in Figure 2. A broadly spread distribution was found among GPs and almost exclusively high scores among specialists.


Self-reported competence, attitude and approach of physicians towards patients with dementia in ambulatory care: results of a postal survey.

Kaduszkiewicz H, Wiese B, van den Bussche H - BMC Health Serv Res (2008)

Histograms of subjective qualification regarding diagnosis (left) and therapy (right) of dementia by profession. 1 = poor, 6 = very good.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2289812&req=5

Figure 2: Histograms of subjective qualification regarding diagnosis (left) and therapy (right) of dementia by profession. 1 = poor, 6 = very good.
Mentions: Participants were questioned regarding the extent to which they felt competent in diagnosing and treating dementia patients. Both professions reported feeling competent with regard to both diagnosis and therapy: on a six point Likert-type scale, the mean score for diagnostic competence was 4.31, and 4.38 for therapeutic competence for GPs (medians 5), and 4.95 for diagnostic competence and 5.03 for therapeutic competence for specialists (medians 6). Differences between specialists and GPs were statistically significant (p < 0.001, MWU). The correlation between diagnostic and therapeutic competence estimates was high in both professional groups, though especially so in the GP sample (Kendall's τ for GPs = 0.589, p < 0.001; for specialists = 0.493, p < 0.001). Distributions for both samples are shown in Figure 2. A broadly spread distribution was found among GPs and almost exclusively high scores among specialists.

Bottom Line: Self-reported competence was strongly associated with general attitude.In particular among GPs, and less so among specialists, a strong positive association was found between self-reported competence, general attitude and professional approach (e.g. early detection, active case finding and cooperation with caregivers).Differences between GPs and specialists were smaller than expected and appear to predominantly reflect task differences within the German health care system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. kaduszki@uke.uni-hamburg.de

ABSTRACT

Background: Caring for patients with dementia is a demanding task. Little is known as to whether physicians feel competent enough to perform this task or whether a lack of self-perceived competence influences attitudes and professional approach. Even less is known with respect to potential differences between general practitioners (GPs) and specialists. The purpose of this study was to investigate the interrelationship between the self-perceived competence, attitude and professional approach of physicians in ambulatory care in Germany. A further aim was to compare GPs and specialists with regard to differences in these areas.

Methods: A standardised postal survey was sent to 389 GPs and 239 neurologists and psychiatrists in six metropolitan areas in Germany. The 49-item questionnaire consisted of attitudinal statements to be rated on a Likert-type scale. Return rates were 54 percent for GPs and 40 percent for specialists. Statistical methods used to analyze data included correlation analysis, cluster analysis and ordinal regression analysis.

Results: No differences were found between GPs and specialists with regard to their general attitude towards caring for patients with dementia. Approximately 15 percent of both disciplines showed a clearly negative attitude. Self-reported competence was strongly associated with general attitude. In particular among GPs, and less so among specialists, a strong positive association was found between self-reported competence, general attitude and professional approach (e.g. early detection, active case finding and cooperation with caregivers). Differences between GPs and specialists were smaller than expected and appear to predominantly reflect task differences within the German health care system.

Conclusion: Training opportunities which enable in particular GPs to enhance not only their competence but also their general attitude towards dementia care would appear to be beneficial and might carry positive consequences for patients and their caregivers.

Show MeSH
Related in: MedlinePlus