Attitudes in the management of patients with dementia : comparison in doctors with and without special training

Abstract

Objective: To explore by postal survey the different attitudes towards management of patients with dementia in physicians with and without dementia training. Methods: A questionnaire was sent to 7669 members of the Hong Kong Medical Association, which represents 61% of all locally registered medical practitioners. Results: In all, 448 questionnaires were returned (response rate: 6%). Among these, there were 34 questionnaires with missing data or the respondents indicated that they were either retired or not in practice. Therefore, only 414 questionnaires were used in analysis. Among these, 82 (20%) had received dementia training, 310 (75%) had not, and 22 (5%) did not indicate their choice. Twelve statements were used to explore various attitudes about dementia care. Exploratory factor analysis showed that there were 2 strong factors: confidence and negative views. The mean scores of these 2 factors were significantly different in physicians with and without dementia training. With respect to management of patients with dementia, dementia-trained physicians had significantly greater confidence (mean [standard deviation (SD)] = 5.21 [1.34]) than those who were non-trained (mean [SD] = 3.57 [1.40]; p < 0.001). Conversely, non-trained physicians had significantly stronger negative views (mean [SD] = 3.89 [1.24]) on dementia care than those who were trained (mean [SD] = 3.12 [1.36]; p < 0.001). Discussion: These findings suggest that providing a certain level of dementia care training for physicians is an effective way to improve confidence in managing patients with dementia, and thereby decrease possible negative attitudes towards such care. 目的： 以郵寄問卷方式，檢視並比較曾接受認知障礙症治療專科訓練和沒有接受訓練的醫生對 認知障礙症患者的治療態度。 方法： 問卷寄往7669名香港醫學會會員（佔本港註冊醫生61%）。 結果： 共收回448份問卷（回應率：6%）；由於其中34份問卷的數據不完整或被訪者已退休或已沒行醫，最終只有414份問卷被用作分析。當中，82名（20%）醫生表示曾接受認知障礙症治療訓練，310名（75%）表示沒有，其餘22名（5%）沒有給予答案。問卷包括12項有關對治療認知障礙症態度的聲明。探索性因素分析顯示2項關鍵因素：信心和負面觀點。這2項因素的平均得分於上述2組醫生間有明顯差別。曾接受訓練的醫生（平均得分：5.21，標準差：1.34）在治療認知障礙症方面較沒有訓練的醫生（平均得分：3.57，標準差：1.40；p < 0.001）更有信心；而後者（平均得分：3.89，標準差：1.24；p < 0.001）也較前者（平均得分：3.12，標準差：1.36）對治療持負面態度。