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Published in: BMC Primary Care 1/2018

Open Access 01-12-2018 | Research article

The needs of informal caregivers and barriers of primary care workers toward dementia management in primary care: a qualitative study in Beijing

Authors: Meirong Wang, Shuang Shao, Jing Li, Yingjie Liu, Xiaojingyuan Xu, Juan Du

Published in: BMC Primary Care | Issue 1/2018

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Abstract

Background

Informal caregivers of people with dementia in Beijing are increasingly called upon to provide home-based care for their patients due to the increasing number of dementia patients and the shortage of standardized institutional solutions of care for patients in China. This study aimed to clarify the needs of informal caregivers and barriers of primary care workers toward dementia management in primary care in Beijing to provide references that may help to improve the care and services provided to individuals with dementia and their family caregivers residing in urban China.

Methods

A mixed-methods approach was used in this study. We performed individual in-depth interviews with 10 informal caregivers. Moreover, we carried out focus group interviews with 29 primary care workers. Content analysis was used to separately identify themes and codes. Discrepancies were discussed until final agreement was achieved.

Results

Three themes representing the core attitudes of informal caregivers and primary care workers were identified: care knowledge and skills, psychological counseling, and collaborative management. Most primary care workers believed that the management of dementia patients in primary care was necessary. However, due to the heavy work load and different medical specialties involved, these workers were unable to manage it.

Conclusions

Professional training focused on dementia for primary care workers should be strengthened. At the same time, the establishment of a community-based dementia team management model that includes specialists, community health service centers (CHSCs), and community committees should be explored.
Literature
5.
go back to reference Bamford C, Poole M, Brittain K, Chew-Grahamet C, Fox C, Iliffe S, et al. Understanding the challenges to implementing case management for people with dementia in primary care in England: a qualitative study using normalization process theory. BMC Health Serv Res. 2014;14(1):549.CrossRef Bamford C, Poole M, Brittain K, Chew-Grahamet C, Fox C, Iliffe S, et al. Understanding the challenges to implementing case management for people with dementia in primary care in England: a qualitative study using normalization process theory. BMC Health Serv Res. 2014;14(1):549.CrossRef
6.
go back to reference Iliffe S, Robinson L, Bamford C, Waugh A, Fox C, Livingston G, et al. Introducing case management for people with dementia in primary care: a mixed-methods study. Br J Gen Pract. 2014;64(628):735–41.CrossRef Iliffe S, Robinson L, Bamford C, Waugh A, Fox C, Livingston G, et al. Introducing case management for people with dementia in primary care: a mixed-methods study. Br J Gen Pract. 2014;64(628):735–41.CrossRef
7.
go back to reference Khanassov V, Vedel I. Family physician-case manager collaboration and needs of patients with dementia and their caregivers: a systematic mixed studies review. Ann Fam Med. 2016;14(2):166–77.CrossRef Khanassov V, Vedel I. Family physician-case manager collaboration and needs of patients with dementia and their caregivers: a systematic mixed studies review. Ann Fam Med. 2016;14(2):166–77.CrossRef
8.
go back to reference Spenceley SM, Sedgwick N, Keenan J. Dementia care in the context of primary care reform: an integrative review. Aging Ment Health. 2015;19(2):107–20.CrossRef Spenceley SM, Sedgwick N, Keenan J. Dementia care in the context of primary care reform: an integrative review. Aging Ment Health. 2015;19(2):107–20.CrossRef
10.
go back to reference Xu J, Wang J, Wimo A, Fratiglioni L, Qiu C. The economic burden of dementia in China, 1990–2030: implications for health policy. Bull World Health Organ. 2017;95(1):18–26.CrossRef Xu J, Wang J, Wimo A, Fratiglioni L, Qiu C. The economic burden of dementia in China, 1990–2030: implications for health policy. Bull World Health Organ. 2017;95(1):18–26.CrossRef
11.
go back to reference Yu X, Chen S, Chen X, Jia J, Li C, Liu C, et al. Clinical management and associated costs for moderate and severe Alzheimer's disease in urban China: a Delphi panel study. Transl Neurodegener. 2015;4(1):15.CrossRef Yu X, Chen S, Chen X, Jia J, Li C, Liu C, et al. Clinical management and associated costs for moderate and severe Alzheimer's disease in urban China: a Delphi panel study. Transl Neurodegener. 2015;4(1):15.CrossRef
12.
go back to reference Chen Z, Yang X, Song YT, Song BB, Zhang Y, Liu JW, et al. Challenges of dementia care in China. Geriatrics. 2017;2(1):7.CrossRef Chen Z, Yang X, Song YT, Song BB, Zhang Y, Liu JW, et al. Challenges of dementia care in China. Geriatrics. 2017;2(1):7.CrossRef
13.
go back to reference Arango Lasprilla JC, Moreno A, Rogers H, Francis K. The effect of dementia patient's physical, cognitive, and emotional/behavioral problems on caregiver well-being: findings from a Spanish-speaking sample from Colombia, South America. Am J Alzheimers Dis Other Demen. 2009;24(5):384.CrossRef Arango Lasprilla JC, Moreno A, Rogers H, Francis K. The effect of dementia patient's physical, cognitive, and emotional/behavioral problems on caregiver well-being: findings from a Spanish-speaking sample from Colombia, South America. Am J Alzheimers Dis Other Demen. 2009;24(5):384.CrossRef
14.
go back to reference Yang PP, Shen J. Abuse tendency among dementia caregivers: a qualitative research. Chin J Prac Nurs. 2013;29(1):27–30 (in Chinese). Yang PP, Shen J. Abuse tendency among dementia caregivers: a qualitative research. Chin J Prac Nurs. 2013;29(1):27–30 (in Chinese).
15.
go back to reference Tang Y. The establishment of mental health and long-term care system for the main caregivers of the disabled elderly. Academic Forum. 2012;35(9):168–73 (in Chinese). Tang Y. The establishment of mental health and long-term care system for the main caregivers of the disabled elderly. Academic Forum. 2012;35(9):168–73 (in Chinese).
16.
go back to reference Abdollahpour I, Nedjat S, Salimi Y. Positive aspects of caregiving and caregiver burden: a study of caregivers of patients with dementia. J Geriatr Psychiatry Neurol. 2017;31(1):34–8.CrossRef Abdollahpour I, Nedjat S, Salimi Y. Positive aspects of caregiving and caregiver burden: a study of caregivers of patients with dementia. J Geriatr Psychiatry Neurol. 2017;31(1):34–8.CrossRef
17.
go back to reference Hao W, Wu J, Zhang H, Zou BH, Wang ZW. Supportive care demands of family caregivers of community-dwelling patients with dementia. Chin Nurs Manag. 2015;15(11):1294–7 (in Chinese). Hao W, Wu J, Zhang H, Zou BH, Wang ZW. Supportive care demands of family caregivers of community-dwelling patients with dementia. Chin Nurs Manag. 2015;15(11):1294–7 (in Chinese).
21.
go back to reference Lu FH, Zeng H, Ji SY, Zhu HR, Lv XF. A review of community nursing interventions for Alzheimer’s disease. J Nurs Sci. 2016;31(13):110–3 (in Chinese). Lu FH, Zeng H, Ji SY, Zhu HR, Lv XF. A review of community nursing interventions for Alzheimer’s disease. J Nurs Sci. 2016;31(13):110–3 (in Chinese).
22.
go back to reference Xiao WY, Zheng SH, He XZ. The effect of community nursing intervention on quality of life of Alzheimer patients and caregivers. Chin J Gen Pract. 2016;14(1):150–2 (in Chinese). Xiao WY, Zheng SH, He XZ. The effect of community nursing intervention on quality of life of Alzheimer patients and caregivers. Chin J Gen Pract. 2016;14(1):150–2 (in Chinese).
23.
go back to reference Zhang WL, Zhao LJ. Effect of community nursing intervention on dementia patients and their caregivers. J Clin Med. 2014;1(12):2254 (in Chinese). Zhang WL, Zhao LJ. Effect of community nursing intervention on dementia patients and their caregivers. J Clin Med. 2014;1(12):2254 (in Chinese).
25.
go back to reference Yu L, Xu Q, Wang ZY, Chen G, Cao WY, Mi JH, et al. A survey on the attitudes and confidence of GPs in handling dementia and its related problems. Natl Med J China. 2013;93(35):2794–8 (in Chinese). Yu L, Xu Q, Wang ZY, Chen G, Cao WY, Mi JH, et al. A survey on the attitudes and confidence of GPs in handling dementia and its related problems. Natl Med J China. 2013;93(35):2794–8 (in Chinese).
28.
go back to reference Jiggins CK, Evans B. Qualitative descriptive methods in health science research. Herd. 2016;9(4):16–25.CrossRef Jiggins CK, Evans B. Qualitative descriptive methods in health science research. Herd. 2016;9(4):16–25.CrossRef
29.
go back to reference Academy of Cognitive Disorder of China. Expert consensus on long-term healthcare of patients with cognitive disorders in China. Chin J Geriatr. 2016;35(10):1051–60 (in Chinese). Academy of Cognitive Disorder of China. Expert consensus on long-term healthcare of patients with cognitive disorders in China. Chin J Geriatr. 2016;35(10):1051–60 (in Chinese).
33.
go back to reference Hg VDR, Meiland FJ, Maroccini R, Comijs HC, Jonker C, Dröes RM. Subjective needs of people with dementia: a review of the literature. Int Psychogeriatr. 2007;19(3):559–92.CrossRef Hg VDR, Meiland FJ, Maroccini R, Comijs HC, Jonker C, Dröes RM. Subjective needs of people with dementia: a review of the literature. Int Psychogeriatr. 2007;19(3):559–92.CrossRef
34.
go back to reference Dong CF. Nursing intervention for the main caregivers of dementia patients. Chin J Trauma and Disability Med. 2012;20(5):107–9 (in Chinese). Dong CF. Nursing intervention for the main caregivers of dementia patients. Chin J Trauma and Disability Med. 2012;20(5):107–9 (in Chinese).
35.
go back to reference Hu P, Liu Q. Effects of predictive nursing on elderly patients with Alzheimer's disease. Nurs J Chin PLA. 2013;30(10):32–4 (in Chinese). Hu P, Liu Q. Effects of predictive nursing on elderly patients with Alzheimer's disease. Nurs J Chin PLA. 2013;30(10):32–4 (in Chinese).
36.
go back to reference Patel V, Xiao S, Chen H, Hanna F, Jotheeswaran AT, Dan L, et al. The magnitude of and health system responses to the mental health treatment gap in adults in India and China. Lancet. 2016;388(10063):3074–84.CrossRef Patel V, Xiao S, Chen H, Hanna F, Jotheeswaran AT, Dan L, et al. The magnitude of and health system responses to the mental health treatment gap in adults in India and China. Lancet. 2016;388(10063):3074–84.CrossRef
39.
go back to reference Dang S, Badiye A, Kelkar G. The dementia caregiver--a primary care approach. South Med J. 2008;101(12):1246–51.CrossRef Dang S, Badiye A, Kelkar G. The dementia caregiver--a primary care approach. South Med J. 2008;101(12):1246–51.CrossRef
40.
go back to reference Yang XL, Chen M, Zhang H, Tian AJ, Li L. Application of Plato analysis in negative influencing evaluation of Alzheimer caregivers. J Nurs Train. 2014;22:2046–7 (in Chinese). Yang XL, Chen M, Zhang H, Tian AJ, Li L. Application of Plato analysis in negative influencing evaluation of Alzheimer caregivers. J Nurs Train. 2014;22:2046–7 (in Chinese).
41.
go back to reference De LJ, Wind AW, Iliffe S, Moniz-Cook ED, Wilcock J, González VM. The primary care diagnosis of dementia in Europe: an analysis using multidisciplinary, multinational expert groups. Aging Ment Health. 2008;12(5):568–76.CrossRef De LJ, Wind AW, Iliffe S, Moniz-Cook ED, Wilcock J, González VM. The primary care diagnosis of dementia in Europe: an analysis using multidisciplinary, multinational expert groups. Aging Ment Health. 2008;12(5):568–76.CrossRef
42.
go back to reference Hinton L, Franz CE, Reddy G, Flores Y, Kravitz RL, Barker JC. Practice constraints, behavioral problems, and dementia care: primary care physicians' perspectives. J Gen Int Med. 2007;22(11):1487–92.CrossRef Hinton L, Franz CE, Reddy G, Flores Y, Kravitz RL, Barker JC. Practice constraints, behavioral problems, and dementia care: primary care physicians' perspectives. J Gen Int Med. 2007;22(11):1487–92.CrossRef
43.
go back to reference Liu JH, Hao, Chen H, Xiang YQ, Qiu D, Li YJ Community social function of schizophrenia application case management interventions to improve performance evaluation J Int Psychia 2016; (1):72–6. (in Chinese). Liu JH, Hao, Chen H, Xiang YQ, Qiu D, Li YJ Community social function of schizophrenia application case management interventions to improve performance evaluation J Int Psychia 2016; (1):72–6. (in Chinese).
44.
go back to reference Li W, Zhang XY, Zhao ZR. Study on the effect of case management on improving the quality of life of patients with dementia. Chin J Clin Rat Drug Use. 2014;27:163–4 (in Chinese). Li W, Zhang XY, Zhao ZR. Study on the effect of case management on improving the quality of life of patients with dementia. Chin J Clin Rat Drug Use. 2014;27:163–4 (in Chinese).
45.
go back to reference Pimouguet C, Lavaud T, Dartigues JF, Helmer C. Dementia case management effectiveness on health care costs and resource utilization: a systematic review of randomized controlled trials. J Nutr Health Aging. 2010;14(8):669–76.CrossRef Pimouguet C, Lavaud T, Dartigues JF, Helmer C. Dementia case management effectiveness on health care costs and resource utilization: a systematic review of randomized controlled trials. J Nutr Health Aging. 2010;14(8):669–76.CrossRef
46.
go back to reference Iliffe S, De LJ, Van HH, Kenny G, Lewis A, Vernooijdassen M. Understanding obstacles to the recognition of and response to dementia in different European countries: a modified focus group approach using multinational, multi-disciplinary expert groups. Aging Ment Health. 2005;9(1):1–6.CrossRef Iliffe S, De LJ, Van HH, Kenny G, Lewis A, Vernooijdassen M. Understanding obstacles to the recognition of and response to dementia in different European countries: a modified focus group approach using multinational, multi-disciplinary expert groups. Aging Ment Health. 2005;9(1):1–6.CrossRef
47.
go back to reference Stephan A, Bieber A, Hopper L, Joyce R, Irving K, Zanetti O, et al. Barriers and facilitators to the access to and use of formal dementia care: findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries. BMC Geriatr. 2018;18(1):131.CrossRef Stephan A, Bieber A, Hopper L, Joyce R, Irving K, Zanetti O, et al. Barriers and facilitators to the access to and use of formal dementia care: findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries. BMC Geriatr. 2018;18(1):131.CrossRef
48.
go back to reference Iliffe S. Rapid appraisal of barriers to the diagnosis and management of patients with dementia in primary care: a systematic review. BMC Fam Pract. 2010;11:52.CrossRef Iliffe S. Rapid appraisal of barriers to the diagnosis and management of patients with dementia in primary care: a systematic review. BMC Fam Pract. 2010;11:52.CrossRef
49.
go back to reference China Ministry of Health. Yearbook of Chinese health statistics 2018. 1st ed. Beijing: Peking Union Medical College; 2018. China Ministry of Health. Yearbook of Chinese health statistics 2018. 1st ed. Beijing: Peking Union Medical College; 2018.
Metadata
Title
The needs of informal caregivers and barriers of primary care workers toward dementia management in primary care: a qualitative study in Beijing
Authors
Meirong Wang
Shuang Shao
Jing Li
Yingjie Liu
Xiaojingyuan Xu
Juan Du
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2018
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-018-0890-7

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