Clinicians’ communication with patients receiving a MCI diagnosis: The ABIDE project


Autoři: Leonie N. C. Visser aff001;  Ingrid S. van Maurik aff002;  Femke H. Bouwman aff002;  Salka Staekenborg aff004;  Ralph Vreeswijk aff005;  Liesbeth Hempenius aff006;  Marlijn H. de Beer aff007;  Gerwin Roks aff008;  Leo Boelaarts aff009;  Mariska Kleijer aff010;  Wiesje M. van der Flier aff002;  Ellen M. A. Smets aff001
Působiště autorů: Department of Medical Psychology, Amsterdam Public Health research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands aff001;  Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands aff002;  Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands aff003;  Department of Neurology, Tergooi Ziekenhuis, Blaricum, The Netherlands aff004;  Department of Clinical Geriatrics, Spaarne Gasthuis, Haarlem, The Netherlands aff005;  Geriatric Center, Medical Center Leeuwarden, Leeuwarden, The Netherlands aff006;  Department of Neurology, Reinier de Graaf Gasthuis, Delft, The Netherlands aff007;  Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands aff008;  Geriatric Department, NoordWest Ziekenhuis Groep, Alkmaar, The Netherlands aff009;  Department of Neurology, LangeLand Ziekenhuis, Zoetermeer, The Netherlands aff010
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227282

Souhrn

Background

We aimed to explore clinicians’ communication, including the discussion of diagnosis, cause, prognosis and care planning, in routine post-diagnostic testing consultations with patients with Mild Cognitive Impairment (MCI).

Methods

Thematic content analysis was used to analyze audiotaped consultations in which 10 clinicians (eight neurologists and two geriatricians) from 7 memory clinics, disclosed diagnostic information to 13 MCI patients and their care partners. We assessed clinician-patient communication regarding diagnostic label, cause, prognosis and care planning to identify core findings.

Results

Core findings were: clinicians 1) differed in how they informed about the MCI label; 2) tentatively addressed cause of symptoms; 3) (implicitly) steered against further biomarker testing; 4) rarely informed about the patient’s risk of developing dementia; 5) often informed about the expected course of symptoms emphasizing potential symptom stabilization and/or improvement, and; 6) did not engage in a conversation on long-term (care) planning.

Discussion

Clinicians’ information provision about the underlying cause, prognosis and implications for long-term (care) planning in MCI could be more specific. Since most patients and care partners have a strong need to understand the patient’s symptoms, and for information on the prognosis and implications for the future, clinicians’ current approach may not match with those needs.

Klíčová slova:

Alzheimer's disease – Biomarkers – Cognitive impairment – Dementia – Diagnostic medicine – Long-term care – Memory – Prognosis


Zdroje

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Článek vyšel v časopise

PLOS One


2020 Číslo 1