Difficulties in disclosing the diagnosis of dementia: a qualitative study in general practice

Phillips, Jill, Pond, Constance Dimity, Paterson, Nerida Elizabeht, Howell, Cate, Shell, Allan, Stocks, Nigel P., Goode, Susan M. and Marley, John E. (2012) Difficulties in disclosing the diagnosis of dementia: a qualitative study in general practice. British Journal of General Practice, 62 601: e546-e553. doi:10.3399/bjgp12X653598


Author Phillips, Jill
Pond, Constance Dimity
Paterson, Nerida Elizabeht
Howell, Cate
Shell, Allan
Stocks, Nigel P.
Goode, Susan M.
Marley, John E.
Title Difficulties in disclosing the diagnosis of dementia: a qualitative study in general practice
Journal name British Journal of General Practice   Check publisher's open access policy
ISSN 0960-1643
1478-5242
Publication date 2012-08-01
Sub-type Article (original research)
DOI 10.3399/bjgp12X653598
Open Access Status DOI
Volume 62
Issue 601
Start page e546
End page e553
Total pages 8
Place of publication London, United Kingdom
Publisher Royal College of General Practitioners
Formatted abstract
Background: Dementia is an insidious and stigmatised condition, and research indicates that GPs find communicating this diagnosis particularly problematic. Delays in diagnosismay impede optimal patient care. Little research has been published on Australian GPs' perceptions of barriers to disclosing the diagnosis of dementia.
Aim: To explore GPs' perceptions of barriers to disclosing the diagnosis of dementia.
Design and setting: Qualitative study in the general practice consultation context.
Method: Semi-structured, audiorecorded interviews were conducted with GPs from three capital cities and one regional centre in Australia. Interviews were transcribed verbatim and thematic analysis was conducted.
Results: GPs' lack of confidence in having a correct diagnosis, concern to act in patients' best interests, and the stigma associated with the 'dementia' label influenced the disclosure process. GPs found it challenging to identify dementia in the consultation context. It was difficult to raise the issue when both the patient and their family/carer(s) ignore/are unaware of symptoms of cognitive decline. Referral to a specialist was favoured to confirm suspicions, although this did not always result in a definitive diagnosis. Opinions differed as to whether the GP or the specialist was better placed to deliver the diagnosis. GPs preferred disclosure to the patient with his/her family/carer(s) present; associated issues of confidentiality and the importance of offering hope emerged. The severity of the patient's dementia also guided the diagnostic disclosure process. GPs often used euphemisms for dementia when disclosing the diagnosis, to soften themessage.
Conclusion: Complex issues surround the disclosure of dementia. Communicating this diagnosis remains particularly challenging for many GPs.
Keyword Dementia
Diagnosis
Disclosure
Family practice
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Faculty of Medicine
 
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