Older adults with dementia: knowledge and attitudes of physicians in health units

Authors

  • Ana Beatriz Quintes Steiner Universidade Federal de São Paulo
  • Alessandro Ferrari Jacinto Universidade Federal de São Paulo
  • Vanessa de Albuquerque Citero Universidade Federal de São Paulo

DOI:

https://doi.org/10.11606/s1518-8787.2020054002451

Keywords:

Physicians, Primary Care, Health Knowledge, Attitudes, Practice, Patients, Aged, Dementia

Abstract

OBJECTIVE: To describe the knowledge and attitudes of general practitioners of the basic health network of the city of São Paulo in relation to patients with dementia and identify patterns of attitudes. METHODS: A total of 10% of the basic health units in the city of São Paulo (n = 45) were randomly distributed into six regional health coordination centers. Up to two general practitioners were interviewed in each unit, with a total of 81 physicians interviewed. They answered the translated and cross-culturally adapted version for Brazil of two British questionnaires, the knowledge quiz (knowledge about dementias) and the attitude quiz (attitude towards the patient afflicted with dementia), as well as a sociodemographic and occupational questionnaire to understand the profile of general practitioners working in primary care. Descriptive data analysis, factor analysis of the main components of the attitude quiz and study of association between attitudes and knowledge were performed, in addition to the multiple linear regression test to determine the relationship between occupational profile and knowledge about attitude patterns in dementia. RESULTS: The physicians interviewed had a median of five-year graduation time; 35.8% worked exclusively with primary care, and less than 40% had completed, or were attending, medical residency or specialization. Physicians showed a lower knowledge about the diagnosis of dementia than about the epidemiology of the disease and its therapeutic management. Their attitudes towards patients afflicted with dementia resulted in four factors: proactive optimism, delegated optimism, implicit dismay, and explicit dismay. The regression study showed that the attitude of explicit dismay decreases the longer the weekly working hours of the physician in the units, and that the delegated optimistic attitude of the physician decreases in the same situation. CONCLUSION: Investment in training is essential to improve physicians’ performance in the field of dementia in primary care.

Author Biographies

  • Ana Beatriz Quintes Steiner, Universidade Federal de São Paulo

    Universidade Federal de São Paulo. Escola Paulista de Medicina. Programa de Pós-Graduação em Psiquiatria e Psicologia Médica. São Paulo, SP, Brasil

  • Alessandro Ferrari Jacinto, Universidade Federal de São Paulo

    Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina. São Paulo, SP, Brasil

  • Vanessa de Albuquerque Citero, Universidade Federal de São Paulo

    Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Psiquiatria. São Paulo, SP, Brasil

References

Turner S, Iliffe S, Downs M, Wilcock J, Bryans M, Levin E, et al. General practitioner’s knowledge, confidence and attitudes in the diagnosis and management of dementia. Age Ageing. 2004;33(5):461-7. https://doi.org/10.1093/ageing/afh140

Gutierrez BAO, Silva HS, Guimarães C, Campino AC. Impacto econômico da doença de Alzheimer no Brasil: é possível a assistência e reduzir custos? Cienc Saude Coletiva. 2014;19(11):4479-86. https://doi.org/10.1590/1413-812320141911.03562013

Conselho Regional de Medicina do Estado de São Paulo. São Paulo; 2010 [citado 23 nov 2010]. Disponível em: http://www.cremesp.org.br

Prefeitura Municipal de São Paulo. São Paulo; 2019 [citado 28 jun 2019]. Disponível em: http://www.prefeitura.sp.gov.br

Jacinto AF, Oliveira EC, Citero VA. Brazilian transcultural adaptation of an instrument on physician’s knowledge and attitudes towards dementia. Dement Neuropsychol. 2015;9(3):245-50. https://doi.org/10.1590/1980-57642015dn93000006

Jacinto AF, Villas Boas PJF, Mayoral VFS, Citero VA. Knowledge and attitudes towards dementia in a sample of medical residents from a university hospital in São Paulo Brazil. Demen. Neuropsychol. 2016;10(1):37-41. https://doi.org/10.1590/s1980-57642016dn10100007

Ólafsdóttir M, Foldevi M, Marcusson J. Dementia in primary care: why the low detection rate? Scand J Prim Health Care. 2001;19(3):194-8. https://doi.org/10.1080/028134301316982469

Keller I, Makipaa A, Kalenscher T, Kalache A. Global survey on geriatrics in the medical curriculum. Geneva: World Health Organization; 2002.

Tsolaki M, Papaliagkas V, Anogianakis G, Barnabei R, Emre M, Frolich L, et al. Consensus statement on dementia education and training in Europe. J Nutr Health Aging. 2010;14(2):131-5. https://doi.org/10.1007/s12603-009-0238-z

Connolly A, Iliffe S, Gaehl E, Campbell S, Drake R, Morris J, et al. Quality of care provided to people with dementia: utilisation and quality of the annual dementia review in general practice Br J Gen Pract. 2012;62(595):e91-8. https://doi.org/10.3399/bjgp12X625148

Published

2020-12-12

Issue

Section

Original Articles

How to Cite

Steiner, A. B. Q., Jacinto, A. F., & Citero, V. de A. (2020). Older adults with dementia: knowledge and attitudes of physicians in health units. Revista De Saúde Pública, 54, 137. https://doi.org/10.11606/s1518-8787.2020054002451