PMID- 29220480
OWN - NLM
STAT- MEDLINE
DCOM- 20190923
LR  - 20220330
IS  - 1468-2834 (Electronic)
IS  - 0002-0729 (Print)
IS  - 0002-0729 (Linking)
VI  - 47
IP  - 2
DP  - 2018 Mar 1
TI  - 'Working away in that Grey Area...' A qualitative exploration of the challenges 
      general practitioners experience when managing behavioural and psychological 
      symptoms of dementia.
PG  - 295-303
LID - 10.1093/ageing/afx175 [doi]
AB  - BACKGROUND: general practitioners (GPs) have identified the management of 
      behavioural and psychological symptoms of dementia (BPSD) as a particularly 
      challenging aspect of dementia care. However, there is a paucity of research on 
      why GPs find BPSD challenging and how this influences the care they offer to 
      their patients with dementia. OBJECTIVES: to establish the challenges GPs 
      experience when managing BPSD; to explore how these challenges influence GPs' 
      management decisions; and to identify strategies for overcoming these challenges. 
      DESIGN: qualitative study of GPs experiences of managing BPSD. METHODS: 
      semi-structured interviews were conducted with 16 GPs in the Republic of Ireland. 
      GPs were purposively recruited to include participants with differing levels of 
      experience caring for people with BPSD in nursing homes and in community settings 
      to provide maximum diversity of views. Interviews were analysed thematically. 
      RESULTS: three main challenges of managing BPSD were identified; lack of clinical 
      guidance, stretched resources and difficulties managing expectations. The lack of 
      relevant clinical guidance available affected GPs' confidence when managing BPSD. 
      In the absence of appropriate resources GPs felt reliant upon sedative 
      medications. GPs believed their advocacy role was further compromised by the 
      difficulties they experienced managing expectations of family caregivers and 
      nursing home staff. CONCLUSIONS: this study helps to explain the apparent 
      discrepancy between best practice recommendations in BPSD and real-life practice. 
      It will be used to inform the design of an intervention to support the management 
      of BPSD in general practice.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the British 
      Geriatrics Society.
FAU - Jennings, Aisling A
AU  - Jennings AA
AD  - Dept. of General Practice, University College Cork, Cork, Ireland.
FAU - Foley, Tony
AU  - Foley T
AD  - Dept. of General Practice, University College Cork, Cork, Ireland.
FAU - McHugh, Sheena
AU  - McHugh S
AD  - Dept. of Epidemiology and Public Health, University College Cork, Cork, Ireland.
FAU - Browne, John P
AU  - Browne JP
AD  - Dept. of Epidemiology and Public Health, University College Cork, Cork, Ireland.
FAU - Bradley, Colin P
AU  - Bradley CP
AD  - Dept. of General Practice, University College Cork, Cork, Ireland.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Age Ageing
JT  - Age and ageing
JID - 0375655
SB  - IM
MH  - *Attitude of Health Personnel
MH  - Conflict, Psychological
MH  - Dementia/diagnosis/epidemiology/psychology/*therapy
MH  - Female
MH  - General Practitioners/*psychology
MH  - *Health Knowledge, Attitudes, Practice
MH  - *Health Services for the Aged/standards
MH  - Humans
MH  - Interviews as Topic
MH  - Ireland/epidemiology
MH  - Male
MH  - Motivation
MH  - Patient Advocacy
MH  - Physician-Patient Relations
MH  - Practice Guidelines as Topic
MH  - *Practice Patterns, Physicians'/standards
MH  - Professional-Family Relations
MH  - Qualitative Research
MH  - Workload
PMC - PMC6016685
EDAT- 2017/12/09 06:00
MHDA- 2019/09/24 06:00
PMCR- 2017/12/06
CRDT- 2017/12/09 06:00
PHST- 2017/06/14 00:00 [received]
PHST- 2017/10/26 00:00 [accepted]
PHST- 2017/12/09 06:00 [pubmed]
PHST- 2019/09/24 06:00 [medline]
PHST- 2017/12/09 06:00 [entrez]
PHST- 2017/12/06 00:00 [pmc-release]
AID - 4654493 [pii]
AID - afx175 [pii]
AID - 10.1093/ageing/afx175 [doi]
PST - ppublish
SO  - Age Ageing. 2018 Mar 1;47(2):295-303. doi: 10.1093/ageing/afx175.