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Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy

BACKGROUND: Portugal has a Dementia Strategy that endorses care coordination in the community, but the strategy is not implemented despite there being a network of multidisciplinary primary care clinics that could support it. Recent research into barriers to dementia management in primary care has f...

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Autores principales: Balsinha, Conceição, Iliffe, Steve, Dias, Sónia, Freitas, Alexandre, Barreiros, Filipa F., Gonçalves-Pereira, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919178/
https://www.ncbi.nlm.nih.gov/pubmed/35177149
http://dx.doi.org/10.1017/S1463423621000876
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author Balsinha, Conceição
Iliffe, Steve
Dias, Sónia
Freitas, Alexandre
Barreiros, Filipa F.
Gonçalves-Pereira, Manuel
author_facet Balsinha, Conceição
Iliffe, Steve
Dias, Sónia
Freitas, Alexandre
Barreiros, Filipa F.
Gonçalves-Pereira, Manuel
author_sort Balsinha, Conceição
collection PubMed
description BACKGROUND: Portugal has a Dementia Strategy that endorses care coordination in the community, but the strategy is not implemented despite there being a network of multidisciplinary primary care clinics that could support it. Recent research into barriers to dementia management in primary care has focused essentially on general practitioners’ (GPs) factors and perspectives. A comprehensive triangulated view on the barriers to dementia management emphasising teamwork is missing. AIM: To explore the barriers to the implementation of the Portuguese Dementia Strategy by primary care teams, from the perspectives of service users and professionals. METHODS: Purposive sampling was used to recruit 10 GPs, 8 practice nurses, 4 social workers, 8 people with dementia and 10 family carers from 6 practices in different social contexts within the Lisbon metropolitan area. The analytical framework combined codes derived from the transcripts with codes from the available literature. Themes focused on the access to professionals/community services, care coordination within healthcare teams, and between health and community services. FINDINGS: Several system barriers were identified (undefined roles/coordination within teams, time constraints, insufficient signposting to community services) along with individual barriers (limited competence in dementia, unrecognised autonomy, limited views on social health and quality of life (QoL)), hindering users access to dementia services. CONCLUSION: Enhanced competence in dementia, and nurse-led systematic care of people with dementia and their carers, are necessary. They can be effective in improving the QoL in dementia, but only if associated with better community support.
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spelling pubmed-89191782022-03-22 Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy Balsinha, Conceição Iliffe, Steve Dias, Sónia Freitas, Alexandre Barreiros, Filipa F. Gonçalves-Pereira, Manuel Prim Health Care Res Dev Research Article BACKGROUND: Portugal has a Dementia Strategy that endorses care coordination in the community, but the strategy is not implemented despite there being a network of multidisciplinary primary care clinics that could support it. Recent research into barriers to dementia management in primary care has focused essentially on general practitioners’ (GPs) factors and perspectives. A comprehensive triangulated view on the barriers to dementia management emphasising teamwork is missing. AIM: To explore the barriers to the implementation of the Portuguese Dementia Strategy by primary care teams, from the perspectives of service users and professionals. METHODS: Purposive sampling was used to recruit 10 GPs, 8 practice nurses, 4 social workers, 8 people with dementia and 10 family carers from 6 practices in different social contexts within the Lisbon metropolitan area. The analytical framework combined codes derived from the transcripts with codes from the available literature. Themes focused on the access to professionals/community services, care coordination within healthcare teams, and between health and community services. FINDINGS: Several system barriers were identified (undefined roles/coordination within teams, time constraints, insufficient signposting to community services) along with individual barriers (limited competence in dementia, unrecognised autonomy, limited views on social health and quality of life (QoL)), hindering users access to dementia services. CONCLUSION: Enhanced competence in dementia, and nurse-led systematic care of people with dementia and their carers, are necessary. They can be effective in improving the QoL in dementia, but only if associated with better community support. Cambridge University Press 2022-02-18 /pmc/articles/PMC8919178/ /pubmed/35177149 http://dx.doi.org/10.1017/S1463423621000876 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Research Article
Balsinha, Conceição
Iliffe, Steve
Dias, Sónia
Freitas, Alexandre
Barreiros, Filipa F.
Gonçalves-Pereira, Manuel
Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy
title Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy
title_full Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy
title_fullStr Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy
title_full_unstemmed Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy
title_short Dementia and primary care teams: obstacles to the implementation of Portugal’s Dementia Strategy
title_sort dementia and primary care teams: obstacles to the implementation of portugal’s dementia strategy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919178/
https://www.ncbi.nlm.nih.gov/pubmed/35177149
http://dx.doi.org/10.1017/S1463423621000876
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