Skip to main content Accessibility help
×
Home

Exploring Rural Family Physicians’ Challenges in Providing Dementia Care: A Qualitative Study

  • Adina Constantinescu (a1), Hui Li (a1), Jennifer Yu (a1), Cassandra Hoggard (a1) and Jayna Holroyd-Leduc (a2)...

Abstract

Currently, 564,000 Canadians are living with dementia. This number will continue to rise as the population ages. Family physicians play an integral role in the diagnosis and management of dementia patients. Although studies have looked at family physician perspectives on dementia care in the urban setting, much less is known about challenges in rural areas. This study aimed to explore rural family physicians’ experiences in caring for patients with dementia in rural Alberta, Canada. We conducted three semi-structured focus groups with 16 family physicians to evaluate barriers and facilitators to providing care to persons with dementia in three rural communities. We developed focus group questions based on the theoretical domains framework (TDF) and analysed them using a framework approach. Physician capabilities, opportunities, and motivations appear to play important roles in caring for these patients. These research findings can be used to advance quality of care for rural dementia patients.

Cinq cent soixante-quatre mille Canadiens sont actuellement atteints de démence. Ce nombre continuera de s’accroître avec le vieillissement de la population. Les médecins de famille jouent un rôle important dans le diagnostic et la gestion des patients avec démence. Bien que des recherches aient montré les perspectives des médecins de famille dans les soins liés à la démence en milieu urbain, les connaissances associées aux défis dans les régions rurales sont encore très limitées. Cette étude visait à explorer les expériences des médecins de famille qui dispensent des soins à des patients avec démence dans des régions rurales en Alberta (Canada). Trois groupes de discussion semi-structurés comprenant 16 médecins de famille ont été organisés afin d’évaluer les barrières et les facilitateurs dans la prestation de soins à des personnes avec démence de trois communautés rurales. Les questions des groupes de discussion ont été élaborées selon le modèle du Theoretical Domains Framework (TDF) et ont été analysées selon cette approche-cadre. Les compétences des médecins, leurs opportunités et leur motivation semblent jouer des rôles majeurs dans les soins destinés à ces patients. Ces résultats de recherche pourraient être utilisés pour améliorer la qualité des soins en milieu rural pour les patients atteints de démence.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Exploring Rural Family Physicians’ Challenges in Providing Dementia Care: A Qualitative Study
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Exploring Rural Family Physicians’ Challenges in Providing Dementia Care: A Qualitative Study
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Exploring Rural Family Physicians’ Challenges in Providing Dementia Care: A Qualitative Study
      Available formats
      ×

Copyright

Corresponding author

La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Adina Constantinescu, M.D., CCFP, CoE Family Medicine Program University of Calgary 2017 26 Ave. SW Calgary, AB T2T1E5 <amconsta@ucalgary.ca>

Footnotes

Hide All
*

We thank Grace Perez and Nathan Turley at the University of Calgary Family Medicine Research Office for their valuable support and guidance throughout this project. We also thank the physicians who participated in focus group discussions in Airdrie, Okotoks, and Black Diamond, Alberta.

Footnotes

References

Hide All
Alzheimer Society of Canada. (2017). Dementia numbers in Canada. Retrieved from http://www.alzheimer.ca/en/About-dementia/What-is-dementia/Dementia-numbers
Barua, B. (2015). Waiting your turn: Wait times for health care in Canada, 2015 Report. Retrieved from https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2015-report
Brodaty, H., & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11(2), 217228.
Buckley, J. S., & Salpeter, S. R. (2015). A risk-benefit assessment of dementia medications: Systematic review of the evidence. Drugs & Aging, 32(6), 453467. doi:10.1007/s40266-015-0266-9
Cane, J., O’Connor, D., & Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science 7(1), 37. doi:10.1186/1748-5908-7-37
Dal Bello-Haas, V. P. M., Cammer, A., Morgan, D., Stewart, N., & Kosteniuk, J. (2014). Rural and remote dementia care challenges and needs: Perspectives of formal and informal care providers residing in Saskatchewan, Canada. Rural and Remote Health, 14(3), 2747.
Forbes, D. A., Finkelstein, S., Blake, C. M., Gibson, M., Morgan, D. G., Markle-Reid, M., … Thiessen, E. (2012). Knowledge exchange throughout the dementia care journey by Canadian rural community-based health care practitioners, persons with dementia, and their care partners: An interpretive descriptive study. Rural and Remote Health, 12(4), 2201.
Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13, 117. doi:10.1186/1471-2288-13-117
Gauthier, S., Patterson, C., Chertkow, H., Gordon, M., Herrmann, N., Rockwood, K., … Soucy, J. (2012). Recommendations of the 4th Canadian Consensus Conference on the diagnosis and treatment of dementia (CCCDTD4). Canadian Geriatrics Journal, 15(4), 120126.
Green, J., & Thorogood, N. (2014). Qualitative methods for health research (3rd ed.). Thousand Oaks, CA: Sage.
Greenway-Crombie, A., Snow, P., Disler, P., Davis, S., & Pond, D. (2012). Influence of rurality on diagnosing dementia in Australian general practice. Australian Journal of Primary Health, 18(3), 178184. doi:10.1071/PY12008
Herron, R., Rosenberg, M., & Skinner, M. (2016). The dynamics of voluntarism in rural dementia care. Health & Place, 41, 3441.
Innes, A., Morgan, D., & Kostineuk, J. (2011). Dementia care in rural and remote settings: A systematic review of informal/family caregiving. Maturitas, 68, 3446.
Kitzinger, J. (2005). Focus group research: Using group dynamics to explore perceptions, experiences and understandings. In Holloway, I. (Ed.), Qualitative research in health care (pp. 5670). Maidenhead, ENG: Open University Press.
Koller, D., Eisele, M., Kaduszkiewicz, H., Schön, G., Steinmann, S., Wiese, B., … van den Bussche, H. (2010). Ambulatory health services utilization in patients with dementia—Is there an urban-rural difference? International Journal of Health Geographics, 9, 59. doi:10.1186/1476-072X-9-59
Michie, S., Johnston, M., Abraham, C., Lawton, R., Parker, D., & Walker, A. (2005). Making psychological theory useful for implementing evidence based practice: A consensus approach. Quality and Safety in Health Care, 14(1), 2633. doi:10.1136/qshc.2004.011155
Michie, S., Johnston, M., Francis, J., Hardeman, W. & Eccles, M. (2008). From theory to intervention: Mapping theoretically derived behavioural determinants to behaviour change techniques. Applied Psychology, 57, 660680. doi:10.1111/j.1464-0597.2008.00341.x
Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science 6, 42. http://doi.org/10.1186/1748-5908-6-42
Parmar, J., Dobbs, B., McKay, R., Kirwan, C., Cooper, T., Marin, A., & Gupta, N. (2014). Diagnosis and management of dementia in primary care: Exploratory study. Canadian Family Physician Medecin De Famille Canadien, 60(5), 457465.
Patterson, C., Grek, A., Gauthier, S., Bergman, H., Cohen, C., Feightner, J. W., … Hogan, D. B. (2001). The recognition, assessment and management of dementing disorders: Conclusions from the Canadian Consensus Conference on Dementia. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, 28(S1), S3–S16.
Pimlott, N. J. G., Persaud, M., Drummond, N., Cohen, C. A., Silvius, J. L., Seigel, K., … Dalziel, W. B. (2009a). Family physicians and dementia in Canada: Part 1. Clinical practice guidelines: Awareness, attitudes, and opinions. Canadian Family Physician / Medecin De Famille Canadien, 55(5), 506–7.e1–5.
Pimlott, N. J. G., Persaud, M., Drummond, N., Cohen, C. A., Silvius, J. L., Seigel, K., … Dalziel, W. B. (2009b). Family physicians and dementia in Canada: Part 2. Understanding the challenges of dementia care. Canadian Family Physician / Medecin De Famille Canadien, 55(5), 508–9.e1–7.
Pimlott, N. J. G., Siegel, K., Persaud, M., Slaughter, S., Cohen, C., Hollingworth, G., … Eliasziw, T. (2006). Management of dementia by family physicians in academic settings. Canadian Family Physician, 52(9), 11081109.
Pomerantz, A. (2009). Ethics conflicts in rural communities: Overlapping roles. In Nelson, W. A. (Ed.), Handbook for rural healthcare ethics: A practical guide for professionals. Lebanon, NH: University Press of New England for Dartmouth College Press.
Pope, C., Ziebland, S., & Mays, N. (2000). Qualitative research in health care. Analysing qualitative data. BMJ (Clinical Research Ed.), 320(7227), 114116.
Stewart, T. V., Loskutova, N., Galliher, J. M., Warshaw, G. A., Coombs, L. J., Staton, E. W., … Pace, W. D. (2014). Practice patterns, beliefs, and perceived barriers to care regarding dementia: A report from the American Academy of Family Physicians (AAFP) national research network. Journal of the American Board of Family Medicine: JABFM, 27(2), 275283. doi:10.3122/jabfm.2014.02.120284
Turner, S., Iliffe, S., Downs, M., Wilcock, J., Bryans, M., Levin, E., … O’Carroll, R. (2004). General practitioners’ knowledge, confidence and attitudes in the diagnosis and management of dementia. Age and Ageing, 33(5), 461467. doi:10.1093/ageing/afh140
Van Hout, H., Vernooij-Dassen, M., Poels, P., Hoefnagels, W., & Grol, R. (2000). Are general practitioners able to accurately diagnose dementia and identify Alzheimer’s disease? A comparison with an outpatient memory clinic. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 50(453), 311312.
Wiersma, E. C., & Denton, A. (2013). From social network to safety net: Dementia-friendly communities in rural northern Ontario. Dementia, 15(1), 5168.
Williams, M. E., & Connolly, N. K. (1990). What practicing physicians in North Carolina rate as their most challenging geriatric medicine concerns. Journal of the American Geriatrics Society, 38(11), 12301234.
Woods, R. T., Moniz-Cook, E., Iliffe, S., Campion, P., Vernooij-Dassen, M., Zanetti, O., & Franco, M. (2003). Dementia: Issues in early recognition and intervention in primary care. Journal of the Royal Society of Medicine, 96(7), 320324.
Wu, C., Gao, L., Chen, S., & Dong, H. (2016). Care services for elderly people with dementia in rural China: A case study. Bulletin of the World Health Organization, 94(3), 167173. doi:10.2471/BLT.15.160929

Keywords

Related content

Powered by UNSILO
Type Description Title
WORD
Supplementary materials

Constantinescu et al. supplementary material
Appendix 1

 Word (15 KB)
15 KB
WORD
Supplementary materials

Constantinescu et al. supplementary material
Appendix 2

 Word (14 KB)
14 KB

Exploring Rural Family Physicians’ Challenges in Providing Dementia Care: A Qualitative Study

  • Adina Constantinescu (a1), Hui Li (a1), Jennifer Yu (a1), Cassandra Hoggard (a1) and Jayna Holroyd-Leduc (a2)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.