Management of dementia in primary health care: the experiences of collaboration between the GP and the district nurse.
OBJECTIVE
The objective of this study was to explore the context and experiences of collaboration between the GP and the district nurse (DN) in diagnosing dementia, in order to identify possible procedures to improve care.


METHODS
Two group interviews were conducted with four DNs and five GPs, respectively, working in the municipality of Copenhagen.


RESULTS
The group interviews revealed that the suboptimized collaboration could be due to different inter-professional diagnostic strategies and a lack of understanding of the importance of early, shared, decision making. This could create conflicts between the groups.


CONCLUSIONS
This study indicates a possibility for improved collaboration between the two professional groups in diagnosing dementia. Possible approaches for improved care should focus on an inter-professional understanding of the importance of early, shared, decision making, emphasizing early identification and care of diagnosed demented patients. Establishing a shared collaboration model including out-patient memory clinics, GPs and DNs could be a first step. This model should also take into account an evaluation of possible consequences for the diagnosed demented patients in terms of treatment and care and consider the indication for referrals to a comprehensive diagnostic evaluation. We are at present planning a study to address these aspects.
Waldorff
F B
FB
Central Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Denmark.
Bülow
L B
LB
Malterud
K
K
Waldemar
G
G
D000328:Adult; D003299:Cooperative Behavior; D003657:Decision Making; D003704:Dementia / Q000175:diagnosis* / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D019555:Physician-Nurse Relations; D011320:Primary Health Care