'Working away in that Grey Area...' A qualitative exploration of the challenges general practitioners experience when managing behavioural and psychological symptoms of dementia

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dc.contributor.author Jennings, Aisling A.
dc.contributor.author Foley, Tony
dc.contributor.author McHugh, Sheena M.
dc.contributor.author Browne, John P.
dc.contributor.author Bradley, Colin P.
dc.date.accessioned 2018-01-03T11:25:35Z
dc.date.available 2018-01-03T11:25:35Z
dc.date.issued 2017-12-06
dc.identifier.citation Jennings, A. A., Foley, T., McHugh, S., Browne, J. P. and Bradley, C. P. (2017) '‘Working away in that Grey Area…’ A qualitative exploration of the challenges general practitioners experience when managing behavioural and psychological symptoms of dementia', Age and Ageing, pp. 1-9. doi: 10.1093/ageing/afx175 en
dc.identifier.startpage 1 en
dc.identifier.endpage 9 en
dc.identifier.issn 0002-0729
dc.identifier.uri http://hdl.handle.net/10468/5213
dc.identifier.doi 10.1093/ageing/afx175
dc.description.abstract 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. en
dc.description.sponsorship Atlantic Philanthropies and the Health Service Executive, Ireland (PREPARED (Primary Care Education, Pathways and Research of Dementia). PREPARED is supported by a €1.2 million three year grant (2015–2018)); Irish College of General Practitioners (career research grant); Centre for Ageing Research and Development in Ireland, CARDI (Fellowship) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Oxford University Press (OUP) en
dc.rights © The Authors 2017. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons AttributionNon-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com en
dc.subject General practitioners (GPs) en
dc.subject Dementia en
dc.subject Behavioural and psychological symptoms (BPSD) en
dc.subject Qualitative en
dc.subject Neuropsychiatric symptoms en
dc.subject Dementia en
dc.subject Ireland en
dc.subject Nursing homes en
dc.subject Physicians en
dc.subject Family en
dc.subject Behavior en
dc.subject Sedative en
dc.subject Community en
dc.subject Family caregivers en
dc.title 'Working away in that Grey Area...' A qualitative exploration of the challenges general practitioners experience when managing behavioural and psychological symptoms of dementia en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Aisling Jennings, Department of General Practice, University College Cork, Cork, Ireland. +353-21-490-3000 Email: aisling.jennings@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2017-12-22T10:51:35Z
dc.description.version Published Version en
dc.internal.rssid 413576220
dc.contributor.funder Atlantic Philanthropies en
dc.contributor.funder Irish College of General Practitioners en
dc.contributor.funder Centre for Ageing Research and Development in Ireland en
dc.contributor.funder Health Service Executive, Ireland
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Age and Aging en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress aisling.jennings@ucc.ie en
dc.internal.IRISemailaddress j.browne@ucc.ie en

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