1. Managing the transition to non-driving in patients with dementia in primary care settings: facilitators and barriers reported by primary care physicians
- Author
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Jacki Liddle, Geoffrey Mitchell, Theresa Scott, Nancy A. Pachana, and Elizabeth Beattie
- Subjects
Male ,Automobile Driving ,Decision Making ,Primary care ,Physicians, Primary Care ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,General Practitioners ,medicine ,Humans ,Dementia ,In patient ,030212 general & internal medicine ,Cognitive skill ,Driving cessation ,Qualitative Research ,Physician-Patient Relations ,Primary Health Care ,Accidents, Traffic ,Focus Groups ,medicine.disease ,Focus group ,Metropolitan area ,Psychiatry and Mental health ,Clinical Psychology ,Identification (information) ,Female ,Geriatrics and Gerontology ,Psychology ,Gerontology ,030217 neurology & neurosurgery - Abstract
Objectives:This research addresses dementia and driving cessation, a major life event for affected individuals, and an immense challenge in primary care. In Australia, as with many other countries, it is primarily general practitioners (GPs) who identify changes in cognitive functioning and monitor driving issues with their patients with dementia. Qualitative evidence from studies with family members and other health professionals shows it is a complicated area of practice. However we still know little from GPs about how they manage the challenges with their patients and the strategies that they use to facilitate driving cessation.Methods:Data were collected through five focus groups with 29 GPs at their primary care practices in metropolitan and regional Queensland, Australia. A semi-structured topic guide was used to direct questions addressing decision factors and management strategies. Discussions were audio recorded, transcribed verbatim and thematically analyzed.Results:Regarding the challenges of raising driving cessation, four key themes emerged. These included: (i) Considering the individual; (ii) GP-patient relationships may hinder or help; (iii) Resources to support raising driver retirement; and (iv) Ethical dilemmas and ethical considerations. The impact of discussing driving cessation on GPs is discussed.Conclusions:The findings of this study contribute to further understanding the experiences and needs of primary care physicians related to managing driving retirement with their patients with dementia. Results support a need for programs regarding identification and assessment of fitness to drive, to upskill health professionals and particularly GPs to manage the complex issues around dementia and driving cessation, and explore cost-effective and timely delivery of such support to patients.
- Published
- 2019