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Family Practice Vol. 18, No. 5, 549-552
© Oxford University Press 2001

Health Services Research

Management of dementia in primary health care: the experiences of collaboration between the GP and the district nurse

Frans Boch Waldorffa, Lars Bo Bülowb, Kirsti Malteruda,c and Gunhild Waldemard

a Central Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen,
b Municipality of Copenhagen, Health Care Department,
d Memory Disorders Research Unit, The Neuroscience Centre, Rigshospitalet, Copenhagen University Hospital, Denmark and
c Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Norway.

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.

Keywords. Collaboration, dementia, district nurse, general practice, inter-professional relations.


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