Help-seeking preferences in the area of mild cognitive impairment: comparing family physicians and the lay public

Factors influencing the help-seeking behavior in patients with mild cognitive impairment: a qualitative study

BACKGROUND

The early diagnosis and intervention of mild cognitive impairment (MCI) patients is expected to delay the progression of AD. Delayed treatment will lead to MCI patients missing the best intervention expectation. At present, the medical help-seeking behavior of this group is not optimistic. This study aimed to explore influencing factors of help-seeking behavior among patients with MCI in China based on the help-seeking behavior model.

METHODS

Twenty-two patients with MCI were recruited to participate in semi-structured interviews via purposeful sampling with a qualitative, descriptive design. Data were analyzed by qualitative content analysis.

RESULTS

The study revealed the main influencing factors of help-seeking behavior among MCI patients in China included perceived disease threat, symptom attribution, disease knowledge, use of cognitive compensation strategies, sense of foreseeable burden, social support, economic condition, and accessibility of medical service.

CONCLUSIONS

The help-seeking behavior of patients with MCI is affected by multiple factors. There are some key factors in different stages of the help-seeking process. Healthcare providers can utilize these factors to design targeted interventions for promoting early help-seeking of patients with MCI.

Where did I put my glasses? The lived experience of older adults seeking medical help for perceived memory problems

Purpose: This study aimed to examine the lived experience of older adults who seek medical help for perceived memory problems, defined as "help-seekers." We examined how they make sense of their experience of memory problems, the effect on everyday life and the role of personal and environmental factors.Materials and methods: A qualitative approach was used. Twelve help-seekers recruited from geriatric clinics participated in qualitative interviews, using thematic analysis with an interpretative phenomenological analysis.Results: Four themes emerged: (1) memory problems in daily life; (2) negative beliefs and emotional responses; (3) coping with memory problems; and (4) memory problems in context. The study describes the implications of memory problems on engagement in meaningful and self-defining occupations, and the negative beliefs and emotions embedded in the experience of memory loss. The results revealed three types of coping responses: active problem solving, reframing perception of the problem and avoidant behaviors. The study highlights the importance of both the social environment and aging process in the lived experience of help-seekers.Conclusions: Multiple personal and social factors interacted and mediated the meaning of memory loss in help-seekers. The study reveals a complex clinical picture that may impede successful occupational engagement of help-seekers.Implications for rehabilitationThe evaluation of older adults reporting memory problems should include assessments of everyday functioning, memory related beliefs, emotional status, self-efficacy, and the social environment.The interaction between memory problems and bio-psycho-social changes related to aging should be considered in treating older adults with reported memory problems.Design of group interventions addressing daily functioning, coping strategies and memory related beliefs are recommended.

Is there an association between help-seeking for early detection of Alzheimer's disease and illness representations of this disease among the lay public?

OBJECTIVE

Help-seeking (HS) for early detection of Alzheimer's disease (AD) is clearly essential because therapeutic interventions are recognized as being most efficient in the early stages of the disease. Using the Self-Regulation Model as its conceptual framework, the present study examined the relationship between HS for early detection of AD and lay persons' beliefs and emotional reactions towards AD.

METHODS

A convenience sample of 236 community-dwelling adults, aged 50 and above, completed HS measures related to early detection of AD, HS sources, cognitive and emotional representations, perceived threat, familiarity with AD, and socio-demographic questionnaires.

RESULTS

Participants expressed low HS levels for early detection of AD. However, participants expressed higher levels of HS willingness if checking for AD would be included in the routine medical examinations conducted by their GPs. Multiple regression analyses showed that AD consequences and perceived threat were the main predictors of HS for early detection of AD, explaining 9.2% of the variance.

CONCLUSIONS

Our findings stress the need to increase the lay public's knowledge about available treatment options and their efficacy, even in the advances stages of the disease when the consequences of the disease are much more severe. AD awareness programs should also pay attention to the potential fear which may exist in the case of HS for early detection of AD. Copyright © 2017 John Wiley & Sons, Ltd.

Comparative analysis of the expected demands for nursing care services among older people from urban, rural, and institutional environments

Background

Demand for nursing and social services may vary depending on the socio-demographic variables, health status, receipt of formal and informal care provided, and place of residence.

Objectives

To conduct a comparative analysis of the expectations of older people from urban, rural, and institutional environments concerning nursing care with respect to the care provided and elements of a comprehensive geriatric assessment.

Material and methods

The study comprised 2,627 individuals above the age of 65 years living in urban (n=935) and rural (n=812) areas as well as nursing homes (n=880).

Results

Family care was most often expected both in urban (56.6%) and rural (54.7%) environments, followed by care provided simultaneously by a family and nurse (urban – 18.8%; rural – 26.1%) and realized only by a nurse (urban – 24.6%; rural – 19.2%). Not surprisingly, nursing home residents most commonly expected nursing care (57.5%) but 33.1% preferred care provided by family or friends and neighbors. In the whole cohort of people living in the home environment (n=1,718), those living with family demonstrated willingness to use primarily care implemented by the family (62.0%), while respondents living alone more often expected nursing services (30.3%). In the logistic regression model, among the respondents living in the city, only the form of care already received determined the expectations for nursing care. Among the respondents living in the county, the presence of musculoskeletal disorders, better nutritional status, and current care provided by family decreased expectations for nursing care. Higher cognitive functioning, symptoms of depression, and living alone increased the willingness to obtain nursing care.

Conclusion

Older inhabitants of urban areas, rural areas, and those residing in institutions have different expectations for individual nursing care. Nearly 45% of seniors living in the community expect to obtain nursing care, while only 1.6% do not expect any social or nursing help. While the expectations for the provision of nursing care are significantly increased by living alone, they are decreased by having access to care provided by family. Support for families to take care of elderly relatives would appear to be essential for an effective nursing and social care system.