GPs, stigma and the timely diagnosis of dementia : a qualitative exploration. The implications of general practitioners' perceptions of dementia as a stigma for timely diagnosis.

摘要

BackgroundudThe focus of this study is on how far GPs¿ perceptions of dementia map ontoudthe components and contributing factors to stigma as described by Link andudPhelan (2001; 2006) and Jones et al. (1984).udAimudThe study explores GPs¿ perceptions of dementia as a stigma, develops audspecific conceptualization of the stigma of dementia and considers implicationsudfor timely diagnosis.udMethodsudData from twenty-three GPs in northern England were collected by semistructuredudtelephone interviews. Within the context of a qualitative design, audcombined process of grounded theory and framework analysis was adopted toudcollect and analyse data. udResults The findings reveal that GPs¿ perceptions of dementia map onto Link andudPhelan and Jones¿ identification of contributing factors and components ofudstigma and may hinder timely diagnosis. Three themes emerged reflecting auddynamic process of making sense of dementia, relating perceptions to oneselfudand considering the consequences of dementia. Within those themes, certainudcategories had particular salience for GPs, namely the characteristics of theudattribute, existential anxiety and discrimination. The themes and categories areudinter-related and can be considered as parts of a system. Perceived lack ofudreciprocity could be detected in most categories which suggests that it isudinfluential in the social construction of the stigma of dementia.udConclusionudThe data suggest that current conceptualizations of stigma are insufficient toudfully account for the stigma of dementia. A specific conceptualization of theudstigma of dementia is proposed and the implications of GPs¿ perceptions forudtimely diagnosis are discussed.