Perceived Confidence in Ability to Diagnose and Manage Dementia among Fourth Year Psychiatry Residents

Perceived Confidence in Ability to Diagnose and Manage Dementia among Fourth Year Psychiatry Residents

2016 AAGP Annual Meeting 4. Seematter-Bagnoud L, Karmaniola A, Santos-Eggimann B: Adverse life events among community-dwelling persons aged 65– 70 yea...

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2016 AAGP Annual Meeting 4. Seematter-Bagnoud L, Karmaniola A, Santos-Eggimann B: Adverse life events among community-dwelling persons aged 65– 70 years: gender differences in occurrence and perceived psychological consequences. Soc Psychiatry Psychiatr Epidemiol 2010; 45:9–16 5. Jang Y, Haley WE, Small BJ, et al: The role of mastery and social resources in the associations between disability and depression in later life. Gerontologist 2002; 42:807–813

Poster Number: EI 64

Perceived Confidence in Ability to Diagnose and Manage Dementia among Fourth Year Psychiatry Residents Karina Davis, MD University of Michigan, Dexter, MI Introduction: As the number of Americans over the age of 65 increases, a growing number of older adults will require mental health care, yet there is a limited number of providers with subspecialty geriatric training. Therefore, general adult psychiatrists will inevitably care for an increasing number of elderly patients. It is currently estimated that almost one third of individuals above 85 have a diagnosis of dementia and the global prevalence of dementia is expected to dramatically increase as the population ages (Alzheimer’s Desease Facts and Figures, 2015. https://www.alz.org/facts/downloads/ facts_figures_2015.pdf. Accessed 15 Oct 2015). Given the prevalence of dementia within the geriatric population, large numbers of elderly individuals seeking psychiatric treatment will likely have an underlying cognitive disorder. Given the prevalence of cognitive impairment in older adults and the shortage of geriatric psychiatrists, it is critical that general adult psychiatrists seeing these older adults are comfortable with the evaluation and management of dementia. In addition, since many of individuals with dementia will have associated behavioral and psychological symptoms including depression, agitation, and psychosis there is a pressing need to ensure psychiatrists are adequately trained in the skills necessary to care for these patients. Furthermore, being able to effectively communicate with patient families about prognosis, safety issues and dementiarelated resources are additional critical aspects of dementia care that psychiatrists need to be comfortable with. It is unclear to what extent psychiatrists feel prepared to provide clinical care for the growing population of patients with dementia following general adult psychiatry training. In order to gain an understanding of the self-perceived level of confidence psychiatrists have after residency training, a national survey will be conducted to assess fourth year residents’ confidence in managing and diagnosing dementia. In order to gain a further understanding of senior resident’s perspectives on dementia care and whether they view it as an integral part of their training experience, the survey will also assess how important residents view these skills for their future careers. Methods: Study Design and Sample Cross-sectional study using a brief, 10-item online survey will be conducted to assess fourth year psychiatric residents’ self-perceived confidence in dementia diagnosis and management. Email invitations will be sent out to fourth year residents at a variety of ACGME-approved psychiatry residency programs across the country. Survey Monkey will be used to ensure respondent anonymity. Approval for this study through the University of Michigan Institutional Review Board is pending. Measures A survey was developed to assess psychiatric resident’s self-confidence in a specific areas related to diagnosing and managing dementia, based on a similar instrument to assess trainee confidence in palliative care (Manu, E et al. “Self Perceived Competence Amount Medical Residents in Skills Needed to Care for Patients with Advanced Dementia Versus Metastatic Cancer.” J Canc Educ (2012) 27: 515–520). Using a 4-point Likert scale, residents will be asked to rate their confidence in areas such as completing a dementia evaluation, differentiating between different types of dementia, discussing diagnosis with patient/family, and managing dementia-related agitation. Residents will also be asked they would feel more comfortable referring a dementia evaluation to another provider such as a neurologist. Finally, the survey will include items regarding whether they anticipate they will need to diagnose and manage dementia in their future careers. Data Analysis: Analysis will begin with descriptive statistics to summary respondent characteristics (age, gender). Frequency distributions for each survey item will be calculated, with items ranked by resident level of confidence. Results: We anticipate that respondents may have limited confidence in their ability to diagnose dementia, and less confidence in the ability to manage behavioral symptoms such as agitation. We also anticipate that residents will generally not think these skills are important for their future work. Conclusions: If our hypotheses are correct, our results will likely suggest that general adult psychiatry residents need more training in the evaluation and management of cognitive disorders given the aging of the patient population for which they will provide care.

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Am J Geriatr Psychiatry 24:3, Supplement 1