Evaluation des Göttinger Kooperationsprojekts FIDEM (Frühe Informationen und Hilfen bei Demenz): Projekt-Etablierung und Erfahrungen von ärztlichen sowie nicht-ärztlichen Beteiligten
Evaluation of the cooperation model FIDEM (early information and support in dementia) in Göttingen: Project implementation and experiences of medical and non-medical participants
von Lea Kristin Oberbach
Datum der mündl. Prüfung:2024-02-27
Erschienen:2024-02-21
Betreuer:PD Dr. Michael Belz
Gutachter:PD Dr. Michael Belz
Gutachter:Prof. Dr. Eva Hummers
Gutachter:Prof. Dr. Inga Zerr
Dateien
Name:Dissertation_eDiss_Oberbach.pdf
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Format:PDF
Zusammenfassung
Englisch
Early information and support in dementia (FIDEM) is a cooperation model that focuses on networking between general practitioners and non-medical cooperation partners (e.g. occupational therapists, care counselling, other non-medical care providers). The project aims to improve the support of people with dementia and to attain a reduced work-load of cooperation partners. Especially the general practitioners ought to experience work-relief by allowing them to systematically assign their patients to non-physician healthcare providers. The objective of this work is to present the implementation of FIDEM between 2017 and 2019, including the comparison with the predecessor projects FIDEM I and II. Additionally, experiences of cooperation partners were surveyed through questionnaires for quality management which were filled out by participants attending the semi-annual network meetings. The primary aim was to evaluate the satisfaction with FIDEM and the relief vs. additional workload due to participation in the project. The comparison of FIDEM Göttingen with FIDEM I and II showed many similarities. Examples are that the primary care givers took the role of navigator during each project and the realization of regular network meetings. However, there were several modifications in the context of FIDEM Göttingen. For instance, for this particular project there was no time limit – instead, from the beginning long-term implementation and permanent adoption by the cooperation partners was planned. The analysis proved a successful implementation of the project. It resulted in seven networks and was adopted by 29 practices of primary care physicians and 49 non-medical institutions. In the period reviewed, five network meetings took place within each network. Overall, the evaluation of questionnaires completed by 80 cooperation partners showed a high degree of satisfaction of both the medical and the non-medical participants regarding all aspects of FIDEM. In addition, all cooperation partners confirmed a reduction in workload due to participation, which was significantly higher for general practitioners across all scales (all p values < 0.001). The job satisfaction captured independently of FIDEM, which was surveyed as control variable, showed no significant differences between the medical and non-medical participants. Therefore, differences between cooperation partners concerning satisfaction with the network model and the reduction in workload are with little likelihood due to differences in FIDEM-independent job satisfaction. The project led to patients with dementia and their relatives being assigned to non-physician healthcare providers. The number of patients informed about FIDEM by the general practitioners at the respective time of the survey differed greatly (M = 7.95, SD = 9.20). The reason most frequently given by general practitioners for informing patients with dementia was a high burden of family members. More than two thirds of medical and non-medical cooperation partners stated no difficulties with the integration of patients in FIDEM and the transmission to network partners. Among the presented challenges, the refusal of participation by a patient or a family member was mentioned most frequently. All in all, a successful implementation of the network model FIDEM Göttingen was recorded. The high level of satisfaction as well as reduction in workload for general practitioners indicates a positive impact of the cooperation model on the cooperation partners and suggests a continuation and expansion of FIDEM. That work-relief was not gained at the expense of an additional workload for non-medical cooperation partners. Nevertheless, further research should follow. Aspects such as the effects of the project on the participating patients and their family members need to be investigated.
Keywords: dementia; cooperation project; networking; caregivers; psychosocial interventions; general practitioners; outpatient care
Schlagwörter: Demenzversorgung; Kooperationsmodell; Netzwerkbildung; Psychosoziale Maßnahmen; Hausärzte; Ambulante Versorgung