Calia, Clara

Turnbull, Sue

Hurley, Siobhan Rose

2023-10-03T09:48:09Z

2023-10-03T09:48:09Z

2023-10-03

This thesis aimed to explore the experiences of clinicians delivering a diagnosis of dementia. The first chapter is a thematic synthesis of clinicians’ perceptions of the barriers and facilitators to communicating a diagnosis to those from migrant backgrounds. From the extant literature, several themes were constructed, including (1) service access (2) perceptions of migrant beliefs (3) relationships and (4) quality of diagnostic process. Barriers to the diagnosis of dementia were linked to migrants’ inability to access services as well as cultural beliefs impeding the acceptance of a diagnosis. Clinicians reported a need to enhance the provision and quality of interpreters to bolster the validity of the diagnostic process. Clinicians report a lack of cultural competence and require more training on cultural sensitivity. Further research examining facilitators to diagnosis of dementia is required, since the limited literature points mainly to barriers inherent in the process. Additionally, observational research is needed to corroborate self-reported practice. The second chapter is an empirical study exploring how a diagnosis of dementia is shared and communicated by clinicians working in secondary care. The study aimed to explore clinicians’ perceptions of good diagnostic practice, as well as their experiences of communicating a diagnosis in the context of technological and linguistic barriers. Sixteen individual interviews were conducted with clinicians working in different areas of Scotland. Reflexive thematic analysis was used to construct themes and subthemes from the data. This resulted in four overarching themes: (1) Relationships involved in communicating a diagnosis; (2) Personal factors in communication; (3) Strategies and techniques in communication and (4) Equity and risk. The findings echo results from the extant literature on best practices in diagnostic communication, although the findings here offer points of subtle divergence. The study advances the current literature in its examination of diagnostic practice during COVID-19, as well as experiences of communicating a diagnosis to those from migrant backgrounds. To the researcher’s knowledge, this is the first study to explore these issues in a UK context. The study is limited by its small sample size, and by the self-reported nature of the data. Further observational research is needed to understand if clinicians implement their self-reported practice. Future research examining the value of self-reported practice is needed to synthesise comprehensive guidelines for communicating a diagnosis of dementia.

https://hdl.handle.net/1842/41019

http://dx.doi.org/10.7488/era/3758

en

The University of Edinburgh

Dementia

Diagnosis

Migrant

Communication

Virtual

COVID-19

Barriers and facilitators in diagnosing dementia in migrant populations: a systematic review of European health professionals' perspectives; and, Communicating a diagnosis of dementia in secondary care: a reflexive thematic analysis of multidisciplinary perspectives

Thesis or Dissertation

Doctoral

DClinPsychol Doctorate in Clinical Psychology