RESUMEN
Background& : The geriatric population in India is projected to increase from 8% to a staggering 20% by 2050. The combination of a population boom along with advances in medicine resulting has resulted in an increase in life span, leaving India with a potential geriatric healthcare crisis in its hands leaves India with a potential geriatric healthcare crisis in its hands. India currently produces as few as 20 geriatricians per year due to limited PG seats and has only a handful of fully functioning Geriatric Departments in the public healthcare sector. Thus, there is a need to fully assess the knowledge, attitudes and current practices in geriatric healthcare among medical professionals and interns across the country. OBJECTIVE: To investigate the knowledge, attitudes and practices and perceived needs of physicians towards specialised geriatric healthcare and to assess the views towards geriatric medicine as a career option among medical interns in India. DESIGN: Cross-sectional, web-based survey by forwarding the link via social media platforms. SETTING: MBBS graduates undergoing their rotatory internship and residents/postgraduate doctors in specialties relevant to the care of older persons throughout India. PARTICIPANTS: A total of 800 Indian medical interns and professionals. MEASUREMENTS: Demographic characteristics of medical professionals and interns included age, gender, branch of practice, working sector, availability of any geriatric facility in their workplace, etc. Responses were weighted to maintain nationwide representativeness. Knowledge, attitudes, current practices and perceived needs regarding specialised geriatric healthcare were the primary outcome measurements. RESULTS: Insufficient knowledge (48.5% of professionals) regarding any specialised branch of geriatric healthcare was found. Only 9.0% medical professionals performed 'Comprehensive Geriatric Assessment' and even the mean score of practice of CGA was low. 96% professionals and 92% interns felt the need for specialised geriatric services throughout India with majority feeling the need for specialised OPDs. 32.7% of Interns were willing to opt for post-graduation in Geriatrics, if given a choice and those with any specialised geriatric facility available at their institute were more willing. More than 85% professionals and interns had affirmative attitudes towards the possible benefits of specialised healthcare. CONCLUSION AND IMPLICATIONS: There is poor practice of specialised geriatric healthcare throughout India and also a high prevalence of perceived needs among professionals and interns regarding facilities like OPDs, wards and departments. Highly affirmative attitudes were observed among both interns and professionals indicating the acceptance of suggested strategies. Majority of interns were convinced of opting for post-graduation in geriatrics when incentivized, indicating the need for prioritizing interns for capacity building in the future.
Asunto(s)
Internado y Residencia , Médicos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Atención a la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , India , Encuestas y CuestionariosRESUMEN
BACKGROUND: Within the next few decades, India will witness a staggering increase in its elderly population owing to advancements in health care. However, an increase in life span is not mutually inclusive with high quality of living. Old age is associated with multiple ailments which decreases functionality and increases dependency, several of which go undiagnosed while catering to primary complaints. This prompts the need for a comprehensive approach to the healthcare of the elderly for which Comprehensive Geriatric Assessment (CGA is widely practiced in the west. OBJECTIVES: This study was conducted to estimate the prevalence of undiagnosed medical problems by Comprehensive Geriatric Assessment (CGA) Screening and explore its applicability in Indian tertiary healthcare setup. METHODOLOGY: Following ethical approval of the institute, a cross-sectional study was conducted among 262 geriatric patients with age over 60 years, from seven out-patients departments. A Comprehensive Geriatric Assessment (CGA) inventory was prepared by compiling screening instruments for Visual acuity, Hearing acuity, Dependency, Functionality, Depression, Cognitive impairment, Fall risk, Urinary incontinence, Nutritional Status and Insomnia. The participants were administered the screening inventory once they had already undergone a normal check-up in the OPDs. RESULTS: Overall, 262 geriatric patients underwent CGA screening (Female: 57.3%, Male: 42.7%). There was a high prevalence of problems going undiagnosed ranging from 58.65% to 95.45% in various OPDs. Some problems had a significantly greater overall prevalence and were also prevalent in going undiagnosed in particular OPDs (urinary incontinence in Gynaecological OPD, p=0.003; insomnia in surgical OPD, p<0.005). Many patients who screened positive for certain problems were found to have a few other problems as well (dependency and cognitive impairment, p=0.003; insomnia and depression, p=0.0001). CONCLUSION: This study showed a high prevalence of problems going undiagnosed along with their associations with particular OPDs and other problems. Participants of this study showed a considerable acceptability for CGA. This reaffirmed the need for CGA in every geriatric patient in our tertiary care setup.