Instruments in general practice to identify and to measure (over)burden due to informal care for caring relatives: a scoping review protocol.

INTRODUCTION: Family caregivers provide by far the largest share of long-term, unpaid care for their primarily elderly and chronically ill relatives or friends. This is associated with a higher risk of psychological and physical overload for the caregivers due to the persistently high time, financial and emotional burden.Recognising the effects of persistent burden on caring relatives at an early stage significantly contributes to the appropriate coordination of available resources and mediation of individual support to maintain a functional caring relationship without excessive demands. General practitioners are usually responsible for the early detection of burden arising from informal care and the coordination of adequate measures. The objective of this review is to give an overview of instruments to identify and measure (over)burden of caring relatives in German general practice and to describe their characteristics. METHODS AND ANALYSIS: We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist in addition to the Joanna Briggs Institute Reviewer's Manual to describe the aims and methods of the planned scoping reviews. This protocol has been registered with Open Science Framework (OSF), https://osf.io/9ce2k. Two reviewers will run the search to identify studies in four databases (PubMed, LIVIVO, the Cochrane Library and CINAHL) in June and July 2023. Abstracts, titles and full-text publications will be screened to extract data from each included study using a data extraction form. Additionally, an overview of all studies including main study characteristics and detailed information on identification instruments will be given to map the different instruments and tools and to clarify statements concerning their use and practicability in general practice. ETHICS AND DISSEMINATION: Ethical approval or consent to participate is not required, as data in this study consists of published studies and not individual data from human or animal participants. Dissemination will consist of publications, presentations and other knowledge translation activities.

[Caring relatives in General practice-General practitioners' perspectives and solution approaches]. / Pflegende Angehörige in der hausärztlichen Praxis ­ Hausärztliche Sichtweisen und Lösungsansätze.

BACKGROUND: General practitioners are usually responsible for the early detection of burden due to informal care and the coordination of adequate measures. Their individual perspectives and approaches for identifying and supporting caregiving relatives have hardly been examined yet. OBJECTIVE: The study therefore examined subjective perspectives of general practitioners regarding the identification and care of family caregivers in general practitioners' practices. The results will help to evaluate the needs for improvement and conditions for implementation of an instrument to identify informal carers. MATERIAL AND METHODS: To answer the question, we conducted 12 guideline-based expert interviews with general practitioners from Saxony-Anhalt. To evaluate the interviews, we used qualitative content analysis (Mayring). RESULTS: With respect to the medical care and support of caring relatives, the examination of subjective attitudes and perspectives confirmed that general practitioners occupy a central position. It also showed possibilities to improve or to facilitate support of caring relatives. Time-dependent problems and a lack of communication complicate support. Home care services and regional consulting services are available but a systematic cooperation and coordination of competences is still lacking. CONCLUSION: A screening instrument for family caregivers (identification, measuring subjective burden) represents a meaningful intervention. The special requirements and characteristics of interventions used in general medical practice have to be researched, the burden scale for family caregivers should be adapted and implemented accordingly. The cooperation of all actors must be a central aspect of future efforts.

Finding common (research) ground between general practitioners and neuroscientists: the vital role of knowledge circulation in closing the evidence-to-practice gap.

BACKGROUND: It may take 15 years or longer before research evidence is integrated into clinical practice. This evidence-to-practice gap has deleterious effects on patients as well as research and clinical processes. Bringing clinical knowledge into the research process, however, has the potential to close the evidence-to-practice gap. The NEUROTRANS-Project attempts to bring research and practice together by focusing on two groups that usually operate separately in their communities: general practitioners and neuroscientists. Although both groups focus on dementia as an area of work, they do so in different contexts and without opportunities to share their expertise. Finding new treatment pathways for patients with dementia will require an equal knowledge exchange among researchers and clinicians along with the integration of that knowledge into research processes, so that both groups will benefit from the expertise of the other. METHODS: The NEUROTRANS-Project uses a qualitative, multi-stage research design to explore how neuroscientists and general practitioners (GPs) approach dementia. Using a grounded theory methodology, it analyzes semi-structured interviews, case vignettes, focus groups with GPs in Saxony-Anhalt, Germany, and informal conversations with, and observations of, neuroscientists from the German Center for Neurodegenerative Diseases in Magdeburg. RESULTS: The NEUROTRANS-Project identified a clear division of labor between two highly specialized professional groups. Neuroscientists focus abstractly on nosology whereas general practitioners tend to patient care following a hermeneutic approach integrating the patients' perspective of illness. These different approaches to dementia create a barrier to constructive dialogue and the capacity of these groups to do research together with a common aim. Additionally, the broader system of research funding and health care within which the two groups operate reinforces their divide thereby limiting joint research capacity. CONCLUSIONS: Overcoming barriers to research collaboration between general practitioners and neuroscientists requires a shift in perspective in which both groups actively engage with the other's viewpoints to facilitate knowledge circulation (KC). Bringing 'art into science and science into art', i.e. amalgamating the hermeneutic approach with the perspective of nosology, is the first step in developing joint research agendas that have the potential to close the evidence-to-practice gap.