Exploratory study of French healthcare workers' experiences of anosognosia in Alzheimer's disease and related disorders

Abstract

Background: Anosognosia or lack of insight is a common feature of Alzheimer's disease (AD) and associated disorders. It is an impairment in the ability to recognize the disease and related symptoms. Anosognosia is associated among patients with poor compensatory strategies, behavioral disorders, apathy and caregiver burden. Therefore, its early identification by healthcare workers is a major challenge in order to provide support for both patients and caregivers.

Objective: To explore the knowledge, attitudes and experiences of French healthcare workers relating to anosognosia in AD and related disorders.

Methods: An online self-completed questionnaire was created for the study. It was anonymous and divided into three dimensions: general knowledge, confidence, and subjective experiences of anosognosia. One hundred and eleven healthcare workers completed the questionnaire. Mann Whitney and Kruskal Wallis tests were used to determine the variables associated with the total knowledge and confidence scores. Ordinal logistic regressions were performed to explore the associations between subjective experiences and demographics.

Results: The participants had moderate knowledge. Knowledge scores were influenced by their experience in the geriatric field, type of profession, workplaces and training. The areas where knowledge was poorest were anosognosia assessment and management. The participants with the lowest knowledge levels were those interacting the most with patients, especially at home. Overall, they identified difficulties related to anosognosia and did not seem confident about their ability to deal with this condition.

Conclusions: This study determines specific areas for training on anosognosia, such as identification, assessment and management of this condition.

Keywords: Alzheimer's disease; anosognosia; awareness; caregiving; healthcare workers knowledge.