ABSTRACT

There is a growing consensus that cognitive assessments should form part of routine clinical care in Multiple Sclerosis (MS). However, what remains unclear is which assessments are preferred by “stakeholders” (including people with MS, family members, charity volunteers, clinicians, and healthcare commissioners), in which contexts, and in which formats. Therefore, the aim of this study was to collect and synthesize stakeholders’ perceptions of the assessments that are acceptable and feasible for routine administration in the UK healthcare system.

We interviewed 44 stakeholders and held one focus group (n = 5). We asked stakeholders about their experience with cognitive impairment and assessment and their views on how cognitive assessment could be implemented within routine clinical care.

Using framework analysis, we summarized three themes: the current cognitive screening situation; the suitability of commonly used assessments; and feasibility aspects, including modality and location of testing. All participants acknowledged that cognitive impairment could have a significant impact on the quality of life, but that assessment and monitoring are not routinely performed in clinics. Barriers and enablers were described, and most participants reported that brief, routine screening with tests such as symbol substitution was acceptable. Electronic, self-administration of cognitive screening would be beneficial in minimizing clinic attendance and staff time.

摘要

越来越多的共识是，认知评估应成为多发性硬化症 (MS) 常规临床护理的一部分。然而，尚不清楚的是“利益相关者”（包括 MS 患者、家庭成员、慈善志愿者、临床医生和医疗保健专员）更喜欢哪些评估，在哪些情况下以及以何种形式。因此，本研究的目的是收集和综合利益相关者对英国医疗保健系统常规管理可接受和可行的评估的看法。

我们采访了 44 位利益相关者并举行了一个焦点小组 ( n  = 5)。我们向利益相关者询问了他们在认知障碍和评估方面的经验，以及他们对如何在常规临床护理中实施认知评估的看法。

通过框架分析，我们总结了三个主题：当前的认知筛查情况；常用评估的适用性；可行性方面，包括测试的方式和地点。所有参与者都承认认知障碍可能对生活质量产生重大影响，但评估和监测并不是在诊所常规进行的。描述了障碍和促成因素，大多数参与者报告说，简短的常规筛查以及符号替换等测试是可以接受的。认知筛查的电子、自我管理将有利于最大限度地减少诊所出勤率和员工时间。