Keywords: dementia, primary care physician, preparedness, GPACS-D, Theoretical Domains Framework, Ukraine, Mental Health Gap Action Programme, mhGAP

Background:

In Ukraine, approximately 500,000 people live with dementia, but the predicted underdiagnosis rate of this syndrome may be up to 94%. This means that only a small proportion of people with this condition are actually “visible” to the healthcare system – most cases remain unnoticed, undiagnosed, and, consequently, without proper care. Since 2023, medical care for patients with mental health issues has been included in the list of medical services at the primary healthcare level. In parallel, training under the Mental Health Gap Action Programme is being scaled up across Ukraine.

Research questions:

Does the level of preparedness of primary care physicians in the Chernivtsi region change after they participate in the training under the mhGAP program, which includes the "Dementia" module (4.5 hours)?
What are the facilitators and barriers to providing medical care to patients with dementia?

Method:

The study employs a mixed-methods explanatory sequential design. The quantitative component combines descriptive, correlational, and longitudinal quasi-experimental strategies. The qualitative phase uses qualitative description with deductive thematic analysis. Participants are 150-200 primary care physicians attending the mhGAP training, which includes the 4.5-hour "Dementia" module. Instruments include an online questionnaire (sociodemographics, GPACS-D) and a semi-structured interview guide. Quantitative analysis includes descriptive statistics, correlations, quasi-experimental testing, CFA, and Cronbach's α. Qualitative data undergo deductive thematic analysis (based on the Theoretical Domains Framework), allowing for inductive wartime-specific themes.

Results:

It will be obtained after the study is conducted.

Conclusions:

The study will allow for translation, cultural adaptation, and initial psychometric validation of the Ukrainian version of the GPACS-D. It will assess the dynamics of changes in primary care physicians' preparedness to provide dementia care following mhGAP training and at 3-month follow-up. Qualitative data will identify modifiable contextual factors that facilitate and hinder the provision of dementia care in primary care settings.

Points for discussion:

Is short-term training sufficient to ensure the preparedness to provide care to patients with dementia?

How can the sustainability of primary care physicians' preparedness to provide dementia care be ensured?

What contextual factors can help or hinder physicians in providing medical care to patients with dementia?