Clinician and Client Reports of the Negative Effects of Neuropsychological Assessment for Dementia

ObjectiveNeuropsychological assessment (NPA) is recommended to support differential diagnosis of dementia but little is known about its impact on clients and their experience of negative effects. This study investigated clinicians' understanding of their clients' negative experiences and explored similarities in clinician and client reports.MethodA mixed-methods approach was employed using qualitative and quantitative data. Semi-structured interviews with clinicians, and a questionnaire for clinicians and clients were collected from NHS settings across Scotland. Reflexive Thematic Analysis was used to analyse 11 clinician interviews. Descriptive statistics were reported for the 25 clinician and 12 client questionnaires and exploratory analysis investigated associations between clinician and clients reporting of negative experiences.ResultsIn the qualitative analysis, three overarching themes and 13 sub-themes were identified. The over-arching themes were: assessment can produce negative impacts for clients, indirect factors can produce harmful effects, and clinicians can take action to reduce adverse effects of NPA. For the questionnaire responses, the most endorsed negative effects were the same for clients and clinicians and included feeling stressed, worried, disappointed with their performance in assessment, frustrated, critical of themselves and worried about the outcome.ConclusionThese data provide some of the first clear empirical descriptions of the negative effects of NPA as reported by both clinicians and clients. The study also identified challenges with recruiting clients who are willing to give feedback on their experience of assessment. Future studies are needed to refine the available data capture methods and to determine if the current results are replicable.