Understanding current practice and challenges to the implementation of rehabilitation for people living with dementia: insights from health professionals in Malaysia.

Abstract

To examine Malaysian health professionals' knowledge, attitudes, confidence, beliefs, and practices regarding dementia rehabilitation, and to identify perceived barriers and enablers. An online survey assessed dementia knowledge (DKAS), attitudes (DAS; GPACS-D for doctors), rehabilitation confidence, beliefs, and perceived barriers/enablers, alongside five open-text questions. Quantitative data were analysed descriptively, and qualitative responses underwent content analysis. Ninety-seven participants completed the survey. Dementia knowledge was moderate (mean DKAS 32.5/50), with the largest gaps in communication and behavioural symptoms. Doctors showed higher knowledge but lower rehabilitation confidence, whereas some allied health professionals demonstrated lower knowledge but higher confidence. Misconceptions persisted regarding when rehabilitation is appropriate, the breadth of professional roles, and the extent of assistance required. Attitudes were generally positive, and overall rehabilitation confidence was moderate (mean 3.0/5). Key barriers included limited family awareness, workforce shortages, and inadequate funding, while enablers included family involvement, public education, and specialised training. Qualitative analysis identified four categories: workforce and training gaps, family and societal awareness, system and service constraints, and strategies and resource needs. Malaysian health professionals value dementia rehabilitation but face implementation challenges. Strengthening training, role clarity, family engagement, and system-level investment is essential to improving access and delivery.