| 26 Quality assessment The quality of the studies was high to moderate, with MMAT ratings of 80 -100% (6 studies), 60% (2 studies), 40% (1 study). The two qualitative studies that were complemented with surveys (41, 44) did not identify themselves as mixed method studies and mainly focused on the qualitative part of their study, therefore only the qualitative parts of these studies were assessed for quality criteria and used for data synthesis. For the qualitative studies with an 80100% score the qualitative approach was adequate for the research question, findings were (mostly) adequately derived from the data and interpretation of results was substantiated by data (for example by using quotes). For the studies with an 60% score it was unclear if all results were substantiated with data and whether the data collection methods were adequate to address the research question. In the study with a 40% score, it was impossible to tell how the findings were derived from the data and if there was coherence between data sources, collection, analysis and interpretation. Findings Six analytic themes emerged from our data synthesis. Preferences for starting a diagnostic trajectory for dementia arose from (1) views on diagnostic trajectories. These views are influenced by (2) symptom normalization or validation, (3) the support or wishes of the social network, (4) interaction with HCPs, (5) the health status of the PwMC, and (6) societal factors such as stigmatization, cultural beliefs, and socioeconomic status (see Figure 2). See the appendix for an extensive overview of the themes, categories, codes, and illustrative quotes.
RkJQdWJsaXNoZXIy MTk4NDMw