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Bacsu JDR, Spiteri RJ, Nanson K, Rahemi Z, Webster C, Norman M, Stone C. Understanding stigma of dementia during COVID-19: a scoping review. Front Psychiatry 2024; 15:1261113. [PMID: 38600982 PMCID: PMC11004454 DOI: 10.3389/fpsyt.2024.1261113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Stigma of dementia is one of the greatest challenges for people living with dementia. However, there is little research on the different types of stigma of dementia in the COVID-19 pandemic. The purpose of this scoping review is to synthesize the existing literature on dementia-related stigma (self, public, and structural stigma), during the pandemic. Methods Guided by Arksey and O'Malley's scoping review framework and PRISMA guidelines, CINAHL, EMBASE, Google Scholar, Medline, PsycINFO, and Web of Science were searched for English language literature from January 2020 to June 2023. Inclusion criteria consisted of peer-reviewed, original research articles addressing stigma of dementia during the COVID-19 pandemic. Thematic analysis was used to analyze the data and steps were taken to ensure rigor. Results Fifteen articles met our inclusion criteria. Four primary themes were identified including: 1) COVID-19 stereotypes and assumptions of dementia; 2) human rights issues and deprived dignity; 3) disparate access to health services and supports; and 4) cultural inequities and distrust. Discussion The COVID-19 pandemic has contributed to the stigmatization of people living with dementia. Further research is needed to develop, implement, and evaluate interventions targeted towards the different types of dementia-related stigma (including self, public, and structural stigma). Moreover, our findings highlight the need for more collaborative research that prioritizes the lived experience and input of diverse people living with dementia. Research partnerships with diverse people living with dementia are vital to improving future pandemic planning. Only through evidence-informed research and lived experience can we begin to fully address the different types of dementia-related stigma and enhance the quality of life of people living with dementia.
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Affiliation(s)
| | - Raymond J. Spiteri
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kate Nanson
- School of Nursing, Thompson Rivers University, Kamloops, BC, Canada
| | - Zahra Rahemi
- School of Nursing, Clemson University, Clemson, SC, United States
| | | | - Myrna Norman
- Engagement of People with Lived Experience of Dementia (EPLED), Maple Ridge, BC, Canada
| | - Chantelle Stone
- Department of Psychology, Thompson Rivers University, Kamloops, BC, Canada
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Błaszkiewicz M, Szcześniak D, Ciułkowicz M, Kowalski K, Rymaszewska JE, Bartosz B, Bulińska K, Karczewski M, Brodaty H, Rymaszewska J. Biomedical knowledge of dementia is not enough to counteract its stigma - quantitative research among future medical and social care staff in Poland. Aging Ment Health 2024:1-9. [PMID: 38407168 DOI: 10.1080/13607863.2024.2320139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The aim is to assess the level of stigmatization and knowledge of dementia among university students of medical, rehabilitation and social faculties in Poland. Possible correlates of these concepts and group differences are also investigated. METHODS We applied quantitative methods using an online questionnaire comprising sociodemographics, the Alzheimer's Disease Knowledge Scale, a vignette of a person with dementia and the modified Family Stigma in Alzheimer's Disease Scale. RESULTS Students had low levels of dementia knowledge and moderate levels of stigma. Medical science students had significantly better knowledge than the other groups but did not differ in their level of stigma. Relationships between the main variables were complex. Emotional and cognitive stigmatizing attributions were negatively correlated with knowledge about communication and behaviors of people with dementia. Better knowledge on causes and characteristics, as well as on risks and health promotion of the disease also triggered fewer negative attributions toward people with dementia. CONCLUSIONS If health-related programs are to be effective, they should provide opportunities for the acquisition of relevant knowledge and skills that also address the stigmatization of people living with dementia. Well-established biomedical knowledge on dementia must be supplemented with a person-centered approach and proper communication skills.
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Affiliation(s)
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Marta Ciułkowicz
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | - Julia E Rymaszewska
- Department and Clinic of Dermatology, Allergology and Venerology, Wrocław Medical University, Wrocław, Poland
| | - Bogna Bartosz
- Institute of Psychology, University of Wroclaw, Wrocław, Poland
| | - Katarzyna Bulińska
- Department of Physiotherapy, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | - Maciej Karczewski
- Department of Applied Mathematics, University of Environmental and Life Sciences, Wroclaw, Poland
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Joanna Rymaszewska
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
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Angelidou IA, Makri M, Beyreuther K, Boada Rovira M, Despoti A, Engelborghs S, Miguel A, Rodríguez I, Stocker H, Temmerman J, Tsolaki M, Yener G, Yerlikaya D, Teichmann B. Attitudes toward pre-symptomatic screening for Alzheimer's dementia in five European countries: a comparison of family members of people with Alzheimer's dementia versus non-family members. Front Genet 2023; 14:1305107. [PMID: 38162684 PMCID: PMC10757380 DOI: 10.3389/fgene.2023.1305107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction: Pre-symptomatic screening is getting more attention in healthcare as it detects the risk for developing neurodegenerative diseases like Alzheimer's disease (AD), which is very useful for treatment or prevention. AD screening could play an important role in individuals with at least one affected first-degree relative, but also without family history. As the demand for screening is rising worldwide, it is important to consider possible cross-cultural differences in attitudes toward pre-symptomatic screening in order to tailor healthcare services to the needs of each country. Objective: This study aims to investigate the attitudes of family members and non-family members of people with dementia toward pre-symptomatic screening and explore possible differences in attitudes across five European countries (Belgium, Germany, Greece, Spain, Turkey) using translated versions of the "Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening" questionnaire (PRE-ADS). Methods: The multicultural sample (N = 650) was recruited from samples that were previously used in validation studies of the translated PRE-ADS versions. The subscale "Acceptability of Screening", consisting of five PRE-ADS items to specifically explore willingness to undergo screening, was created. Ιnternal consistency was measured, and structural validity was determined using Confirmatory Factor Analysis (CFA). Group comparisons were performed to investigate differences in attitudes toward pre-symptomatic AD screening regarding family history and country of origin using the PRE-ADS and the "Acceptability of Screening" mean scores. Results: Construct validity was acceptable for the PRE-ADS. Both the PRE-ADS (α = 0.76) and its subscale "Acceptability of Screening" (α = 0.90) had good internal consistency. Overall, 56.9% of the total sample expressed a positive intention toward pre-symptomatic AD screening. T-tests showed significantly higher mean scores of participants with an affected family member. An international comparison revealed differences in the "Acceptability of Screening" mean score across the five European countries. No cross-cultural differences were found for the PRE-ADS mean score after adjusting for confounding variables. Conclusion: The PRE-ADS and its subscale are reliable tools for assessing pre-symptomatic AD screening attitudes. Variations in the acceptability of screening seem to be linked to family history and cultural influences. Further research with larger samples is needed to explore underlying relationships.
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Affiliation(s)
| | - Marina Makri
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Association of Alzheimer Disease and Related Disorders, Thessaloniki, Greece
- Laboratory of Neurodegenerative Disease, Center for Interdisciplinary Research and Innovation (CIRI—AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konrad Beyreuther
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Mercè Boada Rovira
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona–Universitat Internacional de Catalunya, Barcelona, Spain
| | - Akyllina Despoti
- Clinical Ergospirometry, Exercise and Rehabilitation Lab, School of Medicine, National and Kapodistrian University of Athens, Zografou, Greece
| | - Sebastiaan Engelborghs
- Department of Neurology and NEUR Research Group, Center for Neurosciences, Universitair Ziekenhuis Brussel and Vrije Universiteit Brussel, Brussel, Belgium
| | - Andrea Miguel
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona–Universitat Internacional de Catalunya, Barcelona, Spain
| | - Isabel Rodríguez
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona–Universitat Internacional de Catalunya, Barcelona, Spain
| | - Hannah Stocker
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Joke Temmerman
- Department of Neurology and NEUR Research Group, Center for Neurosciences, Universitair Ziekenhuis Brussel and Vrije Universiteit Brussel, Brussel, Belgium
| | - Magda Tsolaki
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Görsev Yener
- Faculty of Medicine, Izmir University of Economics, Izmir, Turkiye
| | - Deniz Yerlikaya
- Faculty of Medicine, Izmir University of Economics, Izmir, Turkiye
| | - Birgit Teichmann
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
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Vasquez L, Schultz M, Ishado E, Borson S, Sadak T. Building a dementia-capable nursing workforce. J Prof Nurs 2023; 46:31-38. [PMID: 37188419 DOI: 10.1016/j.profnurs.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Undergraduate nursing students will play a pivotal role in caring for the rising numbers of older adults and people living with dementia (PLWD). However, many do not receive training in geriatrics or dementia and do not enter this field post-graduation, contributing to the workforce shortage. OBJECTIVE We aimed to capture students' interest and intention to work with PLWD, their suggestions about training, and to evaluate interest in a new elective long-term care (LTC) externship. METHODS We developed and administered a survey to Bachelor of Science in Nursing students consisting of questions modified from the Dementia Attitude Scale and related to respondents' health care experience, attitudes about caring for older adults, comfort working with PLWD, and willingness to develop geriatric and dementia care skills. We then conducted focus groups about desired curricular and clinical content. RESULTS Seventy-six students completed the survey. The majority reported low interest in working with and low knowledge of caring for older adults and PLWD. Six focus group participants expressed interest in participating in hands-on learning opportunities. Participants identified specific training components to attract students to geriatrics education. CONCLUSIONS Our findings informed the development, piloting, and evaluation of a new LTC externship at the University of Washington Schoool of Nursing.
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Fear about Alzheimer's disease among Israeli and German laypersons, persons with Mild Neurocognitive Disorder and their relatives: a qualitative study. Int Psychogeriatr 2021; 33:1019-1034. [PMID: 33046144 DOI: 10.1017/s1041610220003397] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Alzheimer's disease (AD), the most common type of dementia, is one of the most feared diseases, obstructing help-seeking, and leading to discrimination. While research interest in fear of developing AD is increasing, little is known about its characterization, triggers, and consequences, especially among different cultures. In this study, we aimed at exploring and characterizing AD fear as experienced by laypersons (LP), persons with Mild Neurocognitive Disorder (MND), and their relatives, in Israel and Germany. DESIGN A qualitative study using focus groups (FGs) and semi-structured interviews was used. Thematic content analysis was conducted to extract key themes. SETTING Israeli and German not yet diagnosed people. PARTICIPANTS The study included a total of 130 participants (63 Israeli and 67 German participants) representing 3 groups: LP (n = 82), persons with MND (n = 28), and relatives of persons with MND (n = 20). RESULTS Two overarching themes were identified across groups and countries: fear of developing AD and fear of stigmatization. Other types of fear, such as fear of a person with AD, fear about the impact of a diagnosis of AD on family members, fear of becoming a caregiver, and fear of losing one's self-determination because of developing AD, were specific to a group type or country. Different types of fear were awakened by different triggers, and were dealt with different coping strategies.
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Werner P, Kim S. A Cross-National Study of Dementia Stigma Among the General Public in Israel and Australia. J Alzheimers Dis 2021; 83:103-110. [PMID: 34250936 PMCID: PMC8461698 DOI: 10.3233/jad-210277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite the increasing amount of research on dementia stigma, there is a dearth of cross-national studies conducted on this subject. This is surprising since the experience of stigma is closely associated to socio-cultural aspects. OBJECTIVE The present study intended to expand knowledge about the impact of culture on dementia stigma by comparing the level and correlates of stigmatic beliefs about dementia among the general public in Israel and Australia. METHODS A cross-sectional study using an online survey was conducted with two age-matched samples: 447 adults in Israel and 290 adults in Australia. RESULTS Overall, dementia stigma was moderate in both countries. However, the level of dementia stigma was significantly higher in Australia than in Israel. Lower levels of subjective knowledge and higher levels of ageism were associated with increased levels of stigmatic beliefs in both countries. Gender was a significant correlate of dementia stigma, with male participants reporting higher levels of public stigma than women, although this gender difference was mainly driven by the Australian sample. CONCLUSION Our findings indicate that providing knowledge and decreasing ageist attitudes should be key considerations in dementia awareness and stigma reduction campaigns despite the cultural context. In addition, developing gender-specific messages should be considered as a way of improving the effects of such campaigns.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Sarang Kim
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, Australia
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Kim S, Richardson A, Werner P, Anstey KJ. Dementia stigma reduction (DESeRvE) through education and virtual contact in the general public: A multi-arm factorial randomised controlled trial. DEMENTIA 2021; 20:2152-2169. [PMID: 33517746 DOI: 10.1177/1471301220987374] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the efficacy of the Dementia Stigma Reduction (DESeRvE) programme, aimed at reducing the general public dementia-related stigma utilising 'education' and 'contact' approaches. METHODS A total of 1024 Australians aged between 40 and 87 years (M = 60.8, SD = 10.1) participated in a factorial randomised controlled trial. This trial examined four conditions: online education programme (ED), contact through simulated contact with people with dementia and carers (CT), education and contact (ED+CT) and active control. Cognitive, emotional and behavioural aspects of dementia-related stigma were measured with a modified Attribution Questionnaire, and dementia knowledge was measured with the Dementia Knowledge Assessment Scale at the baseline, immediately and 12 weeks after the completion of the intervention. RESULTS All four groups improved (reduction in scores) significantly from baseline to week 12 in dementia-related stigma, and the effects were stronger for those with higher baseline stigma scores. Intervention groups also improved significantly from baseline in dementia knowledge. Especially, the ED (β = .85, SE = .07; p < .001) and ED+CT (β = .78, SE = .08; p < .001) groups at immediate follow-up and CT (β = .21, SE = .09; p < .05) and ED+CT (β = .32, SE = .09; p < .001) at 12-week follow-up showed significant effects. CONCLUSIONS Findings suggest that DESeRvE can be a valuable tool to enhance public's dementia knowledge and reduce dementia-related stigma, especially for those with higher levels of stigma. Reduction in stigma, however, may take a longer time to achieve, whereas improvement in dementia knowledge is instant.
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Affiliation(s)
- Sarang Kim
- Centre for Research on Ageing, Health & Wellbeing, Research School of Population Health, 2219Australian National University, Canberra, Australia; Wicking Dementia Research & Education Centre, 3925University of Tasmania, Hobart, Australia
| | - Alice Richardson
- Statistical Consulting Unit, 2219Australian National University, Canberra, Australia
| | - Perla Werner
- Department of Community Mental Health, 26748University of Haifa, Israel
| | - Kaarin J Anstey
- 6803Neuroscience Research Australia, Sydney, Australia; School of Psychology, 7800University of New South Wales, Sydney, Australia
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Werner P, AboJabel H, Maxfield M. Conceptualization, measurement and correlates of dementia worry: A scoping review. Arch Gerontol Geriatr 2020; 92:104246. [PMID: 32980573 DOI: 10.1016/j.archger.2020.104246] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The combination of a growing population of older adults and increasing prevalence and awareness of dementia diagnoses suggests that dementia worry may also intensify. As a relatively new area of investigation, the dementia worry literature is growing, but variability in definitions and measurement continue. A scoping review was conducted to gather and examine existing research, as well as assist in guiding future studies in this area. The review focused on characterizing the conceptualization, measurement, and correlates of dementia worry. METHODS Using PubMed, CINAHL, AgeLine, and PsycINFO, a search of literature concerning dementia worry was completed. RESULTS A total of 45 articles examining dementia worry fulfilled the inclusion criteria. Most studies were cross-sectional (n = 39), quantitative (n = 38), and conducted in the United States (n = 22). Inconsistencies in the conceptualization, measurement, and correlates examined make it difficult to determine the meaning and true levels of dementia worry. CONCLUSIONS Recent attention to dementia worry has increased awareness of the basic concept and its correlates. However, the lack of unity in the definition and measurement of dementia worry impedes advancement in this research area, as well as in establishing its clinical significance.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Israel.
| | - Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Israel.
| | - Molly Maxfield
- Edson College of Nursing and Health Innovation, Arizona State University, USA.
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Werner P, Raviv-Turgeman L, Corrigan PW. The influence of the age of dementia onset on college students' stigmatic attributions towards a person with dementia. BMC Geriatr 2020; 20:104. [PMID: 32171246 PMCID: PMC7071751 DOI: 10.1186/s12877-020-1505-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 03/04/2020] [Indexed: 01/24/2023] Open
Abstract
Background Research in the area of public stigma and Alzheimer’s disease (AD) is limited to examining stigmatic beliefs towards persons aged 65 and over (i.e., persons with late-onset dementia). The aim of the present study was to compare college students’ stigmatic attributions towards an older and a younger person with AD, using an attributional model of stigma. Method A cross-sectional study was conducted with 375 college students (mean age = 25.5, 58.9% female, 64.3% Jewish) who answered a computerized, self-administered, structured questionnaire after being presented with one of two randomly distributed vignettes varying in the age of the person with AD – 80 or 50 years of age. Cognitive, emotional and behavioral attributions of stigma were assessed using an adapted version of the Attribution Questionnaire. Other variables examined included background information, experiences and concerns about developing AD. T-tests and Ordinary Least Square (OLS) hierarchical regressions were used to analyze results. Results Similar to previous studies, students’ levels of dementia stigma were low to moderate. Negative attributions were consistently and significantly higher (β = .17 to .33, p < .01), and positive attributions were significantly lower (β = −.26, p < .01) when the target person was younger rather than older. Conclusion The differences in stigmatic beliefs towards a younger and older person with AD point to the theoretical and practical importance of clearly stating the age of the target person in stigma studies as well as in programs aimed at reducing public stigma towards persons with AD.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel.
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