Knowledge gap regarding dementia care among nurses in Taiwanese acute care hospitals: A cross-sectional study

The enjoyment of life in patients with Alzheimer's disease: correlations with caregivers' perceptions, caregiving attitudes, and empowerment levels

AIMS

This study aims to analyse the current state of life enjoyment among Alzheimer's disease patients; and explore the correlations between life enjoyment of patients with Alzheimer's disease and caregiver's knowledge of Alzheimer's disease, caregiving attitudes and caregiving empowerment.

DESIGN

This research adopted a cross-sectional study approach.

METHODS

A cross-sectional survey was conducted from May to August 2024. A convenience sampling method was employed to recruit 417 inpatients with Alzheimer'sdisease and their caregivers from tertiary-level hospitals, elderly healthcare facilities, and community welfare centres in Changsha, Hunan Province, China. The data collection tools included a general information questionnaire, the Pleasant Events Scale for Patients with Dementia (PES-AD), the Alzheimer's Disease Knowledge Scale (ADKS), the Scale of Attitude Toward with Dementia (ATD) and the Empowerment Scale for Family Caregivers with Dementia (EFCD). The SPSS27.0 software was utilized to analyse the current state and influencing factors of the life enjoyment of patients with Alzheimer's disease, and to investigate the correlations among caregivers' caregiving attitudes, caregiving empowerment, knowledge level about the disease and patients' life enjoyment.

RESULTS

Patients with Alzheimer's disease obtained scores of (17.33 ± 2.71) on the Pleasant Events Scale, (15.16 ± 2.99) on the Alzheimer's Disease Knowledge Scale, (24.70 ± 1.21) on the Scale of Attitude Toward with Dementia, and (26.88 ± 1.65) on the Empowerment Scale for Family Caregivers with Dementia. The results of the Pearson's correlation analysis indicated that there was a positive correlation between the Alzheimer's disease pleasant events of patients and the knowledge, attitude, and empowerment of caregivers regarding Alzheimer's disease (P < 0.05). The results of multiple linearregression analyses showed that patients' gender, age, self-care situations, severity of diseases, caregiver's cumulative duration of caregiving, the availability of shared caregivers, and whether caring for patients feels stress, whether or not educated about AD, knowledge of Alzheimer's disease, caregiving attitudes, and caregiving empowerment were the main influences on patients' sense of life enjoyment (P < 0.05).

CONCLUSION

The life pleasure of Alzheimer's disease patients was at a medium level; caregivers' knowledge of Alzheimer's disease was at a medium level, while their caregiving attitude and caregiving empowerment were at a medium-high level. Future research can identify the most effective interventions based on caregivers' knowledge of Alzheimer's disease. This will facilitate the enhancement of disease-related health knowledge education and training, elevate caregivers' awareness of the disease, and thereby improve the life pleasure of Alzheimer's Disease (AD) patients.

IMPACT

At present, the caregiving issues for Alzheimer's Disease Patients represents a global public health challenge, with caregiving capacity also significantly impacting patients' quality of life. Thus, in order to decelerate AD progression and improve patients' quality of life, a comprehensive analysis of caregivers' Alzheimer's Disease knowledge, caregiving attitudes, caregiving empowerment, and their correlation with patient outcomes is crucial for promoting the physical and mental health of AD patients in the future.

Knowledge and Attitude of Nurses in Wuxi, China Towards Alzheimer's Disease: A Cross-Sectional Study

AIM

This study investigated knowledge and attitude towards Alzheimer's disease among nurses in China.

DESIGN

A cross-sectional design.

METHODS

A total of 186 nurses were recruited in Wuxi, China from January to March 2024. The Alzheimer's Disease Knowledge Scale and Dementia Attitudes Scale were used to evaluate nurses' knowledge and attitudes towards Alzheimer's disease. Descriptive statistics, univariate analysis and multivariate linear regression analysis were utilised to evaluate the levels and influencing factors of their knowledge and attitudes towards Alzheimer's disease.

RESULTS

The participants' average the Alzheimer's Disease Knowledge Scale and Dementia Attitudes Scale scores were 20.82 ± 2.31 (approximately 69.4% correctly) and 86.23 ± 14.14 (approximately 61.6%), respectively. Professional titles and whether or not they had received previous training about Alzheimer's Disease were among the factors affecting their dementia knowledge. Education background and workplace were the influencing factors of nurses' attitude towards dementia.

CONCLUSION

Nursing personnel in the Wuxi region demonstrate a limited understanding of Alzheimer's disease, coupled with positive attitudes towards its care. It is imperative to implement effective strategies to enhance in-service training for nurses regarding dementia. This initiative aims to elevate their level of knowledge, improve their attitudes towards dementia care, and ultimately enhance the quality of nursing provided to individuals with dementia.

Emerging trends in cognitive impairment and dementia among older populations in Asia: A systematic review

Background

Dementia and cognitive impairment rates in Asia have significant policy implications. Contrary to the existing literature, which primarily focused on the Western region, in this study, we provide novel insights into previously unexplored geographical contexts. We aimed to evaluate the prevalence of cognitive impairment and dementia in Asia.

Methods

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched six bibliographic databases: Web of Science, Medline, Science Direct, Ovid, Google Scholar, and PubMed. We targeted cross-sectional studies on dementia and cognitive impairment in Asia, published between 2019-23.

Results

Our extensive search yielded 2593 original articles, of which 39 met eligibility criteria. This selection unveiled a significant rise in dementia and cognitive impairment prevalence in Asia, aligning now with trends observed in Western countries - a novel finding that challenges previous assumptions about regional prevalence disparities. The studies predominantly conducted in East Asia (n = 29), along with limited research from Southeast (n = 2), South (n = 7), and Central Asia (n = 1), underscore the geographical gaps in current research. This shift in prevalence patterns is potentially linked to demographic changes, urbanisation, environmental factors, ethnic diversity, and neuroimaging advancements. Identifying modifiable risk factors associated with dementia in these regions presents new avenues for prevention and intervention strategies.

Conclusions

Current dementia research in Asia is concentrated in East Asia, with limited data from Southeast, South, and Central Asia. Comprehensive studies across all parts of Asia are crucial to establishing robust data collection methods and identifying modifiable risk factors. This can help manage and mitigate the growing burden of dementia in these societies.

Intervention to improve acute care nurses confidence and knowledge in hospital dementia care

PROBLEM

Acute care nurses are the front line of hospital care for persons with dementia (PwD), yet many have inadequate dementia education and lack the confidence to appropriately manage PwD in the hospital setting.

IMPLEMENTATION

Two acute care units with high rates of PwD in a large tertiary-care hospital were provided an education intervention involving interactive case-based discussion of the challenges of inpatient dementia care.

RESULTS

Out of 190 nurses, 171 completed a one-hour virtual educational session, 142 completed pre/post-session confidence surveys, and 123 completed pre/post-session knowledge tests. There was a statistically significant improvement in knowledge scores from 75.8% pre-session to 88.4% post-session (p < 0.001), and pre/post-session dementia care confidence increased from 3.49 to 4.44 ( + 27.22%; p < 0.001) CONCLUSION: An interactive virtual education intervention improves acute care nurses' confidence and knowledge in managing PwD in the acute care setting and may improve hospital outcomes for this population.

Impact of settings and culture on nurses' knowledge of and attitudes and perceptions towards people with dementia: An integrative literature review

BACKGROUND

Well-trained nurses are required to support dementia patients; however, the quality of the provided dementia nursing care can be impacted by nurses' knowledge, attitudes and perceptions towards people with dementia.

AIM

To obtain an overview of the current nursing practice towards people with dementia around the world.

DESIGN

An integrated literature review was conducted based on Whittemore and Knafl's method.

RESULTS

A total of 72 articles met the inclusion criteria. Three main themes were identified: (1) nurses' knowledge, attitudes and perceptions towards dementia; (2) nursing experience of caring for people with dementia in acute and community care settings; and (3) dementia nursing care across health regions.

CONCLUSION

Nurses play the role of facilitators in the efficient delivery of quality care for dementia patients. A variety of attitudes and perceptions towards people with dementia were found to be triggered by the severity of dementia, religion, ethnicity and gender.

IMPLICATIONS FOR PRACTICE

Healthcare organisations and educational settings need to coordinate and function together to improve nurses' knowledge and encourage positive attitudes towards people with dementia.

Increasing awareness, sensitivity, and empathy for Alzheimer's dementia patients using simulation

BACKGROUND

Alzheimer's Disease (AD), a type of dementia that interferes with memory, thinking, and behavior is the most common type of dementia. As a result, it is a leading contributor to death and disability for those over the age of 65. Therefore, future nurses must have the knowledge and skills to manage patients with AD in any setting spanning the healthcare continuum.

OBJECTIVE

The goal of this project was to evaluate perceptions of awareness, knowledge and sensitivity of future nurses concerning AD patients before and after participation in a simulated virtual reality dementia experience.

DESIGN/PARTICIPANTS

A quasi-experimental repeated measure pre-post design was used with a convenience sample of 163 undergraduate baccalaureate nursing students from three different courses at large public university in the Midwest.

METHODS

Students were placed in teams of four to participate in a 45-minute interactive simulated virtual reality dementia experience. Each session started with a 15-minute team pre-briefing session, followed by a 10-minute individual simulation, which was then followed by a 30-minute team debriefing session facilitated by faculty using the Plus/ Delta debriefing technique. The Dementia Attitudes Scale (DAS), The Knowledge About Memory Loss and Care Test (KAML-C), and the Healthcare Tour Survey were administered pre/post participation. Qualitative data was also collected from student reflections.

RESULTS

Statistically significant changes (p < 0.001) were noted in the pre/post DAS survey and the Healthcare Tour Survey. No significant change was noted on the KAML-C, although there was a trend towards improvement. No differences were noted between courses on any of the surveys.

CONCLUSION

Using a virtual reality dementia experience proved to be a valuable strategy to increase student perceptions of awareness, knowledge, and sensitivity of AD. Further exploration is warranted to establish how these may be further facilitated to translate into improved care for those with AD.

Attitudes toward people with dementia among communication science and disorders students

The purpose of this study was to: 1) explore attitudes among Communication Sciences and Disorders (CSD) students toward people with dementia, 2) investigate factors that might be associated with the expressed attitudes, and 3) suggest a means for promoting positive attitudes among CSD students. 94 CSD students completed a three-section online survey via Qualtrics. First, participants provided demographic information in three categories: person, courses, and experiences. Second, they completed a 25-item quiz on aging and dementia. Finally, each participant submitted responses to the Scale of Attitude toward People with Dementia. A stepwise regression analysis revealed two factors that best predicted positive attitudes of participants toward people with dementia. The first factor was having completed more courses on gerontology and/or dementia and the second factor was having found the courses beneficial for their future career as speech-language pathologists. The findings of this study imply that providing CSD students with more courses in gerontology and/or dementia may foster more positive attitudes toward people with dementia. These findings indicate that maximum benefit may be achieved by designing courses on gerontology and dementia that include professional practice-oriented activities and assessments.

A qualitative focus group discussion study on the experiences of Certified Nurses in Dementia Nursing related to effective staff education

Aim

To explore the experiences of Certified Nurses in Dementia Nursing (DCNs) concerning the effective education of staff in acute hospitals.

Background

In Japan, the number of inpatients with dementia who need medical care continues to increase. DCNs play an important role in educating medical staff about dementia care in acute hospitals. However, there is a lack of a clear understanding in this regard.

Design

A qualitative design using a thematic analysis.

Methods

Data were extracted from a focus group discussion conducted with 10 DCNs working in 10 different acute hospitals in central Japan. Participants answered semi-structured, open-ended questions about their experiences related to effective staff education. Categories, subcategories and themes were created. This study complied with the Standards for Reporting Qualitative Research.

Results

The two themes identified were "building a foundation for dementia care education" and "continuous support based on practical processes."

Exploring dementia care competence of nurses working in acute care settings

AIMS AND OBJECTIVES

To examine the current status of dementia care competence of nurses working in acute care settings as well as the relationship between competence and demographic attributes.

BACKGROUND

Most people with dementia are older individuals when they are admitted to unfamiliar acute care settings for treatment, and they are prone to displaying BPSD. If nurses working in acute care settings are not sufficiently competent in dementia care, providing proper patient care is difficult.

DESIGN

The study used a one-sample descriptive-correlation design.

METHODS

This study enrolled nurses at two medical centres in southern Taiwan as the research participants and performed a stratified random sampling according to the units where they served. The Dementia Care Competence Scale was used for data collection. An independent samples t test, ANOVA and Pearson's product-moment correlation were performed for data analysis (See STROBE).

RESULTS

A total of 308 valid questionnaires were collected. The results showed that dementia care competence of nurses working in acute care settings was moderate. In particular, they had insufficient knowledge of the special needs related to dementia and lacked the skills and patience necessary for identifying, preventing and managing BPSD. Additionally, although the nurses tended to have a positive attitude, they seldom communicated with people with dementia. This study also found that dementia care competence was better in nurses who were older, who had more seniority, who had taken care of people with dementia for a longer period of time and who had received training in dementia care.

CONCLUSIONS

Dementia care training topics for nurses working in acute care settings should include palliative care for dementia, skills for managing behavioural and psychological symptoms of dementia and communication techniques for improving person-centred care. Nurses should also be encouraged to maintain a warm, friendly attitude when providing patient care.

RELEVANCE TO CLINICAL PRACTICE

Continuing education in managing behavioural and psychological symptoms of dementia is necessary for currently practicing acute care nursing staff and should be developed according to the staff's educational background and needs.

Dental Hygiene Students' Attitudes and Knowledge Regarding People with Dementia: A Four-Year Prospective Study

In an increasingly aging society, dental hygienists who are prepared to provide care for patients with dementia are much needed. The aim of this study was to identify factors related to dental hygiene students' willingness to treat patients with dementia, including their attitudes towards these patients and their knowledge of the disease. All 134 students in three dental hygiene programs in Japan were invited to participate in the study; data were analyzed for 122 students (91% response rate). Students' attitudes towards patients with dementia and their knowledge of dementia were assessed in the first, second, and third years and at the end of the third year. Questionnaires were administered to assess the students' willingness to treat patients with dementia, relationship and cohabitation with individuals with dementia, and cohabitation with elderly people. For each characteristic, a higher score implied better/more favorable behavior/performance. Students' scores for attitudes towards patients with dementia peaked at the end of the third year, following a decrease earlier in the third year. Meanwhile, their scores for knowledge increased with each year. Their dementia-related attitudes and knowledge were inversely correlated in the first year, but the correlation became positive after the third year. The proportion of students who expressed willingness to treat was highest at the end of the third year, following a decline earlier in the third year. The willingness to treat was positively correlated with yearly promotion (odds ratio: 1.20 [1.01-1.43]; p=0.035) and attitudes (odds ratio: 1.08 [10.4-1.11]; p<0.001), but not with knowledge (p=0.973). These results support the idea that, to promote dental hygiene students' willingness to treat patients with dementia, it is important to cultivate in them a positive attitude towards these patients.

Attitudes towards people with dementia: a cross-sectional study comparing dental hygiene students with registered dental hygienists

OBJECTIVE

In order to adequately care for patients with dementia, it is necessary for dental hygienists to develop unprejudiced attitudes towards and obtain sufficient knowledge of dementia. The aim of this study was to assess attitudes towards and knowledge of dementia among Japanese dental hygiene students and identify related factors to the attitude and the knowledge. We compared the attitude and the knowledge between dental hygiene students and practising dental hygienists.

BACKGROUND

Dental hygienists are required to care for patients with dementia by developing appropriate attitudes towards dementia and gaining knowledge of dementia.

MATERIAL AND METHODS

Between May 2016 and July 2016, 191 third-grade dental hygiene students and 64 registered dental hygienists were surveyed. We modified questionnaires to assess attitudes towards and knowledge of dementia. Ageism was assessed using the Fraboni Ageism scale. To determine potential dementia awareness factors, information regarding participants' experiences with dementia was collected.

RESULTS

Factor analysis revealed four factors in the attitude scale (Cronbach's α, 0.652-0.820). All item-total correlation coefficients for the knowledge scale were above 0.3, and Cronbach's α was 0.827. All awareness factors for dementia were significantly different between students and registered dental hygienists. Total scores of attitude and knowledge were higher among registered dental hygienists, indicating better attitude and knowledge, but total scores of ageism were lower among registered dental hygienists, indicating worse ageism. Multiple regression analysis revealed that the attitudes towards dementia correlated with years of experience, ageism, interest in dementia and desire to work with patients with dementia.

CONCLUSION

Registered dental hygienists had more positive and more knowledge compared to dental hygiene students. Attitudes towards dementia, but not knowledge of dementia, were significantly positively correlated with ageism.

Community health professionals' dementia knowledge, attitudes and care approach: a cross-sectional survey in Changsha, China

BACKGROUND

Community health professionals play a significant role in dementia care. However, little is known about community health professionals' capacity in dementia care, especially in low and middle-income countries. The aim of the present study was to assess community health professionals' dementia knowledge, attitudes and care approach in China, a country with the largest population of people with dementia in the world and where community based dementia care services are much needed.

METHODS

A cross-sectional survey was conducted. 450 health professionals were recruited into the study using random sampling from community health service centres in Changsha, China. Their knowledge, attitudes and care approach were assessed utilising the Chinese version of the Alzheimer's Disease Knowledge Scale, Dementia Care Attitude Scale and Approach to Advanced Dementia Care Questionnaire respectively.

RESULTS

A total of 390 participants returned the questionnaire (response rate 87%). Age, education, professional group and care experience were associated with knowledge scores, and overall dementia knowledge was poor. Attitudes were generally positive and influenced by age, professional group, gender and care experience. The experience of caring for people with dementia was positively associated with a person-centred care approach, although the participants tended not to use a person-centred care approach. A statistically significant association was found between knowledge and attitudes (r = 0.379, P < 0.001), and between attitudes and care approach (r = 0.143, P < 0.001). However, dementia knowledge has no relationship with a person-centred approach.

CONCLUSIONS

Community health professionals showed generally positive attitudes towards people with dementia. However, they demonstrated poor dementia knowledge and tended not to use a person-centred care approach. The results suggest that a multifaceted approach consisting of educational interventions for community health professionals, and policy and resource development to meet the demand for community dementia care services, is urgently needed in China.