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Schwarz B, Richardson M, Camp K. Impact of a short-duration experiential learning activity on DPT students' attitudes toward patients living with a dementia. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:276-288. [PMID: 36774647 DOI: 10.1080/02701960.2023.2177648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Healthcare practitioners (HCP) have expressed inadequate preparation in providing care to patients living with a dementia. Research suggests experiential learning activities (ELAs) can improve HCP knowledge and comfort toward this population. The purpose of this study was to evaluate the impact of a short-duration (2-hour) dementia ELA on Doctor of Physical Therapy (DPT) students' knowledge and comfort toward individuals living with a dementia. Participants included a sample of first-year DPT students (n=82). In this pre-experimental, single-site, longitudinal study, students participated in an ELA at a memory care facility. They completed a dementia knowledge and comfort survey pre-(T1) and post-ELA(T2), as well as prior to their first clinical experience (nine months post-ELA; T3). Pre- and post-survey analysis demonstrated significant improvements between T1 to T2 and T1 to T3 with overall effect sizes ranging from very large (d=1.256) to huge (d=1.520). There were no significant differences between T2 to T3 analysis. Students demonstrated positive improvements in attitudes toward individuals living with a dementia following this ELA. Improvements were maintained over time. An ELA as short as two hours may improve person-centered care for patients living with a dementia. These types of activities should be considered for inclusion in DPT curricula.
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Affiliation(s)
- Brandy Schwarz
- Doctor of Physical Therapy Program, Hawai'i Pacific University, Honolulu, USA
| | - Mike Richardson
- Department of Physical Therapy, Hanover College, Hanover, USA
| | - Kathlene Camp
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, USA
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Munsterman E, Perez A, Hodgson N, Cacchione P. Dementia friendly in the context of hospitalization: A concept analysis using the Walker & Avant Method. J Adv Nurs 2024. [PMID: 38433345 DOI: 10.1111/jan.16133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/06/2023] [Accepted: 02/17/2024] [Indexed: 03/05/2024]
Abstract
AIM(S) To evaluate the literature to inform and propose a conceptual definition for dementia friendly in the context of hospitalization. METHODS The Walker & Avant method for concept analysis was utilized for this review. DATA SOURCES (INCLUDE SEARCH DATES) Initial search conducted June 2022. Repeated search conducted in February 2023. Databases for the literature search include Scopus, PubMed, CINAHL, PsycINFO, and AGELINE. RESULTS Five attributes of the concept of dementia friendly in the context of hospitalization were identified including: staff knowledge/education, environmental modification, person-centred care, nursing care delivery and inclusion of family caregivers. Based on these attributes a conceptual definition is proposed. CONCLUSION A clarified definition for dementia friendly in the context of hospitalization will aid in understanding the concept, provide guidance for hospitals seeking to implement dementia-friendly interventions and benefit researchers aiming to study the impact of such programs. REPORTING METHOD: n/a. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
| | - Adriana Perez
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nancy Hodgson
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Lu JY, Lee YH, Wang YF. Dilemmas and support strategies in dementia care: Experiences of case managers in Taiwan. DEMENTIA 2024; 23:234-250. [PMID: 38055838 DOI: 10.1177/14713012231221025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Objective: This study aimed to examine the dilemmas encountered and the countermeasures adopted by case managers, who care for individuals with dementia. The study also aimed to identify the types of support and assistance case managers require.Methods: In this qualitative study, the researchers conducted semi-structured interviews with 10 case managers, six from integrated dementia care centers and four from community-based dementia care centers in Taiwan.Results: The results are as follows: (1) Case managers providing services for individuals with dementia primarily encountered two major dilemmas, including cognitive differences (such as a lack of understanding of dementia, differences in ideas about dementia care, and distrust of the professionalism of case managers) with family members and their own insufficient professional capabilities, which made it difficult to reach a consensus on caregiving with family members and address the diverse conditions of individuals with dementia. (2) In response to these dilemmas, case managers adopted various approaches to enhance families' understanding of dementia and facilitate reaching a consensus on care. They also improved their professional capabilities through team discussions and resource networking. (3) The support and assistance required by case managers are continuous learning, the enhancement of their professional competencies, organizational support, and workload management.Conclusion: The findings of this study contribute to an understanding of the dilemmas faced by case managers in Taiwan's centers for integrated dementia care and community-based dementia care centers during policies implementation, as well as the strategies they adopted and the assistance they required. These results can also offer recommendations for policies, professional training, dementia services, and resources to reduce the disparity between policy and practice.
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Affiliation(s)
- Jing-Yi Lu
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Ya-Hui Lee
- Department of Adult and Continuing Education, National Chung Cheng University, Chiayi, Taiwan
| | - Yi-Fen Wang
- Department of Senior Citizen Services, National Tainan Junior College of Nursing, Tainan, Taiwan
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Gurtmann S, Schwahn C, Krüger M, Janowitz D, Pilz K, Biffar R, Grabe HJ, Söhnel A. Proposing a communication module to enhance dental students' attitudes towards people with dementia: Phase 1 of a curriculum revision study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:251-258. [PMID: 37550952 DOI: 10.1111/eje.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/17/2023] [Accepted: 07/08/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION The number of mentally altered patients a dentist meets in practice is increasing and interaction with them can be very challenging. As a baseline for an interventional study, we want to assess the attitude of dental students and identify areas of improvement in patient communication. This work compares the attitude of dental students towards people suffering from dementia to the attitudes of trained medical caregivers and the general population. Our aim is to use the results to assess the need for training in communicating with mentally altered patients. MATERIALS AND METHODS Fourth-year dental students attended two lectures on dementia given by a psychiatrist as part of the geriatric dentistry lecture and were questioned afterwards using the Dementia Attitude Scale. In 2016 and 2017, 73 students at the University of Greifswald were interviewed. The response rate was 84%. Using a factor analysis, the Dementia Attitude Scale's validated questions were interpreted and compared with data from nursing staff from Switzerland and the USA. RESULTS The factor analysis of the data showed the same two-factor loadings as the comparative groups, and that dental students' attitude is more comparable to the general population than to medically trained nursing staff. CONCLUSION Given the results, we conclude that the implementation of a communication module can serve in improving the attitude of dental students towards patients with dementia.
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Affiliation(s)
- Sonja Gurtmann
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Markus Krüger
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Kristin Pilz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Reiner Biffar
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Hans-J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Andreas Söhnel
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
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Chenoweth L, Burley C, Cook J, Cheah SL, Reyes P, Maiden G, McGuire J, McCade D, Brodaty H, Sukhapure M, Harrison F, Williams A. Improving Healthcare Quality and Clinical Outcomes for Persons with Dementia in the Sub-Acute Hospital Through Person-Centered Care Practice. J Alzheimers Dis 2024; 98:619-628. [PMID: 38427481 DOI: 10.3233/jad-231056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Person-centered care is considered beneficial for persons with dementia. Objective To evaluate the impact of a person-centered knowledge translation intervention on the quality of healthcare and outcomes for persons with dementia. Methods Over nine months, sub-acute hospital nursing, allied health, and medical staff (n = 90) participated in online and/or face-to-face person-centered education and were supported by senior nursing, allied health, and medical staff champions (n = 8) to implement person-centered healthcare. The quality of healthcare service, ward climate and care delivery were evaluated pre/post study intervention. In the week following hospital admission (Time 1) and week of discharge (Time 3), agitation incidence (co-primary outcome) was assessed in participants with dementia (n = 80). Participant delirium (co-primary outcome), accidents/injuries, psychotropic medicines, length of stay, readmission and discharge destination (secondary outcomes) were compared with a retrospective group (n = 77) matched on demographics, cognition and function in activities of daily living. Results Improvements occurred post-intervention in service quality by 17.5% (p = 0.369, phi = 0.08), ward climate by 18.1% (p = 0.291, phi = 0.08), and care quality by 50% (p = 0.000, phi = 0.37). Participant agitation did not change from Time 1 to Time 3 (p = 0.223). Relative to the retrospective group, significant reductions occurred in participant delirium (p = 0.000, phi = 0.73), incidents/injuries (p = 0.000, phi = 0.99), psychotropic medicine use (p = 0.030, phi = 0.09), and hospital readmissions within 30 days (p = 0.002, phi = 0.25), but not in discharge to home (p = 0.171). Conclusions When person-centered healthcare knowledge is translated through staff education and practice support, persons with dementia can experience improved healthcare services and clinical outcomes, while healthcare services can benefit through reductions in unplanned service use.
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Affiliation(s)
- Lynn Chenoweth
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Australia
| | - Claire Burley
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Australia
| | - Jacquelene Cook
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Australia
- Department of Aged Health, Chronic Care and Rehabilitation, Concord Hospital, Sydney, Australia
| | - Seong-Leang Cheah
- Research Unit, Justice Health and Forensic Mental Health Network, AGSM (G27), UNSW, Sydney, Australia
| | - Patricia Reyes
- War Memorial Hospital, St Vincent's Hospital Health Network, Sydney, Australia
- Discipline of Medicine, UNSW Medicine and Health, UNSW, Sydney, Australia
| | - Genevieve Maiden
- War Memorial Hospital, St Vincent's Hospital Health Network, Sydney, Australia
| | - Jane McGuire
- War Memorial Hospital, St Vincent's Hospital Health Network, Sydney, Australia
| | - Donna McCade
- War Memorial Hospital, St Vincent's Hospital Health Network, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Australia
| | - Mayouri Sukhapure
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Australia
| | - Fleur Harrison
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Australia
| | - Anna Williams
- School of Nursing and Midwifery, Western Sydney University, NSW, Penrith, Australia
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Hauer K, Dutzi I, Werner C, Bauer J, Ullrich P. Delirium Prevention in Early Rehabilitation During Acute Hospitalization and Implementation of Programs Specifically Tailored to Older Patients with Cognitive Impairment: A Scoping Review with Meta-Analysis. J Alzheimers Dis 2024; 97:3-29. [PMID: 38073387 DOI: 10.3233/jad-230644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
BACKGROUND No systematic review on delirium prevention within early, hospital-based rehabilitation on implementation of approaches specifically tailored for patients with cognitive impairment (PwCI), such as Alzheimer's disease or vascular dementia, has been published despite the high relevance of specific medical care in this vulnerable population. OBJECTIVE To document design and effectiveness of delirium prevention programs by early rehabilitation during acute, hospital-based medical care and implementation of programs specifically tailored to PwCI. METHODS In a three-step approach, we first identified published systematic reviews of hospital-based, early rehabilitation interventions for older persons (>65 years) in relevant databases. In a second step, we screened each single trial of included reviews according to predefined inclusion criteria. In a third step, we analyzed studies with focus on delirium prevention. RESULTS Among n = 25 studies identified, almost all intervention programs did not specifically target cognitive impairment (CI). Interventions were heterogeneous (modules: n = 2-19); almost all study samples were mixed/unspecified for cognitive status with more affected patients excluded. Only one study exclusively included delirium patients, and only one included CI patients. Results of random effect meta-analysis showed significant effects of generic programs to reduce delirium incidence during hospitalization by 41% (p < 0.001, odds ratio, 95% confidence interval: 0.59 [0.49, 0.71] with modest heterogeneity (I2: 30%). CONCLUSIONS Study results document a lack of implementation for delirium prevention programs specifically tailored to PwCI by early, hospital-based rehabilitation. Specifying existing rehab concepts or augmenting them by CI-specific modules may help to develop, optimize, and implement innovative delirium prevention in PwCI in acute medical care.
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Affiliation(s)
- Klaus Hauer
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
- Robert Bosch Gesellschaft für Medizinische Forschung mbH, Stuttgart, Germany
| | - Ilona Dutzi
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Christian Werner
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen Bauer
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Phoebe Ullrich
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
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Manietta C, Purwins D, Reinhard A, Feige M, Knecht C, Alpers B, Roes M. Contextualizing the results of an integrative review on the characteristics of dementia-friendly hospitals: a workshop with professional dementia experts. BMC Geriatr 2023; 23:678. [PMID: 37858073 PMCID: PMC10585930 DOI: 10.1186/s12877-023-04312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/13/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND To become a dementia-friendly hospital (DFH) is increasingly being discussed in health care practice, research, politics and society. In our previous integrative review, we identified six characteristics of DFHs. To thoroughly discuss and contextualize these characteristics in relation to hospitals in Germany, we involved professional dementia experts in our review process. METHODS At the end of our review process, we involved professional dementia experts at the 'contributing' level of the ACTIVE framework to discuss and reflect on the six DFH characteristics we identified. We conducted a group process in the form of a one-day workshop. The workshop consisted of four steps: 1. presentation of review results (input), 2. modification of DFH characteristics and rating of their relevance in smaller working groups, 3. discussion of group results in plenary and 4. questionnaire for prioritization and rating of feasibility. The data were analyzed in MAXQDA using content analysis and descriptive statistics. RESULTS A total of 16 professional dementia experts working in hospitals participated in the workshop. All the previously identified characteristics of a DFH were rated as relevant or very relevant for patients with dementia, their relatives and health care professionals from the professional dementia experts' perspective. They made a few modifications of the six characteristics at the level of subcategories, aspects, and descriptions. The feasibility of the characteristics in hospitals was critically discussed regarding resources, hospital structures and processes, the role of nurses, and the current care situation of people with dementia in hospitals. More than half of the subcategories of the characteristics were considered very difficult or difficult to implement by most professional dementia experts. CONCLUSION The involvement of professional dementia experts helped us contextualize our review findings within the German hospital setting. These results highlight the need to consider resources, funding options, influencing factors, and the current situation and culture of care provided by hospitals before implementing DFH characteristics. Beside the involvement of professional dementia experts and various health care professionals, the involvement of other stakeholders, such as people with dementia and their relatives, is necessary in future research for the development of a DFH.
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Affiliation(s)
- Christina Manietta
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany.
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
| | - Daniel Purwins
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Anneke Reinhard
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
| | - Melanie Feige
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Knecht
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
- FH Münster University of Applied Sciences, Münster, Germany
| | - Birgit Alpers
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Roes
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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Duarte N, Alves S, Gomes B. Evaluation of a Dementia Training Course for Staff of a Center of Dementia Care. Dement Geriatr Cogn Disord 2023; 52:205-213. [PMID: 37257431 PMCID: PMC10614232 DOI: 10.1159/000529856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/13/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Literature shows poor dementia training and competencies among health and social professionals. Due to the growing prevalence of people with dementia and all the related care demands, specialized training is increasingly needed but must be effective in terms of impact on knowledge, behaviors, and attitudes. We aimed to analyze the impact of a first-level dementia training course for staff of a new specialized center for people with dementia, considering the first three levels of Kirkpatrick's evaluation framework, namely, staff reaction (satisfaction), skills and learning (knowledge and dementia attitudes), and behavior changes. METHODS This is a single-center group pre-post design study of a 12-session online course. An online questionnaire was administered to measure satisfaction, expectations, knowledge/learning, attitudes (Dementia Attitude Scale), and new behaviors/practices. We compared perceived knowledge (Wilcoxon signed-rank test) and attitudes (paired t test). Thematic analysis explored new behaviors/practices. RESULTS Eighty-five professionals and 1 volunteer were included (median age 31, 92% female). Satisfaction with the training was high (median 4/5). Perceived knowledge improved (median 3-4; p < 0.001). The knowledge test median score was 70.8%. After training, participants showed better attitudes toward dementia (mean 116.5, SD 10.3, to mean 122.2, SD 11.5; p < 0.001). Most (93%) said their behavior/practice changed. Thematic analysis yielded four new behavior/practice dimensions: care provision/interaction, communication, family/caregivers, and self-confidence. CONCLUSIONS The course improved all dimensions evaluated, suggesting it effectively provides first-level dementia training. This may be transferable to similar settings.
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Affiliation(s)
- Natália Duarte
- Santa Casa da Misericórdia de Riba D’Ave, CIDIFAD – Centro de Investigação, Diagnóstico, Formação e Acompanhamento das Demências, Riba de Ave, Portugal
- CINTESIS@RISE, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Sara Alves
- Santa Casa da Misericórdia de Riba D’Ave, CIDIFAD – Centro de Investigação, Diagnóstico, Formação e Acompanhamento das Demências, Riba de Ave, Portugal
- CINTESIS@RISE, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Barbara Gomes
- Santa Casa da Misericórdia de Riba D’Ave, CIDIFAD – Centro de Investigação, Diagnóstico, Formação e Acompanhamento das Demências, Riba de Ave, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- King’s College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
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García-Sanjuán S, Esteve-Ríos A, Fernández-Alcántara M, Valero-Soriano M. Experience of Operating Room Health Care Providers in the Management of Patients With Dementia. Res Gerontol Nurs 2023; 16:125-133. [PMID: 36881009 DOI: 10.3928/19404921-20230301-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
The management of hospitalized patients with dementia is more complicated compared to patients without dementia, specifically in the surgery ward. The aim of the current study was to explore the experiences of operating room health care providers in the management of patients with dementia. A descriptive qualitative study was designed. Twenty semi-structured interviews were conducted with surgical professionals. Content analysis was performed. Four main themes emerged: Communication Issues, Experience-Based Protocol, Emotions, and Perceived Needs. Health care providers in a surgical ward face numerous challenges when attending to patients with dementia and tend to use strategies based on their own experience due to lack of specific action protocols. Therefore, specific training of the surgical team and protocols are needed to ensure quality care. [Research in Gerontological Nursing, xx(x), xx-xx.].
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Paul P, Mahfoud ZR, Malik RA, Kaul R, Muffuh Navti P, Al-Sheikhly D, Chaari A. Knowledge, Awareness, and Attitude of Healthcare Stakeholders on Alzheimer's Disease and Dementia in Qatar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4535. [PMID: 36901551 PMCID: PMC10002196 DOI: 10.3390/ijerph20054535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Dementia is characterized by progressive cognitive decline, memory impairment, and disability. Alzheimer's disease (AD) accounts for 60-70% of cases, followed by vascular and mixed dementia. Qatar and the Middle East are at increased risk owing to aging populations and high prevalence of vascular risk factors. Appropriate levels of knowledge, attitudes, and awareness amongst health care professionals (HCPs) are the need of the hour, but literature indicates that these proficiencies may be inadequate, outdated, or markedly heterogenous. In addition to a review of published quantitative surveys investigating similar questions in the Middle East, a pilot cross-sectional online needs-assessment survey was undertaken to gauge these parameters of dementia and AD among healthcare stakeholders in Qatar between 19 April and 16 May 2022. Overall, 229 responses were recorded between physicians (21%), nurses (21%), and medical students (25%), with two-thirds from Qatar. Over half the respondents reported that >10% of their patients were elderly (>60 years). Over 25% reported having contact with >50 patients with dementia or neurodegenerative disease annually. Over 70% had not undertake related education/training in the last 2 years. The knowledge of HCPs regarding dementia and AD was moderate (mean score of 5.3 ± 1.5 out of 7) and their awareness of recent advances in basic disease pathophysiology was lacking. Differences existed across professions and location of respondents. Our findings lay the groundwork for a call-to-action for healthcare institutions to improve dementia care within Qatar and the Middle East region.
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Affiliation(s)
| | - Ziyad Riyad Mahfoud
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, NY 10065, New York, USA
| | - Rayaz A. Malik
- Division of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, UK
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| | | | - Phyllis Muffuh Navti
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Deema Al-Sheikhly
- Division of Medical Education, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
- Division of Continuing Professional Development, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Ali Chaari
- Premedical Division, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
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Sullivan TO, McVeigh JG, Timmons S, Foley T. Education and training interventions for physiotherapists working in dementia care: a scoping review. Physiotherapy 2022; 119:89-99. [PMID: 36972651 DOI: 10.1016/j.physio.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/14/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Physiotherapy plays a key role in many aspects of dementia care, most notably in maintaining mobility. However, there is a lack of dementia care training at undergraduate and postgraduate level, and more importantly, a paucity of evidence as to what constitutes effective dementia education and training for physiotherapists. The aim of this scoping review was to explore and map the evidence, both quantitative and qualitative, relating to education and training for physiotherapists. DESIGN This scoping review followed the Joanna Briggs Institute methodology for scoping reviews. A chronological narrative synthesis of the data outlined how the results relate to the objectives of this study. SETTING All studies, both quantitative and qualitative on dementia education and training conducted in any setting, including acute, community care, residential or any educational setting in any geographical area were included. PARTICIPANTS Studies that included dementia education and training for both qualified and student physiotherapists were considered RESULTS: A total of 11 papers were included in this review. The principal learning outcomes evaluated were knowledge, confidence, and attitudes. Immediate post- intervention scores showed an improvement in all three outcomes. The Kirkpatrick four level model was used to evaluate the level of outcome achieved. Most educational interventions reached Kirkpatrick level 2, which evaluates learning. A multi-modal approach, with active participation and direct patient involvement seems to enhance learning. CONCLUSIONS Allowing for the heterogeneity of intervention design and evaluation, some common components of educational interventions were identified that led to positive outcomes. This review highlights the need for more robust studies in this area. Further research is needed to develop bespoke dementia curricula specific to physiotherapy. CONTRIBUTIONS OF THE PAPER.
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Yang T, Gong D, Peng Y, Yang Y. Effects and influencing factors of Internet-based training on primary prevention of dementia among primary health care workers. NURSE EDUCATION TODAY 2022; 116:105454. [PMID: 35785654 DOI: 10.1016/j.nedt.2022.105454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Existing evidence-based guidelines and summaries on dementia prevention are not effectively disseminated and used by primary health care workers in developing countries. As such, the lack of knowledge and skills is a major obstacle to dementia prevention and has posed a need for relevant training. OBJECTIVES To evaluate the effects of an Internet-based dementia-related training program with the aim to improve the competence of primary health care workers to early detection of symptoms of memory disorder and dementia, and to provide effective guidance and consultation for residents. DESIGN A survey with 12 weeks follow-up. SETTINGS An Internet-based training program was conducted in four primary healthcare institutions in China between April and September 2020. PARTICIPANTS Primary health care workers, including doctors and nurses. METHODS A localized Internet-based training program on primary prevention of dementia for primary health care workers was built, based on existing guidelines. Self-made measures were used to evaluate the knowledge, self-efficacy, and behavioral intentions of primary health care workers. Data were collected before the training (T0), after the training (T1), and Week 12 after the training (T2). Differences between the different time points were tested using a generalized estimation equation. RESULTS There were 268 study participants, 120 of whom completed the training and the questionnaire three times consecutively. At T1 and T2, the knowledge, self-efficacy, and behavioral intention scores were higher than those at T0 (all B > 0, all p < 0.05. The knowledge scores were influenced by age, years of work, and occupation of participants. The self-efficacy and behavioral intention scores were influenced by age, dementia training history, and reception of complaints of memory loss. Eighty percent of the participants were satisfied with the training. CONCLUSIONS This study confirmed that Internet-based training on the primary prevention of dementia is highly accepted and improves the knowledge, self-efficacy, and behavioral intention of primary health care workers.
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Affiliation(s)
- Tiantian Yang
- School of Nursing, Third Military Medical University/Army Medical University, Chongqing, China
| | - De Gong
- School of Nursing, Third Military Medical University/Army Medical University, Chongqing, China
| | - Yan Peng
- School of Nursing, Third Military Medical University/Army Medical University, Chongqing, China
| | - Yanni Yang
- School of Nursing, Third Military Medical University/Army Medical University, Chongqing, China.
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13
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Carpenter CR, Leggett J, Bellolio F, Betz M, Carnahan RM, Carr D, Doering M, Hansen JC, Isaacs ED, Jobe D, Kelly K, Morrow-Howell N, Prusaczyk B, Savage B, Suyama J, Vann AS, Rising KL, Hwang U, Shah MN. Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review. J Am Med Dir Assoc 2022; 23:1313.e15-1313.e46. [PMID: 35940681 PMCID: PMC10802113 DOI: 10.1016/j.jamda.2022.02.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research. DESIGN Systematic scoping review. SETTINGS AND PARTICIPANTS PLWD and their care partners in the ED setting. METHODS Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized. RESULTS From 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication. CONCLUSIONS AND IMPLICATIONS Research exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange.
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Affiliation(s)
- Christopher R Carpenter
- Department of Emergency Medicine, Washington University in St. Louis School of Medicine, Emergency Care Research Core, St. Louis, MO, USA.
| | - Jesseca Leggett
- Department of Emergency Medicine, Washington University in St. Louis School of Medicine, Emergency Care Research Core, St. Louis, MO, USA
| | | | - Marian Betz
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA
| | - Ryan M Carnahan
- Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, IA, USA
| | - David Carr
- Department of Medicine and Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Michelle Doering
- Becker Medical Library, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | | | - Eric D Isaacs
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Deborah Jobe
- Person Living with Dementia, 2021-2022 Alzheimer's Association National Early Stage Advisory Group, St. Louis MO, USA
| | | | - Nancy Morrow-Howell
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Beth Prusaczyk
- Department of Medicine, Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Bob Savage
- Person Living with Dementia, LiveWell Alliance, Plantsville, CT, USA
| | - Joe Suyama
- Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Kristin L Rising
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ula Hwang
- Department of Emergency Medicine, Yale University, New Haven, CT, USA
| | - Manish N Shah
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA
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14
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Chenoweth L, Williams A, Fry M, Endean E, Liu Z. Outcomes of Person-centered Care for Persons with Dementia in the Acute Care Setting: A Pilot Study. Clin Gerontol 2022; 45:983-997. [PMID: 34229578 DOI: 10.1080/07317115.2021.1946233] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This pilot study assessed clinical outcomes and quality care for persons with dementia in an acute hospital with PCC, compared with usual care. METHODS Forty-seven consented persons 60 years and over with dementia were assigned to PCC (n = 26) or usual care (control) (n = 21). Hospital nurses and allied health staff received 3 h of face-to-face education in PCC, and practice support by four PCC-trained nurse champions. Control group staff received 3 h of face-to-face education on dementia and delirium care clinical guidelines. Primary outcomes behavioral/neuropsychiatric symptoms and care quality were analyzed based on repeated measures at baseline (Time 1), 4-5 days after baseline (Time 2) and day 8-10 after baseline (Time 3) where available. RESULTS Compared with controls, at Time 2 PCC produced statistically significant improvements in behavioral/neuropsychiatric symptoms (adjusted p = .036) and care quality (adjusted p = .044). Where length of stay exceeded 8 days after baseline (Time 3), there was a sustained improvement in quality care (p = .007), but not in behavioral/neuropsychiatric symptoms (p = .27). CONCLUSIONS PCC can improve care quality for persons with dementia; nursing; agitation; paid caregivers with dementia and reduce behavioral/neuropsychiatric symptoms during short hospital stays. CLINICAL IMPLICATIONS Hospital systems need to support PCC to reduce behavioral/neuropsychiatric symptoms in dementia during long hospital stays.
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Affiliation(s)
- Lynn Chenoweth
- Centre for Healthy Brain Ageing, Faculty of Medicine, University of New South Wales (Sydney), Sydney, NSW, Australia
| | - Anna Williams
- School of Nursing (Sydney), The University of Notre Dame Australia, Fremantle, NSW, Australia
| | - Margaret Fry
- Northern Sydney Local Health District, Sydney; Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Zhixin Liu
- Stats Central, University of New South Wales (Sydney), Sydney, NSW, Australia
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15
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Rosi A, Govoni S, Del Signore F, Tassorelli C, Cappa S, Allegri N. Italian Dementia-Friendly Hospital Trial (IDENTITÀ): efficacy of a dementia care intervention for hospital staff. Aging Ment Health 2022; 27:921-929. [PMID: 35773241 DOI: 10.1080/13607863.2022.2084507] [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] [Indexed: 11/01/2022]
Abstract
This study investigated the short-term impact and the retention of a dementia care intervention for healthcare staff working in an Italian acute hospital setting. Additionally, we identified the predictors of improvement across the intervention. Sixty-two healthcare staff from an Italian public hospital participated in a dementia care intervention consisting of 5 modules delivered in a 5-hour training program focusing on dementia management, knowledge, and care. A pre-test/post-test and six-months follow-up design was used to evaluate participants' changes in knowledge, attitudes, and confidence in dementia. The intervention significantly improved healthcare staff's dementia knowledge and confidence immediately after the end of the intervention. No significant changes were observed from post-test to follow-up, indicating retention of these outcomes over six months. Regarding attitude to dementia, we found an immediate improvement only in the Recognition of Personhood scale. Looking at the predictors of improvement, healthcare staff with lower levels of knowledge, attitudes, and confidence in dementia at pre-test were those who improved more following the intervention. These findings provide further evidence that dementia care interventions are suitable initiatives to promote knowledge and skills required to manage the needs of people with dementia in an acute hospital setting.
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Affiliation(s)
- Alessia Rosi
- Brain and Behavioral Sciences Department, University of Pavia, Pavia, Italy
| | - Stefano Govoni
- Drug Sciences Department, University of Pavia, Pavia, Italy.,CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Federica Del Signore
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Brain and Behavioral Sciences Department, University of Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Cappa
- IRCCS Mondino Foundation, Pavia, Italy.,University School for Advanced Studies, IUSS, Pavia, Italy
| | - Nicola Allegri
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
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16
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Teichmann B, Gkioka M, Kruse A, Tsolaki M. Informal Caregivers' Attitude Toward Dementia: The Impact of Dementia Knowledge, Confidence in Dementia Care, and the Behavioral and Psychological Symptoms of the Person with Dementia. A Cross-Sectional Study. J Alzheimers Dis 2022; 88:971-984. [PMID: 35723101 PMCID: PMC9484115 DOI: 10.3233/jad-215731] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Dementia is rapidly increasing worldwide due to demographic aging. More than two-thirds of patients are cared by family members. The quality of care depends on the caregivers' attitude toward dementia influencing patient care decisions. OBJECTIVE The aim of this study is to examine the factors that influence the caregivers' attitude and whether there is an association between participation in a psycho-educational program and attitude. METHODS We performed a cross-sectional study using a structured closed-ended questionnaire to retrieve socio-demographic information from caregivers and the persons with dementia (N = 86). The study included validated scales such as the Dementia Attitude Scale, the Dementia Knowledge Assessment Tool 2, the Positive Aspects of Caregiving, the Zarit Burden Interview, the Confidence in Dementia Scale, and Spielberger's State-Trait Anxiety Inventory, as well as a neuropsychological battery to assess the condition of people with dementia. RESULTS Our final model explains 55.6% of the total variance and shows a significant correlation of five factors with attitude toward dementia: confidence, behavioral and psychological symptoms of dementia, anxiety as a trait, positive aspects of caregiving, and dementia knowledge. The caregivers who participated in a psycho-educational program showed a significantly more positive attitude toward dementia, better dementia knowledge, higher confidence in dementia care, and lower anxiety as a state. CONCLUSION The strong correlation of attitude and knowledge, as well as confidence in dementia care, supports the tripartite model of attitude, which hypothesizes the interrelation of affect, cognition, and behavior.
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Affiliation(s)
- Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Mara Gkioka
- Network Aging Research, Heidelberg University, Heidelberg, Germany.,School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Kruse
- Institute for Gerontology, Heidelberg University, Heidelberg, Germany
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
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17
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Kristiansen S, Olsen LS, Beck M. Hospitality in dementia-friendly environments is significant to caregivers during hospitalisation of their loved ones. A qualitative study. J Clin Nurs 2022; 32:2790-2801. [PMID: 35692079 DOI: 10.1111/jocn.16400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/07/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVES To explore what is meaningful to caregivers in relation to a dementia-friendly environment during hospitalisation of their loved ones with dementia or cognitive impairment. BACKGROUND Implementation of dementia-friendly initiatives and person-centred care approach have shaped the political agenda within Danish society. Patients with dementia or cognitive impairment and their accompanying caregivers are challenged when admitted to hospital. During hospitalisation, caregivers find themselves in a vulnerable state of mind. Thus, the implementation of a dementia-friendly environment and adherence to person-centred care in hospital settings leaves room for improvement. METHODS This study was guided by a qualitative and explorative approach. Data were collected through 17 semi-structured interviews with caregivers at a subacute neurological ward. Thematic analysis was employed to interpret data. The study reports according to the COREQ checklist. RESULTS The following three themes were identified: 1) Being a watchful bystander. 2) Visiting an undefined and foreign environment. 3) Longing for kindness. CONCLUSION Hospitality expressed by staff towards caregivers is significant in allowing caregivers to experience hospital environments as "friendly." Dementia-friendly environments embrace existential aspects that go far beyond physical spaces; hence, experiences of kind acts shape caregivers' sense of safety and comfort during hospitalisation. Hospitality is an essential part of nursing in dementia care because caregivers are contextually vulnerable. Our study sheds new light on the provision of person-centred care to people with dementia and their families in healthcare. RELEVANCE TO CLINICAL PRACTICE Nurses need to be aware that caregivers experience vulnerability and to involve caregivers in the care provided for patients with dementia. We recommend that a permanent contact person be appointed to follow patients throughout their admission period. Furthermore, systematic interventions focusing on phenomena such as hospitality and kindness may serve to form a person-centred clinical culture; an issue that warrants further investigation.
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Affiliation(s)
| | - Lotte Schelde Olsen
- Department of Neurology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Malene Beck
- Institute of Health, Department of Nursing Science, Aarhus University, Copenhagen, Denmark.,Research Unit of Progrez, NSR Hospitals, Zealand University, Roskilde, Denmark
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18
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Manietta C, Purwins D, Reinhard A, Knecht C, Roes M. Characteristics of dementia-friendly hospitals: an integrative review. BMC Geriatr 2022; 22:468. [PMID: 35641899 PMCID: PMC9158310 DOI: 10.1186/s12877-022-03103-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dementia-friendly initiatives are becoming common in society, politics, and research, including health care. Regarding efforts to improve care for patients with dementia in hospitals, the term dementia-friendly hospital is being used increasingly. However, a theoretical understanding of this term and the underlying concept are missing. This integrative review aims to identify current descriptions of dementia-friendly hospitals and to analyze their characteristics. METHODS An integrative review was conducted. The databases MEDLINE, CINAHL, PsycInfo, Cochrane Library, and additional resources were searched. Two reviewers independently screened publications for inclusion. We extracted data from the included publications and analyzed the descriptions of dementia-friendly hospitals using inductive content analysis in an iterative process. RESULTS We identified 4191 records and included 34 publications on 17 descriptions of dementia-friendly hospitals. These were found in the context of practice projects (n = 8), recommendations (n = 6) and research (n = 3). Our analysis resulted in six characteristics of dementia-friendly hospitals. Characteristics related to the patients and their care are continuity, person-centeredness, consideration of phenomena within dementia and environment. Additional characteristics are valuing relatives and knowledge and expertise within the hospital. CONCLUSION Dementia-friendly hospitals are currently characterized more by healthcare practices and professional dementia experts than by the results of empirical studies. Additionally, the perspective of people with dementia is underrepresented in current descriptions. Accordingly, further research is needed that involves people with dementia in order to develop a theoretical understanding and suitable concepts of dementia-friendly hospitals, since their perspective is essential.
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Affiliation(s)
- Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany. .,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
| | - Daniel Purwins
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany.,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Anneke Reinhard
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany
| | - Christiane Knecht
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.,FH Münster University of Applied Sciences, Münster, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany.,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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19
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Mickelson Weldingh N, Kirkevold M. What older people and their relatives say is important during acute hospitalisation: a qualitative study. BMC Health Serv Res 2022; 22:578. [PMID: 35488250 PMCID: PMC9052562 DOI: 10.1186/s12913-022-07981-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the growing population of older people across the world, providing safe and effective care is an increasing concern. Older persons in need for hospitalisation often have, or are susceptible to develop, cognitive impairment. Hospitals need to adapt to ensure high-quality care for this vulnerable patient group. Several age-friendly frameworks and models aiming at reducing risks and complications have been promoted. However, care for older people must be based on the persons' reported needs, and relatives are often an important part of older persons' social support. The primary aim of this study was to explore older peoples' and their relatives' experiences of acute hospitalisation and determine what is important for them to experience a good hospital stay. The study was not limited to patients with cognitive impairment; but included a wider group of older individuals vulnerable to developing delirium, with or without an underlying chronic cognitive impairment. METHODS This study had a qualitative research design in which people aged 75 years or older and their relatives were interviewed during an acute hospitalisation. The study was conducted at two medical wards at a large university hospital in Norway, and included a total of 60 participants. All interviews were informed by a semi-structured interview guide and were thematically analysed. RESULTS Four major themes were identified in the older people's and the relatives' descriptions of how they experienced the hospital stay and what was important for them during the hospital stay: being seen and valued as a person, individualised care, patient-adapted communication and information, and collaboration with relatives. The themes span both positive and negative experiences, reflecting great variability in the experiences described. The presence of these four characteristics promoted positive experiences among patients and relatives, whereas the absence or negative valuation of them promoted negative experiences. CONCLUSIONS The findings underscore the interrelatedness of older people and their relatives and that patients and relatives are quite consistent in their experiences and opinions. This suggests that listening to the concerns of relatives is important, as they can voice the older patient's needs and concerns in situations where older people might find it difficult to do so. Furthermore, the results underscore how 'small things' matter in relation to how health professionals capture the patient's individual values, need for care, information and involvement of relatives and that these are essential to ensure predictability and security and a good stay for older people and their relatives.
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Affiliation(s)
- Nina Mickelson Weldingh
- Division of Research and Innovation, Department of Research Support Service, Akershus University Hospital, Lørenskog, Norway.
| | - Marit Kirkevold
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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20
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Allegri N, Rosi A, Del Signore F, Cremascoli R, Cappa S, Tassorelli C, Govoni S. Dementia-friendly intervention for hospitalized older adults with cognitive impairments: results of the Italian Dementia-Friendly Hospital Trial (IDENTITÀ). Aging Ment Health 2022; 26:716-724. [PMID: 33759658 DOI: 10.1080/13607863.2021.1901261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: To evaluate whether a short training focused on improving dementia care practices of the hospital staff was able to counteract functional loss and to decrease negative outcomes at discharge among hospitalized older adults with cognitive impairment.Method: Sixty-eight hospitalized participants aged 65 and over with cognitive impairment were included in the study, allocated in the control group (n = 34) and intervention group (n = 34). The intervention consisted of a short training of the hospital staff aimed at improving the management of patients with cognitive impairment. Participants were evaluated within 48 h of hospital admission and at discharge using a battery of tests including Barthel Index, Mini-Mental State Examination, and Hospital Anxiety and Depression Scale.Results: The intervention group demonstrated shorter hospital length of stay and a maintenance of the functional status at discharge compared to the control group. We observed no differences in cognitive ability between the two groups, and a trend towards a decrease of anxious symptoms in the intervention group compared to the control group.Conclusion: The results suggest that an intervention, focused on improving dementia care practices in healthcare staff, has the potential to improve the outcomes for hospitalized older adults with cognitive impairment.
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Affiliation(s)
- Nicola Allegri
- IRCCS Mondino Foundation, Pavia, Italy.,CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Alessia Rosi
- Brain and Behavioral Sciences Department, University of Pavia, Pavia, Italy
| | | | - Riccardo Cremascoli
- IRCCS Mondino Foundation, Pavia, Italy.,Brain and Behavioral Sciences Department, University of Pavia, Pavia, Italy
| | - Stefano Cappa
- IRCCS Mondino Foundation, Pavia, Italy.,University School for Advanced Studies, IUSS, Pavia, Italy
| | - Cristina Tassorelli
- IRCCS Mondino Foundation, Pavia, Italy.,Brain and Behavioral Sciences Department, University of Pavia, Pavia, Italy
| | - Stefano Govoni
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy.,Drug Sciences Department, University of Pavia, Pavia, Italy
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21
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Quick SM, Snowdon DA, Lawler K, McGinley JL, Soh SE, Callisaya ML. Physical Therapist and Physical Therapist Student Knowledge, Confidence, Attitudes, and Beliefs About Providing Care for People With Dementia: A Mixed-Methods Systematic Review. Phys Ther 2022; 102:6527603. [PMID: 35157773 PMCID: PMC9155993 DOI: 10.1093/ptj/pzac010] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 10/11/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to determine physical therapists' and physical therapist students' attitudes and beliefs, knowledge, and confidence in working with people with dementia. METHODS This was a mixed-methods systematic review. Participants included physical therapists working in any clinical specialty and physical therapist students who had completed at least 1 clinical placement. Eleven databases were searched. The evidence was evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. Data synthesis followed a convergent integrated approach according to Joanna Briggs Institute methodology for mixed-methods systematic reviews. Quantitative data were "qualitized" using thematic analysis and synthesized with qualitative data using thematic synthesis. RESULTS Fifteen studies were included (9 quantitative and 6 qualitative studies). Seven key themes evolved. Five related to the belief that (1) working with people with dementia is complex and challenging; (2) opportunities for education in dementia care are lacking; (3) working with people with dementia is a specialized area of practice; (4) there are unsupportive systems for working with people with dementia; and (5) people with dementia deserve rehabilitation, but their potential to improve is less certain. One theme related to knowledge (lack of knowledge in some areas of dementia care), and 1 theme related to confidence (lack of confidence in working with people with dementia). CONCLUSIONS Physical therapists and physical therapist students believe that working with people with dementia can be challenging. The low levels of knowledge and confidence in areas important to working with people who have dementia suggest that more education about dementia is needed. IMPACT This mixed-methods systematic review highlights that physical therapists and physical therapist students believe that working with people who have dementia is complex and challenging. Physical therapists want more training and support in this growing area of practice.
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Affiliation(s)
- Stephen M Quick
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia,Academic Unit, Peninsula Health, Melbourne, Australia,Address all correspondence to Mr Quick at:
| | - David A Snowdon
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia,Academic Unit, Peninsula Health, Melbourne, Australia
| | - Katherine Lawler
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | | | - Sze-Ee Soh
- Department of Physiotherapy, Monash University, Melbourne, Australia,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michele L Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia,Academic Unit, Peninsula Health, Melbourne, Australia,Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia
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22
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Abstract
Health care providers do not always possess the knowledge and skills necessary to optimally manage behavioral symptoms in patients with Alzheimer's disease (AD). The purpose of the current project was to evaluate the use of a simulated virtual reality AD experience on nursing staff sensitivity, awareness, and perceptions of caring for patients with AD. A quasi-experimental design was used. The Long Tour Survey and Approaches to Dementia Questionnaire were administered pre and post simulation and the Perceptions of Caring surveys were administered 3 to 6 weeks post-intervention. Total scores, although not statistically significant, revealed a slight change in the total score and hope subscale, representing more optimism toward people with dementia. The virtual reality AD simulation was a beneficial experience but unable to demonstrate a real change for the majority of participants. [Journal of Gerontological Nursing, 47(11), 39-47.].
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23
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Schneider J, Miller J, Teschauer W, Kruse A, Teichmann B. Evaluation and Effectiveness of a Two-Day Dementia Training Program for Hospital Staff Working in an Emergency Department. J Alzheimers Dis 2021; 84:1631-1644. [PMID: 34719490 PMCID: PMC8764588 DOI: 10.3233/jad-210505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Entering the hospital via an Emergency Department (ED) is a pivotal moment in the life of People with Dementia (PwD) and often starts an avoidable downward spiral. Therefore, it is required to further educate ED staff to raise awareness of the needs of PwD. Although there are many studies about existing dementia training programs for the hospital setting, empirical evidence for the ED setting and cross-level training evaluations are lacking. Objective: The study aims to evaluate a two-day dementia training course for ED staff on the outcome levels of learning, individual performance, and organizational performance. Furthermore, the study examines whether the training fulfilled participants’ expectations. Methods: Mixed methods were used to assess data from head nurses, nursing, and administrative staff working in EDs. We conducted semi-structured interviews three weeks before (N = 18) and eight months after (N = 9) the training. Questionnaire data were assessed before the training, three months, and six months after the training (N = 44). A qualitative content analysis was conducted to analyze qualitative data; quantitative data was described descriptively. Results: The intervention seems to be effective on both learning and individual performance levels. However, we did not observe any changes in the organizational performance. The training program met attendees’ expectations only partly. The working environment of EDs needs to be taken more into account. Conclusion: Hospital staffs’ expectations of a dementia training program depend on the work area in which they operate. Results support the implementation of intervention bundles to enable sustainable cross-level changes.
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Affiliation(s)
- Julia Schneider
- Network Aging Research, Heidelberg University, Heidelberg, Germany.,Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Jennifer Miller
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Winfried Teschauer
- German Alzheimer's Association, Bavaria, Nuremberg.,Institute of Health, Bavarian Health and Food Safety Authority, Nuremberg, Germany
| | - Andreas Kruse
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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Gkioka M, Schneider J, Kruse A, Tsolaki M, Moraitou D, Teichmann B. Evaluation and Effectiveness of Dementia Staff Training Programs in General Hospital Settings: A Narrative Synthesis with Holton's Three-Level Model Applied. J Alzheimers Dis 2021; 78:1089-1108. [PMID: 33104033 PMCID: PMC7739966 DOI: 10.3233/jad-200741] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: People with Dementia (PwD) are frequently admitted to hospital settings. The lack of proper dementia knowledge, poor communication skills, negative attitudes toward dementia, and lack of confidence affects the quality of care, thus development of dementia trainings has increased. Nevertheless, literature regarding the effectiveness of training implementation is limited. Objective: The aim of this narrative synthesis is to 1) identify the characteristics of training programs and 2) explore the effectiveness of these training programs in everyday clinical practice. Methods: A systematic search in PubMed, PsycINFO, CINAHL, and Cochrane was conducted, including qualitative and quantitative peer-reviewed studies. Holton’s evaluation model with its three outcome levels (learning, individual performance, and organizational results) was adopted. 14 studies were included. Results: The synthesis of the results was divided into two parts: 1) to describe the characteristics and content of trainings 2) to evaluate the effectiveness of training programs according to the three outcome levels of Holton’s model, taking into consideration its construct domains: ability, motivation, and environment. Learning outcomes were assessed in all selected studies: 13 studies observed changes in individual performance, four studies reported changes within the organizational level, and only five showed sustainable changes over time. Conclusion: Person-centered care (PCC) approaches, interactive and varied teaching methods, supporting conditions like champions, action plans, and setting care policies, are all characteristics of effective trainings. Successful programs should be sustainable over time, demonstrating positive outcomes across the organization. Based on current findings, there is a lack of adequate evaluation with regard to training programs on the organizational level.
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Affiliation(s)
- Mara Gkioka
- Network Aging Research, Heidelberg University, Heidelberg, Germany.,School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Julia Schneider
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Andreas Kruse
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Magda Tsolaki
- 1st Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece
| | - Despina Moraitou
- School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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Quick SM, Snowdon DA, Lawler K, McGinley JL, Soh SE, Callisaya ML. Physiotherapists' and physiotherapy students' attitudes and beliefs about working with people with dementia: a mixed methods systematic review protocol. JBI Evid Synth 2021; 19:1971-1976. [PMID: 34400598 DOI: 10.11124/jbies-20-00303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this review is to explore the attitudes and beliefs of physiotherapists and physiotherapy students working with people with dementia. A second objective is to explore their knowledge and confidence in this area. INTRODUCTION Dementia is a leading cause of disability. It poses a challenge to individuals and health systems due to the complex nature of its presentation. With a growing body of evidence supporting physiotherapists' role in the care of people with dementia, it is important to understand their knowledge, confidence, attitudes, and beliefs in managing this role. INCLUSION CRITERIA The review will consider quantitative, qualitative, and mixed-methods studies that include physiotherapists and physiotherapy students who have worked or had a clinical placement in any setting where people with dementia might access physiotherapy care. Studies investigating one or more of the following topics will be included: knowledge, confidence, attitudes, and beliefs about working with people with any type of dementia. METHODS MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), Emcare, PsycINFO (Ovid), Scopus, Web of Science, Informit, ERIC (ProQuest), ProQuest Dissertations, and Google Scholar will be searched without a date limit for studies published in English. All study types will be screened for inclusion and critically appraised for methodological quality by two independent reviewers. Methodological quality will be assessed using the appropriate JBI critical appraisal checklist for each study type. Data will be extracted using standardized JBI tools for mixed methods systematic reviews. A convergent integrated approach to synthesis and integration will be used. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020181845.
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Affiliation(s)
- Stephen M Quick
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Vic, Australia.,Academic Unit, Peninsula Health, Melbourne, Vic, Australia
| | - David A Snowdon
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Vic, Australia.,Academic Unit, Peninsula Health, Melbourne, Vic, Australia
| | - Katherine Lawler
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tas, Australia
| | - Jennifer L McGinley
- Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia
| | - Sze-Ee Soh
- Department of Physiotherapy, Monash University, Melbourne, Vic, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Vic, Australia
| | - Michele L Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Vic, Australia.,Academic Unit, Peninsula Health, Melbourne, Vic, Australia.,Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Tas, Australia
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Osuoha P, Masoud SS, Leibas M, Cleveland LM, Reed CC, Piernik-Yoder B, White CL. "Getting to Know Them": Person-Centered Care for Patients With Dementia in Acute Care. J Gerontol Nurs 2021; 47:37-44. [PMID: 34039092 DOI: 10.3928/00989134-20210408-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Older adults with dementia are reported to have twice as many hospital stays as their age-matched counterparts without dementia. Acute care hospitals are generally not equipped to provide best care for persons with dementia. The purpose of the current qualitative study was to gain an understanding of the needs and perspectives of nursing staff and patient care technicians regarding delivering person-centered care (PCC) to patients with dementia. Nine focus groups (N = 49) were conducted. Participants discussed the importance of "getting to know them" as the basis for their care. Several themes emerged that served to support or detract from providing PCC: (a) communication, (b) education, and (c) care environment. Findings from this study support the desire of nurses and patient care technicians to provide PCC, highlight challenges, and indicate needed system-level changes to education, communication, and the care environment to support best practices. [Journal of Gerontological Nursing, 47(5), 37-44.].
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"EduKation demenz® Nursing" in the acute hospital setting : Evaluation of a dementia training program: a pilot study. Z Gerontol Geriatr 2021; 54:659-666. [PMID: 33433665 DOI: 10.1007/s00391-020-01838-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND An increasing number of people with dementia (PwD) are being hospitalized due to acute conditions. The surrounding conditions and procedures in acute hospitals are not oriented to the special needs of this vulnerable patient group. The behavior of PwD poses particular challenges and burdens for nursing staff. OBJECTIVE The aim of this pilot study was to evaluate the effectiveness of a 2-day dementia training program with a self-reflection component compared to a standard 1.5‑h training of nursing staff caring for PwD in acute hospitals. METHODS A nonrandomized pretest-posttest study with a control group was conducted in three German acute hospitals. Through a questionnaire, nursing staff caring for PwD were examined for potential changes in attitude, strain and confidence levels. The intervention group (n = 32) received a 2-day training program, "EduKation demenz® Nursing", the control group (n = 36) participated in a short,1.5‑h dementia training. RESULTS Compared to the control group, the intervention group demonstrated statistically significant improvement in perceived strain (p = 0.007) and in confidence in caring for PwD (p < 0.001). There were positive but not significant changes in attitude (p = 0.176). CONCLUSION "EduKation demenz® Nursing", a 2-day training program with a self-reflection component, could provide more effective support for nursing staff in acute hospitals caring for PwD than a 1.5‑h training. Results indicate, however, that general conditions in acute hospitals should be changed to allow nursing staff to apply the knowledge gained.
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Petty S, Griffiths A, Coleston DM, Dening T. Improving emotional well-being for hospital-based patients with dementia. QUALITY IN AGEING AND OLDER ADULTS 2020. [DOI: 10.1108/qaoa-05-2020-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Improving hospital care for people with dementia is a well-established priority. There is limited research evidence to guide nursing staff in delivering person-centred care, particularly under conditions where patients are emotionally distressed. Misunderstood distress has negative implications for patient well-being and hospital resources. The purpose of this study is to use the expertise of nurses to recommend ways to care for the emotional well-being of patients with dementia that are achievable within the current hospital setting.
Design/methodology/approach
A qualitative study was conducted in two long-stay wards providing dementia care in a UK hospital. Nursing staff (n = 12) were asked about facilitators and barriers to providing emotion-focused care. Data were analysed using thematic analysis.
Findings
Nursing staff said that resources existed within the ward team, including ways to gather and present personal information about patients, share multidisciplinary and personal approaches, work around routine hospital tasks and agree an ethos of being connected with patients in their experience. Staff said these did not incur financial cost and did not depend upon staffing numbers but did take an emotional toll. Examples are given within each of these broader themes.
Research limitations/implications
The outcome is a short-list of recommended staff actions that hospital staff say could improve the emotional well-being of people with dementia when in hospital. These support and develop previous research.
Originality/value
In this paper, frontline nurses describe ways to improve person-centred hospital care for people with dementia.
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Effects of a Person Centered Dementia Training Program in Greek Hospital Staff-Implementation and Evaluation. Brain Sci 2020; 10:brainsci10120976. [PMID: 33322754 PMCID: PMC7763588 DOI: 10.3390/brainsci10120976] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
People with Dementia (PwD) are frequently admitted in general hospitals. However, health care professionals have lack of dementia knowledge, negative attitudes toward dementia, and lack of confidence in caring those patients. The aim of this study is to develop, implement and evaluate a dementia staff training program in Greek general hospitals. It was a repeated-measures research design. Fourteen (14) two-day workshops were conducted, consisting of six targeted and interactive modules. Staff members (N = 242) attended the program and were assessed according to (1) individual performance: questionnaires about attitudes towards dementia, confidence in care, knowledge about dementia and anxiety before, immediately after the training and three months later, (2) an overall training evaluation immediately after the training and (3) an evaluation of training implementation three months later. Positive attitudes towards dementia, improvement of confidence in care and decrease of feeling of anxiety as a trait, were sustained over time. Knowledge about dementia also increased after the training and sustained, with, however, a slight decrease over time. A well applied training program seems to provide the basis of a better care in PwD during hospitalization. However, changes in the organizational level and a transformation of care culture are necessary for training sustainability over time.
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Gwernan-Jones R, Lourida I, Abbott RA, Rogers M, Green C, Ball S, Hemsley A, Cheeseman D, Clare L, Moore D, Burton J, Lawrence S, Rogers M, Hussey C, Coxon G, Llewellyn DJ, Naldrett T, Thompson Coon J. Understanding and improving experiences of care in hospital for people living with dementia, their carers and staff: three systematic reviews. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Being in hospital can be particularly confusing and challenging not only for people living with dementia, but also for their carers and the staff who care for them. Improving the experience of care for people living with dementia in hospital has been recognised as a priority.
Objectives
To understand the experience of care in hospital for people living with dementia, their carers and the staff who care for them and to assess what we know about improving the experience of care.
Review methods
We undertook three systematic reviews: (1) the experience of care in hospital, (2) the experience of interventions to improve care in hospital and (3) the effectiveness and cost-effectiveness of interventions to improve the experience of care. Reviews 1 and 2 sought primary qualitative studies and were analysed using meta-ethnography. Review 3 sought comparative studies and economic evaluations of interventions to improve experience of care. An interweaving approach to overarching synthesis was used to integrate the findings across the reviews.
Data sources
Sixteen electronic databases were searched. Forwards and backwards citation chasing, author contact and grey literature searches were undertaken. Screening of title and abstracts and full texts was performed by two reviewers independently. A quality appraisal of all included studies was undertaken.
Results
Sixty-three studies (reported in 82 papers) were included in review 1, 14 studies (reported in 16 papers) were included in review 2, and 25 studies (reported in 26 papers) were included in review 3. A synthesis of review 1 studies found that when staff were delivering more person-centred care, people living with dementia, carers and staff all experienced this as better care. The line of argument, which represents the conceptual findings as a whole, was that ‘a change of hospital culture is needed before person-centred care can become routine’. From reviews 2 and 3, there was some evidence of improvements in experience of care from activities, staff training, added capacity and inclusion of carers. In consultation with internal and external stakeholders, the findings from the three reviews and overarching synthesis were developed into 12 DEMENTIA CARE pointers for service change: key institutional and environmental practices and processes that could help improve experience of care for people living with dementia in hospital.
Limitations
Few of the studies explored experience from the perspectives of people living with dementia. The measurement of experience of care across the studies was not consistent. Methodological variability and the small number of intervention studies limited the ability to draw conclusions on effectiveness.
Conclusions
The evidence suggests that, to improve the experience of care in hospital for people living with dementia, a transformation of organisational and ward cultures is needed that supports person-centred care and values the status of dementia care. Changes need to cut across hierarchies and training systems to facilitate working patterns and interactions that enable both physical and emotional care of people living with dementia in hospital. Future research needs to identify how such changes can be implemented, and how they can be maintained in the long term. To do this, well-designed controlled studies with improved reporting of methods and intervention details to elevate the quality of available evidence and facilitate comparisons across different interventions are required.
Study registration
This study is registered as PROSPERO CRD42018086013.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 43. See the NIHR Journals Library website for further project information. Additional funding was provided by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
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Affiliation(s)
- Ruth Gwernan-Jones
- Evidence Synthesis Team, PenCLAHRC, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Ilianna Lourida
- Evidence Synthesis Team, PenCLAHRC, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rebecca A Abbott
- Evidence Synthesis Team, PenCLAHRC, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Morwenna Rogers
- Evidence Synthesis Team, PenCLAHRC, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Colin Green
- Health Economics Group, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Susan Ball
- Health Statistics Group, PenCLAHRC, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | | | | | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Darren Moore
- Graduate School of Education, College of Social Sciences and International Studies, University of Exeter, Exeter, UK
| | - Julia Burton
- Alzheimer’s Society Research Network Volunteers, c/o University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sue Lawrence
- Alzheimer’s Society Research Network Volunteers, c/o University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
| | | | | | | | - David J Llewellyn
- Mental Health Research Group, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
- The Alan Turing Institute, London, UK
| | | | - Jo Thompson Coon
- Evidence Synthesis Team, PenCLAHRC, University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK
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Keogh B, Ting To W, Daly L, Hynes G, Kennelly S, Lawlor B, Timmons S, O'Reilly S, Bracken-Scally M, Ciblis A, Cole N, Drury A, Pittalis C, Kennelly B, McCarron M, Brady AM. Acute hospital staff's attitudes towards dementia and perceived dementia knowledge: a cross-sectional survey in Ireland. BMC Geriatr 2020; 20:376. [PMID: 32998718 PMCID: PMC7526250 DOI: 10.1186/s12877-020-01783-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/21/2020] [Indexed: 11/13/2022] Open
Abstract
Background Little is known about staff’s attitudes in Irish acute hospital settings towards people living with dementia and their perceived dementia knowledge. The aim of this study was to understand the general level of dementia knowledge and attitudes towards dementia in different types of hospital staff, as well as to explore the potential influence of previous dementia training and experience (having a family member with dementia) and the potential moderating effects of personal characteristics. This data was required to plan and deliver general and targeted educational interventions to raise awareness of dementia throughout the acute services. Methods A cross-sectional survey was carried out among a diverse range of hospital staff (n = 1795) in three urban acute general hospitals in Ireland, including doctors, nurses, healthcare attendants, allied professionals, and general support staff. Participants’ perceived dementia knowledge and attitudes were assessed as well as their previous dementia training and experience. To measure participant’s attitude towards dementia, the validated Approaches to Dementia Questionnaire (ADQ) was used. Results Hospital staff demonstrated positive attitudes towards people living with dementia, and believed they had a fair to moderate understanding of dementia. Both ‘having previous dementia training’ and ‘having a relative living with dementia’ predicted attitude towards dementia and perceived dementia knowledge. Interestingly, certain personal staff characteristics did impact dementia training in predicting attitude towards dementia and perceived dementia knowledge. Conclusion This study provides a baseline of data regarding the attitudes towards dementia and perceived dementia knowledge for hospital staff in Irish acute hospitals. The results can inform educational initiatives that target different hospital staff, in order to increase awareness and knowledge to improve quality of dementia care in Irish hospitals.
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Affiliation(s)
- Brian Keogh
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland.
| | - Wing Ting To
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Louise Daly
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Geralyn Hynes
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Siobhan Kennelly
- Medicine for the Elderly, Connolly Hospital, Blanchardstown and National Clinical Integrated Care Programme, Health Services Executive, Dublin, Ireland
| | - Brian Lawlor
- Director Mercer's Memory Clinic, St James's Hospital, Dublin 8, School of Medicine and Global Brain Institute, Trinity College Dublin, Dublin, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork and Mercy University Hospital, Cork, Ireland
| | - Susan O'Reilly
- Medicine for the Elderly, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | | | - Aurelia Ciblis
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Natalie Cole
- National Research and Development Office, Health Service Executive, Dublin, Ireland
| | - Amanda Drury
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Chiara Pittalis
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Brendan Kennelly
- School of Business and Economics, National University of Ireland Galway, Galway, Ireland
| | - Mary McCarron
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Anne-Marie Brady
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
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Toubøl A, Moestrup L, Ryg J, Thomsen K, Nielsen DS. Stakeholder perspectives of the dementia-friendly hospital: A qualitative descriptive focus group study. DEMENTIA 2020; 20:1501-1517. [PMID: 32930603 DOI: 10.1177/1471301220947848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The term dementia-friendly hospital is increasingly used to describe a variety of initiatives and strategies that are implemented to meet the challenges faced by patients with dementia during hospitalization. However, no definition of the dementia-friendly hospital currently exists. This qualitative focus group study aimed to describe stakeholders' perspectives of the dementia-friendly hospital. Four stakeholder groups were included: people with dementia, relatives, hospital staff, and representatives from the Danish Alzheimer Association. The thematic analysis suggests that a person-centered approach is a key feature. This approach is described as a continuously reflexive awareness of how to see the person behind the dementia diagnosis. We discuss possible revision of the current dementia discourse and the implications of the findings for future practice and research.
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Affiliation(s)
- Annemarie Toubøl
- 138728Health Sciences Research Center, UCL University College, Denmark
| | - Lene Moestrup
- Health Sciences Research Center, 138728UCL University College, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Katja Thomsen
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Dorthe S Nielsen
- Centre for Global Health, 6174University of Southern Denmark, Denmark
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Gkioka M, Tsolaki M, Papagianopoulos S, Teichmann B, Moraitou D. Psychometric properties of dementia attitudes scale, dementia knowledge assessment tool 2 and confidence in dementia scale in a Greek sample. Nurs Open 2020; 7:1623-1633. [PMID: 32802384 PMCID: PMC7424436 DOI: 10.1002/nop2.546] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/08/2020] [Accepted: 05/20/2020] [Indexed: 12/16/2022] Open
Abstract
Aim Τo validate the Greek version of the Dementia Knowledge Assessment Tool 2, the Dementia Attitudes Scale and Confidence in Dementia Scale. Design A quantitative cross-sectional design was applied for translation and validation. The STROBE checklist for observational research has been followed to this survey. Method Two hundred and twelve students from the School of Psychology (Aristotle University of Thessaloniki). Psychometric properties were assessed through construct validity (principal component analysis), internal consistency (Cronbach's alpha) and convergent validity. Results High internal reliability was found for Confidence in Dementia Scale (α = 0.85), adequate reliability for Dementia Attitudes Scale (α = 0.74) and acceptable reliability for Dementia Knowledge Assessment Tool 2 (α = 0.68). Construct validity was satisfactory for Dementia Attitudes Scale (two factors: social comfort and knowledge). The convergent validity was supported to this survey. All three tools are reliable and valid to measure knowledge, confidence and attitudes towards dementia in Greek research context.
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Affiliation(s)
- Mara Gkioka
- Network Aging ResearchUniversity of HeidelbergHeidelbergGermany
- School of MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Magdalini Tsolaki
- School of MedicineAristotle University of ThessalonikiThessalonikiGreece
- 1st Department of ΝeurologyAHEPA University HospitalThessalonikiGreece
| | - Sotirios Papagianopoulos
- School of MedicineAristotle University of ThessalonikiThessalonikiGreece
- 3rd Department of NeurologyPapanikolaou General HospitalThessalonikiGreece
| | | | - Despina Moraitou
- Laboratory of PsychologySection of Experimental & Cognitive PsychologySchool of PsychologyAristotle University of ThessalonikiThessalonikiGreece
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Schneider J, Schönstein A, Teschauer W, Kruse A, Teichmann B. Hospital Staff's Attitudes Toward and Knowledge About Dementia Before and After a Two-Day Dementia Training Program. J Alzheimers Dis 2020; 77:355-365. [PMID: 32741821 PMCID: PMC7592687 DOI: 10.3233/jad-200268] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: The outcomes of hospitalized People with Dementia (PwD) are likely to be negative due to, among other key causes, negative staff attitudes and limited staff knowledge regarding dementia. Targeted interventions have been shown to positively change the attitudes of the hospital staff while also increasing their overall knowledge of dementia. However, training effects are often short-lived and frequently long-term effects are not examined in studies. Objective: To examine whether attending a dementia training program changes the attitudes of hospital staff toward PwD and/or increases their knowledge levels about dementia, and whether or not these changes are stable. Methods: The training program lasted two days and N = 60 attending hospital staff members agreed to participate in the study. Data were assessed with questionnaires prior to the training, 3 months, and 6 months after the training. German versions of the Dementia Attitude Scale (DAS-D) and the Knowledge in Dementia (KIDE) scale were used. Additionally, data about perception of PwD and confidence in dealing with challenging behavior were collected and analyzed. Results: After the training program, participants showed a significantly better attitude toward PwD as measured by DAS-D. These time-effects occurred in both DAS-D subscales (“dementia knowledge” and “social comfort”). Although a positive trend could be seen in the KIDE scale, no statistically significant increase occurred over time. Conclusion: Specialist training programs seem to be promising in positively changing attitudes toward and increasing knowledge about PwD with long-term effects. Further research should address the effects of attitude change in patient care.
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Affiliation(s)
- Julia Schneider
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Anton Schönstein
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Winfried Teschauer
- German Alzheimer's Association, Bavaria, Nuremberg; Institute of Health, Bavarian Health and Food Safety Authority, Nuremberg, Germany
| | - Andreas Kruse
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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Feast AR, White N, Candy B, Kupeli N, Sampson EL. The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review. Int J Geriatr Psychiatry 2020; 35:463-488. [PMID: 32011033 DOI: 10.1002/gps.5280] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/21/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND People with dementia are at greater risk of being admitted to hospital where care may not be tailored to their needs. Interventions improving care and management are vital. AIM Assess the effectiveness of interventions designed to improve the care and management of people with dementia in hospital. METHOD Six medical and trial registry, and grey literature databases were searched (1999-1998/2018). Search terms included "Dementia," "Hospital," and "Intervention" and limited to experimental designs. Interventions designed to improve the care and management of people with dementia in the general hospital setting were examined. Outcomes included behavioural and psychological symptoms of dementia (BPSD), psychosocial, clinical, staff knowledge, and length of hospital stay. The CASP tools, Cochrane risk of bias tool, and GRADE system assessed methodological quality and certainty of evidence. RESULTS 9003 unique citations were identified; 24 studies were included. Studies were limited in study design and their conduct was at a risk of bias. There is very low-quality evidence that multisensory behaviour therapy reduces BPSD. There is low-quality evidence that a multidisciplinary programme reduces postoperative complications and that robot-assisted therapy, music therapy, multimodal-comprehensive care, person-centred care, and family-centred function-focused care interventions improved staff knowledge, competence, efficacy, and communication. No studies reported reduced length of stay. CONCLUSIONS Whilst we found that these interventions improved the care and management of people with dementia in hospital, it was low- to very low-quality evidence. New clinical recommendations cannot be made based on current evidence, and robust trial designs are necessary to inform evidence-based care.
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Affiliation(s)
- Alexandra R Feast
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Nicola White
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Bridget Candy
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Elizabeth L Sampson
- Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, UK
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Yous ML, Ploeg J, Kaasalainen S, Martin LS. Healthcare professionals' perceptions of P.I.E.C.E.S. education in supporting care delivery for older adults with responsive behaviours of dementia in acute care. GERONTOLOGY & GERIATRICS EDUCATION 2020; 41:32-51. [PMID: 30704367 DOI: 10.1080/02701960.2019.1572011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Introduction: In acute care settings persons with dementia often use responsive behaviours such as yelling and hitting as a meaningful mode of communication. Staff dementia care education programs such as P.I.E.C.E.S. may help to address these gaps in care. P.I.E.C.E.S. is a holistic clinical assessment framework that focuses on Physical, Intellectual, and Emotional health, Capabilities of an individual, and the living Environment of a person and the Social being.Aims: The aim of this interpretive descriptive study was to explore the perceptions of healthcare professionals of P.I.E.C.E.S. and recommendations to enhance its uptake.Methods: A total of 15 healthcare professionals from acute medical settings in a hospital in Ontario participated in face-to-face, semi-structured interviews. Experiential thematic and secondary data analyses were performed.Findings: P.I.E.C.E.S. had many positive perceived impacts such as promoting interdisciplinary collaboration. However, participants reported that it was challenging to sustain P.I.E.C.E.S. in practice which led to a tapering off of it approximately one year post-education. A barrier to applying P.I.E.C.E.S. was limited time.Conclusions: Findings indicate the need for educational reinforcements and sustainability strategies for dementia care programs in acute care settings. Organizations should implement regular interdisciplinary meetings to provide opportunities for staff to apply P.I.E.C.E.S.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Jenny Ploeg
- School of Nursing, Scientific Director, Aging, Community and Health Research Unit, Faculty of Health Sciences and Associate Member, Department of Health, Aging and Society, McMaster University, Hamilton, ON, Canada
| | | | - Lori Schindel Martin
- Faculty of Community Services, Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
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Grey T, Fleming R, Goodenough BJ, Xidous D, Möhler R, O'Neill D. Hospital design for older people with cognitive impairment including dementia and delirium: supporting inpatients and accompanying persons. Hippokratia 2019. [DOI: 10.1002/14651858.cd013482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Thomas Grey
- Trinity College Dublin; TrinityHaus, School of Engineering; 16 Westland Row Dublin Leinster Ireland DO2 YY50
| | - Richard Fleming
- University of Wollongong; Dementia Training Australia; Rm. 114, ITAMS Building, Innovation Campus Wollongong NSW Australia 2522
| | - Belinda J Goodenough
- University of Wollongong; Dementia Training Australia; Rm. 114, ITAMS Building, Innovation Campus Wollongong NSW Australia 2522
| | - Dimitra Xidous
- Trinity College Dublin; TrinityHaus, School of Engineering; 16 Westland Row Dublin Leinster Ireland DO2 YY50
| | - Ralph Möhler
- School of Public Health, Bielefeld University; Department of Health Services Research and Nursing Science; Universitätsstrasse 25 Bielefeld Germany 33615
| | - Desmond O'Neill
- Trinity College; Centre for Ageing, Neuroscience and the Humanities; Trinity Centre for Health Sciences, Tallaght Hospital Dublin Ireland 24
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Zygouris S, Gkioka M, Moraitou D, Teichmann B, Tsiatsos T, Papagianopoulos S, Tsolaki M. Views of nursing staff on computerized dementia screening : A validation and pilot study in a general hospital. Z Gerontol Geriatr 2019; 52:258-263. [PMID: 31641839 PMCID: PMC6821656 DOI: 10.1007/s00391-019-01633-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/20/2019] [Indexed: 11/28/2022]
Abstract
Background Cognitive disorders such as dementia are common among older adults admitted to general hospitals. They can complicate treatment leading to longer hospitalization and worse outcomes. They often remain underdiagnosed as the busy routine of the hospital does not enable efficient screening and available screening instruments are not suitable for the hospital environment. Computerized cognitive testing (CCT) has been proposed as an efficient screening method as it can be employed by nonspecialists, such as nurses while featuring automatic scoring and interpretation of results. Objective This study validated a newly developed questionnaire for measuring the attitudes of Greek nurses towards computerized dementia screening. Material and methods The questionnaire was validated in a sample of 212 undergraduate psychology students and subsequently administered to a sample of 19 nurses working in a general hospital. Reliability of the questionnaire was calculated using Cronbach’s alpha (= 0.762). Factor analysis revealed the existence of a single factor (acceptability-feasibility) that accounted for 33.73% of variance with an eigenvalue of 3.036. Results The total score of all the items loading on the single factor (acceptability-feasibility) was calculated. Scores ranged between 10 and 40 with the average score for the validation group being 29.33 (SD = 4.89) and the average score for the nurses’ group being 29.50 (SD = 3.20). Discussion The questionnaire has acceptable reliability. Results indicate that acceptability-feasibility is high in both groups and there were no statistically significant differences between the two groups. Electronic supplementary material The online version of this article (10.1007/s00391-019-01633-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stelios Zygouris
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece. .,Network Aging Research, Heidelberg University, Heidelberg, Germany.
| | - Mara Gkioka
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Despoina Moraitou
- School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | | | | | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
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Lüdecke D, Poppele G, Klein J, Kofahl C. Quality of life of patients with dementia in acute hospitals in Germany: a non-randomised, case-control study comparing a regular ward with a special care ward with dementia care concept. BMJ Open 2019; 9:e030743. [PMID: 31494617 PMCID: PMC6731932 DOI: 10.1136/bmjopen-2019-030743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/26/2019] [Accepted: 08/20/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To identify factors that predict the quality of life (QoL) of patients with dementia in acute hospitals and to analyse if a special care concept can increase patients' QoL. DESIGN A non-randomised, case-control study including two internal medicine wards from hospitals in Hamburg, Germany. SETTING AND PARTICIPANTS In all, 526 patients with dementia from two hospitals were included in the study (intervention: n=333; control: n=193). The inclusion criterion was an at least mild cognitive impairment or dementia. The intervention group was a hospital with a special care ward for internal medicine focusing on patients with dementia. The control group was from a hospital with a regular care ward without special dementia care concept. OUTCOME MEASURES Our main outcome was the QoL (range 0-100) from patients with dementia in two different hospitals. A Bayesian multilevel analysis was conducted to identify predictors such as age, dementia, agitation, physical and chemical restraints, or functional limitations that affect QoL. RESULTS QoL differs significantly between the control (40.7) and the intervention (51.2) group (p<0.001). Regression analysis suggests that physical restraint (estimated effect: -4.9), psychotropic drug use (-4.4) and agitation (-2.9) are negatively associated with QoL. After controlling for confounders, the positive effect of the special care concept remained (5.7). CONCLUSIONS A special care ward will improve the quality of care and has a positive impact on the QoL of patients with dementia. Health policies should consider the benefits of special care concepts and develop incentives for hospitals to improve the QoL and quality of care for these patients.
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Affiliation(s)
- Daniel Lüdecke
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georg Poppele
- Station DAVID, Evangelisches Krankenhaus Alsterdorf, Hamburg, Germany
| | - Jens Klein
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Kofahl
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Flood J, O'Hanlon S, Gibb M, O'Donovan A. Caring for patients with dementia undergoing radiation therapy–A national audit. J Geriatr Oncol 2019; 10:811-818. [DOI: 10.1016/j.jgo.2019.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/22/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
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Evripidou M, Merkouris A, Charalambous A, Papastavrou E. Implementation of a training program to increase knowledge, improve attitudes and reduce nursing care omissions towards patients with dementia in hospital settings: a mixed-method study protocol. BMJ Open 2019; 9:e030459. [PMID: 31326938 PMCID: PMC6661557 DOI: 10.1136/bmjopen-2019-030459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 06/16/2019] [Accepted: 06/28/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION There is an evidence showing that when nurses have to allocate their time because of a lack of resources, older patients and especially those with dementia have a secondary care priority. The purpose of this study is to advance the level of knowledge, promote positive attitudes of nurses and reduce care deficits towards people with dementia through the implementation of a training programme. The programme will be enriched by an observational study of the care of patients with dementia to identify areas of missed care. METHOD AND ANALYSIS This study will follow a mixed methodology consisting of three stages: (1) evaluation of the level of nurses' knowledge and attitudes towards dementia care through the use of structured questionnaires, (2) observational study to evaluate nursing care in hospital settings, in order to detect any missed care and (3) quasi-experimental study, with a before-and-after design, through the implementation of the training programme in order to increase nurses' knowledge, improve attitudes and consequently to promote care for patients with dementia. The data will be analysed with descriptive and inferential statistics with the use of the SPSS V.24.0 and with content analysis as regard to the observational data. ETHICS AND DISSEMINATION The protocol was approved by the National Bioethics committee and other local committees (ΕΕΒΚ: 2018.01.02). The participants will give their informed consent and the anonymity and confidentiality. Also, the protection of data will be respected. The results of the study will be disseminated in peer-reviewed international journals and conferences. If the intervention is successful, the training package will be given to the continuous education unit of the National Professional Association in order to be used on a regular basis.
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Affiliation(s)
- Melina Evripidou
- Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Anastasios Merkouris
- Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Andreas Charalambous
- Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Nursing, Turun Yliopisto, Turku, Finland
| | - Evridiki Papastavrou
- Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Knifton C, MacRae R, Jack-Waugh A, Brown M, Surr C, Thompson R, Baillie L. Perspectives: Dementia education in Higher Education Institutions, now and in the future: the role of the professional regulatory bodies in the UK. J Res Nurs 2019; 24:271-278. [PMID: 34394535 DOI: 10.1177/1744987119838645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Chris Knifton
- Faculty of Health and Life Sciences, Leicester School of Nursing and Midwifery, De Montfort University, UK
| | - Rhoda MacRae
- Alzheimer Scotland Centre for Policy and Practice, School of Health and Life Sciences, University of the West of Scotland, UK
| | - Anna Jack-Waugh
- Alzheimer Scotland Centre for Policy and Practice, School of Health and Life Sciences, University of the West of Scotland, UK
| | - Margaret Brown
- Alzheimer Scotland Centre for Policy and Practice, School of Health and Life Sciences, University of the West of Scotland, UK
| | - Claire Surr
- Centre for Dementia Research, Leeds Beckett University, UK
| | - Rachel Thompson
- Professional & Practice Development Lead, Admiral Nursing with Dementia UK
| | - Lesley Baillie
- School of Health and Social Care, London South Bank University, UK
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Gaston S, Porritt K, Jordan Z. Correctional nurse education and training for the care and support of prisoners with dementia: a systematic review of text and opinion protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2019; 17:1043-1050. [PMID: 31192896 DOI: 10.11124/jbisrir-2017-004034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The objective of this systematic review is to synthesize the best available evidence on the perceived education and training required for correctional nurses to care for and support prisoners with dementia in the Australian context. The review questions are.
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Affiliation(s)
- Sherryl Gaston
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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Leggett A, Connell C, Dubin L, Dunkle R, Langa KM, Maust DT, Roberts JS, Spencer B, Kales HC. Dementia Care Across a Tertiary Care Health System: What Exists Now and What Needs to Change. J Am Med Dir Assoc 2019; 20:1307-1312.e1. [PMID: 31147289 DOI: 10.1016/j.jamda.2019.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study explored the process of care for persons living with dementia (PLWDs) in various care settings across a tertiary care system and considers challenges and opportunities for change. DESIGN Aimed at quality improvement, qualitative interviews were conducted with key stakeholders in dementia care across geriatric outpatient clinics, medical and psychiatric emergency departments, and the main hospital in 2016. SETTING AND PARTICIPANTS Forty-nine interactive interviews were conducted with a purposive and snowball sampling of health care professionals (physicians, nurses, social workers, administrators) and families in a large, academic health care system. MEASURES Qualitative interview guides were developed by the study team to assess the process of care for PLWDs and strengths and challenges to delivering that care. RESULTS Key themes emerging from the interviews in each care setting are presented. The outpatient setting offers expertise, a multidisciplinary clinic, and research opportunities, but needs to respond to long waitlists, space limitations, and lack of consensus about who owns dementia care. The emergency department offers a low nurse/patient ratio and expertise in acute medical problems, but experiences competing demands and staff turnover; additionally, dementia does not appear on medical records, which can impede care. The hospital offers consultative services and resources, yet the physical space is confined and chaotic; sitters and antipsychotics can be overused, and placement outside of the hospital for PLWDs can be a challenge. CONCLUSIONS AND IMPLICATIONS Five key recommendations are provided to help health systems proactively prepare for the coming boom of PLWD and their caregivers, including outpatient education, a dementia care management program to link services, Internet-based training for providers, and repurposing sitters as Elder Life specialists.
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Affiliation(s)
- Amanda Leggett
- Program for Positive Aging and Department of Psychiatry, University of Michigan, Ann Arbor, MI.
| | - Cathleen Connell
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Leslie Dubin
- School of Social Work, University of Michigan, Ann Arbor, MI; Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Ruth Dunkle
- School of Social Work, University of Michigan, Ann Arbor, MI
| | - Kenneth M Langa
- Department of Internal Medicine, Institute for Social Research, Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI
| | - Donovan T Maust
- Program for Positive Aging and Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - J Scott Roberts
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Beth Spencer
- School of Social Work, University of Michigan, Ann Arbor, MI
| | - Helen C Kales
- Program for Positive Aging and Department of Psychiatry, University of Michigan, Ann Arbor, MI
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Abley C, Dickinson C, Andrews Z, Prato L, Lindley L, Robinson L. Training interventions to improve general hospital care for older people with cognitive impairment: systematic review. Br J Psychiatry 2019; 214:201-212. [PMID: 30784394 DOI: 10.1192/bjp.2019.29] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND In response to increasing numbers of older people in general hospitals who have cognitive impairment such as dementia and delirium, many hospitals have developed education and training programmes to prepare staff for this area of clinical practice.AimsTo review the evidence on educational interventions on hospital care for older people with cognitive impairment. METHOD A mixed methods systematic review and narrative synthesis was undertaken. The following electronic databases were searched: Medline, Embase, CINAHL, PsycINFO, EBM Reviews, ASSIA and Scopus, as well as Health Management Information Consortium (HMIC), ProQuest, PubMed and SCIE: Social Care Online. Initial searches were run in August 2014 (update search September 2016). Titles and abstracts of studies retrieved were screened independently. The full text of eligible studies were then independently assessed by two review team members. All included studies were assessed using a standard quality appraisal tool. RESULTS Eight studies relating to delirium, six on dementia and two on delirium and dementia were included, each testing the use of a different educational intervention. Overall, the quality of the studies was low. In relation to delirium, all studies reported a significant increase in participants' knowledge immediately post-intervention. Two of the dementia studies reported an increase in dementia knowledge and dementia confidence immediately post-intervention. CONCLUSIONS The variety of outcomes measured makes it difficult to summarise the findings. Although studies found increases in staff knowledge, there is insufficient evidence to conclude that educational interventions for staff lead to improved patient outcomes.Declaration of interestNone.
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Affiliation(s)
- Clare Abley
- Nurse Consultant and Clinical Senior Lecturer,The Newcastle upon Tyne Hospitals NHS Foundation Trust,Institute of Health and Society and Newcastle Institute for Ageing,Newcastle University,UK
| | - Claire Dickinson
- Research Associate,Institute of Health and Society,Newcastle University,UK
| | - Zoe Andrews
- Student Intern,Institute of Health and Society,Newcastle University,UK
| | - Laura Prato
- Research Assistant,Institute of Health and Society,Newcastle University,UK
| | - Lyndsay Lindley
- Research Assistant,Institute of Health and Society,Newcastle University,UK
| | - Louise Robinson
- Professor of Primary Care and Ageing,Institute of Health and Society; andDirector,Newcastle Institute for Ageing,Newcastle University,UK
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Evripidou M, Charalambous A, Middleton N, Papastavrou E. Nurses' knowledge and attitudes about dementia care: Systematic literature review. Perspect Psychiatr Care 2019; 55:48-60. [PMID: 29766513 DOI: 10.1111/ppc.12291] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 04/11/2018] [Accepted: 04/22/2018] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To explore nurse's knowledge and attitudes toward the care of people with dementia. DESIGN AND METHODS A systematic review informed by the PRISMA-P (preferred reporting items for systematic reviews and meta-analyses protocols) guidelines in four databases (CINAHL, PsyINFO, Pubmed, Cohrane, EMBASE) using keywords "attitudes," "behaviors," "dementia," "knowledge," and "nurses." Predetermined inclusion criteria were selected. The review was conducted between January 1 and December 30, 2017. FINDINGS Sixteen quantitative studies, one qualitative, and two mixed methods studies were included. Nurses lack knowledge, communication skills, management strategies, and confidence in the provision of dementia care. Interventional studies suggested that knowledge and attitudes improved after training programs were implemented. PRACTICE IMPLICATION This review contributes to care advancement and practice development through the reinforcement of organizational support and educational opportunities for nurses.
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Affiliation(s)
- Melina Evripidou
- School of Health Sciences, Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Andreas Charalambous
- School of Health Sciences, Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- School of Health Sciences, Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Evridiki Papastavrou
- School of Health Sciences, Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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Harwood RH, O’Brien R, Goldberg SE, Allwood R, Pilnick A, Beeke S, Thomson L, Murray M, Parry R, Kearney F, Baxendale B, Sartain K, Schneider J. A staff training intervention to improve communication between people living with dementia and health-care professionals in hospital: the VOICE mixed-methods development and evaluation study. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundTwenty-five per cent of hospital beds are occupied by a person living with dementia. Dementia affects expressive communication and understanding. Health-care professionals report a lack of communication skills training.ObjectivesTo identify teachable, effective strategies for communication between health-care professionals and people living with dementia, and to develop and evaluate a communication skills training course.DesignWe undertook a systematic literature review, video-recorded 41 encounters between staff and people with dementia, and used conversation analysis to investigate communication problems and solutions. We designed a communication skills training course using coproduction and multiple pedagogic approaches. We ran a pilot, followed by six courses for health-care professionals. We measured knowledge, confidence and communication behaviours before, immediately after and 1 month after the course, and undertook interviews with participants and managers. Behaviours were measured using blind-rated videos of simulations.SettingGeneral hospital acute geriatric medical wards and two hospital clinical skills centres.ParticipantsWe video-recorded 26 people with dementia and 26 professionals. Ten experts in dementia care, education, simulation and communication contributed to intervention development. Six health-care professionals took part in a pilot course, and 45 took part in the training.ResultsThe literature review identified 26 studies describing 10 communication strategies, with modest evidence of effectiveness. Health-care professional-initiated encounters followed a predictable phase structure. Problems were apparent in requests (with frequent refusals) and in closings. Success was more likely when requests were made directly, with high entitlement (authority to ask) and with lowered contingencies (made to sound less difficult, by minimising the extent or duration of the task, asking patients ‘to try’, offering help or proposing collaborative action). Closings were more successful if the health-care professional announced the end of the task, made a specific arrangement, body language matched talk, and through use of ‘closing idioms’. The training course comprised 2 days, 1 month apart, using experiential learning, including lectures, video workshops, small group discussions, simulations (with specially trained actors) and reflections. We emphasised the incorporation of previous expertise and commitment to person-centred care. Forty-four participants returned for the second training day and 43 provided complete evaluation data. Knowledge and confidence both increased. Some behaviours, especially relating to closings, were more commonly used after training. The course was rated highly in interviews, especially the use of simulations, real-life video clips and interdisciplinary learning. Participants reported that they found the methods useful in practice and were using them 1 month after the course finished.LimitationsData were from people with moderate to severe dementia, in an acute hospital, during health-care professional-initiated interactions. Analysis was limited to problems and solutions that were likely to be ‘trainable’. Actors required careful preparation to simulate people with dementia. Communication skills training course participants were volunteers, unlikely to be representative of the general workforce, who displayed high levels of baseline knowledge, confidence and skills. Before-and-after evaluations, and qualitative interviews, are prone to bias.ConclusionsRequests and closings pose particular difficulties for professionals communicating with people with dementia. We identified solutions to these problems and incorporated them into communication skills training, which improved knowledge, confidence and some communication behaviours. Simulation was an effective training modality.Future workFurther research should investigate a wider range of health, social care and family carers. Conversation analysis should be used to investigate other aspects of health-care communication.Study registrationThe systematic literature review is registered as CRD42015023437.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Rowan H Harwood
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Rebecca O’Brien
- School of Health Sciences, University of Nottingham, Nottingham, UK
- CityCare Partnership CIC, Nottingham, UK
| | - Sarah E Goldberg
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Rebecca Allwood
- School of Health Sciences, University of Nottingham, Nottingham, UK
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Alison Pilnick
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Suzanne Beeke
- Language and Cognition Research, University College London, London, UK
| | - Louise Thomson
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Megan Murray
- Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Ruth Parry
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Fiona Kearney
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Bryn Baxendale
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Kate Sartain
- Patient and Public Contributor, Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Justine Schneider
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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Jack-Waugh A, Ritchie L, MacRae R. Assessing the educational impact of the dementia champions programme in Scotland: Implications for evaluating professional dementia education. NURSE EDUCATION TODAY 2018; 71:205-210. [PMID: 30296731 DOI: 10.1016/j.nedt.2018.09.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/10/2018] [Accepted: 09/24/2018] [Indexed: 06/08/2023]
Abstract
Increasing numbers of people with dementia are living longer with a higher likelihood of requiring hospital care for physical conditions including falls, infections and stroke (Boaden, 2016). However, the literature is replete with descriptions of poor care and hospital care experiences that have fallen well below the expectations of people with dementia, their families and friends. Although poor care is unacceptable, it is unsurprising given that dementia education for health and social care professionals is often inadequate and inconsistent. This results in most healthcare staff being ill-equipped and lacking the confidence to work with people living with dementia. The first of Scotland's National Dementia Strategies committed to "improve the response to dementia in general hospital settings including alternatives to admission and better planning for discharge" (Scottish Government, 2010). The educational response was the commissioning of the Dementia Champions programme. Since 2011, the programme has developed over 800 health and social care professionals working in general hospital and related settings to be change agents in dementia care. This article will outline the theoretical underpinning of the programme and present pooled results from four cohorts (2014-2017) (n = 524). A repeated measure design (pre and post programme) was used to measure attitudes towards people with dementia; self-efficacy and knowledge of dementia. The findings suggest that the education had a statistically significant positive effect on all intended outcomes, indicating the potential for practice change. We discuss these findings in relation to the literature, and respond to the calls for high quality evaluation to measure the effectiveness of dementia education, the challenges and potential directions for measuring educational effectiveness and capturing transfer of learning.
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Affiliation(s)
- A Jack-Waugh
- Alzheimer Scotland Centre for Policy and Practice, School of Health & Life Sciences, University of the West of Scotland, Lanarkshire Campus, Hamilton International Technology Park, South Lanarkshire, G72 OLH, Scotland, UK.
| | - L Ritchie
- Alzheimer Scotland Centre for Policy and Practice, School of Health & Life Sciences, University of the West of Scotland, Lanarkshire Campus, Hamilton International Technology Park, South Lanarkshire, G72 OLH, Scotland, UK.
| | - R MacRae
- Alzheimer Scotland Centre for Policy and Practice, School of Health & Life Sciences, University of the West of Scotland, Lanarkshire Campus, Hamilton International Technology Park, South Lanarkshire, G72 OLH, Scotland, UK.
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The training of therapeutic radiographers in dementia care: a literature review. JOURNAL OF RADIOTHERAPY IN PRACTICE 2018. [DOI: 10.1017/s1460396918000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundIn the United Kingdom, 7·1% of people aged over 65 live with dementia. The National Dementia Strategy emphasises the need for a skilled workforce competent in dementia care. In all, 50% of cancer patients are in the 70 plus age group, suggesting that education of therapeutic radiographers in the care of the patient with dementia is key. The aim of the study was to review the literature regarding training of therapeutic radiographers on dementia and use the findings to make recommendations for training in the future in order to provide the best care.Materials and methodsA literature search of electronic databases holding peer-reviewed journals was conducted. Search terms were generated using the Population Intervention Comparison Outcome (PICO) method and retrieved articles were evaluated using the Critical Appraisal Skills Programme (CASP) tool. Additional evidence was accessed through snowballing and from grey literature.ResultsThe search failed to find any studies on dementia care education within a radiotherapy setting and only a limited number were found in the acute care setting. There appeared to be a large variation in the education provision for healthcare professionals on the subject of dementia care, both at the pre-registration and post-registration stages.FindingsThere is no evidence of a standardised education programme for healthcare professionals in dementia care. In the future, therapeutic radiographers are likely to see more patients with dementia but currently some may not have had the education and training to provide effective holistic care.
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Boltz M, Kuzmik A, Resnick B, Trotta R, Mogle J, BeLue R, Leslie D, Galvin JE. Reducing disability via a family centered intervention for acutely ill persons with Alzheimer's disease and related dementias: protocol of a cluster-randomized controlled trial (Fam-FFC study). Trials 2018; 19:496. [PMID: 30223870 PMCID: PMC6142366 DOI: 10.1186/s13063-018-2875-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/23/2018] [Indexed: 01/03/2023] Open
Abstract
Background Hospitalized older persons with Alzheimer’s disease and related dementias are at greater risk for functional decline and increased care dependency after discharge due to a combination of intrinsic factors, environmental, policy, and care practices that restrict physical and cognitive activity, lack of family involvement and limited staff knowledge of dementia care. We have developed a theory-based intervention, Family centered Function-focused Care, that incorporates an educational empowerment model for family caregivers (FCGs) provided within a social-ecological framework to promote specialized care to patients with dementia during hospitalization and the 60-day post-acute period. Primary aims are to test the efficacy of the intervention in improving physical and cognitive recovery in hospitalized persons living with Alzheimer’s disease and related dementias (ADRD) and improving FCG preparedness and experiences. Method We will implement Family centered Function-focused Care in a cluster-randomized trial of 438 patient/FCG dyads in six hospital units randomized within three hospitals. We hypothesize that patients who receive the intervention will demonstrate better physical function, less delirium occurrence and severity, neuropsychiatric symptoms, and depression compared to those in the control condition (Education-only). We also hypothesize that FCGs enrolled in Family centered Function-focused Care will experience increased preparedness for caregiving, and less strain, burden, and desire to institutionalize, as compared to FCGs the control group. We will also examine the costs and relative cost savings associated with the intervention and will evaluate the cultural appropriateness of Family centered Function-focused Care for families from diverse backgrounds. Discussion Our theory-based intervention makes use of real-world applicable approaches in a novel and innovative way to change the paradigm of how we currently look at acute care and post-acute transitions in persons with ADRD. Trial registration ClinicalTrials.gov, ID: NCT03046121. Registered on 8 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2875-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marie Boltz
- The Pennsylvania State University, College of Nursing, 306 Nursing Sciences Building, University Park, PA, 16802, USA.
| | - Ashley Kuzmik
- The Pennsylvania State University, College of Nursing, 306 Nursing Sciences Building, University Park, PA, 16802, USA
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Rebecca Trotta
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline Mogle
- The Pennsylvania State University, College of Nursing, 306 Nursing Sciences Building, University Park, PA, 16802, USA
| | | | - Douglas Leslie
- The Pennsylvania State University, College of Nursing, 306 Nursing Sciences Building, University Park, PA, 16802, USA
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