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Błaszkiewicz M, Szcześniak D, Ciułkowicz M, Kowalski K, Rymaszewska JE, Bartosz B, Bulińska K, Karczewski M, Brodaty H, Rymaszewska J. Biomedical knowledge of dementia is not enough to counteract its stigma - quantitative research among future medical and social care staff in Poland. Aging Ment Health 2024; 28:1317-1325. [PMID: 38407168 DOI: 10.1080/13607863.2024.2320139] [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: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The aim is to assess the level of stigmatization and knowledge of dementia among university students of medical, rehabilitation and social faculties in Poland. Possible correlates of these concepts and group differences are also investigated. METHODS We applied quantitative methods using an online questionnaire comprising sociodemographics, the Alzheimer's Disease Knowledge Scale, a vignette of a person with dementia and the modified Family Stigma in Alzheimer's Disease Scale. RESULTS Students had low levels of dementia knowledge and moderate levels of stigma. Medical science students had significantly better knowledge than the other groups but did not differ in their level of stigma. Relationships between the main variables were complex. Emotional and cognitive stigmatizing attributions were negatively correlated with knowledge about communication and behaviors of people with dementia. Better knowledge on causes and characteristics, as well as on risks and health promotion of the disease also triggered fewer negative attributions toward people with dementia. CONCLUSIONS If health-related programs are to be effective, they should provide opportunities for the acquisition of relevant knowledge and skills that also address the stigmatization of people living with dementia. Well-established biomedical knowledge on dementia must be supplemented with a person-centered approach and proper communication skills.
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Affiliation(s)
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Marta Ciułkowicz
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | - Julia E Rymaszewska
- Department and Clinic of Dermatology, Allergology and Venerology, Wrocław Medical University, Wrocław, Poland
| | - Bogna Bartosz
- Institute of Psychology, University of Wroclaw, Wrocław, Poland
| | - Katarzyna Bulińska
- Department of Physiotherapy, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | - Maciej Karczewski
- Department of Applied Mathematics, University of Environmental and Life Sciences, Wroclaw, Poland
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Joanna Rymaszewska
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
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Albers B, Bergmann JM, Rodrigues Recchia D, Müller-Widmer R, Hohmann A, Pinkert C, Berner N, Kunz LK, Teupen S. Dementia mindset of caregivers providing residential care for older persons: study protocol for a replication study on the validation of the Dementia Mindset Scale. BMJ Open 2024; 14:e081355. [PMID: 39277210 PMCID: PMC11404143 DOI: 10.1136/bmjopen-2023-081355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2024] Open
Abstract
INTRODUCTION Professional caregivers' perspectives on dementia and on people living with dementia (PlwD) can influence their feelings, judgements and behaviours in work situations, for example, how they think about symptoms, disease progression and the impact on a person's quality of life. Their individual dementia mindset, which can be investigated with the 12-item Dementia Mindset Scale (DMS), might influence job satisfaction, work-related well-being and person-centred care. The aim of the proposed replication study is to confirm the results of the original study of the DMS and to test whether a malleable mindset is correlated with higher levels of caregiver education, dementia-specific professional experience/competence and dementia knowledge. METHODS AND ANALYSIS Professional caregivers in residential care facilities for older persons who work directly with PlwD will be asked to answer an anonymous web-based online survey. The survey encompasses five standardised questionnaires: the DMS, the Dementia Knowledge Assessment Scale, the Oldenburg Burnout Inventory, the Job-related Affective Well-being Scale and the Sense of Competence in Dementia Care Staff Scale. In addition, job satisfaction, the educational background, professional experience and work situation are surveyed. For replication, the analyses will re-evaluate the psychometric properties (structural validity, model fit, internal consistency and predictive validity) by applying descriptive statistics, regression analysis, confirmatory factor analysis and correlation analysis. The additional analyses will use descriptive statistics, regression analysis and correlation analysis. Rasch analysis will be used to rank the difficulty of the items. ETHICS AND DISSEMINATION This study was approved by the ethics committee of the German Society of Nursing Science (ID number 23-004). No personal information will be gathered. The results of the study will be distributed nationally and internationally through peer-reviewed academic journals, conferences, institutional websites and journals for nursing care practice.
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Affiliation(s)
- Bernd Albers
- German Centre for Neurodegenerative Diseases Witten, Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Johannes Michael Bergmann
- German Centre for Neurodegenerative Diseases Witten, Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Daniela Rodrigues Recchia
- Faculty of Health, Chair of Research Methods and Statistics in Psychology, Witten/Herdecke University, Witten, Germany
| | - René Müller-Widmer
- German Centre for Neurodegenerative Diseases Witten, Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Andreas Hohmann
- German Centre for Neurodegenerative Diseases Witten, Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | | | - Nora Berner
- German Centre for Neurodegenerative Diseases Witten, Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Lena K Kunz
- Department of Psychology, University of Groningen, Groningen, Netherlands
| | - Sonja Teupen
- German Centre for Neurodegenerative Diseases Witten, Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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Stafford A, Bender S, Parsons K, Sung B. Evaluating a virtual reality dementia training experience using psychophysiological methods: A randomised controlled study. Australas J Ageing 2024; 43:523-532. [PMID: 38406892 DOI: 10.1111/ajag.13294] [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: 11/08/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Virtual reality (VR) is increasingly used for training the dementia care workforce. It is unknown whether VR is superior to traditional training techniques in improving dementia care amongst practicing nurses. This study compared the impact of a VR application on nurses' knowledge and attitudes towards people living with dementia, to video-based, non-immersive training. METHODS Twenty-two registered and enrolled nurses were randomised to either interactive VR experience or video footage captured from within the app. Participants completed surveys pre- and post-training to assess their knowledge of dementia, attitudes towards dementia and person-centredness. Engagement with training was assessed objectively using facial electromyography, and subjectively with self-reported scales. RESULTS Virtual reality evoked objectively significant greater positive and negative emotional responses than video (positive emotion fEMG: VR mean .012 mV vs. video .005 mV, F[1, 20] = 8.70, p = .01; negative emotion fEMG: VR mean .018 mV vs. video .008 mV, F[1, 20] = 18.40, p < .001). Self-ratings of engagement and emotional state were similar. There was little change in the VR group's knowledge of, and attitudes towards, dementia; the video group's dementia knowledge improved (total DKAS mean differences: VR .1 t = .07, df = 9, p = .95 vs. video -2.3 t = -2.265, df = 11, p = .045). CONCLUSIONS Virtual reality is more engaging than traditional training in highly experienced dementia care practitioners. Despite this, VR may not be superior to traditional training techniques to improve knowledge and attitude for many learners. A focus of future research in the area should be on how to capitalise on VR's greater emotional engagement so that Australia's nursing workforce is better equipped to care for the increasing number of people living with dementia.
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Affiliation(s)
- Andrew Stafford
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - Stuart Bender
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Western Australia, Australia
| | - Kiran Parsons
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - Billy Sung
- School of Management and Marketing, Curtin University, Bentley, Western Australia, Australia
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Jagoda T, Dharmaratne SD, Rathnayake S. Designing an mHealth application for informal carers concerning the management of behavioural and psychological symptoms of dementia: a need analysis survey. BMC Health Serv Res 2024; 24:930. [PMID: 39143591 PMCID: PMC11325574 DOI: 10.1186/s12913-024-11273-9] [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] [Received: 04/27/2024] [Accepted: 07/02/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Informal carers face difficulties and challenges when dealing with the behavioural and psychological symptoms of dementia (BPSD) of their family members or friends residing at home. Mobile health (mHealth) applications are promising for educating and supporting carers. However, needs analysis studies have not been conducted in Sri Lanka to develop mHealth applications for informal carers of people with dementia. AIMS To explore the needs to design an mHealth application for informal carers of people with dementia concerning the management of BPSD. METHOD An exploratory cross-sectional survey was conducted among a convenience sample (N = 203) of informal carers as a part of developing an mHealth application. Family members, relatives, or friends who lived with people with dementia and provided care on an unpaid basis for more than three months were included. The questionnaire included sociodemographic data, carer-rated prevalence and severity of BPSD, and informal carers' knowledge of dementia, carer burden, information-seeking sources, availability of smartphones, mHealth information seeking and perception of mHealth information seeking related to managing BPSD. Descriptive analysis and inferential tests were performed. RESULTS Informal carers of people with dementia were predominantly female (70.4%), and 64% showed low knowledge of dementia. Of the participants, 35% reported a high carer burden, 53.7% reported a low burden, and only 11.3% reported no carer burden. Most of their care recipients (97%) had at least one BPSD. The prevalence and severity of BPSD were significantly and positively correlated with the carer burden. The participants' main source of information was health professionals. Most of them owned smartphones (63.5%), but none used mHealth applications for dementia-related information seeking. Approximately half of the respondents were ready to spend time (52.7%) and money (46.8%) on mHealth information seeking. Perceived mHealth usefulness was significantly associated with dementia knowledge, smartphone ownership, and readiness to spend time and money on mHealth information seeking. CONCLUSION Informal carers of people with dementia were affected by BPSD in their care recipients. This study explored carers' educational needs concerning dementia, BPSD, and carer burden. Informal carers could adapt mHealth for dementia-related information seeking. Their unmet needs in managing BPSD should be explored.
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Affiliation(s)
- Thilanka Jagoda
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
- Department of Nursing & Midwifery, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
| | - Samath D Dharmaratne
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Postgraduate Institute of Medical Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Sarath Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Zauszniewski JA, Almutairi R, Jeanblanc A, Juratovac E. Need-based intervention delivery for family caregivers of older adults with dementia. Arch Psychiatr Nurs 2024; 51:133-136. [PMID: 39034069 PMCID: PMC11391353 DOI: 10.1016/j.apnu.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/26/2024] [Accepted: 05/18/2024] [Indexed: 07/23/2024]
Abstract
Research on family caregivers of persons with dementia abounds with studies of psychoeducational and cognitive-behavioral interventions to reduce stress and promote mental health. Yet, the caregiver's needs for such interventions are rarely documented. This study of 87 dementia caregivers examined their needs for dementia education and Resourcefulness Training© using baseline cut scores on validated measures of dementia knowledge and resourcefulness skills. While 66 % showed high need for dementia education, 61 % showed moderate to high need for Resourcefulness Training© and 55 % showed moderate to high need for both, prompting future research to explore advantages of delivering both interventions to dementia caregivers.
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Sun H, Liu W, Sun X, Gao Y, Chen Y, Lin Y, Song J, Zhang Z, Wang BH, Li L, Feng H, Tan H, Chen Q, Peng L, Dai W, Wu IXY. Development and Validation of Knowledge Assessment Scales for Dementia and Urinary Incontinence in Community Older People. J Appl Gerontol 2024; 43:1042-1051. [PMID: 38488166 DOI: 10.1177/07334648241236036] [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: 08/09/2024] Open
Abstract
To develop and validate scales for reliably assessing dementia and urinary incontinence knowledge of older adults in the community. Items were generated through a literature review, refined through a Delphi study (n = 19), and then revised through a pilot study (n = 29). Item analysis and exploratory factor analysis were applied to finalize the scales (n = 244). Construct validity, reliability, and acceptability were evaluated (n = 243). The two knowledge assessment scales for dementia and urinary incontinence, respectively, comprised 12 items and 8 items. Model fit indicators of both met the criteria of confirmatory factor analysis. Cronbach's α were .82 and .70, respectively. Completion ratio and completion time of the two scales was 83.51% and 4.22 ± 1.90 minutes. The knowledge assessment scales for dementia and urinary incontinence with satisfactory validity, reliability, and acceptability, could be served as valid tools for disease prevention and management among older adults in the community.
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Affiliation(s)
- Hui Sun
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Wenqi Liu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yancong Chen
- Changsha Municipal Center for Disease Control and Prevention, Changsha, China
| | - Yali Lin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Jinlu Song
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Zixuan Zhang
- Changsha Municipal Center for Disease Control and Prevention, Changsha, China
| | - Betty H Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Lingqi Li
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Hui Feng
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hongzhuan Tan
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Qiong Chen
- Xiangya Hospital of Central South University, Changsha, China
| | - Linlin Peng
- Xiangya Hospital of Central South University, Changsha, China
| | - Wenjie Dai
- Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
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Buwembo DR, Gumikiriza-Onoria JL, Kamada L, Kaddu-Mukasa M, Kagaayi J, Kiguli J, Sajatovic M, Nakasujja N, Makumbi F. Measuring the quality of self-care of elderly patients with dementia in a developing country. ACADEMIA MENTAL HEALTH & WELL-BEING 2024; 1. [PMID: 39252694 PMCID: PMC11381492 DOI: 10.20935/mhealthwellb7300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
In developing countries like Uganda, people with dementia are cared for by non-medically trained family members with minimal support from the formal healthcare system. The quality of care in this setting is largely unknown but significantly affects the well-being of those with dementia. A tool designed to measure the quality of informal care for old frail adults with or without dementia was translated into Luganda. A committee of experts reviewed and finalized the translation, which was pilot-tested and then used to measure the quality of dementia self-care. We consecutively enrolled 105 caregivers of elderly people with dementia; the median age was 35 years (Interquartile Range 26-47 years), and 67% were females, taking care of a grandparent (44%) or a parent (34%). We used confirmatory factor analysis to assess for structural validity and computed correlation coefficients and Cronbach's alpha to assess for discriminant validity and internal reliability, respectively. The three-factor model applied to the 20 items, adequately fit the data (Comparative Fit Index = 0.88, Tucker-Lewis Index = 0.87, Root Mean Square Error of Approximation = 0.08; 90% Confidence Interval (0.06-0.09), Standardized Root Mean Square Residual = 0.089). There was good discriminant validity, and correlation coefficients between dimensions/scales and the Dementia Knowledge Assessment Scale scores were low. There was good internal reliability with all items Cronbach's alpha ranging from 0.69 to 0.89. Our findings demonstrated that this culturally adapted, shorter measurement tool is valid and reliable. The tool can be used by researchers, health workers, and agencies to assess the quality of self-care for elderly people with dementia in Uganda.
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Affiliation(s)
- Dennis Rogers Buwembo
- Brain Health Training Program, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Lwere Kamada
- Department of Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mark Kaddu-Mukasa
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joseph Kagaayi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Juliet Kiguli
- Department of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, School of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Noeline Nakasujja
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Fredrick Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Zhang Y, Teo WP, Theng YL. Co-Creating a Synchronous Tele-Education Program With Community-Dwelling Older Adults Using a Participatory Approach: A Mixed-Methods Study. J Appl Gerontol 2024:7334648241260614. [PMID: 39034286 DOI: 10.1177/07334648241260614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
There is a pressing need to include older individuals in health education and uncover their specific needs. Leveraging the advantages of digitized health education, this study employed a participatory approach to engage community-dwelling older adults in co-creating a synchronous tele-education program, with dementia as the focus due to its rising prevalence and associated stigma in Singapore. Our findings demonstrate the preliminary effectiveness and feasibility of tele-education. Participants' feedback and recommendations provided valuable insights and could guide the future development of a comprehensive tele-education program. Participants' satisfaction with the co-design workshops also indicates the potential of involving older generations in the design process of user-centered digital health interventions in online environments. Moving forward, the study advocates collaboration among health institutes, government and social agencies, and community organizations, alongside systematic evaluation of the long-term impacts of tele-education, with the aim of improving health outcomes and reducing health inequalities among the older population.
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Affiliation(s)
- Yichi Zhang
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
- Ageing Research Institute of Society and Education, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore
| | - Wei-Peng Teo
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
- Science of Learning in Education Centre, Office of Education Research, National Institute of Education, Nanyang Technological University, Singapore
| | - Yin-Leng Theng
- Ageing Research Institute of Society and Education, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore
- Centre of Healthy and Sustainable Cities, Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
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Middleton LE, Pelletier C, Koch M, Norman R, Dupuis S, Astell A, Giangregorio L, Freeman S. Dementia-Inclusive Choices for Exercise Toolkit: Impact on the Knowledge, Perspectives, and Practices of Exercise Providers. J Aging Phys Act 2024; 32:360-369. [PMID: 38262407 DOI: 10.1123/japa.2022-0401] [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] [Received: 11/30/2022] [Revised: 08/23/2023] [Accepted: 11/14/2023] [Indexed: 01/25/2024]
Abstract
Physical activity improves the well-being of persons living with dementia but few exercise programs include them. The Dementia-Inclusive Choices for Exercise (DICE) toolkit aims to improve exercise providers' understanding of dementia and ability to support persons living with dementia in physical activity. We evaluated the co-designed DICE toolkit with exercise providers using a mixed-methods approach comprising pre/post questionnaires and interviews and reflection diaries. Among 16 participants, self-efficacy for exercise delivery to persons living with dementia and both knowledge and attitudes toward dementia significantly improved. Thematic analysis suggested participants (a) had a deeper understanding of the variability of dementia, (b) were planning for equitable access for persons living with dementia, (c) planned to promote social connection through exercise, and (d) were optimistic for future engagement with persons living with dementia. The DICE toolkit may improve exercise providers' knowledge and confidence to plan proactively to support persons living with dementia in programs and services.
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Affiliation(s)
- Laura E Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo,ON, Canada
| | - Chelsea Pelletier
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Melissa Koch
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Rebekah Norman
- Recreation and Leisure Studies, University of Waterloo, Waterloo, ON, Canada
| | - Sherry Dupuis
- Schlegel-UW Research Institute for Aging, Waterloo,ON, Canada
- Recreation and Leisure Studies, University of Waterloo, Waterloo, ON, Canada
| | - Arlene Astell
- Department of Psychiatry, University of Toronto, Toronto, ON, USA
| | - Lora Giangregorio
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo,ON, Canada
| | - Shannon Freeman
- Department of Nursing, University of Northern British Columbia, Prince George, BC, Canada
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Wiese LK, Williams IC, Holt JK, Williams CL, Lingler J, Galvin JE, Schoenberg NE. Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults. Aging Ment Health 2024; 28:943-956. [PMID: 38127408 PMCID: PMC11144567 DOI: 10.1080/13607863.2023.2294062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer's disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment. METHODS An adaptation of Schoenberg's Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later. RESULTS This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ2(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ2(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics. CONCLUSION Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Ishan C Williams
- University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Janet K Holt
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
- Southern Illinois University, Edwardsville, IL, USA
| | | | - Jennifer Lingler
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
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Heynderickx PC, Creten S, Dieltjens SM. Rumor Has it: "Dementia" A Discourse-Analytical Analysis of Obituaries of People With Dementia. OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:1430-1445. [PMID: 35007173 DOI: 10.1177/00302228211060594] [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: 11/16/2022]
Abstract
Despite the increasing incidence of the condition, people with dementia face a double stigma: ageism and the stigma of mental illness. The stigmatization of the condition has negative consequences, and can even lead to self-stigmatization. To develop adequate education programs to overcome the harmful stigma, the degree and the characteristics of that stigmatization have to be identified. In this study, the content and the language of obituaries of well-known people with dementia are analyzed using a qualitative bottom-up approach. If mentioned, the dementia receives little attention and the information given does not exceed common knowledge. Euphemistic language such as metaphors is introduced not to circumvent the condition, but to palliate its degressive nature.
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Affiliation(s)
| | - Silke Creten
- KU Leuven-Faculty of Arts-campus Antwerpen, Antwerp, Belgium
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12
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Giebel C, Hanna K, Tetlow H, Gabbay M, Cannon J. Co-producing a board game to learn and engage about dementia inequalities: First impacts on knowledge in the general population. Health Expect 2024; 27:e13977. [PMID: 39102705 PMCID: PMC10792594 DOI: 10.1111/hex.13977] [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: 12/11/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Receiving and accessing care after a diagnosis of dementia, both for the person and their carer, are fraught with inequalities. The aim of this public engagement activity was to co-produce a board game about dementia inequalities to facilitate learning, dialogue and educate about different barriers, and facilitators, to diagnosis and care and to test the game's impact on dementia knowledge with the general public. METHODS Two virtual and two face-to-face workshops with people with dementia, unpaid carers, health and social care professionals and Third Sector representatives were held between October 2022 and June 2023. Virtual workshops involved discussions of inequalities and how a board game may feature inequalities. The first face-to-face workshop was split into the same activities, aided by outcomes from workshops 1 and 2. Workshop 4 attendees tested the prototype. The impact of the game on knowledge about dementia and inequalities was tested at a game play workshop in October 2023. RESULTS Forty stakeholders attended four workshops. Workshops provided step-by-step thoughts on how the game could be designed or modified. The final game, prototype tested in workshop 4, consists of a one-sided, two-half board depicting the prediagnosis process (left half) and postdiagnosis process (right half). Fifty-two members of the general public participated in the game play workshop, which led to significant improvements in knowledge about dementia (p < .001) and inequalities (p < .001). DISCUSSION The game can be used to improve knowledge about dementia inequalities for health and social care professionals, carers, people living with dementia, decision makers and the general public. PATIENT OR PUBLIC CONTRIBUTION This engagement activity fully involved people with dementia, unpaid carers, health and social care professionals and Third Sector representatives throughout, with two unpaid carers as public advisers on the team.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
- NIHR Applied Research Collaboration North West CoastLiverpoolUK
| | - Kerry Hanna
- School of Health SciencesUniversity of LiverpoolLiverpoolUK
| | - Hilary Tetlow
- NIHR Applied Research Collaboration North West CoastLiverpoolUK
- SURF LiverpoolLiverpoolUK
| | - Mark Gabbay
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
- NIHR Applied Research Collaboration North West CoastLiverpoolUK
| | - Jacqui Cannon
- NIHR Applied Research Collaboration North West CoastLiverpoolUK
- Lewy Body SocietyWiganUK
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Seltmann H, Teichmann B. Dementia Knowledge, Attitude toward Dementia, and Confidence in Dementia Care: Impact of a Dementia Training on German Nursing Students. J Alzheimers Dis 2024; 98:1107-1119. [PMID: 38517791 DOI: 10.3233/jad-231338] [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: 03/24/2024]
Abstract
Background The number of people with dementia (PwD) in acute care hospitals is steadily increasing, posing a challenge for those who work closely with patients. To date, no German study has addressed the extent to which prospective nurses benefit from dementia training in terms of their knowledge, attitudes, and confidence in caring for PwD. Objective The aim of this study is to investigate whether a validated dementia training for registered nurses can positively change nursing students' knowledge about dementia, their attitude toward PwD, and their confidence in caring for them, as well as the stability over time. Methods In the one-group pre-test, post-test design, a sample of 81 nursing students was recruited from two nursing schools in Germany between May and June 2023. They completed a questionnaire consisting of the Dementia Knowledge Assessment Scale, the Dementia Attitude Scale, and the Confidence in Dementia Scale, as well as sociodemographic questions and experiences with PwD at three measurement points. The data were analyzed using the Wilcoxon test and repeated measures ANOVA. Results The training has a significant effect on knowledge in dementia (z = -5.07, p < 0.001), attitude toward PwD (z = -4.42, p < 0.001), and confidence in caring for them at the post-test (z = -3. 21, p < 0.001, r = 0.36). The repeated measures ANOVA shows stability over time only for dementia knowledge. Conclusions The results indicate the need for further research in this field as well as the validation of the dementia training specifically addressing nursing students.
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Affiliation(s)
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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Skowronek A, Bojkowska-Otrębska K, Łabuz-Roszak B. Public Knowledge about Dementia in Poland-A Survey Study. J Clin Med 2023; 12:7675. [PMID: 38137744 PMCID: PMC10743585 DOI: 10.3390/jcm12247675] [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: 10/29/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Based on worldwide estimates, the number of people with dementia will increase significantly in the coming decades. Therefore, knowledge about dementia and its modifiable risk factors plays a crucial role in prevention. Although dementia is still incurable, an early diagnosis might help to slow down its progression and improve the quality of patients' lives. The aim of the study was to assess public knowledge about dementia and its risk factors in Poland. METHODS The research was conducted in 2022 using a self-constructed questionnaire by applying computer-assisted web interviewing (CAWI). RESULTS A total of 304 completed surveys were obtained (mean score of 16.95 ± 2.79 points out of 23.6). The scores were significantly higher for people associated with the medical community in comparison to those unrelated to the medical community (18.23 ± 2.61 and 16.15 ± 2.59, respectively; p = 0.0001). A moderate negative correlation was found between the results and the ages of the respondents (R = -0.44; p = 0.001). No statistically significant differences were reported in the results between people involved in providing care to patients with dementia or those who had a patient with dementia in the family and those who were not involved in such care or had no relative with dementia. CONCLUSIONS Knowledge about dementia and its risk factors in Poland is not satisfactory and should be improved. Special attention should be paid to educating the families and caregivers of people with dementia.
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Affiliation(s)
- Alicja Skowronek
- Student Scientific Association at the Department of Neurology, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland;
| | | | - Beata Łabuz-Roszak
- Department of Neurology, St. Jadwiga Provincial Specialist Hospital, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland
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Smaling HJ, Jingyuan X, Nakanishi M, Shinan-Altman S, Mehr DR, Radbruch L, Gaertner J, Werner P, Achterberg WP, van der Steen JT. Interventions that may increase control at the end of life in persons with dementia: the cross-cultural CONT-END acceptability study protocol and pilot-testing. BMC Palliat Care 2023; 22:142. [PMID: 37752467 PMCID: PMC10523619 DOI: 10.1186/s12904-023-01249-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Interventions such as advance care planning (ACP), technology, or access to euthanasia may increase the sense of control over the end of life. In people with advanced dementia, the loss of cognitive and physical function limits the ability to control care. To date, little is known about the acceptability of these interventions from the perspective of persons with dementia and others involved. This study will examine the cross-cultural acceptability, and factors associated with acceptability, of four end-of-life interventions in dementia which contain an element of striving for control. Also, we report on the development and pilot testing of animation video vignettes that explain the interventions in a standardized manner. METHODS Cross-sectional mixed-methods vignette study. We assess acceptability of two ACP approaches, technology use at the end of life and euthanasia in persons with dementia, their family caregivers and physicians in six countries (Netherlands, Japan, Israel, USA, Germany, Switzerland). We aim to include 80 participants per country, 50 physicians, 15 persons with dementia, and 15 family caregivers. After viewing each animation video, participants are interviewed about acceptability of the intervention. We will examine differences in acceptability between group and country and explore other potentially associated factors including variables indicating life view, personality, view on dementia and demographics. In the pilot study, participants commented on the understandability and clarity of the vignettes and instruments. Based on their feedback, the scripts of the animation videos were clarified, simplified and adapted to being less slanted in a specific direction. DISCUSSION In the pilot study, the persons with dementia, their family caregivers and other older adults found the adapted animation videos and instruments understandable, acceptable, feasible, and not burdensome. The CONT-END acceptability study will provide insight into cross-cultural acceptability of interventions in dementia care from the perspective of important stakeholders. This can help to better align interventions with preferences. The study will also result in a more fundamental understanding as to how and when having control at the end of life in dementia is perceived as beneficial or perhaps harmful. TRIAL REGISTRATION The CONT-END acceptability study was originally registered at the Netherlands Trial Register (NL7985) at 31 August, 2019, and can be found on the International Clinical Trials Registry Platform.
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Affiliation(s)
- Hanneke J.A. Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Gebouw 3, Postal zone V0-P, P.O. Box 9600, Leiden, 2300 RC The Netherlands
- University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Xu Jingyuan
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Gebouw 3, Postal zone V0-P, P.O. Box 9600, Leiden, 2300 RC The Netherlands
| | - Miharu Nakanishi
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Gebouw 3, Postal zone V0-P, P.O. Box 9600, Leiden, 2300 RC The Netherlands
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - David R. Mehr
- Department of Family and Community Medicine, University of Missouri, Columbia, MO USA
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
- Centre for Palliative Medicine, Helios Hospital Bonn/Rhein-Sieg, Bonn, Germany
| | - Jan Gaertner
- Palliative Care Center Hildegard, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Wilco P. Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Gebouw 3, Postal zone V0-P, P.O. Box 9600, Leiden, 2300 RC The Netherlands
- University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
- Center for Old Age Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Gebouw 3, Postal zone V0-P, P.O. Box 9600, Leiden, 2300 RC The Netherlands
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
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La Vallee L, Johnson JL, Shade K. Improving Dementia-Specific Referrals From the Acute Care Setting: A Quality Improvement Project. Prof Case Manag 2023; 28:224-234. [PMID: 36630223 DOI: 10.1097/ncm.0000000000000635] [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: 01/12/2023]
Abstract
PURPOSE OF STUDY The purpose of this quality improvement project was to design and implement an education and referral protocol for care coordination staff to use when working with hospitalized patients with dementia and their families. The goal was to increase delivery of dementia resource education and dementia-specific referrals during the discharge planning process. PRIMARY PRACTICE SETTING The practice setting for this project was an acute care hospital in Northern California. The care coordination department collaborated with the Northern California Chapter of the Alzheimer's Association to improve the delivery of referrals and follow-up with patients and families who were interested in additional information and support related to dementia. METHODOLOGY AND SAMPLE Twenty-one members of the care coordination department received education on the dementia disease process as well as community resources available to the patient population. The registered nurse care coordinators (RNCCs) and social workers (SWs) within the department then implemented a referral protocol to connect patients with dementia and their families to the Alzheimer's Association. Referral volume was captured over a 60-day preimplementation period, a 60-day implementation period, and a 60-day postimplementation period. The Northern California Chapter of the Alzheimer's Association tracked referral volume. A paired-sample t test was used to examine pre/postimplementation Dementia Knowledge Assessment Scale (DKAS) scores to evaluate the impact of the education intervention. Care coordination staff completed a pre/postimplementation survey on knowledge of community resources for dementia and confidence in connecting patients to these resources. They also completed a postimplementation survey about the benefit of the project to their care coordination practice. RESULTS There was a modest, yet positive increase in referral volume over the 60-day implementation period ( n = 6) compared with the preimplementation period ( n = 1). An increase was sustained during the 60-day postimplementation period ( n = 4). Pre/posttimplementation DKAS scores significantly improved for care coordination staff postimplementation ( p < .001) by an average of 7 points. Fifty-three percent of RNCC and SW staff responded to the postimplementation survey, and results indicated they thought the project was beneficial ( n = 8) or somewhat beneficial ( n = 1) to practice. In addition, RNCC and SW staff reported an increase in awareness of available community resources and confidence in connecting patients and families to these resources. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE Case management professionals have an important role in providing education and support to patients and families across the continuum of care. The complexity and trajectory of illness, shortage of qualified providers, and gaps in provider knowledge about resources place patients with dementia and their families in an increasingly vulnerable position within the health care system. This quality improvement project demonstrates that care coordination staff can improve referrals to resources when in contact with patients and families in the acute care setting. Case managers can ensure patients with dementia and their families have access to the resources in the community that may prevent return to the emergency department or rehospitalization.
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Affiliation(s)
- Lisamarie La Vallee
- Lisamarie La Vallee, DNP-C, MSN, RN, ACM, is an assistant professor at Samuel Merritt University, Sacramento, CA. She has experience in acute care case management, education, and consulting. Her clinical and research interests include improving transitions of care and health equity for diverse populations
- Jonni Johnson, PhD, is a senior research scientist for the California Department of Public Health/Center for Health Statistics and Informatics. She received her doctoral degree from UC Davis in Developmental Psychology. Her main areas of study include memory development, atypical memory functioning, and quantitative psychology
- Kate Shade, PhD, RN, is an assistant professor at Cal State East Bay and an adjunct associate professor at Samuel Merritt University, Sacramento, CA. Dr. Shade has experience in public health case management and program evaluation. She has conducted research with youth involved in the juvenile justice system
| | - Jonni L Johnson
- Lisamarie La Vallee, DNP-C, MSN, RN, ACM, is an assistant professor at Samuel Merritt University, Sacramento, CA. She has experience in acute care case management, education, and consulting. Her clinical and research interests include improving transitions of care and health equity for diverse populations
- Jonni Johnson, PhD, is a senior research scientist for the California Department of Public Health/Center for Health Statistics and Informatics. She received her doctoral degree from UC Davis in Developmental Psychology. Her main areas of study include memory development, atypical memory functioning, and quantitative psychology
- Kate Shade, PhD, RN, is an assistant professor at Cal State East Bay and an adjunct associate professor at Samuel Merritt University, Sacramento, CA. Dr. Shade has experience in public health case management and program evaluation. She has conducted research with youth involved in the juvenile justice system
| | - Kate Shade
- Lisamarie La Vallee, DNP-C, MSN, RN, ACM, is an assistant professor at Samuel Merritt University, Sacramento, CA. She has experience in acute care case management, education, and consulting. Her clinical and research interests include improving transitions of care and health equity for diverse populations
- Jonni Johnson, PhD, is a senior research scientist for the California Department of Public Health/Center for Health Statistics and Informatics. She received her doctoral degree from UC Davis in Developmental Psychology. Her main areas of study include memory development, atypical memory functioning, and quantitative psychology
- Kate Shade, PhD, RN, is an assistant professor at Cal State East Bay and an adjunct associate professor at Samuel Merritt University, Sacramento, CA. Dr. Shade has experience in public health case management and program evaluation. She has conducted research with youth involved in the juvenile justice system
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Bushell D, Jones C, Moro C. The effectiveness of educational interventions in the community that aim to improve informal carers knowledge of dementia anatomy, physiology, progression, and impact on behavior: a systematic review. FRONTIERS IN DEMENTIA 2023; 2:1156863. [PMID: 39082003 PMCID: PMC11285698 DOI: 10.3389/frdem.2023.1156863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/30/2023] [Indexed: 08/02/2024]
Abstract
Introduction Dementia education is a vital component of dementia care and management for patients and their informal carers and family. To fully understand dementia, some knowledge of the anatomy and physiology of the brain may be necessary and would help informal carers understand behaviors of dementia to help cope with care provision. Method This integrative review aims to identify, appraise, and assess whether dementia education resources include information detailing the anatomy of the brain and its relationship with dementia and whether this information improves knowledge (PROSPERO Registration Number: CRD42022320530). Literature published from 2012 until May 4, 2022 was searched in eight databases with six articles meeting the inclusion criteria. Results Using the Mixed Methods Appraisal Tool (2018) methodological quality varied across studies. There are limited educational interventions which incorporate information on the anatomy and the physiology of the brain. None of the interventions focused solely on providing neurological education; however, all contained at least some content that addressed this, as per inclusion criteria. In most cases, the educational interventions were well-received and delivered, which did not differ, whether they were delivered in person or virtually. The majority of the studies reported an increase in dementia knowledge (measured pre-post or perceived) following the intervention. Discussion Educational interventions on brain anatomy and physiology remain limited, and if included, are often not the focus, and as such more rigorous study is required to investigate the effect of educational interventions on dementia knowledge and their role in dementia care.
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Affiliation(s)
- Dayna Bushell
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Cindy Jones
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - Christian Moro
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
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Melchior F, Teichmann B. Measuring Dementia Knowledge in German: Validation and Comparison of the Dementia Knowledge Assessment Scale, the Knowledge in Dementia Scale, and the Dementia Knowledge Assessment Tool 2. J Alzheimers Dis 2023:JAD230303. [PMID: 37302037 PMCID: PMC10357161 DOI: 10.3233/jad-230303] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Assessing dementia knowledge is critical for developing and improving effective interventions. There are many different tools to assess dementia knowledge, but only one has been validated in German so far. OBJECTIVE To validate two tools for assessing dementia knowledge-the Dementia Knowledge Assessment Scale (DKAS-D) and the Knowledge in Dementia Scale (KIDE-D) for the German general population-and compare their psychometric properties with the Dementia Knowledge Assessment Tool 2 (DKAT2-D). METHODS A convenience sample of 272 participants completed online surveys. Analyses included internal consistency, structural validity, construct validity through the known-groups method, retest-reliability with a subgroup of n = 88, and floor and ceiling effects. This study used the STROBE checklist. RESULTS Internal consistency was acceptable for DKAT2-D (α= 0.780), very good for DKAS-D (α= 0.873), and poor for KIDE-D (α= 0.506). Construct validity was confirmed for all questionnaires. Retest-reliability was good for DKAT2-D (0.886; 0.825-0.926) and KIDE-D (0.813; 0.714-0.878), while it was great for DKAS-D (0.928; 0.891-0.953). Trends toward ceiling effects were observed for DKAT2-D and KIDE-D, but not for DKAS-D. The principal component analysis did not reveal a coherent structure for DKAT2-D or KIDE-D, while the confirmatory factor analysis proposed the removal of 5 items for DKAS-D resulting in the shortened DKAS20-D, which had nearly identical properties. CONCLUSION Both DKAS-D and its shortened version, DKAS20-D, are reliable instruments for evaluating programs intended for the general population, as they were found to be convincing in all aspects.
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Affiliation(s)
- Florian Melchior
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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Jones D, Capstick A, Faisal M, Frankland J. The impact of dementia education on student paramedics' preparedness to care, knowledge, confidence and attitudes towards dementia: an analytic survey. Br Paramed J 2023; 8:9-17. [PMID: 37284607 PMCID: PMC10240862 DOI: 10.29045/14784726.2023.6.8.1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Background Paramedics play a vital role in the emergency healthcare of people living with dementia. People with dementia often have complex needs, posing challenges for paramedics. Paramedics often lack the confidence and skills to assess people with dementia appropriately, and receive little, if any, dementia education. Aims To evaluate the impact of dementia education on student paramedics' preparedness to care, knowledge, confidence and attitudes towards dementia. Methods A 6-hour education programme on dementia was developed, implemented and evaluated. A pre-test-post-test design using self-completion validated questionnaires was used, to evaluate first-year undergraduate student paramedics' knowledge, confidence and attitudes towards dementia, as well as their preparedness to care for people with dementia. Results A total of 43 paramedic students attended the education programme, with 41 fully completed questionnaires being collected pre-training and 32 post-training. Students reported feeling significantly more preparedness to care for people with dementia after the education session (p < 0.001). They felt their knowledge (100%), confidence (87.5%) and attitudes (87.5%) towards dementia had significantly increased following the education session. Using validated measures, the impact of education was found to be the highest on dementia knowledge (13.8 vs 17.5; p < 0.001) and on confidence (29.14 vs 34.06; p = 0.001), with only a minimal effect on attitudes (101.5 vs 103.4; p = 0.485). The education programme itself was well-evaluated. Conclusion As paramedics are central to the emergency healthcare of people living with dementia, it is essential that the emerging paramedic workforce is equipped with the knowledge, attitudes and confidence to provide quality care for this population. We need to ensure dementia education is embedded in undergraduate curricula, and that consideration is given to the subjects, level and pedagogic approach taken to ensure positive outcomes are maximised.
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Awuol MDA, Innocent BK, Winfred A. Prevalence, factors associated and knowledge of probable dementia among adults 50 years and over attending a faith-based geriatric center in Uganda. Sci Rep 2023; 13:6737. [PMID: 37185948 PMCID: PMC10127194 DOI: 10.1038/s41598-023-33948-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/21/2023] [Indexed: 05/17/2023] Open
Abstract
Dementia is on the rise due to increasing proportion of old people in sub-Saharan Africa (SSA). Although dementia is misattributed to normal ageing or supernatural causes in SSA, it is a brain disease with well-established etiologies. Limited knowledge and understanding of dementia means that many older people are suffering without seeking help and are undiagnosed and untreated. The aim of this study was to determine the prevalence and factors associated with probable dementia and to describe the knowledge of the disease among adults 50 years and over attending a faith-based geriatric center in Uganda. This was a cross-sectional study using quantitative methods. A total of 267 adults 50 years and over attending a faith-based geriatric center in Mukono, Uganda were interviewed between 1 April and 15 May 2022. Interviews were administered using the Early Dementia Questionnaire (EDQ) and Dementia Knowledge Assessment Scale (DKAS). Data on participants' socio-demographics, economic income, living arrangement, history of smoking, alcohol consumption, exercise and past medical history was collected using an additional questionnaire. Adults 50 years and over were included in the study. Logistic regression analyses were done. Probable dementia was 46.2% in the sample. The most common symptoms of probable dementia in the order of their severity were memory symptoms, (β co-efficient β 0.08, p < .001), physical symptoms (β 0.08, p < .001), sleep disturbances (β 0.81, p < .001) and emotions (β 0.04, p < .027). The final degree of association as determined by adjusted PR in the multivariable model revealed that only older age (aPR = 1.88, p < .001) and occasional/non-believer (aPR = 1.61, p = .001) remained significantly related to probable dementia. The study also found that 8.0% of the participants had optimal knowledge of dementia. There is high burden of probable dementia among adults 50 years and over attending a faith-based geriatric center in Mukono, Uganda. Factors associated with probable dementia are older age and being an occasional/non-believer. Knowledge of dementia among older adults is low. There is need to promote integrated early dementia screening, care and educational program in primary care to reduce the disease burden. Spiritual support would be a rewarding investment in the lives of the ageing population.
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Affiliation(s)
| | - Besigye K Innocent
- Department of Family Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ayenyo Winfred
- Soroti Regional Referral Hospital, Sororti District, Uganda
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Relationship Between Dementia Knowledge and Occupational Strain Among Staff of Residential Facilities for Older Adults: A Cross-sectional Survey. AGEING INTERNATIONAL 2023. [DOI: 10.1007/s12126-023-09523-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
AbstractWorking with people living with dementia in residential facilities for older adults can be challenging, and this is exacerbated when staff have a limited understanding of dementia. However, the relationship between knowledge of dementia and strain in caring for people with dementia among residential facility staff is unclear. This cross-sectional study investigated the relationship between dementia knowledge and strain in caring for people with dementia. A questionnaire containing the Dementia Knowledge Assessment and Strain in Dementia Care Scales was administered in 2017 and 2019 to 141 staff in three southern Australian residential facilities for older adults. Bivariate and hierarchical regression analysis examined inter-scale relationships and the power of dementia strain to explain knowledge variance. It was found that staff had substantial gaps in dementia knowledge (mean score 32/50) and low strain in dementia care (mean score 4/16). A positive relationship was found between higher dementia knowledge and greater strain in dementia care (rs = 0.319, p < .001), particularly with feeling that residents are not receiving appropriate care from colleagues (Factor 1 Frustrated Empathy; rs = 0.392, p < .001). Frustrated Empathy explained a significant amount of variance in dementia knowledge beyond demographic variables. The findings suggest that more comprehensive dementia knowledge is associated with higher strain in care of people with dementia, particularly in the context of perceived lapses in the quality of care provided by colleagues. Arguably, organisational-wide dementia education to address identified gaps should be supported by facilitating staff enaction of their knowledge to improve care.
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Aldharman SS, Alayed FT, Aljohani BS, Aladwani AM, Alyousef MA, Hakami KM, Albalawi DM, Alnaaim SA. An Assessment of Dementia Knowledge and Its Associated Factors Among Health College Students in Saudi Arabia. Cureus 2023; 15:e34578. [PMID: 36874297 PMCID: PMC9981551 DOI: 10.7759/cureus.34578] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
Background Dementia is a public health concern and the main cause of impairment and dependency among the elderly worldwide. It is characterized by a progressive decline in cognition, memory, and all domains of quality of life with preserving the level of consciousness. Accurate measurement of dementia knowledge among future health professionals is required to improve targeted educational initiatives and supportive care of patients. This study aimed to assess knowledge of dementia and its associated factors among health college students in Saudi Arabia. Methods A descriptive, cross-sectional study was conducted among health college students from various regions in Saudi Arabia. Data on sociodemographic characteristics and dementia knowledge were gathered using a standardized study questionnaire Dementia Knowledge Assessment Scale (DKAS) distributed on different social media platforms. Data analysis was carried out using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA) statistical software. A P-value of <0.05 was considered significant. Results A total of 1,613 participants were included in the study. The mean age was 20.5 ± 2.5 years (range 18-25 years). The majority of them were males (64.9%), and females represented 35.1%. The mean knowledge score of the participants was 13.68 ± 3.18 (out of 25). According to DKAS subscales, we found that the respondents scored the highest in care considerations (4.17 ± 1.30) and the lowest in risks and health promotion (2.89 ± 1.96). Furthermore, we found that the participants with no previous dementia exposure had a significantly higher level of knowledge than those with previous dementia exposure. In addition, we found that both genders, aged 19, 21, 22, 23, 24, and 25 years; the geographic distribution of respondents; and previous dementia exposure significantly affected the DKAS score. Conclusions Our findings showed that health college students in Saudi Arabia had poor knowledge about dementia. Ongoing health education and comprehensive academic training are recommended to improve their knowledge and provide competent care for dementia patients.
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Affiliation(s)
- Sarah S Aldharman
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Faisal T Alayed
- College of Medicine, Al-Imam Mohammed Ibn Saud Islamic University, Riyadh, SAU
| | - Badr S Aljohani
- Department of Medicine, Alrayan Medical College, Madinah, SAU
| | | | - Meshal A Alyousef
- College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | | | - Saud A Alnaaim
- Department of Neurology, King Faisal University, Al-Ahsa, SAU
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Zhang Q, Deng J, Luo H, Wang L. Senile dementia and psychiatric stigma among community health service providers and relatives of diagnosed and suspected dementia patients: a cross-sectional study. PeerJ 2023; 11:e14613. [PMID: 36647450 PMCID: PMC9840390 DOI: 10.7717/peerj.14613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/01/2022] [Indexed: 01/13/2023] Open
Abstract
Background The number of people suffering from dementia is increasing rapidly in China. Early identification, referral, and intervention for dementia patients within communities are important to public health. However, these measures could be impacted by misconceptions about dementia and associated psychiatric stigma from community health professionals and relatives of dementia patients. Methods A cross-sectional survey was conducted on 249 participants, which included community doctors, community nurses, and relatives of diagnosed and suspected dementia patients in Guiyang, China. Participants were recruited through convenient sampling. The Chinese version of Dementia Knowledge Assessment Scale (DKAS) and the Perceived Psychiatric Stigma Scale (PPSS) were used to evaluate the participants' knowledge of dementia and dementia-related psychiatric stigma. Results A total of 249 participants completed the questionnaire. The participants had moderate overall knowledge of dementia and the associated psychiatric stigma. Participants who were ≥45 years old, had a low level of education, had a low monthly income, or gained knowledge of dementia through non-media channels had lower awareness of dementia and stronger psychiatric stigma. In the "Communication & behavior" subscale of DKAS, all participants had a low level of awareness. Relatives of diagnosed and suspected dementia patients had higher total PPSS and "Marital preclusion" subscale scores than community doctors and nurses but lower psychiatric stigma based on the PPSS "Self-deprecation" subscale score. Conclusions Despite their profession, community doctors and nurses did not show an absolute advantage over relatives of diagnosed and suspected dementia patients in the dementia knowledge, and they even showed higher psychiatric stigma in some subscales. The self-deprecation subscale is related to the identification with negative labels such as "people with a mental illness are the weak". This study shows that reducing stigma on the "Self-deprecation" subscale should be a core component of training and educational programs targeted at improving dementia knowledge among community health service providers.
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Affiliation(s)
- Qiwen Zhang
- Department of Geriatric Psychiatry, The Second People’s Hospital of Guizhou Province, Guiyang, Guizhou, China
| | - Jing Deng
- Department of Psychiatry, The Second People’s Hospital of Guizhou Province, Guiyang, Guizhou, China
| | - Huanyue Luo
- Department of VIP Clinic, The Second People’s Hospital of Guizhou Province, Guiyang, Guizhou, China
| | - Li Wang
- Department of Geriatric Psychiatry, The Second People’s Hospital of Guizhou Province, Guiyang, Guizhou, China
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Makri M, Gkioka M, Moraitou D, Fidani L, Tegos T, Tsolaki M. Attitudes, Motivations, and Barriers to Pre-Symptomatic Alzheimer's Disease Screening: Development and Validation of the 'Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening' (PRE-ADS) Questionnaire. J Alzheimers Dis 2023; 95:1163-1174. [PMID: 37661876 DOI: 10.3233/jad-220954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Pre-symptomatic screening methods for detecting a higher risk of Alzheimer's disease (AD) are gaining popularity; thus, more people are seeking these tests. However, to date, not much is known about the attitudes toward pre-symptomatic AD screening. OBJECTIVE The goal of this study is to examine the psychometric properties of a tool for assessing the attitudes, barriers, and motivations to pre-symptomatic AD screening. METHODS This is a cross-sectional study performed on 208 Greek participants (189 students and 19 caregivers) provided with an online questionnaire. Psychometric properties were assessed through the examination of its construct validity (principal component analysis) and internal consistency. RESULTS Exploratory factor analysis revealed the presence of four factors. The first factor is labeled as "Perceived harms of testing" (10 items), the second "Acceptance of testing" (5 items), the third "Perceived benefits of testing" (6 items), and the fourth factor "Need for knowledge" (4 items). The reliability (internal consistency) of each factor separately was acceptable to good (0.70-0.87) while the internal consistency of the overall questionnaire (25 items) was good (Cronbach's α=0.82). CONCLUSION PRE-ADS is a valid questionnaire that might help in the research of peoples' attitudes related to the pros and cons of pre-symptomatic screening for AD, and the development of effective counseling programs and prevention strategies. However, future research is required in the target population.
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Affiliation(s)
- Marina Makri
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Association of Alzheimer Disease and Related Disorders, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mara Gkioka
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despina Moraitou
- Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Liana Fidani
- Department of Medical Biology-Genetics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Tegos
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magdalini Tsolaki
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Association of Alzheimer Disease and Related Disorders, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ownby RL, Davenport R. An Online Shared Decision-making Intervention for Dementia Prevention: A Parallel-group Randomized Pilot Study. Curr Alzheimer Res 2023; 20:577-587. [PMID: 38047365 DOI: 10.2174/0115672050274126231120112158] [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] [Received: 07/25/2023] [Revised: 01/01/1970] [Accepted: 10/19/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES Evaluate the acceptability and efficacy of an online dementia prevention intervention based on a cognitive behavioral shared decision-making model. MATERIALS AND METHODS This was an unblinded pilot study in which participants were randomly assigned to one of two treatment groups. This study was carried out remotely via telephone, video conferencing, and online data collection. Eighteen English-speaking persons 40 years of age and older interested in developing more brain-healthy lifestyles. Both groups received 12 weekly sessions on lifestyle factors related to cognitive decline. The treatment-as-usual (TAU) group received the information and was encouraged to make lifestyle changes. The cognitive behavioral shared decision- making model (CBSDM) group received structured weekly sessions with support for evidence- informed personal goal choices and behavior change strategies. Primary outcome measures were the Alzheimer's Disease Risk Inventory and the Memory Self-Efficacy and Dementia Knowledge Assessment Scales. Participants reported brain health activities during the first, sixth, and 12th weeks of the study. RESULTS No significant between-group changes were seen in the three primary outcome measures. The intervention was viewed positively by participants, who all said they would participate in it again. Participants in the CBSDM group showed increases in knowledge of dementia risk factors and exercise. Other outcomes were consistent with moderate to large effect sizes for both groups. CONCLUSION An online intervention providing psychoeducation and behavior change support was viewed positively by older adults. Results provide preliminary support for the CBSDM intervention's efficacy in promoting brain health in older adults. CLINICAL TRIAL REGISTRATION NUMBER NCT04822129.
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Affiliation(s)
- Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Rosemary Davenport
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
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Smith GD, Ho K, Lee A, Lam L, Chan S. Dementia literacy in an ageing world. J Adv Nurs 2022; 79:2167-2174. [PMID: 36582068 DOI: 10.1111/jan.15556] [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: 06/07/2022] [Revised: 11/27/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
AIMS This discursive article aims to capture and explore the most pertinent nursing aspects of dementia literacy (DL). BACKGROUND Older people constitute a rapidly increasing proportion of the global population, experiencing higher risk of developing chronic disease, including dementia. It is important that older adults receive and understand reliable health-related information, as age-related changes may affect the level of health literacy in an older person. It has been suggested that older adults may have poorer health literacy than younger adults, associated with poorer health outcomes. Health literacy, how people receive, interpret and act on health information, play a significant role in dementia-related disorders, both as a possible predicter of onset of dementia and as a potential modifier of cognitive decline. Dementia literacy constitutes one aspect of health literacy in relation to nursing care, related to knowledge of dementia-related disorders and approaches towards older people with dementia. DESIGN This discursive article explores the importance of DL for the nursing profession, including dementia-related assessment, education and interventions. METHOD This article is informed by analysis of relevant descriptive and empirical literature and policy documents related to DL, an increasingly important aspect of dementia-related nursing care. Valid assessment tools that can accurately assess aspects an individuals' DL are examined; these have the potential to help nurses detect dementia-related symptoms. With early detection and prevention of dementia, older people may have better chance of benefiting from evolving treatment options. CONCLUSION Greater attention needs to be given to the issue of DL in older people, especially in terms of nursing assessment and care. Globally, increased DL-related education is urgently required to improve knowledge of this concept; this includes public awareness initiatives to better understanding this chronic condition. IMPLICATION NURSING PRACTICE Enhancing DL has the potential to empower older people to have greater access to healthcare services and to make more informed decisions about their health care. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution, as this is a discursive article.
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Affiliation(s)
- Graeme Drummond Smith
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, Hong Kong
| | - Ken Ho
- Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Allen Lee
- Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Linda Lam
- Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong
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27
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Pacifico D, Fiordelli M, Fadda M, Serena S, Piumatti G, Carlevaro F, Magno F, Franscella G, Albanese E. Dementia is (not) a natural part of ageing: a cross-sectional study on dementia knowledge and misconceptions in Swiss and Italian young adults, adults, and older adults. BMC Public Health 2022; 22:2176. [PMID: 36434540 PMCID: PMC9701025 DOI: 10.1186/s12889-022-14578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Increasing public awareness and understanding of dementia is the second key action area of the 2017 WHO Global action plan on a public health response to dementia. To achieve this aim, the first indispensable step is to understand the average level of dementia knowledge and to identify areas of low dementia knowledge. We aimed to quantify dementia knowledge in the general population, and to explore the extent to which it differs by age, sex, education, and indirect experience with dementia. METHODS We conducted an online cross-sectional survey in two Italian-speaking sites, south Switzerland (Ticino) and northern Italy (Piedmont). The survey was distributed between September and December 2019. We registered socio-demographic characteristics including whether the participant had contact with a person living with dementia, and measured dementia knowledge with the Dementia Knowledge Assessment Survey (DKAS). RESULTS Misconceptions about dementia were common among respondents, and lack of knowledge has been identified in dementia causes, characteristics, risk factors, and health promotion. Our results point out the lack of knowledge about how to communicate and relate with, and take care of a person living with dementia. The overall DKAS score was significantly and positively associated with female sex (β = 0.21; p < 0.001), educational level (β = 0.15; p < 0.001) and contact with a person living with dementia (β = 0.17; p < 0.001), but not with age (β = -0.01; p = 0.57). CONCLUSION Our results confirmed that general population's knowledge of dementia is thin. Interventional studies that rely on participatory action research methods are warranted to co-design interventions aimed at improving dementia knowledge and understanding in the public.
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Affiliation(s)
- Deborah Pacifico
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Marta Fadda
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Sabatini Serena
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | | | - Fabio Carlevaro
- grid.7605.40000 0001 2336 6580Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Turin, Italy
| | - Francesca Magno
- grid.7605.40000 0001 2336 6580Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Turin, Italy ,grid.7605.40000 0001 2336 6580University of Turin, Turin, Italy
| | - Giovanni Franscella
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- grid.29078.340000 0001 2203 2861Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland ,grid.8591.50000 0001 2322 4988Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Hung SP, Liao YH, Eccleston C, Ku LJE. Developing a shortened version of the dementia knowledge assessment scale (DKAS-TC) with a sample in Taiwan: an item response theory approach. BMC Geriatr 2022; 22:886. [PMID: 36418953 PMCID: PMC9682634 DOI: 10.1186/s12877-022-03596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The 25-item Dementia Knowledge Assessment Scale (DKAS2) is a widely used tool for measuring knowledge of dementia. To increase the applicability of the Chinese-language version of the tool (DKAS-TC) for the general public, this study aimed to develop a shortened version using the item response theory (IRT) approach. METHODS A total of 401 participants voluntarily completed a Chinese-language version of the DKAS2 questionnaire (DKAS-TC) at the start of dementia awareness training courses in 2020 and 2021. The four Rasch family models were used to analyze the dimensionality of the shortened scale (the DKAS-s) and to confirm its accuracy in measuring dementia knowledge. RESULTS The results justified supported the use of a dichotomous response scale for responding to the DKAS-s and demonstrated good fit of the data to a Rasch model with the four dimensions of "Causes and Characteristics", "Communication and Engagement", "Care Needs", and "Risks and Health Promotion". Moreover, we shortened the DKAS-TC by selecting items that had both above-average discriminative ability and above-average information. The DKAS-s retained 64.13% of the information contained in the DKAS-TC, resulting in a 16-item scale which retained four items in each of the original four dimensions. The DKAS-s also correlated highly (≥0.95) with the DKAS-TC and exhibited a sizeable range of difficulty of dementia knowledge. CONCLUSIONS The DKAS-s is expected to be more efficient in field settings while retaining an acceptable level of psychometric properties when used as a survey instrument to measure the general public's knowledge of dementia.
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Affiliation(s)
- Su-Pin Hung
- grid.64523.360000 0004 0532 3255Center of Teacher Education, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Education, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Han Liao
- grid.64523.360000 0004 0532 3255Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701 Taiwan
| | - Claire Eccleston
- grid.1009.80000 0004 1936 826XWicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Li-Jung Elizabeth Ku
- grid.64523.360000 0004 0532 3255Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701 Taiwan
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Haydon HM, Lotfaliany M, Jones C, Chelberg G, Horstmanshof L, Taylor M, Carey M, Snoswell CL, Hicks R, Banbury A. Health literacy, dementia knowledge and perceived utility of digital health modalities among future health professionals. Australas J Ageing 2022. [DOI: 10.1111/ajag.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Helen M. Haydon
- Centre for Online Health The University of Queensland Woolloongabba Queensland Australia
- Centre for Health Services Research The University of Queensland Woolloongabba Queensland Australia
| | - Mojtaba Lotfaliany
- Centre for Online Health The University of Queensland Woolloongabba Queensland Australia
- Centre for Health Services Research The University of Queensland Woolloongabba Queensland Australia
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health Deakin University Geelong Victoria Australia
| | - Cindy Jones
- Faculty of Health Sciences and Medicine Bond University Robina Queensland Australia
- Menzies Health Institute Queensland Southport Queensland Australia
| | - Georgina R. Chelberg
- Centre for Online Health The University of Queensland Woolloongabba Queensland Australia
- Centre for Health Services Research The University of Queensland Woolloongabba Queensland Australia
| | - Louise Horstmanshof
- Faculty of Health Southern Cross University Lismore New South Wales Australia
| | - Melissa Taylor
- School of Nursing and Midwifery, Centre for Health Research The University of Southern Queensland Ipswich Queensland Australia
| | - Melissa Carey
- Centre for Health Research The University of Southern Queensland Ipswich Queensland Australia
- University of Auckland Auckland New Zealand
| | - Centaine L. Snoswell
- Centre for Online Health The University of Queensland Woolloongabba Queensland Australia
- Centre for Health Services Research The University of Queensland Woolloongabba Queensland Australia
| | - Richard Hicks
- School of Psychology, Faculty of Society and Design Bond University Robina Queensland Australia
| | - Annie Banbury
- Centre for Online Health The University of Queensland Woolloongabba Queensland Australia
- Centre for Health Services Research The University of Queensland Woolloongabba Queensland Australia
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Tierney L, Doherty K, Breen J, Courtney‐Pratt H. Community expectations of a village for people living with dementia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5875-e5884. [PMID: 36106476 PMCID: PMC10086954 DOI: 10.1111/hsc.14018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/22/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Small-scale models of dementia care are a progressive approach to improve care for people living with dementia. These models intend to provide a home-like environment with a small number of residents in each living unit, easy access to services and facilities, a dedicated team of staff and flexible routines. This study was undertaken during the construction phase of a new village and provided a unique opportunity to explore expectations of the village among the local community. Twelve community members participated in two sequential online focus groups over a 2-month period. Focus group discussions were recorded, transcribed and analysed using a reflexive thematic analysis approach. Knowledge of the village varied and was informed by familiarity with other village developments and local marketing about the new village. The findings indicate that the community expect the village to provide residents with optimum dementia care, a safe and enabling physical environment and a vibrant daily life where they are engaged in 'normal' activities. While participants expected the village to be self-contained, they also anticipated strong connections with the wider community. Participants acknowledged that the community need dementia education to ensure these interactions are positive. Community expectations of a new village development for people living with dementia are largely positive and often idealistic. Organisations need to consider these expectations when developing new small-scale facilities and be mindful of how they market these developments to foster realistic expectations. While community enthusiasm about dementia care is encouraging, education is needed to ensure the success of the model.
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Affiliation(s)
- Laura Tierney
- Wicking Dementia Research and Education Centre, College of Health and MedicineUniversity of TasmaniaHobartTasmaniaAustralia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, College of Health and MedicineUniversity of TasmaniaHobartTasmaniaAustralia
| | - Juanita Breen
- Wicking Dementia Research and Education Centre, College of Health and MedicineUniversity of TasmaniaHobartTasmaniaAustralia
| | - Helen Courtney‐Pratt
- Wicking Dementia Research and Education Centre, College of Health and MedicineUniversity of TasmaniaHobartTasmaniaAustralia
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Windle G, Flynn G, Hoare Z, Masterson-Algar P, Egan K, Edwards RT, Jones C, Spector A, Algar-Skaife K, Hughes G, Brocklehurst P, Goulden N, Skelhorn D, Stott J. Effects of an e-health intervention 'iSupport' for reducing distress of dementia carers: protocol for a randomised controlled trial and feasibility study. BMJ Open 2022; 12:e064314. [PMID: 36130751 PMCID: PMC9494593 DOI: 10.1136/bmjopen-2022-064314] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION In the UK, National Health Service (NHS) guidelines recommend that informal carers of people living with dementia should be offered training to help them develop care skills and manage their own physical and mental health. The WHO recommends access to affordable, proven, well-designed, online technologies for education, skills training and support for dementia carers. In response to these recommendations, this multisite randomised controlled trial (RCT) is the first study in the UK to evaluate the clinical and cost-effectiveness of an online support programme developed by the WHO called 'iSupport for dementia carers'. METHODS AND ANALYSIS 350 informal carers (age 18+ years) living in Britain who self-identify as experiencing stress and depression will be recruited. They will be randomised to receive 'iSupport', or standardised information about caring for someone with dementia (control-comparison). Data will be collected via videoconferencing (eg, Zoom) or telephone interview at baseline, 3 months and 6 months. Intention-to-treat analysis will ascertain effectiveness in the primary outcomes (distress and depression) and combined cost, and quality-adjusted life-year data will be used to assess cost-effectiveness compared with usual care from a public sector and wider societal perspective. A mixed-methods process evaluation with a subgroup of carers in the intervention (~N=50) will explore the barriers and facilitators to implementing 'iSupport'. A non-randomised feasibility study will adapt 'iSupport' for young carers (n=38 participants, age 11-17 years). ETHICS AND DISSEMINATION The research plan was scrutinised by National Institute for Health Research reviewers ahead of funding being awarded. Ethical approval was granted by Bangor University's School of Health and Medical Sciences Academic Ethics Committee, reference number 2021-16915. Dissemination plans include delivering events for stakeholders, social media, a project website, developing policy briefings, presenting at conferences and producing articles for open access publications. TRIAL REGISTRATION NUMBER ISRCTN17420703.
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Affiliation(s)
- Gill Windle
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Greg Flynn
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Zoe Hoare
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | - Kieren Egan
- Department of Computer and Information Science, University of Strathclyde, Glasgow, UK
| | | | - Carys Jones
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Katherine Algar-Skaife
- Department of Neuro-medicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Gwenllian Hughes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Paul Brocklehurst
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Nia Goulden
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Debbie Skelhorn
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
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Teichmann B, Melchior F, Kruse A. Validation of the Adapted German Versions of the Dementia Knowledge Assessment Tool 2, the Dementia Attitude Scale, and the Confidence in Dementia Scale for the General Population. J Alzheimers Dis 2022; 90:97-108. [PMID: 36093710 PMCID: PMC9661341 DOI: 10.3233/jad-220678] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: There are almost no validated tools in German that assess dementia knowledge, attitude toward dementia, and confidence in the general population. Objective: Translation and validation of the German version of the Dementia Knowledge Assessment Tool 2 (DKAT2), the Dementia Attitude Scale (DAS), and the Confidence in Dementia Scale (CODE). Methods: Instruments were translated into German and adapted for the general public. A convenience sample of 263 persons was recruited via an online platform. Validation of the tools’ psychometric properties consisted of an assessment of its reliability (internal consistency and 4-week test-retest reliability of a subgroup with n = 110), an analysis of its construct validity through principal component analysis and known-group analysis, convergent validity, and an item analysis for DKAT2-D. This study used the STROBE checklist for reporting. Results: Acceptable to excellent internal reliability was found for DAS-D (α= 0.90), DKAT2-D (α= 0.78), and CODE-D (α= 0.93). The principal component analysis confirmed the two-factor model for the DAS-D as well as the one-factor solution for CODE-D. Intra-class correlation coefficient between the first and the 4-week retest was good (CODE-D: 0.897; 0.849–0.929) to excellent (DKAT2-D: 0.918; 0.879–0.945 and DAS-D: 0.940; 0.910–0.960). Known-group analysis revealed that DAS-D, DKAT-D, and CODE-D could distinguish between individuals with or without experience with people with dementia and with or without participation in a dementia course. Conclusion: The German versions DAS-D, DKAT2-D, and CODE-D are reliable and valid tools to measure knowledge, attitude, and confidence in dementia in the German-speaking general population.
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Affiliation(s)
- Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Florian Melchior
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Department of Applied Psychology, SRH University, Heidelberg, Germany
| | - Andreas Kruse
- Institute for Gerontology, Heidelberg University, Heidelberg, Germany
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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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Zhao Y, Liu L, Ding Y, Chan HYL. Effect of a culturally sensitive DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in China: A quasi-experimental study. NURSE EDUCATION TODAY 2022; 116:105434. [PMID: 35728332 DOI: 10.1016/j.nedt.2022.105434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/27/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Existing educational programmes for building capacity in dementia care are developed in the Western culture; their applicability and cultural relevancy to other cultures is questionable. There is a dearth of culturally specific dementia-care educational programme for Chinese communities. OBJECTIVES To evaluate a culturally specific DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in mainland China. DESIGN A multi-site quasi-experimental study. METHODS Nursing homes were pair-matched and allocated into intervention (n = 5) and control group (n = 5). The DECENT programme was delivered face-to-face using multiple pedagogies for 60-90 min per session by a trained educator once per week over 8 weeks. The primary outcome was the sense of competence in dementia care. The secondary outcomes were dementia knowledge, attitudes towards people with dementia, person-centred care in nursing homes and the severity of behavioral and psychological symptoms of dementia of residents with dementia and staff-perceived disturbance. They were measured at baseline (T0), immediately post-intervention (T1) and 3 months after the intervention (T2). RESULTS The intervention group has significantly greater improvement than control group in sense of competence both at T1 (B = 5.24, p < .001) and T2 (B = 4.43, p = .013). Regarding dementia knowledge and person-centred care, intervention group only showed greater improvement than control group at T1 (B = 3.18, p = .001; B = 5.75, p = .018, respectively), but not at T2 (p = .089 and .104, respectively). Group differences in attitudes and severity of behavioral and psychological symptoms of dementia and staff-perceived disturbance were not significant at both time points. CONCLUSIONS The DECENT programme is applicable and beneficial in improving staff's sense of competence in dementia care in Chinese communities, but reinforcement strategies are needed to sustain the effect for maintaining the learnt knowledge and changed person-centred care practice.
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Affiliation(s)
- Yayi Zhao
- School of Nursing, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Qixia District, Nanjing, 210000, Jiangsu Province, China.
| | - Li Liu
- Xiangya Nursing School, Central South University, No. 172 Tongzi Slopes Road, Yuelu District, Changsha, 410000, Hunan Province, China.
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, Jiangning District, 210000, Jiangsu Province, China.
| | - Helen Y L Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, 999077, Hong Kong Special Administrative Region.
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Hu R, Zhang F, Zhang Y, Lai B, Ma W, Xu X, Ye H, Lv Z, Chan C, Tao Q. Development and Validation of a Knowledge Scale About the Behavioral and Psychological Symptoms of Dementia (KS-BPSD) Among Chinese Formal Caregivers. Clin Gerontol 2022:1-9. [PMID: 35957605 DOI: 10.1080/07317115.2022.2111290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The current study aimed to develop a scale assessing knowledge about behavioral and psychological symptoms of dementia (KS-BPSD) among Chinese formal caregivers and to investigate its psychometric properties and factorial structure. METHODS The scale was generated with a systematic development process, and 229 formal caregivers working at nursing homes were recruited to construct and assess the psychometric properties of the scale. The preliminary scale was reviewed by an expert panel and items were selected based on item discrimination, difficulty, and item-total correlation. RESULTS The final KS-BPSD version consisted of 12 items, loaded into three factors (i.e., Disease Characteristics, Care and Risks, and Treatment Needs) following principal component analysis (PCA). The KS-BPSD showed good test-retest reliability, internal consistency, as well as construct and concurrent validity. CONCLUSIONS The 12-item KS-BPSD was found to have high reliability and preliminary validity in assessing the level of knowledge about patient's BPSD among formal Chinese caregivers in nursing homes. CLINICAL IMPLICATIONS KS-BPSD is a reliable tool to address the knowledge discrepancies and support needs among dementia caregivers, helping to develop and evaluate educational programs in the management of patient's BPSD.
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Affiliation(s)
- Rui Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Yuan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Bingbing Lai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Wenhao Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaohua Xu
- Department of Rehabilitation, Psychiatric Hospital of Guangzhou Civil Affairs Bureau, Guangzhou, China
| | - Hua Ye
- Department of Dementia Care, Home for the Aged Guangzhou, Guangzhou, China
| | - Zeping Lv
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Chetwyn Chan
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - Qian Tao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China.,Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China.,Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Science, Qingdao, China
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Pai CH, Wang YL, Shang Y, Hsu TK. A Study on Multimedia Integrated Pre-service Education to Learning Behavior and Competitiveness in Workplace of Employees in Hospitality. Front Psychol 2022; 13:817960. [PMID: 35910991 PMCID: PMC9328176 DOI: 10.3389/fpsyg.2022.817960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
The domestic situation of the past few years shows the practices of employees’ unpaid leave and layoffs and the constant drain on capital, talent, and technologies in hospitality. Owners expect to reduce the losses to as low as possible by saving on human costs. Nevertheless, in face of such a changing environment, hospitality has to accumulate high-quality human capital through systematic investment, sensitive development, and continuous learning and growth to discover competitive advantages through the cultivation of human capital. The pre-service education of new employees could accelerate their familiarity with the operations of the company and their understanding of their job role and duties. More importantly, with good planning, it could make employees feel emphasized with and respected with the result of largely changing their thoughts and working habits. Aiming at supervisors and employees in hospitality in Zhejiang as the research objects, a total of 420 copies of our questionnaire are distributed, and 357 valid copies were retrieved, with a retrieval rate of 85%. According to the results to propose discussions, it is expected to generate systematic and proper education methods for the pre-service education in hospitality, promote the education effectiveness, and promote employees’ capability and organizational performance.
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Affiliation(s)
- Chih-Hung Pai
- School of Hospitality Management, Zhejiang Yuexiu University, Shaoxing, China
| | - Yu-Lan Wang
- Teacher Education Institute, Weifang University of Science and Technology, Shandong, China
- *Correspondence: Yu-Lan Wang,
| | - Yunfeng Shang
- School of Hospitality Management, Zhejiang Yuexiu University, Shaoxing, China
| | - Ta-Kuang Hsu
- Department of Restaurant, Hotel and Institutional Management, Fu Jen Catholic University, New Taipei City, Taiwan
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Atkinson T, Bray J, Williamson T. 'You're in a new game and you don't know the rules: Preparing carers to care'. DEMENTIA 2022; 21:2128-2143. [PMID: 35801283 PMCID: PMC9483701 DOI: 10.1177/14713012221112242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim Being an informal carer for a person living with dementia can be a demanding role which
can have detrimental effects on personal well-being and affect a person’s ability to
provide care for their loved one. This evaluation of support courses, offered by a
leading UK charity dedicated to dementia family carers, highlights the impact of
training to support the caring role. Setting Participants completed booklets at the training venue and subsequently online or by
post. Interviews with participants took place by telephone. Participants: 84
participants completed booklets containing measures which generated quantitative data
whilst 19 family carers participated in qualitative telephone interviews. Design A mixed methods approach was taken using booklets of validated measures to capture
quantitative data, including capture of demographic information, together with
semi-structured interviews conducted by telephone which were recorded, transcribed and
subsequently analysed using thematic analysis. Results Overall, both the quantitative and qualitative analysis demonstrate that attending the
carers support courses had a positive impact on carers with improvements being
maintained over time. Outcomes indicated that carers generally remained in a better
physical, mental and emotional situation than that experienced before the course. Conclusion Being prepared for the trajectory of the caring role when providing care for a person
living with dementia can help informal carers to be better prepared, better supported
and better informed. Evidence gained from this evaluation demonstrates the impact of the
courses and adds to the current weak evidence base relating to dementia courses aimed at
preparing carers to care.
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Affiliation(s)
- Teresa Atkinson
- The Association for Dementia Studies, 8709University of Worcester, UK
| | - Jennifer Bray
- The Association for Dementia Studies, 8709University of Worcester, UK
| | - Tracey Williamson
- 1507Betsi Cadwaladr University Health Board, Bangor, UK; 8709University of Worcester, UK
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Graham F, Beattie E, Fielding E. Hospital nurses' management of agitation in older cognitively impaired patients: do they recognise pain-related agitation? Age Ageing 2022; 51:6632478. [PMID: 35796135 DOI: 10.1093/ageing/afac140] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND cognitively impaired hospital patients often experience agitation and aggression due to pain. Agitation complicates care, increasing the risk of adverse outcomes and patient-to-nurse violence. Managing agitation is challenging for nurses. Literature suggests they may rely on antipsychotics while missing other more appropriately targeted treatments. However, nurses' management of agitation remains unclear and under-researched. OBJECTIVE the aim of this study was to investigate hospital nurses' management of agitation in older cognitively impaired patients with pain. DESIGN this was a descriptive correlational study using virtual simulation. SETTING AND PARTICIPANTS a total of 274 registered medical and surgical nurses from 10 public hospitals in Queensland, Australia participated in the study. METHODS nurses undertook a virtual simulation requiring them to manage agitation in a patient with dementia and an injury. Nurses also completed a post-simulation questionnaire. Their simulation performances were correlated with demographics such as seniority, workplace, training, experience and gerontology-specific knowledge. Constructed from an original, validated vignette, the simulation included branching pathways, video scenarios and an avatar that could converse with participants. RESULTS thirteen nurses (4.7%) recognised and treated the virtual patient's agitation as pain-related. Most nurses (89%) gave antipsychotics of which 207 (78%) gave these first-line and 102 (38%) used them twice. Independent of other variables, nurses most likely to diagnose pain were dementia-unit nurses (OR = 8.7), surgical-unit nurses (OR = 7.3) and senior nurses (OR = 5). CONCLUSIONS hospital nurses predominately managed agitation with antipsychotics, a decision that most made after undertaking inadequate patient assessments. This confirmed a common gap in practice that may lead to the missing of pain in the clinical care of agitated patients with dementia and/or delirium.
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Affiliation(s)
- Frederick Graham
- Division of Medicine, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- School of Nursing, Queensland University of Technology, Brisbane City, QLD, Australia
| | - Elizabeth Beattie
- School of Nursing, Queensland University of Technology, Brisbane City, QLD, Australia
| | - Elaine Fielding
- School of Nursing, Queensland University of Technology, Brisbane City, QLD, Australia
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Abstract
BACKGROUND A quantitative assessment of the dementia-friendliness of a community can support planning and evaluation of dementia-friendly community (DFC) initiatives, internal review, and national/international comparisons, encouraging a more systematic and strategic approach to the advancement of DFCs. However, assessment of the dementia-friendliness of a community is not always conducted and continuous improvement and evaluation of the impact of dementia-friendly initiatives are not always undertaken. A dearth of applicable evaluation tools is one reason why there is a lack of quantitative assessments of the dementia-friendliness of communities working on DFC initiatives. PURPOSE A scoping review was conducted to identify and examine assessment tools that can be used to conduct quantitative assessments of the dementia-friendliness of a community. DESIGN AND METHODS Peer-reviewed studies related to DFCs were identified through a search of seven electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, EMCare, HealthSTAR, and AgeLine). Grey literature on DFCs was identified through a search of the World Wide Web and personal communication with community leads in Australia, Canada, New Zealand, the United Kingdom, and the United States. Characteristics of identified assessment tools were tabulated, and a narrative summary of findings was developed along with a discussion of strengths and weaknesses of identified tools. RESULTS Forty tools that assess DFC features (built environment, dementia awareness and attitudes, and community needs) were identified. None of the identified tools were deemed comprehensive enough for the assessment of community needs of people with dementia.
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Affiliation(s)
- Laura G Diaz
- School of Rehabilitation Science, Faculty of Health
Sciences, Institute for Applied Health Sciences Building, McMaster University, Hamilton, ON, Canada
| | - Evelyne Durocher
- School of Rehabilitation Science, Faculty of Health
Sciences, Institute for Applied Health Sciences Building, McMaster University, Hamilton, ON, Canada
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Chan CM, Ong MJY, Zakaria AA, Visusasam MM, Ali MF, Jamil TR, Aizuddin AN, Abdul Aziz AF. Assessment of dementia knowledge and its associated factors among final year medical undergraduates in selected universities across Malaysia. BMC Geriatr 2022; 22:450. [PMID: 35610579 PMCID: PMC9129895 DOI: 10.1186/s12877-022-03148-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background The elderly population in Malaysia are projected to reach almost one third of the total population by 2040. The absence of a National Dementia Strategy (NDS) in preparing the healthcare services for the ageing population is compounded by the lack of assessment of preparedness of future healthcare workers to manage complications related to ageing i.e., dementia. Studies in countries with NDS demonstrated lack of dementia knowledge among medical undergraduates. Hence, this study aimed to assess the knowledge on dementia among final year medical undergraduates in Malaysia and its associated factors, using the Dementia Knowledge Assessment Scale (DKAS). Methods This cross-sectional study, employed multistage sampling method to recruit final year medical undergraduates from eleven selected public and private medical institutions across Malaysia. Online self-administered measures were delivered to final year medical undergraduates through representatives of medical students’ society after approval from Deanery and institutional ethics board of participating universities. The measure collected demographic information, previous dementia exposure (i.e., formal or informal) and the 25-item Likert scale DKAS. Bivariate analysis and linear regression were conducted to confirm factors influencing dementia knowledge components. Results A total of 464 respondents from 7 universities participated in this study. Overall dementia knowledge among respondents with and without exposure, was low, with average score of 29.60 ± 6.97 and 28.22 ± 6.98, respectively. DKAS subscales analysis revealed respondents scored highest in care consideration subscale (9.49 ± 2.37) and lowest in communication and behaviour subscale (4.38 ± 2.39). However, only causes and characteristic subscale recorded significantly higher knowledge score among respondents with previous exposure (7.88 ± 2.58) (p =0.015). Higher knowledge of dementia was associated with previous formal dementia education (p=0.037) and informal occupational/working experience in caring for dementia patients (p = 0.001). Informal occupational/working experience (B = 4.141, 95% CI 1.748–6.535, p = 0.001) had greater effect than formal education (i.e. lectures/workshops) (B = 1.393, 95% CI 0.086–2.700, p = 0.037) to influence respondents’ knowledge on dementia. Conclusion Dementia knowledge among final year medical undergraduates is low. To improve dementia knowledge, Malaysian medical curriculum should be reviewed to incorporate formal education and informal occupational/working experience, as early as in undergraduate training to help prepare future healthcare providers to recognise dementia among ageing Malaysians.
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Affiliation(s)
- Chee Mun Chan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Marjorie Jia Yi Ong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Adam Aiman Zakaria
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Monikha Maria Visusasam
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.,Class of 2021/2022, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Fairuz Ali
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Teh Rohaila Jamil
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
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Nugraha S, Tondokoro T, Susilowati IH, Hasiholan BP, Alimoeso S, Rahardjo TBW, Takagi K, Wada K. Knowledge about Dementia and its Associated Factors: Study among the Middle-aged Population in Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Dementia is a general term for loss of memory, language, problem solving, and other thinking skills that can interfere with daily life. Dementia is generally experienced by the older people. Nearly 10 million new cases of dementia reported each year, and more than 50% of dementia patients live in low and middle-income countries. With these potentially increasing number of dementia cases, accurate knowledge about dementia is essential for the community as it could be beneficial for the quality of care and reducing its progression.
AIM: This study aimed to assess knowledge about dementia in the middle-aged age group and to determine the sociodemographic factors associated with knowledge about dementia in Indonesia.
METHODS: A cross-sectional survey targeted the middle-aged population (40–59 years old), using an online questionnaire examining sociodemographic characteristics (age, gender, occupation), living arrangements, and the Dementia Knowledge Assessment Scale.
RESULTS: A total of 1147 respondents were examined, revealing that more than 67% of the participants had poor knowledge about dementia. We revealed that female gender, younger age, and higher occupational level were significantly associated with good knowledge about dementia in various subscales. Interestingly, the living arrangements showed no significant association with knowledge about dementia in any subscale.
CONCLUSION: The results emphasize the importance of intensive public health awareness to improve public knowledge about dementia in Indonesia, specifically targeting men and older individuals, as well as those with lower occupational levels.
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Goldberg LR, Baldock D, Cox T, Hoang H, Cross M, Price AD. Aboriginal Women Learning on Country: Lessons for Educators. Front Public Health 2022; 10:786434. [PMID: 35433617 PMCID: PMC9010380 DOI: 10.3389/fpubh.2022.786434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction This paper details the journey of eight Aboriginal women from Circular Head, a rural and remote area of North-West Tasmania, as they undertook an innovative 2-year program of tertiary studies in dementia to address a documented community need. The Chief Executive Officer of the Circular Head Aboriginal Corporation (CHAC) had identified difficulties being experienced by older members of the community. These difficulties included changes in behavior, memory, and communication, with profound consequences on social engagement and care needs from both individual and community perspectives. The community wished to know if a combined vocational and university program, completed on Country and in community, could serve as a culturally safe education pathway to empower Aboriginal members of a rural and remote area in providing community health and dementia education and care. Methods The nationally funded program included a year-long face-to-face vocational Certificate III in Individual Support (Aging, Home, and Community) on Country, including within-community experience with adults with dementia. This face-to-face learning was combined with online study in the award-winning Bachelor of Dementia care offered by the University of Tasmania. Students received a PhD level stipend to support them in their studies and were guided by an Elder from their community. Results All students completed their Certificate III. The number of units they completed toward the eight required for their Diploma of Dementia Care varied. Emergent themes from students' reflections were holistic and relational, highlighting achievements and challenges, the importance of on Country individual connections and community support, and the value of their current and future contributions to the community. Data from this mixed methods approach documented the impact of the innovative coupling of authentic, culturally appropriate experiential learning with broad and deep academic knowledge about dementia and evidence-based care. Conclusions This program provided students with a work-related qualification embedded within a university education and increased the capacity and capability of this Aboriginal community to provide care for its members with dementia, a documented concern. The combination of vocational learning on Country with online university study established a pathway to improve students' access to and success in higher education and the professional workforce. This assisted in counteracting the negative influences of racism, stigma, rurality, and socio-economic marginalization on educational opportunity for Aboriginal people. Data showed the need for flexibility with this learning journey, and the strengths and resilience of these women as they learned.
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Affiliation(s)
- Lynette R Goldberg
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Dianne Baldock
- Circular Head Aboriginal Corporation, Smithton, TAS, Australia
| | - Terrance Cox
- Circular Head Aboriginal Corporation, Smithton, TAS, Australia.,Centre for Rural Health, University of Tasmania, Launceston, TAS, Australia
| | - Ha Hoang
- Centre for Rural Health, University of Tasmania, Launceston, TAS, Australia
| | - Merylin Cross
- Centre for Rural Health, University of Tasmania, Launceston, TAS, Australia
| | - Andrea D Price
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
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Healthy Lifestyle Behaviors and Viewpoints Among Members of an Alzheimer Prevention Registry. Alzheimer Dis Assoc Disord 2022; 36:111-117. [PMID: 35288521 DOI: 10.1097/wad.0000000000000496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research on Alzheimer disease and related dementias is increasingly focused on preventative strategies to target modifiable risk factors (eg, exercise, diet, cognitive stimulation) to reduce risk of cognitive decline, though it remains difficult for adults to adopt and maintain these behaviors on their own. METHODS/PARTICIPANTS In this survey study, we examined knowledge about modifiable risk factors for dementia, engagement in healthy lifestyle behaviors, and associated barriers/facilitators in an Alzheimer disease prevention registry of at-risk, cognitively normal adults (n=135: 77% female; 96% Caucasian and non-Hispanic; mean age=66.1; 79% with family history of dementia; 46% with subjective memory decline). RESULTS Participants reported high levels of engagement in exercise (mean 3.4 d/wk), a healthy diet (60% with a healthy/balanced diet), and cognitive stimulation (52% engaging in cognitive stimulation 3 to 7 d/wk), and most (56% to 57%) reported moderate to high knowledge about dementia and modifiable risk factors. Family history of dementia was associated with greater knowledge of risk factors for dementia (P=0.017), but not with knowledge of lifestyle recommendations to reduce risk (P=0.85). Most participants (63%) reported a preference for walking/running over other types of aerobic exercise. On average, participants reported that they would be willing to increase healthy lifestyle behaviors to achieve "moderate" risk reduction for dementia (∼21% to 23%, on a scale from 0% to 40%, reflecting mildly to substantially reduced risk). CONCLUSION Results broaden our understanding of current habits and willingness to engage in healthy lifestyle behaviors, which may inform individualized lifestyle interventions and/or design of prevention trials, particularly among at-risk adults with subjective or mild cognitive concerns, who may be especially motivated and able to engage in lifestyle interventions, to optimize brain health and reduce risk of cognitive decline.
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Nkimbeng M, Rosebush CE, Akosah KO, Yam H, Russell WN, Bustamante G, Albers EA, Shippee TP, Sasikumar AP, Gaugler JE. The Immigrant Memory Collaborative: A Community-University Partnership to Assess African Immigrant Families' Experiences with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074075. [PMID: 35409758 PMCID: PMC8997896 DOI: 10.3390/ijerph19074075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/07/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022]
Abstract
Research suggests a disparity in the prevalence of dementia, with Black older adults having double the risk compared to their White counterparts. African immigrants are a fast-growing segment of the U.S. Black population, but the dementia care needs and resources of this population are not fully understood. In this paper, we describe the process of working collaboratively with a community partner and project advisory board to conduct a culturally informed project. Specifically, we describe the process of developing culturally informed instruments to collect data on dementia care needs and resources among African immigrants. Working together with a diverse project advisory board, a guide was developed and used to conduct community conversations about experiences with dementia/memory loss. Transcripts from six conversations with 24 total participants were transcribed and analyzed thematically by two independent coders in Nvivo. These qualitative findings were used to inform the development of a survey for quantitative data collection that is currently ongoing. Themes (e.g., cultural attitudes, challenges, and current resources) from the community conversations that informed the survey are described briefly. Despite the challenges of conducting research during a global pandemic, having trusting relationships with a partnering community organization and project advisory board facilitated the successful development of instruments to conduct preliminary dementia care research in an underserved population. We anticipate that survey results will inform interventions that increase education, outreach, and access to dementia care and caregiving resources for this population. It may serve as a model for community–university partnerships for similar public health efforts in dementia as well as other chronic disease contexts.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
- Correspondence:
| | - Christina E. Rosebush
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Kwame O. Akosah
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Hawking Yam
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Wynfred N. Russell
- African Career Education and Resources Inc., Brooklyn Park, MN 55445, USA; (W.N.R.); (A.P.S.)
| | - Gabriela Bustamante
- Program in Health Disparities Research, Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
- School of Public Health, Universidad San Francisco de Quito, Quito 170901, Ecuador
| | - Elizabeth A. Albers
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Tetyana P. Shippee
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Arundhathi P. Sasikumar
- African Career Education and Resources Inc., Brooklyn Park, MN 55445, USA; (W.N.R.); (A.P.S.)
| | - Joseph E. Gaugler
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
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Crawley S, Moore K, Vickerstaff V, Fisher E, Cooper C, Sampson EL. How do factors of sociodemographic, health literacy and dementia experience influence carers' knowledge of dementia? DEMENTIA 2022; 21:1270-1288. [PMID: 35234067 PMCID: PMC9109238 DOI: 10.1177/14713012221074219] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dementia is a life limiting disease following a progressive trajectory. As carers often become key decision makers, their knowledge of dementia will have health implications for the person living with dementia as well as carer's psychological wellbeing. AIM To explore how sociodemographic factors, health literacy and dementia experience influence family carers knowledge about dementia. METHOD In this cross-sectional, mixed methods study, we interviewed 150 family carers and assessed their dementia knowledge using the Dementia Knowledge Assessment Scale (DKAS). Linear regression analyses were used to examine whether health literacy, previous experiences of dementia, support group attendance and sociodemographic characteristics predicted knowledge. Sixteen carers also completed qualitative interviews which explored unmet information needs. Transcripts and field notes were thematically analysed. RESULTS Most participants were partners (47%) or adult children (48%) and cared for someone with severe (32%) or moderate (43%) dementia. Mean DKAS scores were 34.8/50 (SD = 7.0, range = 17-48) reflecting 8/25 incorrect answers. Backwards elimination regression found greater dementia knowledge was associated with greater health literacy for appraising information (coef 3.48, 95% CI (1.38, 5.58); p = 0.001) and more years of education (coef 0.39, 95% CI (0.12, 0.65); p = 0.004). Although not significant, knowledge was slightly lower in those who attended a support group, and a trend was found between ability to understand health information and knowledge. Only 39% accurately identified dementia as life shortening, indicating notable gaps in knowledge. Four qualitative themes were identified; arm yourself with information, ability to steer through information, other experience of dementia can be helpful and the importance of relationships with health care professionals. CONCLUSIONS In an information age, vast amounts of information are available, but this can bring difficulties. Carers with more years of education and higher health literacy knew more about dementia. Professionals should consider how carers with lower health literacy can be supported through provision of timely, relevant information.
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Affiliation(s)
- Sophie Crawley
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
| | - Kirsten Moore
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
| | - Emily Fisher
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
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Fisher E, Crawley S, Sampson EL, Cooper C, Jones R, Anantapong K, Moore K. Practical and emotional preparation for death: A mixed methods study investigating experiences of family carers of people with dementia. DEMENTIA 2022; 21:934-956. [PMID: 35125034 PMCID: PMC9003776 DOI: 10.1177/14713012211066674] [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] [Indexed: 11/15/2022]
Abstract
Background When family carers are more prepared for the end of the life of a person they care for, they report improved bereavement outcomes. Few studies have explored how carers prepare for the death of a person with dementia. We aimed to explore how carers for people with all stages of dementia experience preparing for end of life care and death. Methods This was a mixed methods cross-sectional study. Family carers of people with dementia (n = 150) completed a structured interview with validated scales, alongside questions about death preparedness and advance decisions. A sub-sample (n = 16) completed qualitative interviews exploring their experiences of planning for end of life. We fitted logistic regression models to explore associations with preparedness, and thematically analysed qualitative data. Results We addressed practical and emotional preparation separately for 143 participants. Fifty seven percent of participants were very practically prepared for death, while only 29% were very emotionally prepared. Male carers were more likely than female carers to report being very emotionally and practically prepared. Higher engagement with healthcare professionals was associated with feeling very practically prepared; although we found that formal discussions of end of life care issues with healthcare professionals did not impact carers’ feelings of preparation. Higher levels of dementia severity and carer depression were associated with feeling very emotionally prepared. Three qualitative themes related to practical and emotional preparation were identified: (1) ambiguity and uncertainty; (2) support from the system; and (3) how death is perceived by the carer. Conclusions While most carers felt practically prepared for death, emotional preparation was much lower. Further research is needed to understand how engagement with healthcare professionals or other forms of social or emotional support could help carers, particularly female carers, to emotionally prepare for their relative’s death.
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Affiliation(s)
- Emily Fisher
- Research Department of Clinical, Educational and Health Psychology, 4919University College London, London, UK
| | - Sophie Crawley
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312University College London, London, UK
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312University College London, London, UK; Department of Psychological Medicine, Royal London Hospital, East London NHS Foundation Trust
| | - Claudia Cooper
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312University College London, London, UK; Division of Psychiatry, 325312University College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, 325312University College London, London, UK
| | - Kanthee Anantapong
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312University College London, London, UK; Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Kirsten Moore
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312University College London, London, UK; National Ageing Research Institute, Parkville, Victoria, Australia
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Gao W, Zhang T, Wang H, Wang S, Liu Y, Pang X. Supporting caregivers of people with dementia: A systematic review of guidelines. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e305-e324. [PMID: 34750910 DOI: 10.1111/hsc.13513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 06/21/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
Caregivers of people with dementia (PwD) frequently experience poor physical, mental and social health. Over the past decade, several guidelines have offered recommendations on supporting caregivers to improve their health outcomes. This systematic review aimed to assess the quality and evidence base of guidelines on supporting caregivers of PwD and review the content of their recommendations on caregiver support to facilitate the adoption and implementation of a specific guideline among policymakers and practitioners. A systematic search for guidelines on supporting caregivers of PwD was performed using journal databases, websites of guideline development organisations and professional dementia-related societies from inception to 30 June 2020. Four independent reviewers performed the quality assessment of the included guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. A thematic synthesis was used to analyse the content of recommendations on caregiver support extracted from the included guidelines by two independent reviewers. The strength of recommendations and level of evidence were reclassified and analysed. Literature searches identified nine guidelines. Their quality was variable. The applicability domain on AGREE II yielded the lowest median score (62.2%; range: 18.6%-86.6%), suggesting that some guidelines lacked applicability in certain fields, leaving them open to interpretation. Most evidence underlying the extracted recommendations was rated as Levels 3 (51.3%) and 4 (31.1%). High-quality evidence is required to fortify these recommendations. The nine guidelines covered six themes-assessment, education, skill training, information provision, psychosocial support and general support policies-which can guide future policies and interventions of caregiver support. The recommendations extracted were consistent across guidelines, but each guideline failed to cover all six themes. Thus, more applicable and comprehensive guidelines that fully address all themes of support for caregivers of PwD are needed.
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Affiliation(s)
- Weijie Gao
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tieling Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongyun Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shanshan Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuling Liu
- Community Health Service Centers of Jieyuan Dao, Tianjin, China
| | - Xiaoli Pang
- Office of Academic Studies, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Zhao Y, Liu L, Ding Y, Shan Y, Chan HYL. Translation and validation of Chinese version of sense of competence in dementia care staff scale in healthcare providers: a cross-sectional study. BMC Nurs 2022; 21:35. [PMID: 35093043 PMCID: PMC8801082 DOI: 10.1186/s12912-022-00815-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/19/2022] [Indexed: 11/24/2022] Open
Abstract
Background Healthcare providers’ dementia-care competence is crucial for quality dementia care. A reliable and valid instrument is needed to assess the gaps in their dementia-care competence, and thereby identifying their educational needs. Therefore, this study aims to translate the 17-item Sense of Competence in Dementia Care Staff (SCIDS) scale into Chinese (SCIDS-C) and to validate the SCIDS-C among Chinese healthcare providers. Methods The translation procedure followed the modified Brislin’s translation model. A cross-sectional survey was conducted using the translated version. The validity, including content validity, confirmatory factor analysis, concurrent validity and known-groups validity, was tested. Reliability in terms of internal consistency and test-retest reliability with a 2-week interval was evaluated. Results A total of 290 healthcare providers in 12 nursing homes and a hospital completed the survey. The scale-level content validity index was .99. The confirmatory factor analysis model marginally supported the original 4-factor structure. Positive but weak correlations were noted between the total score of the SCIDS-C and that of the Dementia Knowledge Assessment Scale (r = .17, p = .005) and Approaches to Dementia Questionnaire (r = .22, p < .001), suggesting acceptable concurrent validity. Differences between health professionals and care assistants were significant in two subscales scores. The internal consistency of the scale was high, with Cronbach’s α of .87. Test-retest reliability was demonstrated with intra-class correlation coefficient of 0.88. Conclusions The SCIDS-C demonstrated acceptable reliability and validity although the known-groups validity between health professionals and care assistants was not fully established. It can be used to measure the level of sense of competence and as an outcome measure in educational intervention aiming at improving dementia care among Chinese healthcare providers. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00815-3.
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Couzner L, Day S, Draper B, Withall A, Laver KE, Eccleston C, Elliott KE, McInerney F, Cations M. What do health professionals need to know about young onset dementia? An international Delphi consensus study. BMC Health Serv Res 2022; 22:14. [PMID: 34974838 PMCID: PMC8722147 DOI: 10.1186/s12913-021-07411-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022] Open
Abstract
Background People with young onset dementia (YOD) have unique needs and experiences, requiring care and support that is timely, appropriate and accessible. This relies on health professionals possessing sufficient knowledge about YOD. This study aims to establish a consensus among YOD experts about the information that is essential for health professionals to know about YOD. Methods An international Delphi study was conducted using an online survey platform with a panel of experts (n = 19) on YOD. In round 1 the panel individually responded to open-ended questions about key facts that are essential for health professionals to understand about YOD. In rounds 2 and 3, the panel individually rated the collated responses in terms of their importance in addition to selected items from the Dementia Knowledge Assessment Scale. The consensus level reached for each statement was calculated using the median, interquartile range and percentage of panel members who rated the statement at the highest level of importance. Results The panel of experts were mostly current or retired clinicians (57%, n = 16). Their roles included neurologist, psychiatrist and neuropsychiatrist, psychologist, neuropsychologist and geropsychologist, physician, social worker and nurse practitioner. The remaining respondents had backgrounds in academia, advocacy, or other areas such as law, administration, homecare or were unemployed. The panel reached a high to very high consensus on 42 (72%) statements that they considered to be important for health professionals to know when providing care and services to people with YOD and their support persons. Importantly the panel agreed that health professionals should be aware that people with YOD require age-appropriate care programs and accommodation options that take a whole-family approach. In terms of identifying YOD, the panel agreed that it was important for health professionals to know that YOD is aetiologically diverse, distinct from a mental illness, and has a combination of genetic and non-genetic contributing factors. The panel highlighted the importance of health professionals understanding the need for specialised, multidisciplinary services both in terms of diagnosing YOD and in providing ongoing support. The panel also agreed that health professionals be aware of the importance of psychosocial support and non-pharmacological interventions to manage neuropsychiatric symptoms. Conclusions The expert panel identified information that they deem essential for health professionals to know about YOD. There was agreement across all thematic categories, indicating the importance of broad professional knowledge related to YOD identification, diagnosis, treatment, and ongoing care. The findings of this study are not only applicable to the delivery of support and care services for people with YOD and their support persons, but also to inform the design of educational resources for health professionals who are not experts in YOD.
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Affiliation(s)
- Leah Couzner
- College of Education, Social Work and Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Sally Day
- College of Education, Social Work and Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Brian Draper
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - Adrienne Withall
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kate E Laver
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | | | | | | | - Monica Cations
- College of Education, Social Work and Psychology, Flinders University, Adelaide, South Australia, Australia. .,College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
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MacRae R, Gamble C, Ritchie L, Jack-Waugh A. Testing the sensitivity of two dementia knowledge instruments in dementia workforce education. NURSE EDUCATION TODAY 2022; 108:105210. [PMID: 34773815 DOI: 10.1016/j.nedt.2021.105210] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/28/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The importance of dementia education in improving the care and support that people living with dementia is well established. Previous research has shown ceiling effects in pre and post educational intervention measures of dementia knowledge using Knowledge in Dementia Scale (KIDE) on post-registered health and social care staff in Scotland. The aim was to test the sensitivity of two dementia knowledge instruments, namely the (KIDE) and the Dementia Knowledge Assessment Scale (DKAS). DESIGN A pre and post evaluation comparison of two dementia knowledge scales. SETTING The tenth cohort of Scotland's National Dementia Champions Education Programme, September 2019-March 2020. PARTICIPANTS Post-registered Health and Social Care staff (n = 117). METHODS Both the DKAS and KIDE scales were administered pre and post programme delivery. Wilcoxon signed-rank tests were performed to examine T1 - T2 differences in dementia knowledge for both validated measures. RESULTS Ceiling effects continued to be present for the KIDE scale at T1 and T2. The DKAS responses showed a different score distribution than that achieved by the KIDE. Ceiling effects noted for KIDE at T1 were not present for the DKAS. Further, at T2, only 6% of respondents scored the maximum on the DKAS. CONCLUSIONS The DKAS appears to be a more useful instrument for measuring knowledge in post-registered health and social care staff; however, there was some evidence of ceiling effects post-intervention. There is a need for both scales to be tested in more educationally diverse populations, so educators and researchers can make informed decisions about the instrument's target range. Additionally, further research is needed to develop new sets of dementia knowledge items suitable for use in trained health and social care staff.
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Affiliation(s)
- Rhoda MacRae
- Alzheimer Scotland Centre for Policy and Practice, Lanarkshire Campus, University of the West of Scotland, United Kingdom of Great Britain and Northern Ireland.
| | - Clair Gamble
- School of Health Sciences, University of Dundee, United Kingdom of Great Britain and Northern Ireland.
| | - Louise Ritchie
- Alzheimer Scotland Centre for Policy and Practice, Lanarkshire Campus, University of the West of Scotland, United Kingdom of Great Britain and Northern Ireland.
| | - Anna Jack-Waugh
- Alzheimer Scotland Centre for Policy and Practice, Lanarkshire Campus, University of the West of Scotland, United Kingdom of Great Britain and Northern Ireland.
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