published_or_final_version / Nursing Studies / Master / Master of Nursing

Background: Dementia is a global chronicle disease which will impact on millions of elders in the following decades. The increased number of patients would be a huge burden for healthcare professionals. It is important to equip nursing students with proper knowledge and attitude to care for patients with dementia in the clinical practicing; however, little is known about the current dementia literacy level among Chinese nursing students. Objective: The aim of the current study are (1) to test the psychometric properties of the Modified Dementia Attitude Scale-Chinese Version (MDAS-C), (2) to investigate the current dementia literacy level among Chinese nursing students in three cities in China, and (3) to identify factors that were associated with nursing students’ dementia literacy. Method: The study consisted of two phases. Phase I was a validation study with cross-sectional design, surveying Year III nursing students in one university in Mainland China. Content validity, internal consistency, convergent validity, the exploratory factor analysis, and the test-retest reliability testing were employed to test the psychometric properties of the MDAS-C. Phase II employed cross-sectional design, surveying all year nursing students in three universities in China. Demographic information, dementia knowledge, attitude toward patients with dementia, and perceptions about healthcare professionals and services related to dementia were measured. Factors that associated with dementia literacy were evaluated. Results: In phase I, a total of 223 students participated. The MDAS-C contained 12 items, and the Cronbach’s alpha of the scale was 0.685. Three factors (‘Interaction with Patient with Dementia’, ‘Responses to Patient with Dementia’ and ‘Feelings of Patient with Dementia’) were identified, explaining 48.50% of variance. The MDAS-C was positively correlated with Kogan Attitude toward Older People Scale- Chinese Version (KAOP-C) (r=0.458, p<0.001) and its positive subscale (r=0.421, p<0.001). The Pearson-correlation for the 2-week interval test-retest reliability for the scale was 0.703 (p<0.001), which was adequate. In Phase II, 563 subjects participated. The mean score of Alzheimer’s Disease Knowledge Scale (ADKS) was 18.92 (SD = 2.90), which was equivalent to 63.1% of the correct answer. Three factors, namely location, year of study, and whether they knew a person with dementia, were associated with their knowledge. The mean score of MDAS-C was 53.71 (SD= 8.59), which was equivalent to 63.9% of the total score. This result reflected that the participants held positive attitudes toward patients with dementia. Two factors, namely location and whether they knew a person with dementia, were associated with their attitudes toward patients with dementia. Majority of the subjects (93.8%) were not aware of community services provided for patients with dementia. Most subjects (92.2%) ranked skill-training services for both patients and caregivers as the most helpful one. Among healthcare professionals, the majority (91.8%) of the participants considered nurses as the most helpful personnel to patients with dementia. Discussion and Conclusion: The current study showed that the MDAS-C had good psychometric properties. This instrument can be used for research and clinical practices. The study also contributed to the understanding of dementia literacy among Chinese nursing students and factors associated with dementia literacy. / published_or_final_version / Nursing Studies / Master / Master of Philosophy

Thesis (Ph.D.) -- La Trobe University, 2004. / "A thesis submitted in total fulfillment of the requirements for the degree of Doctor of Philosophy, School of Public Health, Faculty of Health Sciences, La Trobe University, Bundoora." Research. Includes bibliographical references (leaves 343-362). Also available via the World Wide Web.

People with dementia often have difficulties expressing their needs. Untreated pain within this group can be manifested as depression, agitation or loss in appetite. It can be a challenging task for a nurse to estimate, treat and evaluate pain for people with dementia. With good knowledge and an empathic approach, nurses can often recognize and relieve pain amongst these people. Despite this, litterature often suggest that unrecognized and untreated pain is common within this group. / Personer med demens har ofta svårt att uttrycka sina behov. Obehandlad smärta hos personer med demens kan visa sig som exempelvis depression, agitation eller minskad aptit. Att som sjuksköterska kunna bedöma, behandla och utvärdera smärta hos personer med demenssjukdom kan vara en utmanande uppgift. Med goda kunskaper och ett empatiskt bemötande kan sjuksköterskan ofta uppmärksamma och lindra smärta hos dessa personer. Trots detta finns det mycket i litteraturen som tyder på ouppmärksammad och underbehandlad smärta hos denna patientgrupp.

This study involved 58 persons with dementia living in three rural Canadian long-term care (LTC) facilities. In an attempt to find the relationship between these person's possible pain and levels of agitation, data on five proxy indicators of pain were collected and correlated with scores from the Pittsburgh Agitation Scale (PAS). Results indicated that three of the resident pain measures were significantly correlated with PAS scores. In particular, the palliative consultant pain ratings and the DS-DAT were strongly correlated with total PAS scores, and the five PAS sub-factors. Importantly, the PAS sub-factor of resistance to care was strongly correlated with three of the pain variables. Major study implications include the need for increased use of palliative pain consultants in LTC, and the need for nursing staff to realize that when demented residents resist care, it may be a potential clue that the resident is experiencing untreated pain. / xv, 116 leaves ; 29 cm.

Across Scotland, there is a lack of research in care homes. This thesis explores this topic by examining links between inclusion, participation in general and participation in research and whether those who work and live in the care home environment experience social citizenship. Using a national survey and interviews with residents, staff, relatives and experts in care home research, this thesis investigated whether participation generally was linked to participation in research for residents, staff and visitors in a care home setting. The thesis further explored how social citizenship functions in a care home environment and whether there is a link between participation and citizenship. The findings suggest there is a lack of general participation which is connected with the leadership style and management within the care homes. There is misunderstanding about research and legislation amongst the care home staff, residents, visitors, as well as the junior research staff which inhibited staff and resident participation. Furthermore, citizenship is not experienced universally by residents or staff due to disempowerment, and exclusion occurs amongst residents due to age, frailty and dementia. By facilitating good leadership, communication and relationship-building such issues may be overcome. In addition, the analysis suggests a link is evident between inclusion, participation and citizenship. Where choice is provided and residents have their social position maintained, as well as have a degree of responsibility for shaping events, this leads to participation and inclusivity as described in Bartlett and O’Connor’s (2010) definition of social citizenship. Furthermore, if inclusion is adapted for cognition and frailty, then participation leads to the experience of social citizenship, encouraging a culture which can welcome research. The explicit emphasis on inclusion and participation in research has enabled this under-researched area of participation and experience of social citizenship in care homes to be more fully explored.