Dementia literacy among nursing students in mainland China : a cross sectional study in three cities

Abstract

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.