Effectiveness of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults: A systematic review and meta-analysis.

AIM: This study aims to investigate the efficacy of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults. BACKGROUND: A new approach to teaching to enhance nursing students' attitudes toward and empathy for older adults involves the use of an aging simulation suit. DESIGN: This systematic review and meta-analysis seeks to determine the efficacy of the aged simulation suit on the attitudes and empathy of undergraduate nursing students toward older adults. This protocol for a systematic review and meta-analysis was registered as CRD 42023393879 on the PROSPERO database. METHODS: In February-March 2023, a systematic review with meta-analysis of randomized controlled and quasi-experimental studies was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Population, Intervention, Control, Outcomes, Study Design (PICOS) structure was used for search strategy. Databases CINAHL, Cochrane Library, PubMed, PsycINFO, and Web of Science, as well as ULAKBIM, Turkish Medline, Turkiye Klinikleri, and YOK National Thesis Center, were searched for the articles. The Joanna Briggs Institute Critical Appraisal Tools were used to evaluate the methodological quality of a study and the extent to which its design, conduct, and analysis addressed the possibility of bias. RESULTS: The meta-analyses of attitudes toward older adults included six studies (including 535 nursing students). The intervention group's attitudes toward older adults were found to be similar to those of the control group (SMD: 15.84, Z= 1.98, p= 0.05). The subgroup analyses revealed similarities between intervention group's and the control group's mean score on attitudes toward older adults (SMD: 4.85, Z=0.70, p=0.48, for RCT; SMD: 23.05, Z= 2.02, p=0.04, for quasi-experimental). Three studies (involving 207 nursing students) revealed significantly higher mean empathy score for the control group compared with the intervention group following the intervention (SMD: 7.08, Z=4.82, p=0.00001). The subgroup analyses revealed statistically significantly higher mean level of empathy for the control group compared with the intervention group was after the intervention (SMD: 7.49, Z=3.15, p=0.002, for RCT; SMD: 6.83, Z= 3.65, p=0.0003, for quasi-experimental). CONCLUSIONS: Nursing students should be aware of older adults' feelings and experiences aging-related changes and aged simulation interventions can be a useful intervention to allow students to empathize with an older adult.

The Impact of the COVID-19 Pandemic on the Psychological Well-Being of Caregivers of People with Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09-0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05-2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42-4.95; p < 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13-0.56; p = 0.001; I2 = 54.1%) (p < 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers' psychological well-being is assessed and supported, to benefit both themselves and those for whom they care.

Caregiving Self-Efficacy in Family Caregivers of People with Dementia: The Role of Knowledge of Dementia and Perceived Social Support.

PURPOSE: To examine the role of perceived social support and knowledge of dementia in family caregivers of people with dementia (PwD) regarding caregiving self-efficacy. DESIGN: Descriptive, cross-sectional, and predictive design was used. METHODS: The study was conducted with caregivers of PwD (n:102) between March and May 2022. Data was collected using the following forms: a socio-demographic characteristics form, the revised scale for caregiving self-efficacy (RSCSE), the dementia knowledge assessment scale (DKAS) and the revised form of the multidimensional scale of perceived social support (RFMSPSS). Data was assessed through descriptive statistics and multivariate regression analysis. FINDINGS: The participants' RSCSE, DKAS and RFMSPSS mean scores were 1125.89 ± 417.18 (range:0-1800), 15.70 ± 6.06 (range:0-34), and 52.72 ± 20.07 (range:12-74), respectively. Analysis indicated that DKAS and RFMSPSS predicted positive caregiving self-efficacy scores but it was not statistically significant for DKAS (R2:0.209, F:13.077, p < 0.001). These variables accounted for 21% of total variance of caregiving self-efficacy. RFMSPSS predicted positively and statistically significantly (ß:0.461, p < 0.001) the total score of the self-efficacy scale. CONCLUSIONS: The perceived social support of caregivers of PwD is an important predictor of the self-efficacy level of caregivers. CLINICAL EVIDENCE: In order to enhance improving the quality of the caregiving process, caregivers should be strengthened, and caregiving self-efficacy should be comprehensively evaluated to enable assistance to the caregiver. The social support of caregivers is an important predictor of caregiving self-efficacy. Therefore, social support should be taken into consideration when engaging in appropriate initiatives.

Validation of the Turkish version of the Lewy body composite risk score.

The Lewy Body Composite Risk Score (LBCRS) has been developed to increase the sensitivity and specificity of the diagnosis attributable to Lewy body pathology outside of specialty centers. We aimed to assess the validity and reliability of the Turkish version of the LBCRS in patients with dementia with Lewy Bodies (DLB) and investigate the discriminative power of the test in Turkish patients with Alzheimer's disease (AD) and DLB, and control group. The sample population (n = 512) comprised DLB (n = 113), DLB-Mild Cognitive Impairment (MCI)(n = 12), AD (n = 42), AD-MCI (n = 21), and control group (n = 324). A significant group difference was observed in the Turkish version of the LBCRS scores of the five groups (p < .001). The Cronbach's α value was 0.82 (95% CI: 0.799-0.868). The test-retest reliability score of the scale was r = 0.94 and p < .001. The subscales of the LBCRS (motor and nonmotor subdomains of the disease) were determined to explain 65.961% of the total variance with an eigenvalue >1. In patients with DLB, the cutoff score of ≥3 showed sensitivity (92%) and specificity (81%) (area under the curve [AUC] = 0.883, 95% CI: 0.815-0.951), p < .001) compared with the AD. Compared to the control group, the cutoff score of ≥3 showed a sensitivity of 98% and specificity of 97% (AUC = 0.994, 95% CI: 0.989-0.999, p < .001). The Turkish version of LBCRS permits accurate diagnosis of DLB with high sensitivity and specificity. Also, it can be useful to inform the caregivers regarding the course of the disease during the follow-up.

Validity and reliability of the Turkish version of the ALBA screening instrument for Lewy body dementia in older adults.

ALBA screening instrument (ASI) has been demonstrated to be an effective, cheap, and noninvasive clinical instrument to screen for Lewy body dementia (LBD). We aimed to determine the validity and reliability of the Turkish version of ASI (ASI-T) in patients with LBD and to investigate the discriminative power of the test in patients with Alzheimer's Disease (AD), LBD, and cognitively healthy older adults (controls). 172 older adults over 60 years of age (43 with LBD, 41 AD, and 88 controls) were included. The sensitivity and specificity of the instrument were determined. A significant difference was found in ASI-T total score between people with LBD versus the controls (t=-9.259; p < 0.001), and versus patients with AD (t = 3.490; p = 0.001). Internal consistency of the ASI-T was good(Cronbach's alpha = 0.81). The cutoff score of 7 showed sensitivity (86%) and specificity (81%) (AUC= 0.888,CI0.95, p < 0.001) compared to controls. Also, compared to AD, it showed sensitivity (86%) and specificity(70%) (AUC = 0.590,CI .95, p < 0.001). Moreover, ASI-T demonstrated a significant concurrent validity with MMSE (r = -0.62; p < 0.001) and MoCA (r = -0.54; p = 0.003). In factor analysis, the five subscales accounted for 60% of the total variance. Our findings suggested that the ASI-T is a reliable, valid, and effective instrument for screening LBD. With acceptable psychometric properties, it has the power to distinguish patients with LBD from controls or those with AD.

Translation and Psychometric Evaluation of the Turkish Version of the Motivation to Change Lifestyle for Dementia Risk Reduction Scale (T-MOCHAD-10)

Background and Objectives: The number of people living with dementia is increasing globally, particularly in middle-income countries like Turkey. To reduce risk of dementia, the implementation of lifestyle changes targeting modifiable risk factors are important. This study aimed to translate and validate the Turkish version of the Motivation to Change Lifestyle for Dementia Risk Reduction (T-MOCHAD-10).MethodsCross-sectional psychometric study design was used. After translation and back translation, we assessed face and content validity. For construct validation and reliability assessment, we conducted a survey with 601 individuals aged 40 and above using a socio-demographic form and the T-MOCHAD-10. We used Exploratory Principal Axis Factoring with Oblimin rotation to explore the factor structure. We then confirmed the factor structure using fit indices. Reliability was established using test-re-test, Cronbach's alpha coefficient, item-total and item-subdimensions correlations, ceiling and floor effects, and the Hotelling's T-squared test.ResultsThe T-MOCHAD-10 showed adequate face and content validity (Kendall W=0.09, p=0.60). As in the original scale, a two-factor solution was obtained. All fit indices were ≥0.95, and RMSEA was 0.06. A Cronbach's alpha of 0.79 was obtained and no significant differences were found between test and re-test measures (p>0.05). We found no evidence of ceiling or floor effects, nor response bias (Hotelling's T-squared=4683.80, p<0.001).ConclusionT-MOCHAD-10 is a short measurement tool which provides valid and reliable scores concerning the motivation to change lifestyle for reducing dementia risk among Turkish individuals aged 40 and over. (AU)

Psychometric properties of the Turkish version of the scale for positive aspects of caregiving experience.

PURPOSE: To assess the psychometric properties of the Turkish version of the Scale for Positive Aspects of Caregiving Experience (SPACE). DESIGN AND METHODS: The methodological descriptive study was conducted with 228 family caregivers of people with dementia (PwD) in Turkey, Izmir, between March 2018 and December 2019. FINDINGS: The Turkish version of SPACE is a valid and reliable measurement tool to evaluate the positive experiences of caregivers of PwD in the Turkish society. PRACTICE IMPLICATIONS: It is thought that this measurement tool will be useful for researchers working with primary caregivers in Turkey.

Assessment of Dementia Knowledge Scale for the Nursing Profession and the General Population: Cross-Cultural Adaptation and Psychometric Validation.

BACKGROUND: The incidence of dementia is increasing dramatically worldwide. It is important to determine knowledge about the dementia for it's prevention, early diagnosis, treatment, and care. The psychometric properties of the Turkish version of the Dementia Knowledge Assessment Scale (DKAS-T) were evaluated in this study. METHODS: The psychometric study was conducted. A total of 1592 participants were recruited between November 2019 and March 2020. The data were collected using a sociodemographic form and DKAS-T. The language and content validity, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were used to assess the validity of the scale. The scale's reliability was obtained using Cronbach's alpha coefficient, a paired sample t-test, item-total score correlation, and Hotelling's T-squared test. RESULTS: The mean age of the sample was 29.38 (±11.50) years; 66.8% (n = 1064) were female, and 54.1% (n = 861) reported their income status as income equal to expenditure. The DKAS-T demonstrated content validity and adequate sensitivity (Kendall W = 0.155, p = 0.093). The scale consisted of seventeen items and was unidimensional, which explained 28.705% of the variance. All the factor loadings were found to be >0.30 in factor analysis. In CFA, all of the fit indexes were >0.95 and root mean square error of approximation (RMSEA) was 0.033. A Cronbach's alpha value of 0.836 was obtained for the entire scale. It was determined that the scale has invariance according to time (t = -1.362, p = 0.181). Homogeneity of the scale was 3.26%, and there was no absence of reaction bias (Hotelling's T-squared = 2573.681, p < 0.001). CONCLUSION: The results demonstrated that the instrument is reliable and generates valid data for the Turkish sample. This scale can be used to determine knowledge about dementia and planning educational interventions in the issue.

Quality of life and factors affecting it in patients with Alzheimer's disease: a cross-sectional study.

BACKGROUND: Quality of life (QoL) is a growing area of interest in dementia research. However, it remains a controversial topic. This study aimed to determine the QoL of people with Alzheimer's disease (PwAD) and investigate the factors affecting patients' and caregivers' QoL scores. METHODS: A cross-sectional study design was used. A total of 98 home-dwelling PwADs and their primary caregivers were recruited in the study. Sociodemographic characteristics and QoL scores, activities of daily living (ADL) and instrumental ADL (IADL), Mini-mental State Examination (MMSE) scores, neuropsychiatric inventory (NPI), and NPI-distress were determined to assess the relevant outcomes. All statistical analyses were performed using SPSS version 22.0. Descriptive statistics, t-test, Pearson correlation, and multinomial regression were used for analysis. RESULTS: The patients' ratings of their QoL were higher than those of the caregivers. Caregiver education, patients' ADL, and IADL were associated with the patients' score on the Quality of Life in Alzheimer's Disease (QoL-AD) scale. In addition to these variables, MMSE, NPI, and NPI-distress were associated with the caregiver scores on QoL-AD. CONCLUSION: From a clinical point of view, the proxy-rated scores of QoL cannot replace the self-ratings of the patients. This study suggests that both self- and proxy-rated QoL scores should be applied whenever possible. Focusing on the management of behavioral problems and supporting functionality and cognitive functions may be modifiable factors that may represent targets for intervention to improve the QoL. The findings of this study should also be used to design caregiver educational programs about the determinants of QoL.

The effects of support groups on dementia caregivers: A mixed method study.

The aim of this qualitative and quantitative study was to understand the effects of support group interventions on the caregiving burden of individuals providing care for people with dementia. This study used the Caregiver Burden Inventory, and focus group interviews (18 caregivers), which were conducted using a semi-structured interview form. The initial study sample was 37 primary caregivers; however, the final analysis included 30 caregivers. The quantitative data were analyzed by paired sample t-test. The interviews being analyzed using content analysis. It was found that there was a significant decrease in the scores for total burden (p = 0.049), social burden (p = 0.008) and emotional burden (p = 0.000) after the intervention. The content analyze revealed three main themes ("having knowledge," "calming down," and "acceptance"). Overall, it was concluded that support groups are effective in reducing caregiver burden.