What does the public really know about dementia? A community-based cross-sectional survey in Turkiye.

Despite the increasing burden of dementia, there has been no evaluation of the level of dementia knowledge among the general public in Turkiye. Thus, this study aimed to evaluate the public's knowledge regarding dementia and the factors predicting this knowledge. This is a community-based cross-sectional study. A survey was conducted with 1106 participants between April and August 2023. The research tools were demographic characteristics form, a Turkish version of the dementia knowledge assessment scale (DKAS-T), and a form focusing on sociodemographic information and questions related to the degree of dementia knowledge. The data were analyzed using descriptive statistics, correlation, and multiple regression. The mean score on the DKAS-T was 12.32 ± 6.05 (min: 0 points, max: 33 points) out of 34. The sample recorded an incorrect response for less than half of the items in the dementia knowledge scale. Adjusted R2 was used as explanatory power. Moreover, the results of the multiple regression analysis identified various factors that significantly predicted dementia knowledge scores: age, prior education about dementia, experience of caring for a PwD, interaction with a PwD, and self-reported risk of being diagnosed with dementia in the future. These variables accounted for 18.1% of the total variance of dementia knowledge. Dementia is not well known in the public. The finding underscores the need for targeted educational initiatives to enhance dementia knowledge in the Turkish population. Interventions should focus on addressing specific areas of deficiency identified in the DKAS-T.

The psychometric properties of the Turkish version of the Ostomy Self-Care Index and the Caregiver Contribution to Self-Care in Ostomy Patient Index.

BACKGROUND: Living with an ostomy is a chronic condition, and self-care in such cases improves patient outcomes. PURPOSE: To adapt and test the psychometric properties of the Turkish version of the Ostomy Self-Care Index (T-OSCI) and the Turkish version of the Caregiver Contribution to Self-Care in Ostomy Patient Index (T-CC-OSCI). METHODS: A psychometric study was conducted on a convenience sample of 202 adult patients with an ostomy and their 165 caregivers. Translation and back translation, face and content validity, construct validation, and reliability assessment of the T-OSCI and the T-CC-OSCI were performed. Exploratory factor analysis was used to evaluate the construct validity. Reliability was established using Cronbach α coefficients, ceiling and floor effects, and the Hotelling T2 test, Wilcoxon signed rank test, and intraclass correlation coefficient. RESULTS: Content validity values were in the range of 0.85 to 1 for both the T-OSCI and the T-CC-OSCI. Exploratory factor analysis demonstrated generally acceptable factor loadings. The overall index revealed a high level of internal consistency (T-OSCI = 0.968, T-CC-OSCI = 0.862). No statistically significant difference was found between test-retest measurements. There was no indication of either ceiling or floor effects, or response bias. CONCLUSION: The T-OSCI and the T-CC-OSCI are valid and reliable indexes to measure the self-care of patients with an ostomy and their caregivers. These indexes may allow health care professionals to evaluate self-care in research and clinical settings, identify educational needs, and collaborate in developing and supporting appropriate self-care initiatives for patients with an ostomy and their caregivers.

The impact of scenario-based aging simulation experience on empathy, attitudes toward and willingness to work with older adults in health sciences senior year students: A randomized controlled trial.

AIM: This study was conducted to investigate the impacts of scenario-based aging simulation experience (SBASE) on students' empathy, attitudes toward and willingness to work with older adults. BACKGROUND: Innovative teaching strategies such as SBASE have the potential to provide students with the essential skills required for working with older adults. DESIGN: This study has a randomized controlled trial. METHODS: This study was conducted in west of Turkiye with 120 health sciences senior year students (45 nursing students, 54 medicine students and 21 physical therapy and rehabilitation students) in 2022-2023. The students were randomly assigned to intervention or control group (IG-CG). The IG received SBASE. Pre- and post-tests (after intervention, 1 and 3 months later) were conducted. Data were collected using the descriptive characteristics form, Kogan's attitudes toward old people scale, basic empathy scale and willingness to work with elderly people scale. RESULTS: The IG participants recorded statistically better scores regarding positive attitudes towards older adults, in terms of the group x time interaction (t: 2.521, p: 0.036). However, there was no significant difference in the variables investigated between the groups. CONCLUSIONS: SBASE appeared to be effective in improving health sciences students' positive attitudes towards older adults. Health care providers should have a more positive attitude toward older adults to improve levels of care. DATA AVAILABILITY: Data and supplementary material related to this article can be obtained from the corresponding author upon request.

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.

Does having a family member with dementia affect health beliefs about changing lifestyle and health behaviour for dementia risk reduction?

BACKGROUND: Dementia is a worldwide public health concern. Implementing lifestyle changes that target modifiable risk factors is crucial for reducing the risk of dementia. The aim of this study was to investigate the effect of having family members with dementia on individuals' health beliefs and tendencies towards adopting healthier lifestyles and behaviours. METHODS: A cross-sectional, comparative study was conducted with 338 people aged 40 years and older, of whom 168 have the experience of having family members with dementia, and 170 have no such experience. Data were collected using a characteristics form, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale, and the modified Charlson comorbidity index. Descriptive statistics, Pearson's chi-square and independent t-tests, were used. RESULTS: Those with family members with dementia were more likely to have greater motivation to modify their lifestyle (perceived susceptibility, severity, benefits, and cues to action) to reduce their risk of developing dementia. Additionally, they had greater perceived barriers to gain by adopting a healthy lifestyle, in contrast to those without such family members. CONCLUSION: The presence of family members with dementia could be an important factor to consider when designing initiatives targeting health beliefs related to dementia prevention behaviours and lifestyle changes.

Self-perceived competence and its related factors in nursing students at graduation: the role of self-efficacy.

OBJECTIVES: This study aimed to investigate the level of perceived competence and explore the predictors of competence in nursing students at graduation. METHODS: This cross-sectional study was conducted with students at the point of graduation (n=239). A sociodemographic form and three different scales assessing students' competence, self-efficacy, and self-reflection and insight were used to collect data. Visual Analog Scale (VAS) was used to assess students' satisfaction (i.e., the role as nursing students in the nursing program), job-related stress (i.e., perceived stress related to nursing program), and coping behaviors. The data were analyzed using descriptive statistics and hierarchical linear regression. RESULTS: The mean scores of perceived competence, self-reflection, insight, and self-efficacy were 5.25 ± 0.96 (range: 1-7), 54.51 ± 7.83 (range: 12-96), 33.36 ± 5.40 (range: 8-48), 84.13 ± 12.27 (range: 0-100), respectively. Self-efficacy was the most significant associated factor of the entire group of variables in competence. CONCLUSIONS: Scores of perceived competence of students were optimistic. Self-efficacy was the most important factor affecting competence; that is, the greater the self-efficacy, the better the perceived competence.

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.

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.

Investigation of Factors Affecting Apathy in Three Major Types of Dementia.

INTRODUCION: Apathy is an important factor in the clinical management of dementia, as it has been associated with poor disease outcome, reduced daily functioning and caregiver distress. Considering apathy as a problem that needs to be managed and knowing the factors affecting apathy will enable appropriate initiatives to be planned. This study was conducted to compare apathy across three types of dementia and determine the factors affecting apathy for each of the three types of dementia. METHODS: The sample consisted of 46 patients with Alzheimer's disease (AD), 31 patients with frontotemporal dementia (FTD) and 29 patients with vascular dementia (VaD). Apathy was assessed using the Neuropsychiatric Inventory-apathy subscale (NPI), dementia severity was assessed using the Clinical Dementia Rating Scale (CDR), cognitive status was assessed using the Mini Mental Status Examination (MMSE) functional ability was measured with the Katz Index of Independence in Activities of Daily Living (ADL) and the Lawton-Brody Instrumental Activities of Daily Living (IADL). This is a descriptive and cross-sectional study. RESULTS: Significant differences were found between the apathy score of three types of dementia. Cognitive impairment correlated significantly with the apathy score in AD and VaD. Functionality scores and severity of dementia showed a significant correlation with apathy in each group. No statistically significant relationship was detected between age, gender and apathy. Multiple regression analyses show that apathy scores correlated with IADL in patients with AD. CONCLUSION: This study demonstrated that apathy is very common symptom in patients with FTD as well as patients with AD and VaD. Health professionals need to be aware of recognize apathy. Patients should be assessed for apathy regardless of dementia types, age and gender.

Determining Middle-Aged and Older Adults' Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction.

BACKGROUND: Global population is getting older and the prevalence of dementia continuously increases. Understanding the related health beliefs is bound to enable lifestyle-based interventions that maximize public engagement in dementia risk reduction behaviors. The aim of this study was to determine health beliefs on dementia prevention behaviors and lifestyle changes and to determine the factors influencing these beliefs among middle-aged and older people in Turkey. MATERIALS AND METHODS: This descriptive and cross-sectional study was conducted with 284 individuals aged 40 years and older, using nonprobability convenience sampling. Data were collected using a demographic characteristic form and the Turkish version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia scale. The study utilized the value, mean, percentage frequency distribution, correlation, independent t test, and the one-way analysis of variance test. RESULTS: The mean age of the participants included in the study was 56.99 ± 12.05, 68.7% of individuals were males. The mean education years of the participants were 11.22 ± 4.55. The majority (72.2%) of participants expressed subjective memory complaints. Presence of family history of dementia was 28.2%. Age, gender, education years, subjective memory complaints, presence family history of dementia, prior experience as a caregiver of dementia, and willingness to know their own risk were determined as essential factors that influence several health belief factors related to dementia risk reduction. CONCLUSION: Our findings indicate that males, older adults, and lower-educated and income are priority groups that should be guided for lifestyle and behavioral changes regarding dementia risk reduction.

Turkish Version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia Scale.

OBJECTIVE: This methodological study evaluates the validity and reliability of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale in Turkish. METHODS: The study enrolled 220 individuals aged 40 years and older between September 2017 and June 2018. The Kendall W analysis and content validity index were used for validity; test-retest and confirmatory factor analyses were used for the reliability analysis. RESULTS: The Turkish version of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale has valid content. The Cronbach α coefficient of the scale was .809, and the subscales were in the ranges of .781 to .609. A statistically significant, positive correlation was found between the test and retest scores. CONCLUSIONS: These results show that the scale has validity and reliability for use in the Turkish population.

Attitudes of Nurses in Turkey Toward Care of Dying Individual and the Associated Religious and Cultural Factors.

The aim of this study was to determine the attitudes of nurses working in two university hospitals located in the west and east of Turkey toward care of dying individual as well as religious and cultural factors that influence their attitudes. The descriptive and comparative study was conducted with a total of 189 nurses who were working in adult inpatient clinics of two university hospitals in western (101 nurses) and eastern (88 nurses) Turkey between July and November 2016. The data were obtained by using the questionnaire and Frommelt Attitudes Toward Care of the Dying Scale. As a result of this study, it was determined that in terms of the status of receiving training the end-of-life care the majority of nurses received this training; however, this rate was higher (51.0%) in nurses working in the eastern hospital (p = 0.025). The nurses working in the east (51.6%) were determined to have more problems during caregiving due to their religious and cultural beliefs, the most frequent problem they experienced was "being uncomfortable due to privacy when giving care to patients from opposite gender" (57.1%). The emotions felt mostly by nurses during the care of dying patient were grief (nurses in the east = 48.5%, nurses in the west = 51.5%) and despair (nurses in the east = 40.4%, nurses in the west = 59.6%). Nurses working both in the east (98.27 ± 7.71) and in the west (97.19 ± 8.99) were determined to have positive attitude toward death, and there was no statistically significant difference between both groups in terms of the mean scores of the Attitudes Toward Care of the Dying Scale (p = 0.373). In accordance with these results, it is recommended to focus on death issues in end-of-life care during the nursing education and to support nurses with in-service trainings regularly after the graduation.

Examining Factors Affecting Caregiver Burden: A Comparison of Frontotemporal Dementia and Alzheimer's Disease.

This study was conducted to compare the caregiver burden with regard to Alzheimer's disease (AD) and frontotemporal dementia (FTD) and to determine the factors affecting the caregiver burden of patients with AD and FTD. A comparative descriptive study design was used. The sample consisted of 90 patients with AD and 44 patients with FTD and their caregivers. Sociodemographic questionnaire, Mini-Mental State Examination (MMSE), the Caregiver Burden Inventory (CBI), Neuropsychiatric Inventory (NPI), and Functional Activities Questionnaire (FAQ) were used. Descriptive statistics, t tests, χ2 test, and multinominal regression were used for analysis. No difference was found with subscales and the total score of the CBI, except time dependency scale. The total NPI and FAQ scores correlated significantly, and the MMSE score did not show a significant correlation with the AD and FTD caregiver burden. The presence and frequency of neuropsychological symptoms differ among patients with FTD and AD, and different symptoms affect the caregiver burdens in both groups.