Influence Of Online Learning Combined With Virtual Dementia Tour On Confidence Of Undergraduate Nursing Students In Dementia Care

Objectives1.To systematically evaluate the interventional effect of dementia education on nursing students at home and abroad,so as to provide the new and best evidence for later research on dementia education intervention for undergraduate nursing students.2.To understand the current situation of dementia knowledge,attitude and confidence of undergraduate nursing students,to clarify the influencing factors of confidence in dementia care,and to probe the correlation between dementia knowledge,attitude and confidence of undergraduate nursing students,in order to provide research basis for carrying out dementia education of undergraduate nursing students.3.To deeply explore the effect of dementia online learning combined with virtual dementia tour(VDT)education project on undergraduate nursing students’ confidence in dementia care,in order to provide reference and suggestions for undergraduate nursing students’ dementia education in colleges and universities in the future.MethodsFirstly,databases such as China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,Pubmed,EMbase and CINAHL were searched to collect the literature of intervention of dementia education among nursing students,and the literature quality was appraised strictly.Secondly,using convenience sampling method,470 undergraduate nursing students in the third academic year from three medical colleges and universities in Shandong Province were investigated as the research objects with the general questionnaire,Dementia Knowledge Assessment Tool Version 2(DKAT2),Dementia Attitudes Scale(DAS)and Confidence in Dementia Scale(CODE).At last,50 nursing students involved the cross-sectional survey were selected to participate in dementia online learning and VDT with convenience sampling method.The pretest-posttest self control study was designed to measure the dementia knowledge,attitude and care confidence of nursing students after intervention.With qualitative method,the interview outline was adopted on the semi-structured interview.The quantitative data was analyzed with SPSS21.0,and the qualitative data was analyzed by Colaizzi phenomenological analysis.ResultsA total of 18 studies were included in the systematic review,with the quality of grade B,involving 1679 subjects.470 questionnaires were distributed in the cross-sectional study,of which 442 were valid,with an effective rate of 94.4%.In the pretest-posttest self control study,50 participants involved,and 8 participants of them were lost to follow-up with a lost follow-up rate of 16.0%.Finally 42 of them completed the education intervention,17 students were interviewed in the qualitative study.1.Five educational themes were identified in the systematic review,including practical experience,simulation program,interprofessional education,dementia knowledge training and comprehensive dementia education.Practical experience under the well-support,interprofessional education and simulation experience can improve nursing students ’ knowledge,attitude or confidence/self-efficacy towards patients with dementia.Additionally,dementia knowledge training can augment students’ dementia knowledge,and comprehensive dementia education may have more positive results for nursing students,but more research is needed to prove it.2.The score of DKAT2,DAS and CODE was(13.84±2.90),(87.12±9.78)and(21.73±6.04)respectively among undergraduate nursing students.3.The results of univariate analysis showed that the residence(P=0.018),curriculum learning experience of dementia(P=0.002),experience of contact with dementia patients(P=0.007),experience of participation in dementia learning(P=0.000),willingness of engagement in elderly care(P=0.000)and willingness of receiving dementia education training(P=0.001)had significant effects on nursing students’ confidence in dementia care(P<0.05).4.The confidence in dementia care was positively associated with dementia knowledge and dementia care attitude among undergraduate nursing students(r=0.428,0.527,P<0.01).5.The results of multivariate analysis showed that the curriculum learning experience of dementia,experience of participation in dementia learning,residence,dementia knowledge,attitude towards dementia care had significantly influence on nursing students’ confidence in dementia care(P<0.05).6.After participating in the education project of online learning combined with VDT,students’ score in DKAT2(16.79±1.98),DAS(96.38±9.82)and CODE(27.57±6.09)was respectively higher than before with statistically significant differences(P<0.05).7.The results of qualitative study showed that before the intervention,some nursing students’ knowledge of dementia care came from the media or personal experience other than nursing education,and they expressed negative emotions such as fear,helplessness and sadness towards patients with dementia.After the intervention,most nursing students said that this education project improved their dementia knowledge,attitude towards patients with dementia,and confidence in dementia care.Students also recognized the importance of geriatric care,and had the willingness of continuing to receive dementia education.Conclusions1.Integration well-supported practical experiences into nursing curriculum may be an effective way for nursing students to acquire dementia care ability.Meanwhile,simulation program and dementia knowledge training could serve as a supplement to the clinical placement or preparation before entering clinical experience.Although interprofessional education and comprehensive dementia education programs may be future avenues to increase dementia knowledge,improve attitudes and enhance confidence among nursing students,it is difficult to implement and still needs further research in the future.2.The dementia knowledge of undergraduate nursing students was at moderate level,the attitude was at highly intermediate level,and the confidence in dementia care was at a medium level.3.Confidence in dementia care was positively associated with dementia knowledge and dementia care attitude among undergraduate nursing students.4.The residence,curriculum learning experience of dementia,experience of participation in dementia learning,dementia knowledge,attitude towards dementia were the main influencing factors on confidence in dementia care among nursing students.5.The education project of online learning combined with VDT can increase dementia knowledge,improve attitude towards patients with dementia,enhance confidence in dementia care among undergraduate nursing students,make most of students recognized the importance of geriatric care,and stimulate their interest in learning more about dementia.