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Table 6 Quantitative studies. Characteristics of the Survey/ Questionnaire studies reviewed

From: What is the role of the practice nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)?: a systematic review

Author, year, country

Aim

Research design

Instruments

Sample and size (characteristics)

Type and description of intervention

Analysis method

Outcomes

Trickey et al., 2000 [11]

United Kingdom

To examine the knowledge and attitudes of primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline.

Descriptive

Postal questionnaire survey of primary care nurses responsible for the Over-75 Check

Questionnaire included

-a case vignette for eliciting information about knowledge, attitudes and opinions

-demographic information

127 (65% response rate) respondents

-71% practice based nurses

-11% health visitors

-6% district nurses

-12% other

All respondents were female

75% over 40 years

32% over 50 years

18% had completed a post-registration course in nursing older people

 

Analyses using SPSS 6.0 and the commands ‘descriptives’ and ‘crosstabs”

In response to the vignette

PN were less likely to take any action themselves than were other professionals (61 vs 78%) (just failed to reach statistical significance (chi-squared test P=0.07)

Thematic analysis of the vignettes revealed that the nature of the referral to the GP was influenced by the respondent’s knowledge of dementia, understanding own professional role and by structural constraints such as the need to use the GP to access other services.

It was reported that many professionals undertaking the Over-75 Check are not sufficiently well trained to assess patients who may be displaying signs of cognitive impairment

68% of respondents indicated that new guidelines would ‘definitely help’ them in their practice.

Manthorpe et al., 2003 [12]

United Kingdom

Supplementary papers

Downs & Rae, 1996 [26]

Iliffe et al., 1999 [27]

Illife et al., 2003 [28]

To explore whether Community Mental Health Nurses (CMHNs ), Community Nurses (CNs), and PNs have different perspectives on early diagnosis of dementia

Intervention

Comparative

Questionnaire derived from the Stirling Service Development Centre

asked the nurses about clinical role, experience, case load, epidemiological and clinical knowledge, confidence in recognising the dementias and perceived difficulties in providing care for people with dementia

268 nurses (79 CMHNs, 153 CNs, 36 PNs)

1 day educational workshop on recognition of and response to dementia

Data was aggregated by professional discipline

95% confidence intervals

1.96 x √(p x q/n)

P proportion showing the characteristic

Q proportion not showing the characteristic

n is the sample size

All three nurse disciplines reported experience of working with people with dementia and had similar knowledge related the early signs and symptoms of dementia. However CMHNs were more confident in their diagnostic skills, ability to communicate a diagnosis, provide advice and obtain support services. CMHNs considered they were best placed to coordinate services for people with newly diagnosed dementia and found providing support less difficult than CNs and PNS.

Dementia support in the community was seen as a specialist function, with the key worker role best fulfilled by CMHNs.

Gilbert et al., 2017 [29]

United Kingdom

Supplementary papers

Downs et al., 2006 [30]

Illife et al., 2010 [31]

To explore the service use and reported unmet needs of people with dementia recruited a decade apart

Questionnaire

Comparative

The questionnaire covered demographics and capabilities of the person with dementia as perceived by the support person(s) assessed across nine different activities of daily living

The 2 samples were recruited as part of 2 previous RCT studies [30, 31]

Both samples have similar demographics and the people with dementia had similar degrees of disability and engagement with community services.

Sample 1

Central Scotland and London

2000-2001

Support person(s) = 122

Sample 2

South-East England

2010-2011

Support person(s) = 84

 

Summary descriptive statistics

One-tail chi-square

Fisher-exact analysis

Logistic regression

Binary linear regression analysis

There were significantly more support person(s) who contacted PNs about the person with dementia in the later sample than the earlier (53.6% compared with 36.9%, p=0.01) and less evident use of CNs, psychiatric nurses and health visitors. PN use was associated with having a non-spouse support person(s) (p=0.022) but no other factors were significant. Those who received PN help generally found it useful.

Support person(s)s in the second sample reported that approximate one third of people with dementia were still not getting the support they needed and the majority of support person(s)s reporting behavioural and psychological problems had had no advice on how to manage this