Knowledge, Skills, and Attitudes of Pre-Licensure Nurses Regarding Dementia Care: A Systematic Literature Review

Background: Globally, the prevalence of older persons with dementia is increasing because of a rise in the aging population.  Associated with this increase dementia prevalence are the increasing needs for nursing care of affected individuals and their families/caregivers across healthcare continuum. Therefore, it is essential that pre-licensure nurses acquire appropriate knowledge, skills, and attitudes regarding dementia care during their undergraduate programs to enable them provide effective and holistic dementia care.

Aim: This review presents the extensive findings of published research studies on the knowledge, attitudes, and skills of pre-licensure nurses regarding dementia care and associated pedagogies strategies.

Methods: The framework for this systematic literature review was the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Electronic PubMed, Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Web of Science databases were conducted for eligible studies using keywords that include attitudes, clinical, dementia, knowledge, nurse, skills, students, undergraduate, and teaching.  The eligible criteria applied in selecting the studies were: 1) Inclusion of student nurses as participants , 2) Measurement of knowledge, skills, or attitude regarding dementia care, 3) Measurement of the effectiveness of pedagogy strategies, 4) Published in English language, and 5) Published in peer-reviewed journals between 2004 and 2014.

Results: This review included 12 studies, of which seven were quantitative and five were qualitative.  The studies' locations included Australia, Hong Kong, Korea, Malta, India, Northern Ireland, U.K., and USA.  Most of the studies’ findings suggested significant lack of knowledge and skills among most pre-licensure nurses.  In addition, most studies reported negative attitudes among pre-licensure nurses toward dementia care.  Appropriate clinical placements and hours of teaching were positively correlated with self-efficacy in dementia care and level of dementia knowledge among pre-licensure nurses.

Conclusion: The lack of knowledge, skills, and positive attitude among pre-licensure nurses is an indication of a gap between pre-licensure nurses’ preparedness to meet the needs of dementia patients and their families and the provision of high quality dementia nursing care.