Instrument Development to Measure Nurses' Knowledge and Emotions When Caring for the Older Adult with Delirium and Dementia

Paper

Wednesday, 19 July 2006

This presentation is part of : Developing and Testing Instruments and Scales

Kelli K. Schreiner, MSN, RN and Cindy M. Wamsley, PhD, RN. Nursing Administration, BryanLGH Medical Center, Lincoln, NE, USA

Learning Objective #1: Synthesize nursing knowledge and skills for those caring for the older adult with symptoms of delirium and dementia.
Learning Objective #2: Identify the nurses' feelings that create job dissatisfaction when caring for the older adult with symptoms of delirium and dementia.

INTRODUCTION: Nurses in acute care settings frequently care for patients with delirium and dementia. The time and energy needed for these patients may overwhelm the resources of nurses, causing feelings of frustration for the nurse and poor outcomes for the patient. As interventions are created to assist nurses with these issues, an instrument is needed to measure their effectiveness.

METHODS: A qualitative study was performed exploring nurses’ experiences when caring for patients with delirium and dementia. Results were used to construct an instrument (titled, The Delirium and Dementia Knowledge and Attitudes Instrument) including sections on nurses’ knowledge, skills and attitudes while providing care to patients with delirium and dementia. Content validity was assessed through review by gerontology and mental health experts.

The Delirium and Dementia Knowledge and Attitudes Instrument (DDKAI) and the Human Services Survey created by Maslach (1986) were administered to 26 orthopedic nurses prior to participation in an evidence based educational program. The new instrument was repeated 30-45 days after the intervention.

RESULTS: Scores from DDKAI produced a Cronbach alpha of .70. The average pre-test score on the instrument was 49.9 (14.2) (possible range 6-104). The scores of the emotion subscale of the DDKAI were adequately correlated with those of the Emotional Exhaustion subscale of the Maslach (1986) survey (Pearson R -.43, p = .02) providing evidence of external validation for those scores. The instrument clearly identified the knowledge and skill deficits of the nurses.

DISCUSSION: Nurses strive to provide the highest standard of care; however, they may lack the necessary knowledge and skills. Healthcare can not afford to lose well-trained acute care nurses due to frustration. The instrument developed in this study can be used to assess nursing perspectives and measure the effectiveness of interventions while improving the quality of life and dignity for older patients.

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