Investigation of Factors Related to Nursing Care for Patients with Dementia at Acute Hospitals in Japan

Purpose: As the elderly population increases, the number of patients with dementia being admitted to acute hospitals is increasing year by year. Understanding and adequate assistance for patients with dementia will become more important for nurses at acute hospitals in the days ahead. The purpose of this study was to investigate factors associated with care for patients with dementia conducted by nurses working at acute hospitals.

Methods: Cross-sectional exploratory research design was applied using self-description questionnaires. Participants were nurses working at Tokyo acute hospitals possessing more than 300 beds. The contents of the questionnaire included demographic information assessment and nursing practice for patients with dementia, family support, consideration of privacy, safety and dignity of patients with dementia, allowance of mind and mental health, and interest in dementia care. This research was conducted after approval from the first presenter’s Institutional Review Board. Data were analyzed using SPSS Version 22.0.

Results: Respondents were 362 nurses, from 14 hospitals and the collection rate was 33.8%. Mean average length of the hospital stay was 12.5 (SD=1.6) days. In total, 344 respondents were women and mean age and mean nursing experience of respondents were 35.1 (SD=8.3) and 11.4 (SD=8.2) years, respectively. The data demonstrated that nurses more interested in dementia care performed more assessment of underlying diseases and medications that affect the patient’s cognitive functioning (r =.205, p =.000), assessment of the patient’s communication abilities (r =.200, p =.000), and active communication with patients with dementia (r =.202, p =.000). The data also demonstrated that nurses taking care with allowance of mind and mental health more frequently advise patients’ family members (r =.147, p =.006), assess and provide care for pain felt by patients with dementia (r =.176, p =.001), and talk to the patients using words and a speaking speed that are easy to understand (r =.187, p =.000). It was also demonstrated that more experienced nurses more frequently value the patient’s dignity (r =.129, p =.015), respond to the uncertainties and requests of the patient’s family members (r =.115, p =.030), and provide the patient with high-quality care (r =.145, p =.006). Nurses who experienced care for patients with dementia during the clinical practice in their basic education showed significantly low scores compared to ones without such experience in the assessment of family members (p =.018), involvement with dignity (p =.017), and diligence about privacy (p =.044). Nurses who experienced care for patients with dementia during the clinical practice in their basic education also showed significantly low scores compare to ones without such experience in age (p =.000) and nursing experience (p =.000).

Conclusion: The results indicate that nurses having more interest in patients with dementia, allowance of mind and mental health, and nursing experience perform more assessments and care for patients with dementia. Dementia care experience during the clinical practice in the basic education negatively affected current care for patients with dementia, but it was considered that the negative effects arise from the differences in their amount of experience, as they were significantly younger and had less nursing experience than nurses without clinical practice for patients with dementia in their basic education.

This research was supported by a JSPS Grant-in-Aid for Scientific Research (B) (Grant Number 24406037).