49DEMENTIA COMMUNICATION SKILLS IN PRE-REGISTRATION NURSES- A QUESTION OF KNOWLEDGE OR CONFIDENCE?

Abstract

Background: In a person living with dementia (PWD) the ability to communicate deteriorates with progressive decline in cognitive function. Inexperienced staff including preregistration nurses express anxiety and feel ill prepared to communicate with PWD. Currently there is no evidence-based skills training intervention to support junior staff to develop communication skills in day-to-day interactions with PWD. Aims: This preliminary data analysis from a dementia communication skills project examines pre-registration nurses' baseline levels of a) dementia knowledge, b) ability to recognise person-centred opportunities for communication and c) perceptions of competence and readiness to communicate with PWD. Methods: Pre-registration student nurses allocated to acute older adults units across five London hospital completed online/paper surveys. Confidence was measured using the validated Sense of Competency in Dementia questionnaire (17 items) (Schepers et al. 2012), knowledge was measured using the modified Dementia Knowledge questionnaire (10 items) (Shanahan et al 2013). Recognition of person-centred communication was assessed using bespoke case vignettes (14 items) and perception of readiness for practice was measured using (7 items). Data analysis used descriptive statistics. Median values and Interquartile ranges (IQR) and Person's correlation co-efficient (a measure of association between the constructs) are reported. Results: A response rate of 59% (n = 35/59) was obtained. First year students accounted for 54%, 2nd year 33% and 3rd year 9% of the sample. Survey data indicated reasonably high levels of dementia knowledge, median value = 7 (IQR 6-8, maximum possible score (MPS) of 10) and ability to recognise person-centred responses, median = 9 (IQR 7-10, MPS of 14). A sense of competency in dementia was rated considerably lower, median = 42, (IQR 38-46, MPS of 68) as was perception of readiness to work with people with dementia, median = 20 (IQR 15-23, MPS of 35). In a correlation matrix of the four constructs 'Sense of Competency in Dementia' and perceptions of readiness to work with PWD were moderately correlated, Person's r = 0.68, p < 0.001. There was no correlation with dementia knowledge or ability to recognise person-centred responses (P > 0.05). Conclusion: In pre-registration nurses' confidence to communication with PWD is multifaceted. The data suggests nursing curricula should incorporate specific dementia communication skills training based on a competence framework. Curricula need to develop beyond dementia awareness rising solely based on theoretical knowledge of dementia or person-centred care.