A realist synthesis of dementia education programmes for pre-registration nurses

AimsThe escalating prevalence of dementia globally highlights the urgency for effective nursing care and dementia education. The aim of this review was to synthesize evidence on dementia education programmes for pre-registration nursing, exploring the types implemented, the contexts in which they operate, the mechanisms influencing their success, and their intended and unintended outcomes.DesignA realist synthesis approach was employed to explore the functioning of complex interventions within specific contexts, acknowledging the intricate nature of dementia education programmes and the diverse settings in which they are implemented.Data sourcesA rigorous search strategy was implemented across databases including Medline, CINAHL, Scopus, and ProQuest Health and Medical, supplemented by hand searching and citation searching. Preliminary screening and refinement processes ensured comprehensive coverage of relevant literature.Review methodsA systematic and iterative approach was adopted, involving quality assessment under the headings of relevance, rigour, and richness. Data extraction and synthesis processes were focused on identifying contexts, mechanisms, and outcomes relevant to dementia education in nursing.ResultsA total of 25 studies were reviewed. Key findings highlight the effectiveness of narrative-based learning, varied educational methods, and experienced providers in improving nursing students' knowledge, attitudes, and confidence. These approaches influenced care priorities and increased interest in working with people living with dementia. However, there is a noted gap in understanding the long-term benefits and academic impact of these programmes.ConclusionsDementia education programmes are pivotal in preparing nursing students for effective dementia care. The co-production and design involvement of people living with dementia in curricula development is recommended to enhance relevance and applicability. We call for further research into the long-term benefits of dementia education, the impact of academic recognition, and the alignment of programmes with nursing curricula

The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature

BACKGROUND: As care homes play an important role in the lives of an increasing number of older people, it is pivotal to understand how residents’ and their families engage in decision-making about their care and support. Internationally, there is an increasing emphasis in long-term care settings on the right of residents to be actively involved in all aspects of decision-making about their care and support. However, the steps necessary to achieving a culture of shared decision-making in long-term care settings remain unclear. The aim of this literature review is to summarise what is known in the literature about the factors that influence care home residents’ and families’ engagement with decision-making about their care and support. METHODS: An integrative literature reviews was carried out, guided by the methodological framework proposed by Whittemore and Knafl (2005). CINAHL, Medline Ovid and ProQuest Health and Medical databases were searched for relevant articles from 2011 to 2021. A three-step method was used, including the use of reference and citation management software to manage search results and identify duplicate citations. Abstracts and full texts were reviewed by two reviewers. Details of the selected articles were then extracted using the Data Extraction Form. RESULTS: In total, 913 articles were located and 22 studies were included in the final analysis. The thematic analysis identified three main themes that illustrate the complexities of shared decision-making in care homes: (a) a positive culture of collaborative and reciprocal relationships; (b) a willingness to engage and a willingness to become engaged; and (c) communicating with intent to share and support rather than inform and direct. CONCLUSION: The implementation of shared decision-making in care homes is highly dependent on the support and nurturing of collaborative and reciprocal relationships between residents, families, and staff. Part of this process includes ascertaining the willingness of residents and families to become engaged in shared decision-making. Communication skills training for staff and guided approaches that view decision-making as a supportive process rather than a once off event are essential prerequisites for implementation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-022-03503-8