Knowledge, attitude, and practices of healthcare professionals and formal caregivers towards non- pharmacological intervention for the management of behaviours and psychological symptoms in Australian aged care residents with dementia: A cross-sectional survey

Abstract

Abstract Background: Non-pharmacological interventions (NPIs) are the first line options in the management of behaviours and psychological symptoms of dementia (BPSD). However, NPIs are not frequently used in Australian residential aged care homes (RACHs). This study aimed to assess the knowledge, attitude and practice of the healthcare professionals and formal caregivers towards NPIs for the management of BPSD in Australian RACHs. Method: A cross-sectional, online survey was administered via Qualtrics platform. Information on the knowledge, attitude, and practice towards 25 common types of NPIs was collected from a sample of healthcare professionals and formal caregivers in Australia. Kruskal-Wallis along with Dunn’s post hoc test was used for comparisons among the professions. Results: Responses from 96 respondents were analysed. Most of the respondents were females (80.2%). Of the 25 types of NPIs assessed, 50- 65% of respondents reported that they were extremely familiar with 15 types of NPIs. About 66% of respondents believed that NPIs are more useful than medicines, and 81% reported NPIs should be tried before medicines. However, only validation therapy was always practiced by more than 50% of the respondents. According to Bloom’s cut-off point, 67% had good knowledge, but only 27% had positive attitude and 34% had good practice towards NPIs. There was moderate correlation between the overall knowledge and practice score (r= 0.68, p < .001) as well as attitude and practice (r = 0.43, p < .001). The mean rank of the knowledge, and practice scores for most NPIs were lower for formal caregivers and allied health professionals than nurses, but the difference was statistically significant for only a few NPIs. Nurses exhibited higher total mean ranks for knowledge, attitude, and practice compared to formal caregivers. However, only the difference in attitude score rankings was statistically significant (p = .016). Conclusion: Knowledge, attitude, and practice towards NPIs varied among the professions. The knowledge level was good for two thirds of respondents, but less than one third had positive attitude and one third of respondents had good practice. Education and training focusing on the knowledge and attitude are important to bring about practice change.