Nursing students' cultural beliefs and understanding of dementia: A phenomenological study across three continents.

BACKGROUND: Migrant nurses have reported difficulties adapting to their new culture and providing culturally sensitive care for people with dementia. However, to date no studies have explored the impact of student nurse's cultural heritage on their beliefs and understanding of dementia.

OBJECTIVES: To explore the cultural beliefs of dementia of student nurses studying in England, Slovenia, Philippines and New Zealand.

DESIGN: An explorative hermeneutic phenomenology design.

SETTINGS: Higher Education Institutes delivering undergraduate nursing education in England (University of Greenwich and University of Essex), Slovenia (Angela Boškin Faculty of Health Care), New Zealand (University of Auckland), and the Philippines (University of Silliman).

PARTICIPANTS: Student nurses studying nursing in England (n = 81), Slovenia (n = 41), Philippines (n = 53) and New Zealand (n = 6). Participants from England and New Zealand were from diverse cultural backgrounds. Student nurses at the beginning of their studies (n = 100) and towards the end of their studies (n = 81) participated.

METHODS: Completion of focus groups (n = 23), in England (n = 10), Slovenia (n = 6), Philippines (n = 6), and New Zealand (n = 1). All focus groups were audio recorded and transcribed verbatim. Data was analysed by applying an inductive theoretical approach of the Framework Method, which supports the generation of themes through open unhindered coding, pinpointing, examining, and recording patterns within the data.

RESULTS: Two major themes were identified in the data: familial piety and dementia discourse. Familial piety emerged from the importance of family and caring for family members with dementia, subthemes included: 'my granddad': familial experience, and 'better to be with her': familial home. Dementia discourse emerged from the terminology student nurses applied, such as: 'preconceptions and misconceptions' of aggression, and 'considered crazy' stigma of dementia due to a lack of awareness.

CONCLUSIONS: The cultural heritage of student nurses impacted on their beliefs of dementia; however their understanding of the needs, care and support of a person with dementia changed and developed through clinical experience and education.