Dementia Knowledge and Perceived Competence in Dementia Care among Healthcare Workers in South Africa
Résumé
Background The rapidly aging global population, the prevalence of dementia is rising, placing an increasing burden on healthcare systems, particularly in low- and middle-income countries. Healthcare workers (HCWs) are at the forefront of dementia care, yet their knowledge and perceived competence in this area are often underexplored. Objective This study aimed to assess the capacity of healthcare workers for dementia screening, and management at selected health facilities in OR Tambo district of the Eastern Cape Province of South Africa. Methods A quantitative study was conducted with 425 HCWs from various healthcare facilities. Data were collected using a sociodemographic questionnaire, the Dementia Knowledge Assessment Tool (DKAT-2), and the Sense of Competence in Dementia Care Staff (SCIDS) scale. Descriptive statistics, item-level analysis, and bivariate analyses (Chi-square and Fisher’s Exact tests) were performed to examine the associations between participant characteristics and competence levels. Results Most participants were female (66.8%) and nurses (56.2%). While 63.8% of HCWs demonstrated moderate dementia knowledge, only 0.9% achieved good knowledge, and 35.3% had poor knowledge. Item-level analysis revealed a strong understanding of basic dementia concepts but significant gaps in knowledge about aetiology, differential diagnosis, and late-stage clinical features. Regarding perceived competence, 65.9% reported moderate competence and 34.1% reported high competence. High-competence HCWs consistently scored higher on all SCIDS items, particularly in behavioural management and person-centred care. Facility type was significantly associated with competence level (p = 0.002), with a larger proportion of HCWs in hospitals reporting high competence (64.1%) compared to those in clinics (25.5%) and community health centres (10.3%). Conclusion This study reveals a critical disconnect between moderate dementia knowledge and the application of this knowledge into perceived clinical competence. The pervasive knowledge gaps and the influence of the practice environment highlight the urgent need for targeted, context-specific training programs to equip HCWs with the practical skills required for high-quality dementia care.
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