Increasing nursing students’ self-efficacy in dementia care via GPA Bathing, an online bathing education program: A quasi-experimental pre-post design

Background and purpose: Nursing curricula rarely include formal education on dementia-specific bathing competencies. However, bathing assistance is associated with physical and emotional challenges for both caregivers and people living with dementia. Here, we evaluated the impact of Gentle Persuasive Approaches (GPA) Bathing, a program of online dementia-specific educational units, on bathing-related self-efficacy among nursing students.
Methods: A total of 517 final-year nursing students in a Canadian university completed three GPA Bathing units. Of those, 384 participants completed quantitative and qualitative measures of dementia-specific bathing self-efficacy, including Likert-type ratings and open-ended questions at both the pre- and post-intervention time points. Participants also rated their satisfaction with the units. 
Results: At baseline, participants expressed feelings of fear, incompetence, and uncertainty when faced with escalating responsive behaviours during provision of bathing assistance. They named limited and basic strategies for supporting a person who was distressed during bathing. After three GPA Bathing units, statistically significant improvements were observed in participants’ bathing self-efficacy scores relative to baseline. In participants’ post-intervention qualitative responses, they described developing an expanding theoretical understanding of and confidence in bathing competencies and could name specific and detailed person-centred care approaches.
Conclusions: Findings suggest that three GPA Bathing units equipped a sample of fourth year nursing students with increased confidence in person-centred bathing strategies. This dementia-specific bathing education will allow the students to provide tailored, respectful, and compassionate bathing care as they encounter people living with dementia throughout their careers. Our findings support the need to embed dementia-specific bathing education into nursing curricula.