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JCPSLP
Volume 17, Number 2 2015
79
to dementia,
F
(1,42)=63.58,
p
<0.001 with no interaction
effect between time and knowledge of swallowing changes
in either population [dysphagia:
F
(1,42)=1.12, swallowing
changes in dementia:
p
=0.30;
F
(1,42)=0.37
p
=0.55].
Therefore, knowledge in all areas improved irrespective of
placement type. A placement partly or exclusively
completed in a residential setting compared to an acute
setting, resulted in mean scores (see Table 3) indicating
greater knowledge of communication changes secondary
to dementia but these findings were not significantly
different.
A main effect for time was identified in participants’
confidence in undertaking the assessment and
management of a communication in disorders (see Table 3)
such as; motor speech,
F
(1,42)=62.24,
p
<0.001; aphasia,
F
(1,42)=59.24,
p
<0.001, and cognitive-communication
6.4; 6.2). Despite the increased preference for working
with people with dementia, this client population remained
within the three least preferred options, as did working with
people on a palliative pathway.
Influence of placement setting
A split-plot model ANOVA yielded a main effect for time
(pre- or post-placement) for knowledge of age-related
communication changes or disorders,
F
(1,42)=32.38,
p
<0.001, and communication changes secondary to
dementia,
F
(1,42)=43.52,
p
<0.001. However, no interaction
effect between time and knowledge of communication
changes in either group [
F
(1,42)=2.27,
p
=0.14;
F
(1,42)=2.19,
p
=0.15 respectively] was found. Similarly, a
main effect for time was found for both dysphagia,
F
(1,42)=43.55, p<0.001, and swallowing changes related
Table 2. Change in students’ reported knowledge, confidence, and attitudes post placement (n = 52)
Pre-placement
Post-placement
Wilcoxon Signed Rank
test (z, p)
Knowledge and confidence composite scores
Median¹ (Range)
Median¹ (Range)
Knowledge about communication changes and disorders
5 (4–7)²
4 (2–6)²
-5.218, < .001*
Knowledge about swallowing changes and disorders
6 (2–8)²
3 (2–7)²
-5.113, < .001*
Confidence in managing communication changes and disorders
10 (4–15)³
6 (4–10)³
-6.011, < .001*
Confidence in managing swallowing changes and disorders
8 (3–12)
4
4 (3–9)
4
-5.589, < .001*
Attitudes score
Mean
5
±SD
Mean ±SD
UCLA Geriatric Attitude Scale score
3.83 ±0.42
3.93 ±0.40
-1.919, .05
¹ A lower median reflects greater knowledge and confidence, ² Range: 2–8, ³Range: 4–16,
4
Range: 3–12,
5
A higher mean reflects a more
positive attitude
* Statistically significant change
Table 3. Reported knowledge and confidence following a placement solely in an acute setting or partly or
exclusively in a residential setting
Placement in an acute setting only
(n = 19)
Placement partly or exclusively in a
residential setting (n = 25)
Pre
Mean
1
± SD
Post
Mean
1
± SD
Pre
Mean
1
± SD
Post
Mean
1
± SD
Knowledge about:
Communication changes and disorders
2.32 (.47)
1.80 (.57)
2.58 (.50)
1.68 (.67)
Communication changes secondary to dementia
2.64 (.56)
2.04 (.61)
2.58 (.60)
1.63 (.59)
Dysphagia
2.40 (.64)
1.60 (.57)
2.68 (.82)
1.58 (.50)
Swallowing changes secondary to dementia
2.84 (.62)
1.80 (.76)
2.79 (.71)
1.58 (.50)
Confidence in assessment and management of:
Motor speech disorders
2.32 (.55)
1.68 (.55)
2.63 (.76)
1.32 (.47)
Aphasia
2.32 (.69)
1.56 (.50)
2.58 (.83)
1.37 (.49)
Cognitive-communication disorders
2.60 (.81)
1.84 (.55)
2.79 (.63)
1.63 (.59)
Dysphagia in medically well and medically complex adults
2.52 (.87)
1.36 (.56)
2.79 (.63)
1.58 (.69)
Swallowing changes secondary to dementia
2.88 (.92)
1.72 (.67)
3.00 (.57)
1.53 (.69)
¹ A lower mean reflects greater knowledge and confidence