The doubling of the number of people with dementia in the coming decades coupled with the rapid decline in the working population in our graying society is expected to result in a large decrease in the number of professionals available to provide care to people with dementia. As a result, care will be supplied increasingly by untrained informal caregivers and volunteers. To promote effective care and avoid overburdening of untrained and trained caregivers, they must become properly skilled. To this end, the European Skills Training and Reskilling (STAR) project, which comprised experts from the domains of education, technology, and dementia care from 6 countries (the Netherlands, Sweden, Italy, Malta, Romania, and the United Kingdom), worked together to create and evaluate a multilingual e-learning tool. The STAR training portal provides dementia care training both for informal and formal caregivers. The objective of the current study was to evaluate the user friendliness, usefulness, and impact of STAR with informal caregivers, volunteers, and professional caregivers. For 2 to 4 months, the experimental group had access to the STAR training portal, a Web-based portal consisting of 8 modules, 2 of which had a basic level and 6 additional modules at intermediate and advanced levels. The experimental group also had access to online peer and expert communities for support and information exchange. The control group received free access to STAR after the research had ended. The STAR training portal was evaluated in a randomized controlled trial among informal caregivers and volunteers in addition to professional caregivers (N=142) in the Netherlands and the United Kingdom. Assessments were performed with self-assessed, online, standardized questionnaires at baseline and after 2 to 4 months. Primary outcome measures were user friendliness, usefulness, and impact of STAR on knowledge, attitudes, and approaches of caregivers regarding dementia. Secondary outcome measures were empathy, quality of life, burden, and caregivers' sense of competence. STAR was rated positively by all user groups on both usefulness and user friendliness. Significant effects were found on a person-centered care approach and on the total score on positive attitudes to dementia; both the experimental and the control group increased in score. Regarding empathy, significant improvements were found in the STAR training group on distress, empathic concern, and taking the perspective of the person with dementia. In the experimental group, however, there was a significant reduction in self-reported sense of competence. The STAR training portal is a useful and user-friendly e-learning method, which has demonstrated its ability to provide significant positive effects on caregiver attitudes and empathy.

Aim: To analyse quantitative changes in patient well-being concurrent with chaplaincy interventions in a retrospective study of a group of Primary Care centres in Sandwell and West Birmingham, United Kingdom. Background: Anecdotal evidence suggests that support from trained Primary Care Chaplains may be particularly useful for those with subclinical mental health issues; it can reduce the tendency to ‘medicalise unhappiness’ and is a positive response to patients with medically unexplained symptoms. However, to date there has been no published research attempting to quantify their contribution. Method: Data were gathered from a group of Primary Care Centres, which make use of a shared Chaplaincy service. Demographic data and pre–post scores on the Warwick and Edinburgh Mental Wellbeing Scale (WEMWBS) were collected for patients who had attended consultations with a Chaplain. These were subjected to tests of statistical significance to evaluate the possible contribution of chaplaincy to patient well-being along with possible confounding variables. Findings: a substantial improvement in WEMWBS scores (mean=9 points, BCa 95% CI [7.23, 10.79], P =0.001) post-intervention. The improvement in scores was highest for those with initially lower levels of well-being. There is therefore evidence that chaplaincy interventions correlate with an improvement of holistic well-being as measured by a WEMWBS score. A prospective study on a larger scale would provide more detailed information on the interaction of possible variables. Further study is also required to evaluate the implications of this result for patient outcomes and GP resources. The efficacy of Primary Care Chaplaincy is under-researched and difficult to measure. This paper represents the first attempt to quantify a measurable improvement in the well-being of patients who are referred to the service.

If spirituality is fundamental to personhood, it must be as integral to the life of a person with dementia as to any other person. In this paper, the author uses a three-stage process to explore the features, meanings and significance of spirituality in late-stage dementia. First, a critical literature review is undertaken to evaluate the present state of research and its methodological limitations. The second stage of the argument comprises a critical analysis of the available models of how spirituality may persist beyond the loss of cognitive and communicative capacity, leading the elucidation of two dimensions to spirituality (duration over time and the role of social space) that can sometimes be overlooked. Finally, these findings are brought to bear on wider questions of how person-centred spiritual care may be offered to people with dementia and the role of shared social values in building spiritual resilience.

Historically, spirituality in nursing was considered a fundamental dimension, contributing to patients’ wellbeing. Accordingly, nurses are expected to attend to the spiritual needs of patients as a part of holistic nursing care, and pre-registration nurse education (that is undergraduate nurse education) has a responsibility to equip them to fulfil this aspect of their role. However, the content of spirituality in nurse education programmes lack structure and consistency, hence further investigation into the value of such education and its transferability in clinical practice is needed. Data collection was by individual interviews with 13 pre-registration participants undertaking adult nursing between March 2012 and May 2014. Each interview was digitally recorded and transcribed verbatim. Through theoretical sampling, data collection and analysis occurred in a cyclical manner until theoretical saturation/sufficiency was reached. The participants’ main concerns were: explaining spirituality, remembering spirituality education and content, and uncertainties about facilitating patients’ spiritual needs; these combine to form ‘having sufficient spirituality education to facilitate patients’ spiritual needs’. The substantive theory of ‘Enablement’ (make possible) was constructed to explain how the participants resolved their main concern. This investigation reveals how the participants acquire and translate spirituality education to practice, so realising holistic care.