Understanding the cultural landscape influencing nursing care for people living with dementia in Sub-Saharan Africa: An integrative literature review

With the rise, worldwide, in numbers of people rapidly surviving into older adulthood, the increasing prevalence of dementia has become a global public health priority of significance. The most alarming increase in dementia burden occurs in low and middle-income countries (LMIC), especially in Sub Saharan Africa (SSA). The purpose of this integrative review is to provide evidence-informed recommendations, based on the current literature that guides nurses practicing in SSA on how to safely care for people living with dementia. Cultural, social, and community perceptions, beliefs, and attitudes about dementia affect people living with dementia in profound ways. As such, culture-specific understandings need to be visible in the provision of quality nursing care across the diverse and complex landscape of urban and rural SSA. Whittemore and Knalf’s (2015) integrative literature review methodology and methods were used to conduct searches within CINAHL, PsycINFO, MEDLINE, and PubMed databases for relevant studies and systematic reviews by applying appropriate medical subject headings. Developed inclusion and exclusion criteria systematically guided the process of work through the literature search results. This process led to narrowing the focus of the body of literature and culminated in the selection of 17 peer-reviewed research articles of studies originating from seven SSA countries: Nigeria, South Africa (SA), Democratic Republic of the Congo (DRC), Uganda, Ghana, Kenya, and Tanzania. The set of articles were then each individually analyzed and collectively synthesized to answer the research question: How do cultural, social, and community perceptions, beliefs, and attitudes related to dementia affect people living with dementia and the quality of nursing care provided in Sub Saharan Africa? Four key themes emerged following the extraction of data from the articles: 1) nurses’ limited knowledge of how people live with dementia, especially with the cultural belief of dementia as witchcraft, 2) nurses’ misguided understanding of what help and health-seeking behaviors people experiencing dementia exhibit, 3) nurses’ lack of awareness of dementia-associated stigma and its influence on suffering and illness, and 4) nurses’ need for education related to the provision of nursing best practices when caring for people with dementia. The need for knowledge, understanding, awareness, and education for nurses caring for people living with dementia across Sub-Saharan African communities remains pertinent. There is also a need for these actions to extend deep into communities where traditional knowledge keepers, faith healers, and other healthcare professionals could be allies in supporting the pluralistic and collaborative provision of dementia care. Within SSA, nurses have the capacity to develop and implement low‐resourced nonpharmacological interventions to people living with dementia, and to partner with families in the achievement of patient-centered care. Nurses also have the capacity to provide leadership in orchestrating short and long-term initiatives that shift societal cultural and dementia understanding through practice, education, research, and policy recommendations.