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Knowledge predicts attitudes toward dementia among hospital nurses in Saudi Arabia: a cross-sectional study
Almutairi RR, Almutairi AS.. Research Square, 2026-09-22
Topic: Health services, long-term care and technology
Background Nurses provide most direct care to hospitalized patients with Alzheimer's disease and related dementias (ADRD), yet almost all evidence on their dementia knowledge and attitudes comes from high-income Western countries or East Asia, and Gulf nursing workforces are largely unstudied. Whether the core Knowledge-Attitude-Practice assumption holds in this setting is untested. This study assessed ADRD knowledge and attitudes among nursing staff at a Saudi tertiary hospital and tested the hypothesis that greater knowledge is associated with more positive attitudes. Methods This study used a descriptive cross-sectional design, and data were collected via an online questionnaire. A convenience sample of 126 nurses completed the Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitudes Scale (DAS) at a tertiary hospital in Saudi Arabia. Scores were computed from raw item responses. Analyses in R included Welch tests, correlations, and a hierarchical regression predicting attitudes, with knowledge entered last. A sensitivity analysis established the smallest effects detectable at the achieved sample size. Results The results indicated that Saudi nurses demonstrated moderate knowledge (ADKS M = 18.58, SD = 3.52; 61.9% correct), with the weakest domains being caregiving (49.8%) and risk factors (52.5%). Nurses generally demonstrated positive attitudes toward ADRD (DAS M = 92.98, SD = 17.60). Knowledge correlated positively with attitudes (r = .42, 95% CI [.26, .55], p < .001). Knowledge was the strongest predictor of attitudes in the adjusted model (beta = .38, p < .001), adding 12.7% of explained variance beyond nurse background. Prior training (p = .031) and higher qualification (p = .049) predicted greater knowledge; longer tenure predicted more positive attitudes (p = .014). Conclusions Nurses showed moderate knowledge and positive attitudes, with knowledge closely linked to attitudes. Knowledge was adequate for disease course and diagnosis but fell to chance level for caregiving. Structured dementia training focused on risk factors, caregiving, and the delirium-dementia distinction, together with support for newly appointed staff, may strengthen dementia care readiness in this growing-burden region. Subgroup findings are hypothesis-generating and require replication in larger samples.
Key findings
- This study assessed ADRD knowledge and attitudes among nursing staff at a Saudi tertiary hospital and tested the hypothesis that greater knowledge is associated with more positive attitudes.
- Results The results indicated that Saudi nurses demonstrated moderate knowledge (ADKS M = 18.58, SD = 3.52; 61.9% correct), with the weakest domains being caregiving (49.8%) and risk factors (52.5%).
- Nurses generally demonstrated positive attitudes toward ADRD (DAS M = 92.98, SD = 17.60).
Study details
- Study designcross-sectional
- Effect size61.9%; 49.8%; 52.5%
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 31 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 19 of the 62 points we could judge it on, which is 31 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 19 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 19 of the 62 points we could judge it on is 31 out of 100. |
| Total | 31 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Almutairi, R. R., & Almutairi, A. S. (2026). Knowledge predicts attitudes toward dementia among hospital nurses in Saudi Arabia: a cross-sectional study. Research Square. https://doi.org/10.21203/rs.3.rs-10719820/v1
Vancouver
Almutairi RR, Almutairi AS. Knowledge predicts attitudes toward dementia among hospital nurses in Saudi Arabia: a cross-sectional study. Research Square. 2026. doi:10.21203/rs.3.rs-10719820/v1.
BibTeX
@article{almutairi2026-c3f15f3d,
author = {Almutairi, R. R. and Almutairi, A. S.},
title = {{Knowledge predicts attitudes toward dementia among hospital nurses in Saudi Arabia: a cross-sectional study}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-10719820/v1},
url = {https://doi.org/10.21203/rs.3.rs-10719820/v1}
}
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