Nursing student attitudes toward and preferences for working with older adults

An exploration of medical student attitudes towards older persons and frailty during undergraduate training

INTRODUCTION

Older persons and patients with frailty constitute an ever increasing proportion of hospital patients. Improving student attitudes towards both groups is important in preparing future doctors for this demographic shift. We aimed to investigate medical student attitudes towards older persons and frailty over an entire medical school cohort.

METHODS

All current Brighton and Sussex Medical School students were invited to complete an online questionnaire consisting: (i) the Australian Ageing Semantic Differential (AASD), (ii) the Medical Condition Regard Scale (MCRS) with regards to frailty, (iii) a qualitative question asking participants to record three words regarding both a person over 70 years and frailty.

RESULTS

187 students participated (66% female, 25.2% response rate). Participants reported positive attitudes with mean scores of 73.45/114 on the AASD and 52.4/66 on the MCRS. The most positive attitudes towards both older persons and frailty were held by year 1 students, and most negative by year 3 and year 4 students for older persons and frailty, respectively. Examining AASD subgroups, students held negative attitudes towards the instrumentality (function) of older persons (mean score: 17.6/36) with significant variation across year groups (p < 0.05), with the most negative attitudes expressed in year 3. Word clouds of qualitative responses showed that medical students consider the two concepts differently with frailty attracting more negative associations.

CONCLUSION

Generally medical student attitudes were positive towards older persons and frailty. However, these declined when focusing on the functionality, with word cloud analysis of attitudes revealing a dichotomy between the quantitative and qualitative data surrounding frailty.

Attitudes of Polish Entrepreneurs towards 65+ Knowledge Workers in the Context of Their Pro-Social Attitude and Organizational Citizenship Behavior

In this article, we examine the issue of Polish entrepreneurs’ attitudes towards knowledge workers above the age of 65 in the context of pro-social and citizenship behavior. The article was written as part of the diversity management paradigm. Firstly, it presents the existing literature on the subject, and then, we present our analysis on the results of a longitudinal study conducted among 93 entrepreneurs, owners, and co-owners of small and medium enterprises, during 2014 and 2019. During this time, legal regulation took place twice, extending and then shortening the period of obligatory work enabling employees to acquire the right to retire. The study was carried out using a specially developed questionnaire, whose reliability met the requirements of methodological correctness and two other research tools. Positive, neutral and negative attitudes were identified among entrepreneurs’ attitudes towards knowledge workers aged 65+. The research results show a correlation between the attitudes of entrepreneurs in 2014 and 2019, stabilization of these attitudes (in relation positive, neutral and negative attitudes), and their particularly significant relationship with organization-oriented citizenship behavior.

A Shortage in the Number of Nurses-A Case Study from a Selected Region in the Czech Republic and International Context

A lack of nurses in the Czech Republic is an issue that has been under discussion for several years. The aim of this paper is to analyze the lack and need of general nurses and midwives in the Hradec Kralove region where the shortage is higher than the national average. The used methods are quantitative research and structured interviews, to determine the number of nurses in healthcare institutions. The study uses data obtained from publicly available sources, i.e., Czech Statistical Office (CSO) and the National Institute of Education (NIE). The shortage of nurses in the Hradec Kralove region can be expected by 2030 to be in the range between 647.6 and 667.1 nurses while maintaining the existing conditions, that is, five times more than at present. In addition to the commonly considered measures that appear in the country’s strategies—such as improving the quality of conditions during studies and during employment, specifying or adjusting the role and competency of nurses and midwives in the healthcare system, or unifying employment standards— a focus on promoting the nursing profession can be recommended. Schools and ministries should be encouraged to focus on and invest in the promotion of this profession, so as to play a key role in recruiting new students for the nursing field of study at a time when the nursing profession is perceived positively, as an embodiment of solidarity and selflessness.

Gerontological nurse teachers' abilities and influence on students' willingness in older people nursing: A cross-sectional, correlational survey

BACKGROUND

Previous studies have focused on identifying the factors hindering nursing students' interest in gerontology careers, whereas others have suggested interventions to promote students' interest in older people nursing. However, the role of a teacher is equally vital in shaping students' career preference.

OBJECTIVE

This study therefore explored students' perspectives of their gerontological nurse teachers' abilities and its association with students' willingness to work in older people nursing.

DESIGN

A cross-sectional correlation study.

SETTING

Five Universities of Applied Sciences in Finland.

PARTICIPANTS

Undergraduate nursing students (N = 243).

METHOD

A self-administered survey using the Gerontological Nurse Teacher Scale (GeNTS) and the subscale (Willingness) of the Students' Interest in Nursing Older People Scale (SINOPS). Descriptive and inferential analysis were conducted using SPSS.

RESULTS

There was a moderate positive association (R = 0.25, N = 243, p = 0.000) between students' perspectives of their gerontological nurse teachers' abilities and students' willingness to work in older people nursing. The teachers' abilities to develop gerontological nursing course most influence students' willingness in older people nursing (r = 0.26, p = 0.001), whereas their knowledge and interest in gerontology, least influenced students' willingness in older people nursing (r = 0.14, p = 0.025). Also, the teachers abilities to address students' concerns about aging, promote gerontology careers, and demonstrate leadership skills in gerontology all had a similar statistically significant moderate positive association (r = 0.23, p = 0.001) with students' willingness to work in older people nursing.

CONCLUSION

Faculty need to ensure that there is adequate personal with expertise in gerontological nursing to advocate for resources to establish a reputable gerontological nursing profile in nursing curriculum and to develop and sustain a positive attitude towards older people nursing among students and staff. A qualitative study is needed to understand the reasons behind students' ratings.

Preferences of nursing and medical students for working with older adults and people with dementia: a systematic review

BACKGROUND

A current issue in workforce planning is ensuring healthcare professionals are both competent and willing to work with older adults with complex needs. This includes dementia care, which is widely recognised as a priority. Yet research suggests that working with older people is unattractive to undergraduate healthcare students.

METHODS

The aim of this systematic review and narrative synthesis is to explore the factors related to healthcare (medical and nursing) student preferences' for working with older people and people with dementia. Searches were conducted in five databases: MEDLINE, PsycINFO, CINHAL, BNI, ERIC. Screening, data extraction and quality appraisal were conducted by two independent reviewers. A narrative, data-based convergent synthesis was conducted.

RESULTS

One thousand twenty-four papers were screened (139 full texts) and 62 papers were included for a narrative synthesis. Factors were grouped into seven categories; student characteristics, experiences of students, course characteristics, career characteristics, patient characteristics, work characteristics and the theory of planned behaviour.

CONCLUSION

Health educators should review their role in cultivating student interest in working with older adults, with consideration of student preparation and the perceived value of this work. There is a lack of evidence about the career preferences of students in relation to dementia, and this warrants further research.

Development and validation of gerontological nurse teacher scale

Several studies have advocated for having gerontological nurse teachers with special commitment to implement an aged-friendly curriculum, in order to facilitate student nurses' interest in gerontology careers. However, there is no existing instrument to assess whether gerontological nurse teachers possess such competences. This study describes the development and validation of an instrument for assessing the competence of gerontological nurse teachers. A total of 43 items categorized into seven constructs for the Gerontological Nurse Teacher Scale (GeNTS) emerged from the literature review in 2017. Experts (N = 19) then participated in a two-round Delphi feedback for content validity in May 2018. A pre-pilot study was then undertaken in October 2018 among undergraduate nursing students (n = 7) to ensure readability and understandability, followed by a pilot study on undergraduate nursing students (n = 196) for psychometric assessment. Based on experts' feedback and psychometric assessment, the final version of GeNTS consists of 33 items across five constructs namely: knowledge and interest; theoretical course and practical training development; leadership; gerontology career promotion and concerns about aging. The items are score on a five-point Likert scale from 1 = completely disagree to 5 = completely agree.

Dietetic Students' Perceived Facilitators, Barriers and Perceptions of Working with Older Adults: Implications for Curriculum Development

Objective: The purpose of this study was to explore dietetic students' facilitators, barriers, and perceptions of working with older adults.Method: A purposive sampling method was used to conduct individual, face-to-face-interviews with students majoring in human nutrition (n = 17). All interviews were audio recorded, transcribed verbatim, and coded using NVivo 11 software. A directed content analysis revealed the following themes under categories of (1) perception, (2) barriers, (3) facilitators, and (4) impact of experience.Results: For perception, students discussed older adults' positive and negative personality traits and their physical and cognitive deterioration. Such perception contributed to their view of barriers in interactions with older adults, which were both external and internal in nature. Students mentioned previous experience and knowledge about older adults as well as their own personalities served as major facilitators in interacting with older adults. Gaining experience working with older adults deepened students' understanding of and empathy for this population.Discussion: Findings offer insight into how to develop dietetic curricula to address students' perceptions and resulting barriers for training well-prepared registered dietitians motivated to serve the rapidly growing older adult population.

Career interests of undergraduate nursing students: A ten-year longitudinal study

An understanding of students' career interests at entry and exit from undergraduate nursing programmes could inform decisions regarding curricula and clinical placements. Since 2006, the University of Auckland has surveyed healthcare students at entry to and exit from their respective programmes, collecting information on a range of demographic, and career-related factors. This article describes career interests of over 500 undergraduate nursing students in New Zealand over a ten-year period. All Bachelor of Nursing cohorts commencing between 2006 and 2016 were invited to complete a questionnaire which included questions about their career interests. In total 1875 questionnaires were completed (89% response rate). Among the overall cohort at entry, there was strongest interest for emergency care and child health, and least interest in older person's health. At exit, child health and surgery (general) were of strongest interest to the cohort, while older person's health remained of least interest. The analysis of the paired data (n = 564) identified decreases in interest for mental health and child health over the course of the programme, while there was an increased interest in primary health care. Changes in career interests indicate that education and clinical exposure to specialty areas during the programme may influence career interests.

The Effect of Educational Interventions on Willingness to Work with Older Adults: A Comparison of Students of Social Work and Health Professions

The study examined the effect of an educational intervention on the willingness of Israeli social work students to work with older adults, comparing them to students of nursing, speech therapy, and physiotherapy. A sample of 187 first-year students were divided into two groups: a research group (n=83) exposed to an educational intervention on ageing, and a control group (n=104) that received no intervention of any kind. Following the intervention, ageism among social work students in the research group decreased and positive behavior toward older adults increased. No significant differences were found among students of the health professions following the intervention. In addition, ageism mediated between knowledge of ageing and willingness to work with older adults.Furthermore, the higher the students assessed the contribution of the intervention, the lower their level of ageism, the more positive their behavior toward older adults, and the more willing they were to consider a career in geriatrics. The results suggest that introducing into the curriculum a variety of learning methods aimed at increasing knowledge of ageing and familiarity with the world of older adults is likely to encourage more students of social work and other therapeutic professions to work with the older population.

Career dreams among health care students: I want to make a difference

There is a continuous increase in demand for health services in most countries because people who are older are living longer. Health care for people who are older is not, generally, an attractive career option for undergraduate health professionals. This study investigated career dreams among undergraduates studying a variety of health care subjects to understand what motivates them. Eighteen focus groups were conducted with 90 students, and template analysis was performed within a sociological framework. Four themes emerged from the analysis: no plans to work with people who are older, dreaming of making a difference, seeking variety, and the impact of clinical placements on stimulating or reducing interest in working with people who are older. Geriatrics and gerontology do not offer the opportunities that students are looking for in their future careers. There is a need to change the way we talk about adults who are older everywhere, not just in health care training. However, health care educators should also help students to understand the value of care provided to adults who are older.

Student nurses' career motivation toward gerontological nursing: A longitudinal study

BACKGROUND

The intensity of student nurses' motivation toward a certain career can influence their behaviors for career choice and decision making. However, little is known about the career motivation among student nurses toward gerontological nursing and their influencing factors.

OBJECTIVES

The objectives of this study were to examine student nurses' career motivation toward gerontological nursing and to explore potential predictors using Bandura's reciprocal determinism.

DESIGN

A longitudinal design was used in this study.

SETTINGS AND PARTICIPANTS

A total of 305 student nurses were recruited from six hospitals in Shandong province, and they completed the questionnaires over three stages.

METHODS

Student nurses' career motivation toward gerontological nursing, geriatrics attitudes, aging anxiety, empathy, and clinical practice environment were measured using the motivation questionnaire, the Geriatrics Attitudes Scale, the Anxiety about Aging Scale, the Interpersonal Reactivity Index, and the clinical practice environment questionnaire, respectively. Measurements were performed at the first month, fourth month, and seventh month of student nurses' clinical practice. A series of Pearson correlation, multiple linear regression, and generalized estimating equations were applied to analyze the data.

RESULTS

Among 305 student nurses, the mean scores for career motivation toward gerontological nursing over three stages were 66.11 (SD = 8.98), 67.55 (SD = 8.53) and 66.78 (SD = 9.51), sequentially. There were significant differences in scores for career motivation over time (P < 0.05) and the lowest score was observed at the first month. Geriatric attitudes, aging anxiety, empathy, clinical practice environment and stage of clinical practice were notable predictors of student nurses' career motivation toward gerontological nursing.

CONCLUSIONS

Student nurses' career motivation toward gerontological nursing needs to be improved, especially at the first month of clinical practice. Targeted interventions should cultivate positive geriatric attitudes, relieve anxiety about aging, promote empathy, and enrich the clinical practice environment to improve student nurses' career motivation toward gerontological nursing.

Benefit-cost analysis of an interprofessional education program within a residential aged care facility in Western Australia

Interprofessional education (IPE) programs in residential aged care facilities (RACF) contributes to the care of older adults whilst providing an environment for students to learn and practise in an interprofessional manner. Clinical placements are provided by RACF through funding and support from universities in collaboration with the RACF. Conducting a benefit-cost analysis (BCA) can determine the sustainability of a clinical placement program such as an IPE program but there is limited research reporting the economic aspects of clinical placements even though it is a university and government priority. This study provides a benefit-cost analysis of an interprofessional education program offered by a residential aged care provider in Western Australia. Analysis using a BCA methodology was conducted to provide information about the level and distribution of the costs and benefits from different analytical perspectives over the three-year period of the IPE program. The analysis showed that the program was highly beneficial from an economic efficiency viewpoint, even though it did not present a financial gain for the aged care provider. The benefits accrued mainly to students in terms of increased education and skill, and to residents in terms of health outcomes and quality of life, while the cost was mostly incurred by the care provider. An IPE program in a RACF is a valuable educational learning experience for students and is also socially beneficial for residents and the broader health sector. For IPE programs in aged care to be sustainable, they require the development of collaborative partnerships with external funding.

Relationship Between Gerontological Nursing Education and Attitude Toward Older People

BACKGROUND

Nursing students' attitudes toward older people affect the quality of care provided to the aging population. Although gerontological nursing has been delivered as a stand-alone course in Macao since 2008, Macao nursing students' attitudes toward older people have not been investigated.

OBJECTIVE

The purposes of this study were 1) to explore nursing students' background information and attitudes toward older people and 2) to examine the presence of relationships between these factors and gerontological nursing education in Macao, a special administrative region of China.

METHODS

A cross-sectional survey design was adopted. Nursing students in Macao were invited to complete a questionnaire to record their demographic characteristics and gerontological nursing education and measure their attitudes toward older people using Kogan's Attitudes Toward Older People (KAOP) scale.

RESULTS

Data from 377 (83.04%) nursing students who returned the questionnaire were analyzed. The students were found to have positive attitudes toward older people, with a mean KAOP score of 168.44 ± 18.38 (mean ± standard deviation). In particular, the item with the lowest mean score was "older adults have excessive demands for love" (2.5 ± 1.2), while the item with the highest mean score was "older adults need no more love than others" (6.0 ± 1.0). The results also revealed that Macao nursing students' positive attitudes toward older people were associated with having "religion," "good experience in gerontological nursing taught course," and "good experience in clinical practice with older people," which were thus considered to be the predictors of their positive attitudes toward older people.

CONCLUSION

Religion and gerontological nursing education are associated with Macao nursing students' attitudes toward older people. A longitudinal study is needed to evaluate the gradual changes in nursing students' attitudes. Nursing students' future career choices and perceptions of gerontological nursing education should be explored in a future study.

Preparing nurses and nursing students to care for older adults in lower and middle-income countries: A scoping review

BACKGROUND

The aim of this review was to examine the extent and nature of published literature on nurses' and nursing students' preparedness to care for older adults in lower and middle-income countries.

METHOD

A scoping review with 27 articles, guided by the Arksey and O'Malley (2005) framework was conducted. The following electronic databases were searched: MEDLINE, CINAHL, ERIC and SCOPUS. Grey literature using Google Scholar and ProQuest were also searched. Key search terms and subject headings such as "nursing students", "nurses", "stakeholders", "ministry of health", "readiness", "knowledge", "attitudes", "elder care", "seniors care" and "older adults" were used to identify relevant articles. Studies that reported on gerontological nursing, nursing students' and nurses' knowledge and attitudes towards older adults, and stakeholders/employers' views about nursing students' knowledge and attitudes towards older adults were included.

RESULTS

Nurses reported having moderate to insufficient knowledge in the care of older adults in the majority of the studies. Nursing students reported insufficient knowledge in the care of older adults. However, both nurses and nursing students reported positive attitudes towards the care of older adults but held misconceptions about caring for older adults. Nursing students also reported a low preference for working with older adults.

DISCUSSION AND IMPLICATIONS

The inadequate preparation of nurses and nursing students in the care of older adults means there are opportunities to enhance knowledge about health and nursing care in lower and middle-income countries and build on the positive attitudes towards older adults.

The relationship between nursing students' professional values and their attitudes towards the elderly people: A cross-sectional study

BACKGROUND

Professional values involve standards that are effective in solving problems, interacting with patients, making decisions on patient care and forming the student's attitude. Throughout the course of the nursing students' occupational education, these standards shape their attitudes, beliefs, and behaviors regarding the provision of care for individuals.

OBJECTIVE

The aim of this study was to determine the relationship between nursing students' professional values and their attitudes towards the elderly.

DESIGN

A cross-sectional research design was used in this study.

SETTINGS

This study was conducted at a university in the northeast of Turkey.

PARTICIPANTS

2nd-year (n = 93), 3rd-year (n = 101) and 4th-year (n = 81) nursing students.

METHOD

The data for the study were collected using a Personal Information Form, the Nursing Professional Values Scale- Revised (NPVS-R) and the Ageism Attitude Scale (AAS). In the data analysis, independent samples t-test, ANOVA and Spearman Correlation were used.

RESULTS

The study found that the nursing students' average total NVPS-R score was 86.4 ± 16.2 and their average total AAS score was 82.7 ± 8.8. Furthermore, a significant correlation was observed between the professional values of the students and their attitudes towards the elderly (r = 0.407, p = 0.000). A positive, moderately strong correlation was determined between the total NPVS-R scores and the 'restricted life of elderly people' and 'positive attitudes towards elderly people' sub-scales of AAS (r = 0.418, r = 0.317, p < 0.005, respectively).

CONCLUSION

The present study has demonstrated that the nursing students' professional values are associated with their attitudes towards the elderly. In the light of these results, it is suggested that professional values be taught and that courses on values be added to the curriculum in order to improve the attitudes of the students towards ageism.

The Arabic version of the Kogan Attitudes toward Older People Scale among Saudi nursing students: a psychometric analysis

BACKGROUND

With the steadily increasing size of its elderly popu.lation, Saudi Arabia is currently trying to meet the demands for com.petent care for older people. However, the lack of a valid and reliable measurement instrument in the Arab Peninsula hinders related studies among nursing students in this part of the globe. Given the importance of nursing students' attitudes toward working with older people, a specialized tool that can provide an accurate assessment of students' attitudes toward older adults is necessary.

OBJECTIVE

Evaluate the psychometric properties of the Kogan Attitudes towards Older People Arabic version (KAOP-A) among Saudi nursing students.

DESIGN

Descriptive, cross-sectional.

SETTING

Nursing department of a government university.

SUBJECTS AND METHODS

Using total population sampling, Saudi nursing students were surveyed using the KAOP-A. The tool was culturally adapted to the Arabic language using a forward and backward method. Content and construct validity were established accordingly. The internal consistency was established to support the reliability of the tool.

MAIN OUTCOME MEASURES

The validity and reliability of the KAOP-A.

SAMPLE SIZE

164 nursing students.

RESULTS

The KAOP-A had acceptable content and construct valid.ity. The Exploratory Factor Analysis supported a two-factor solution for the KAOP-A with an explained variance of 60.12%. The computed Cronbach's alpha for the entire scale was 0.89. The mean score of the KAOP-A scale was 121.55 (SD=26.92, range=40-204), indicating a slightly positive attitude toward aging among the students. Nursing students belonging to extended type of family and living in rural community, as well as older students and students who reported higher degree of closeness with their grandparents, exhibited more positive attitudes towards older people.

CONCLUSION

The tool can be used to accurately assess student attitudes towards older people, which can inform the creation of educational policies and interventions geared towards creating a more positive outlook on older adult care among nursing students in Saudi Arabia.

LIMITATIONS

We did not perform test and re-test reliability analysis.

CONFLICT OF INTEREST

None.

Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses

AIM

The purpose of these studies was to determine the reliability and validity of the 24 item Perspectives on Caring for Older Patients (PCOP) scale and further develop the scale as a useful tool for measuring nurses' perspectives toward caring for older patients.

BACKGROUND

Ageism has long been an issue in the U.S. as well as globally and is reflected in the attitudes of nurses caring for older patients. Most research in this area utilizes scales that measure attitudes toward older adults or aging in general which is different from how nurses feel about caring for older patients.

METHODS

Instrument development studies using the PCOP scale were conducted involving two independent samples for exploratory and confirmatory analyses. Study 1 included nurses and nursing students from six hospitals in the U.S. while Study 2 included students in a baccalaureate nursing program. Exploratory factor analysis was conducted in Study 1, and confirmatory factor analysis using structural equation modeling was performed in Study 2. A test of structural invariance was used to confirm stability of factor structure across samples.

RESULTS

Exploratory factor analysis using split samples (Study 1) resulted in a PCOP scale with 12 items, and structural equation modeling confirmed a 9-item factor structure. The test for invariance also showed an excellent fit to the data.

CONCLUSIONS

The revised nine-item PCOP scale is a reliable and valid tool for use in measuring nurses' perspectives toward caring for older patients in the U.S. and internationally.

Undergraduate nursing students and the elderly: An assessment of attitudes in a Turkish university

At times when populations are aging and nursing services for elders are needed, gerontology as a nursing specialty is not a highly sought career choice. The purposes of this study were to assess the overall attitudes of nursing students at a Turkish university toward the elderly and to identify the effects of demographic and social factors on attitudes. Using a non-experimental design, the Turkish version of the Kogan's Attitudes towards Old People (KAOP) Scale was given to undergraduate nursing students. Significant findings demonstrated that the older the student, the worse the attitude and that students willing to work with elders had significantly better total KAOP and better positive item scores than those not willing to work with elders. The findings support educational preparation as a major factor in shaping student attitudes. Geriatric education should be integral to nursing education to help ensure sustainability of nursing services for the elderly population.

Learning about the experience of living with chronic conditions: A framework analysis of nursing students' reflections on their conversations with older adults

Preparing nursing students to work effectively with older adults is an important element of undergraduate nursing education. Reflective journals written as course assignments represent a source of data about students' learning. The aim of this study was to analyze nursing students' reflective journals based on conversations with older adults who are community dwelling, to identify learning in relation to experiences of living with a chronic condition. This was one element of a wider study to evaluate learning partnerships between older adults who are community dwelling and nursing students as an alternative to traditional clinical placements in long-term care settings. Nursing students worked with faculty to complete a qualitative secondary analysis of 47 journals utilizing framework analysis. Students learned about three main aspects of living with chronic conditions: beliefs about chronic conditions, managing chronic conditions, and experiencing chronic conditions, with some evidence that these themes may be interconnected. Findings suggest that learning partnerships with older adults combined with reflective journaling enable nursing students to understand the experience of chronic conditions in later life as reflected within current literature and to identify interventions for gerontological nursing practice. Enabling nursing students to recognize the highly skilled nature of working with older adults with chronic illness has the potential to influence their future career choices.

The effect of first clinical assignments on prelicensure nursing students' attitudes toward older people: an observational study

BACKGROUND

With the global population growth of older people, health care needs nurses interested in caring for this population. Studies have found a relationship between attitudes toward older people and career choices.

AIM

The aim of this study was to determine the effect first clinical experiences had on nursing students' attitudes toward older people.

DESIGN/METHOD

Using an observational research design, first-semester nursing students (n = 53) from the United States were assigned to one of two groups based on sequencing of clinical assignments. Participants completed the Refined Aging Semantic Differential scale three times their first semester.

RESULTS

Students with exposure to long-term and then the acute care setting showed linear improvement in their attitudes toward older people. In addition, a significant improvement in attitudes over time was found (F[2, 96] = 3.56, p = .032) at two time measurements.

CONCLUSION

This study showed that novice students may not recognize the differences in acute and long-term nursing care. Results may assist nursing educators designing curricula.

From apprehension to advocacy: a qualitative study of undergraduate nursing student experience in clinical placement in residential aged care

Background

Undergraduate nursing placement in aged care is forecast to grow in importance with the increasing aging population, and to help to reverse trends in student lack of interest in gerontology careers. However, there is a need to better understand undergraduate nursing students’ experiences on placement with older adults, as well as key features of quality learning within residential aged care. The aim of this study was to explore how nursing students understand learning within residential aged care.

Methods

This qualitative study used a participatory action research approach, and this paper reports on the thematic analysis of data from one cycle of undergraduate nursing placement in a Canadian residential aged care setting, with two groups of 7–8 students and two university instructors. Staff and residents at the research site were also included. Researchers interviewed both groups of students prior to and after placement. Instructors, staff and residents were interviewed post placement.

Results

Students commenced placement full of apprehension, and progressed in their learning by taking initiative and through self-directed learning pathways. Engagement with residents was key to student learning on person-centred care and increased understanding of older adults. Students faced challenges to their learning through limited exposure to professional nursing roles and healthcare aide/student relationship issues. By placement end, students had gained unique insights on resident care and began to step into advocacy roles.

Conclusions

In learning on placement within residential aged care, students moved from feelings of apprehension to taking on advocacy roles for residents. Better formalizing routes for students to feedback their unique understandings on resident care could ensure their contributions are better integrated and not lost when placements end.

Students' Knowledge of and Interest in Older Adults: Impact of a Geriatrics Course

BACKGROUND

The number of older adults living with chronic conditions is steadily increasing, so nurses must be prepared to care for the needs of this population. However, only one third of nursing education programs include a stand-alone geriatrics course.

METHOD

A cross-sectional mixed-methods design was used to compare two cohorts of 46 nursing students. Knowledge, attitude, and interest in older adults were examined using an online survey. The control cohort did not complete the geriatric course.

RESULTS

No demographic differences were found between groups. Completing the geriatric course was not correlated with having greater aging-related knowledge. Decreased interest in working with the older adult population was found.

CONCLUSION

Findings from this cross-sectional pilot study suggest that previous experience with an aging relative was associated with better aging-related knowledge. Further research exploring students' perceptions is needed to understand the relationship between the geriatric course and attitudes toward aging. [J Nurs Educ. 2018;57(2):106-109.].

Factors Influencing New RNs’ Supervisory Performance in Long-Term Care Facilities

Dans les établissements de soins de longue durée (ÉSLD), les infirmières autorisées (IAs) exercent à la fois des fonctions cliniques et de supervision en tant que membres d’une équipe visant à dispenser des soins de grande qualité aux résidents. Les résidents sont affectés par plusieurs comorbidités et leurs besoins en matière de soins sont complexes. Malheureusement, les infirmières nouvellement agréées ne reçoivent que peu de formation en gérontologie et leur expérience de supervision est minimale, ce qui entraîne de faibles taux de rétention et affecte les résultats chez les patients. Cette étude qualitative a exploré les facteurs influençant l’expérience de supervision des nouvelles IA en ÉSLD à porter d’un échantillon de 24 participants en Ontario (Canada). Les données ont été recueillies par la voie d’entrevues individuelles, et une analyse de contenu directe fut réalisée. Trois niveaux d’influence ont été identifiés : influences personnelles, influences organisationnelles et influences externes. Chacun des niveaux présentait des sous-éléments qui décrivaient plus précisément les facteurs ayant de l’impact sur la performance de la nouvelle IA en supervision. La rétention des nouvelles IA en ÉSLD nécessiterait la mise en place d’une formation additionnelle en gérontologie et d’un processus de mentorat par ces organisations, afin d’assurer le développement de leurs rôles de supervision.

An examination of students' perceptions of their interprofessional placements in residential aged care

It is essential that health professionals are trained to provide optimal care for our ageing population. Key to this is a positive attitude to older adults along with the ability to work in teams and provide interprofessional care. There is limited evidence on the impact an interprofessional education (IPE) placement in a residential aged care facility (RACF) has on students. In 2015 in Western Australia, 51 students (30% male, median age 23 years), from seven professions, undertook a placement between 2 and 13 weeks in length at 1 RACF. Pre- and post-placement measurements of attitudes to the elderly were collected using the Ageing Semantic Differential (ASD) questionnaire and level of readiness for interprofessional learning with the Readiness for Interprofessional Learning Scale (RIPLS). A total of 47 students completed matched ASD and RIPLS surveys. The mean total score on the ASD survey decreased significantly from pre- to post-placement from 116.0 to 108.9 (p = 0.033), indicating attitudes became increasingly positive towards older adults. Significant differences post-placement were seen indicating better readiness for interprofessional learning, for two out of four subscales on the RIPLS, namely "teamwork & collaboration" (42.1-44.0; (p = 0.000)) and "positive professional identity" (18.2-19.3 (p = 0.001)). The degree of change is similar to findings from other settings. The results support IPE-focussed student placements within RACF positively influence student's attitudes towards the older adult as well as increase student's readiness for interprofessional learning, confirming RACF are valuable places for training health professionals.

Nursing curriculums may hinder a career in gerontological nursing: An integrative review

OBJECTIVE

To investigate what prevents undergraduate nursing students from choosing gerontological nursing as a career option.

DESIGN

This study utilised an integrative literature review, which allows the inclusion of previous studies with diverse research designs to gain a broader view of the reasons why nursing students do not choose a gerontological nursing career.

METHODS

An electronic database search of CINAHL (Ebsco), Scopus and Eric elicited 251 scientific peer-reviewed empirical studies, published from 2006 to March 2016 in English. After meeting the inclusion criteria, 97 qualified for closer examination. Following exclusion, the final analysis and synthesis included 21 articles.

RESULTS

Four main themes described nursing students' contributing reasons for not selecting gerontological nursing as a career option: socio-demographic factors; experiences, perceptions and knowledge about ageing; perceptions concerning the nature or status of gerontological nursing; and theoretical studies and practical education of nursing curriculum.

CONCLUSIONS

Lack of positive experiences with older people before and during nursing students' studies led to their disinterest in gerontological nursing as a career option. The nursing curriculum also reinforces the perception of modern nursing as technical, with more emphasis on acute and critical care. The findings emphasise the need to implement an age-friendly curriculum and have nurses that specialise in gerontology to serve as mentors and role models. It is important to assist nursing students in identifying the potentials for career advancement in terms of gerontological nursing. There is also a need for nursing faculties to liaise with other stakeholders to develop or improve upon the clinical atmosphere for nursing students during gerontological nursing placement.

IMPLICATIONS FOR PRACTICE

Nursing faculties must review their curriculum to ensure that there is sufficient focus on the needs of older people within the curriculum for every student. Furthermore, respected role models who are knowledgeable and enthusiastic about issues related to older people must teach gerontological nursing courses.

Using action research to build mentor capacity to improve orientation and quality of nursing students' aged care placements: what to do when the phone rings

AIMS AND OBJECTIVES

To describe whether an action research approach can be used to build capacity of residential aged care facility staff to support undergraduate nursing students' clinical placements in residential aged care facilities, using development of an orientation programme as an exemplar.

BACKGROUND

Aged care facilities are unpopular sites for nursing students' clinical placements. A contributing factor is the limited capacity of staff to provide students with a positive placement experience. Strategies to build mentor capability to shape student placements and support learning and teaching are critical if nursing students are to have positive placements that attract them to aged care after graduation, an imperative given the increasing care needs of the ageing population worldwide.

DESIGN

Action research approach employing mixed-methods data collection (primarily qualitative with a quantitative component).

METHODS

Aged care facility staff (n = 32) formed a mentor group at each of two Tasmanian facilities and met regularly to support undergraduate nursing students (n = 40) during placements. Group members planned, enacted, reviewed and reflected on orientation procedures to welcome students, familiarise them with the facility and prepare them for their placement. Data comprised transcripts from these and parallel student meetings, and orientation data from student questionnaires from two successive placement periods (2011/2012).

RESULTS

Problems were identified in the orientation processes for the initial student placements. Mentors implemented a revised orientation programme. Evaluation demonstrated improved programme outcomes for students regarding knowledge of facility operations, their responsibilities and emergency procedures.

CONCLUSION

Action research provides an effective approach to engage aged care facility staff to build their capacity to support clinical placements.

RELEVANCE TO CLINICAL PRACTICE

Building capacity in the aged care workforce is vital to provide appropriate care for residents with increasing care needs.

Nursing students' attitudes toward persons who are aged: An integrative review

OBJECTIVES

To analyze empirical studies from the United States and Canada to gain an understanding on how nursing education affects nursing students' attitudes toward persons who are aged.

DESIGN

An integrative literature review was completed using Garrard's (2011) Matrix Method.

DATA SOURCES

Articles were identified through the electronic database search engines of CINAHL, Pub Med, and Academic Search Complete. Only peer reviewed research articles from 2009 to 2015 were reviewed.

REVIEW METHODS

A review matrix was created to abstract information from 11 studies so that synthesis could occur. Information in the columns of the review matrix was used to compare the studies. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 27 item check list was used to help with reporting the findings. Studies were graded using the American Association of Critical Care Nurses' (AACN) level of evidence.

RESULTS

A key finding is student engagement with gerontological content in the classroom or clinical setting results in improving nursing students' attitudes toward persons who are aged.

CONCLUSIONS

Several gaps exist in the literature. Further research including longitudinal studies and large scale, multi-site samples would add to the existing knowledge.

Impact of a stand-alone course in gerontological nursing on undergraduate nursing students' perceptions of working with older adults: A Quasi-experimental study

BACKGROUND

With an aging population, it is critical that nurses are educated and prepared to offer quality healthcare to this client group. Incorporating gerontology content into nursing curricula and addressing students' perceptions and career choices in relation to working with older adults are important faculty concerns.

OBJECTIVES

To examine the impact of a stand-alone course in gerontological nursing on undergraduate nursing students' perceptions of working with older adults and career intentions.

DESIGN

Quasi-experimental, pre- and post-test design.

SETTING

Medium-sized state university in the Mid Western United States PARTICIPANTS: Data were collected from three student cohorts during the spring semesters of 2012 (n=98), 2013 (n=80) and 2014 (n=88) for a total of N=266 with an average response rate of 85%.

METHODS

A survey instrument was administered via Qualtrics and completed by students prior to, and following completion of the course.

RESULTS

There was an overall significant increase (p=0.000) in positive perceptions of working with older adults among nursing students following completion of the course. The majority of participants (83.5%) reported having previous experience with older adults. Those with previous experience had higher perception scores at pre-test than those without (p=0.000). Post-test scores showed no significant difference between these two groups, with both groups having increased perception scores (p=0.120). Student preferences for working with different age groups suggested an overall increase in preference for working with older adults following the course.

CONCLUSIONS

A course in gerontological nursing, incorporating learning partnerships with community dwelling older adults, promotes positive perceptions of working with older adults, independently of the quality of prior experience. There was some evidence that students changed their preferences of working with different age groups in favor of working with older adults. Further research should be conducted to determine the mechanisms through which this takes place.

A Qualitative Investigation of Gerontological Practice: The Views of Social Work and Psychology Students, Faculty, and Practitioners

Recently there has been an increase in the population of older adults; however, this increase has not been reflected in the helping professions. The aim of this study was to qualitatively investigate barriers to working with older adults within the human service professions. An online survey was sent to students, academic faculty, and practitioners from the disciplines of social work and psychology throughout Australia, addressing issues related to work with older adults. Thematic analysis was used to extract themes and subthemes from the responses (N = 252). The most important finding was that a barrier to working with older adults appears to be a consequence of a perpetuating cycle among students, academic faculty, and professionals collectively. Faculty members did not feel knowledgeable in the area of gerontology and were therefore not able to educate students in this area appropriately, leading to students to enter the workforce as either faculty members and/or practitioners without expertise to work with older adults. This study highlighted the importance of including more comprehensive gerontological information within social sciences' curriculum, which may promote more realistic images of older adults and help alleviate barriers to working with this population.

Determinants of undergraduate nursing students' care willingness towards the elderly in China: Attitudes, gratitude and knowledge

BACKGROUND

An aging population has become a serious problem in China. Improving the nursing students' care willingness is a critical way to solve this dilemma. Few studies reveal the relationship between the knowledge, care willingness, attitude towards the elderly and gratitude. This research has found that the attitude towards the elderly, the knowledge about aging, and gratitude showed correlation with care willingness.

OBJECTIVE

The purpose of this study is to explore the relationships among knowledge about aging, care willingness, attitude towards the elderly and gratitude.

DESIGN

A cross-sectional descriptive design has been used.

METHODS

From November to December 2015, a total of 382 undergraduate nursing students in China completed the questionnaires. The response rate was 95.5%. Four questionnaires including Care Willingness to the Elderly Scale (CW), Kogan's Attitudes towards Old People scale (KAOP), the Facts on Aging Quiz (FAQ), and the Gratitude Scale. Structural equation modeling (SEM) was used to explore the relationship among those variables in this study.

RESULTS

For Chinese nursing students, the care willingness of elderly was in medium-high level. Their attitude towards the elderly and gratitude were at the medium degree, while the knowledge about aging was at a lower level. The attitude towards older people, knowledge about aging, and gratitude were significantly correlated with care willingness. The knowledge about aging has no relationship with the attitude. Gratitude plays a mediation role between the knowledge about aging and care willingness. The experience of caring the elderly could lead to a positive impact in care willingness.

CONCLUSIONS

The nursing students' knowledge about aging had a direct influence on their care willingness. Gratitude plays a mediating role between the knowledge about aging and care willingness to the elderly.

The Effects of Service-Learning on College Students' Attitudes Toward Older Adults

The current U.S. health care workforce shortage is at crisis levels for providers who specialize in elder care. Barriers such as ageism, lack of awareness of the need for workers, and lack of contact with seniors can affect the career choice of young professionals. To explore ways to increase the number of students who pursue gerontology and to expand the elder care workforce, the researchers conducted a qualitative content analysis on the impact of service learning in senior care facilities on students' attitudes toward older adults. Students with senior contact reported increases in positive perceptions of seniors, discovered their own ageist stereotypes, and developed an interest in a career in elder care. Twenty-one months after the service-learning experience, students were surveyed again with their responses indicating continued positive attitude changes along with professional development demonstrating beneficial long-term effects from the experience.

Learning with older people--Outcomes of a quasi-experimental study

BACKGROUND

Nursing students' interest in older people nursing needs to be enhanced, as there is a demand for competent nurses who prefer to work in older people nursing. Educational approaches involving older people are encouraging; they increase positive learning outcomes.

OBJECTIVES

The aim of this study was to evaluate the outcomes of the Learning with Older People Programme (LOPP) in terms of nursing students' interest in older people nursing, their attitudes towards older people and their knowledge level about ageing.

DESIGN

A quasi-experimental, pre-post-test design with non-equivalent comparison group was used.

SETTINGS

Two different Finnish nursing schools geographically apart from each other.

PARTICIPANTS

A nonprobability, convenience sample of nursing students (n=87; n=46 in the intervention group, n=41 in the comparison group) in the middle of their 3.5 year bachelor degree studies and enrolled in compulsory theoretical older people nursing courses participated in the study.

METHODS

Data were collected in 2014 using a structured questionnaire that included background questions, students' interest in older people nursing as a primary outcome measure and their attitudes towards older people and knowledge level about ageing as secondary outcome measures. The data were analysed statistically.

RESULTS

In the intervention group, students' interest in older people nursing was significantly higher and their attitudes towards older people were more positive than those of students in the comparison group. There were no significant differences between the groups in terms of the students' knowledge level about ageing.

CONCLUSIONS

An educational approach involving older people resulted in encouraging outcomes. It is worth considering whether or not older people could be a valuable resource for nursing education.

Attitudes toward and willingness to work with older people among undergraduate nursing students in a public university in Sri Lanka: A cross sectional study

BACKGROUND

With the increased number of older people globally, caring for older people has become a challenge for many countries. Nurses have a pivotal role in providing quality care for older people and care is affected by their attitudes. The preparation of nurses to deliver quality care needs to be instilled during their studying in the Schools of Nursing.

OBJECTIVE

To examine the attitudes of nursing students toward and their willingness to work with older people in Sri Lanka.

METHODOLOGY

A purposive sample of 98 first to fourth year undergraduate nursing students in the Department of Nursing, University of Peradeniya completed a self-administered questionnaire consisting of socio-demographic variables, Kogan's Attitudes toward Older People Scale, and questions related to willingness to work with older people.

RESULTS

Fifty percent of the respondents (n=49) held slightly positive attitudes toward older people while 45% (n=44) held slightly negative attitudes. About one-third of the respondents (29.9%, n=29) selected the elderly group as the least preferred group for their future career from the categorized seven age groups. Only 5.1% (n=5) of the respondents ranked the elderly group as the first preferred group. There was a significant difference in attitudes between students who lived with older people and students who did not live with older people (t=2.565, p=.012). There was a positive relationship between attitudes and preference for working with older people (r=.342, p=.001).

CONCLUSION

Nursing students have moderately positive attitudes toward older people; however, they show little interest in working with older people. Living with older people develops positive attitudes of young people toward older people. Attitudes are related to the selection in area of specialty in nursing. Nursing curricula need to include Gerontological Nursing as a major area.