Attitudes toward the elderly among the health care providers: Reliability and validity of Turkish version of the UCLA Geriatrics Attitudes (UCLA-GA) scale

Intensive care nurses' compassion and patience levels and their attitude towards elderly people

Backgrounds

Intensive care nurses' attitudes towards the elderly and their emotional readiness before giving care can have an impact on the quality of care.

Aims

The objective of this study was to investigate intensive care nurses' compassion and patience levels and their attitude towards elderly people.

Methods

'Data Gathering Form', the 'Compassion Competence Scale', the 'Patience Scale and the University of California at Los Angeles Geriatrics Attitude (UCLA-GA) were used.

Results

A total of 212 intensive care nurses participated in the study. It was found that nurses whose time working in the intensive care unit and total professional experience were 6 years or more and those who were married and had children had higher levels of both compassion and patience. In addition, patience levels were significantly higher in nurses aged 29 or more. It was found that the nurses' sociodemographic and professional characteristics did not affect their UCLA-Geriatrics Attitudes total score.

Conclusion

It was found in the study that there was a significant positive correlation between the nurses' compassion and patience levels and their attitudes toward elderly people.

Broken Toughness: Iranian Older Adults’ Perceptions of Abuse

Background

Older people abuse includes intentional or unintentional conduct or omission of a specific behavior by a trusted person that causes injury or distress to older people. This study described older peoples’ perceptions of abuse in Iranian society.

Methods

This qualitative study applied a conventional content analysis method to understand the perceptions of abuse among older Iranian people. Twenty older residents were selected by purposeful sampling. Data were collected through in-depth, semi-structured, and face-to-face interviews. The six-step Graneheim and Lundman content analysis method guided data analysis. MAXQDA software version 10 was used to manage the data.

Results

The data analysis led to the identification of three main themes: broken toughness, hidden abuse, and exploitation. The first theme had two sub-themes: domination and disturbed peace and tranquility.

Conclusion

Abuse resulted from a combination of causes and factors. Abuse was hidden in many cases and was not limited to physical abuse. The other examples of abuse included disrespect, deprivation of authority, disturbed tranquility, and financial exploitation of older adults.

Attitudes of health professionals toward elderly patients during the COVID-19 pandemic

The perceptions and attitudes of health professionals toward a certain group of society are among the factors affecting the quality of health service. This study aimed to investigate the attitudes of physicians and nurses about ageism in the COVID-19 pandemic. An easy face-to-face survey was used to collect the data. It involves the questions about demographic information and geriatric perspectives, and they were taken from the University of California at Los Angeles Geriatrics Attitudes Scale (UCLA-GAS). In the study, 58.1% of participants were over 35 years old, 76.6% were women, and 50% were physicians out of 308 in total. It was found that most of the participants have worked in inpatient services and intensive care units for the longest time, where the triage issue was the most discussed topic during the pandemic. An average of 75% of the participants stated that they did not witness any ageist attitude in health care provided. In the comparative analyses conducted with the UCLA-GAS sub-dimensions, statistically significant results, which were anti-ageist and prioritized human life, were obtained. In the extraordinary periods such as pandemic, especially physicians should be able to give the treatment without feeling any social or legal concerns during their medical applications with the light of guidelines accepted scientifically, legally, and morally. Thus, health professionals will not only be away from legal concerns such as malpractice but also will not be exhausted mentally and they can provide more sufficient health service by working under these conditions.

Psychometric properties of the Persian version of the UCLA geriatrics attitudes scale (UCLA-GAS)

AIMS

The attitudes toward older patients are considered the main factor in providing health services.

BACKGROUND

There is a lack of a proper short scale to measure attitudes toward older patients among healthcare professionals.

OBJECTIVE

The present study was to assess the psychometric properties of the UCLA Geriatric Attitude scale (UCLA-GAS) among a sample of Iranian healthcare professionals.

METHODS

The method of this study was cross-sectional for psychometric evaluation. The sample included 232 healthcare professionals in Mazandaran city. Study participants were selected by cluster random sampling technique. Psychometric evaluation of the UCLA-GAS assessed through content and construct validity. Content validity was evaluated based on the content validity index (CVI) and construct validity investigated using exploratory and confirmatory factor analysis. Also, convergent validity was assessed using the Kogan's Attitudes Toward Older People Scale (KAOPS) questionnaire. Cronbach's alpha was used to evaluate internal consistency reliability and stability was assessed using test-retest.

RESULTS

Regarding the content validity, CVI and modified Kappa statistic for all items were >0.79 and shows all items where relevant to the UCLA-GAS in the Iranian context. The three dimensions of the UCLA-GAS extracted from factor analysis were labeled: 1- medical/economic burden (6 items) 2- appreciate attitude (5 items), 3- resource allocation (3 items). CFA revealed that the UCLA-GAS structure model was a validated model (CMIN = 2.312, GFI = 0.913, CFI = 0.902, RMSEA = 0.075). The scale had a significant and positive correlation with KAOPS questionnaire. Also, The Cronbach's alpha of the scale was 0.78 and intra-class correlation coefficient (ICC), for total instrument was reported as 0.93 (95% CI: 0.87-0.98) and demonstrated good reliability of the instrument.

CONCLUSION

The result shows the UCLA-GAS is a valid and reliable scale for measuring attitude toward older patient among healthcare professionals. This study recommends using Iranian UCLA-GAS in future research and policy-making.

Transcultural adaptation and validation of a French version of the University of California, Los Angeles geriatrics attitudes scale (UCLA-GAS-F)

Background

In the context of demographic aging, active aging must be encouraged. In addition, the increase in life expectancy requires specific care for the elderly. Therefore, it is important to ensure appropriate training and education to caregivers. Educational institutions put value in positively influencing the attitudes and behaviours towards elderly people in order to ensure the quality of patient care in the future. Questionnaires are often used to assess attitudes. Among them, the University of California, Los Angeles Geriatrics Attitudes Scale (UCLA-GAS) was developed to assess attitudes towards older people and caring for older patients. This scale has been used to evaluate attitude of healthcare professionals and students including undergraduate physiotherapy students. To our knowledge, there is no scale that assesses the same concept in French. Therefore, this study aimed to translate and adapt the UCLA-GAS into French and to test its psychometric properties.

Methods

We conducted this study in two phases. First, we translated and adapted the UCLA-GAS from English into French following the five recommended stages of cross-cultural adaptation. Second, we validated the French version of the scale with undergraduate physiotherapy students. One hundred nineteen students participated from the first to the third academic years. We estimated reliability and validity of the scale. We performed correlation analyses between the French version of the UCLA-GAS (UCLA-GAS-F) with the Aging Stereotypes and Exercise Scale (ASES) and the Attitudes to Aging Questionnaire (AAQ).

Results

The scale was translated and adapted into French. Results of the validation phase showed that the UCLA-GAS-F had high test-retest reliability (ICC 0.83, 95%CI 0.74–0.89), but internal consistency below 0.7 (Cronbach’s alpha 0.49 to 0.57). The scale showed no ceiling or floor effect. As expected, the French version showed a weak correlation to the ASES (r = 0.28, p = .003) and to the AAQ (r = 0.32, p = .001).

Conclusions

Despite low internal consistency, the French version of the UCLA-GAS showed appropriate psychometric properties. Further validation should include healthcare professionals and other healthcare students.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40945-021-00114-1.

Using Virtual Patient Software to Improve Pharmacy Students' Knowledge of and Attitudes Toward Geriatric Patients

Objective. To evaluate the effect of using a virtual patient software program to improve pharmacy students' knowledge of and attitudes toward geriatric patients. Methods. The Virtual Patient for Geriatric Education (VIPAGE) software program was used in two Bachelor of Pharmacy (BPharm) degree programs in Brazilian universities. The virtual consultations were divided into an initial evaluation, care plan, letter of referral to another professional, and evaluation of follow-up. Each weekly session lasted two hours. Students answered questionnaires before and after using the virtual patient software relating to the following: demographics, geriatric experiences, Geriatric Attitudes Scale, and the Facts on Aging Quiz. Results. Of the 128 students who completed the baseline questionnaires, 109 students also completed the second questionnaire. The mean Geriatric Attitudes Scale score before the intervention was 3.7 (SD=0.8) and after was 3.9 (SD=0.7). Significant improvements in Geriatric Attitudes Scale scores after using the virtual patient software were seen in students who were male, whose grandparents were still alive, or whose parents were elderly, who had frequent contact with the elderly, who did not have frequent contact with the elderly, and who did not have professional contact with the elderly. The average score on geriatrics knowledge was 44.7 (SD=12.0) before completing the virtual patient consultations and 52.6 (SD=11.9) after. The mean score measuring students' lack of geriatrics knowledge was 27.3 (SD=15.8) before and 19.1 (SD=12.8) after using the software. Conclusion. Completing virtual patient consultations using the VIPAGE software positively impacted pharmacy students' geriatrics knowledge and attitudes.

Exploring attitudes of physiotherapy students towards a community-based project used as a learning tool

BACKGROUND

Community-based projects are an experiential learning tool that provides students with an opportunity to work within a team, to apply their skills and to learn in real workplace settings. Promoting physical activity is an important component of physiotherapy education, but the best method for training students to promote physical activity is open for discussion.

PURPOSE

This study explored the attitudes and learning experiences of physiotherapy students who worked in groups to complete a community-based project involving the delivery of physical activity programs to a healthy population.

METHODS

Data were collected from a focus group of eight physiotherapy students each of whom had participated in a community-based project early in their studies.

RESULTS

Four themes emerged from the analysis of the data: 1) self-confidence and independence; 2) creativity and innovation; 3) effective communication; and 4) team dynamics. The students had positive attitudes toward community-based projects and reported that their experiences were a highly valued component of their early practice-based learning. The findings of this study are expected to encourage educators to use community-based projects early in undergraduate physiotherapy programs, as it helps students develop professional skills such as effective communication, creativity, and innovation. Students also learned to innovate to solve real-world problems in the workplace such as resource limitations. They also learned to appreciate the importance of team dynamics in a successful intervention.

CONCLUSION

The findings suggest early participation in community-based projects is an excellent way for physiotherapy students to develop the competencies required for clinical practice and for their role in promoting physical activity.

Attitudes toward the elderly among young family physicians in Turkey

Introduction:

General practitioners’(GPs) role is important as they are easily accessible especially for elderly. Young GPs need to improve their attitudes toward the elderly so that they can be a part of solution for health problems of elderly in the future. The aim of this study is to determine attitudes of young GPs toward elderly by the University of California at Los Angeles Geriatrics Attitude Scale (UCLA-GAS).

Methods:

It is a cross-sectional study performed with questionnaires including UCLA-GAS. The study population was 260 young doctors (GP residents and GPs in their first 5 years after qualification). Statistical evaluation of the data included percentage, mean, and Kolmogorov–Smirnov test and analysis of variance test.

Results:

Of the participants, 58.1% (n = 151) were women, 35.4% (n = 94) of them were GPs, and the remaining were GP residents. The mean age was 31.30 ± 5.40 years (range = 24–55 years). The mean score of UCLA-GAS was 46.85 ± 5.63 (range = 30–61). Participants ≤30 years of age had significantly higher scores (47.70 ± 5.99) than age above 30 years (45.68 ± 4.89) (P = 0.003). There was no statistically significant difference between GP residents and GPs (P = 0.989) and between participants who had rotation in elderly healthcare service (n = 63) or not (n = 197) (P = 0.383). However, as the duration of work increased, the score of UCLA-GAS decreased significantly (r = −0.216, P < 0.001).

Conclusion:

Young doctors who were interested in elderly showed more positive attitude as expected. However, the ones who were older and worked longer had less positive attitude. It seems important to understand and prevent this unfavourable attitude with formal education system about elderly healthcare during residency.

Measuring medical students' attitudes and knowledge about geriatrics and gerontology in Brazilian medical students: A comparison of instruments

OBJECTIVE

To compare instruments available for evaluating attitudes and knowledge about geriatrics and gerontology.

METHODS

This cross-sectional study investigated 83 third-year Brazilian medical students (with exposure to geriatrics and gerontology) and 75 incoming students (with no exposure to this content). We used the University of California at Los Angeles Geriatrics Attitudes Scale, Palmore's Facts on Aging Quiz, modified Maxwell-Sullivan Attitude Survey, Aging Semantic Differential Scale and an instrument assessing their cognitive knowledge in geriatrics.

RESULTS

The instruments investigated had moderate-to-high correlations when evaluating similar constructs, had satisfactory or borderline internal consistency for the most part (Cronbach's α: 0.62-0.94) and were capable of discriminating between students exposed or not to practical and theoretical content.

CONCLUSION

Our findings reinforce previous studies that these scales are capable of differentiating students who have or have not had exposure/intervention and, in general, seem to be assessing different constructs.

Medical student attitudes towards older people: a critical review of quantitative measures

OBJECTIVES

Further research into medical student attitudes towards older people is important, and requires accurate and detailed evaluative methodology. The two objectives for this paper are: (1) From the literature, to critically review instruments of measure for medical student attitudes towards older people, and (2) To recommend the most appropriate quantitative instrument for future research into medical student attitudes towards older people.

RESULTS

A SCOPUS and Ovid cross search was performed using the keywords Attitude and medical student and aged or older or elderly. This search was supplemented by manual searching, guided by citations in articles identified by the initial literature search, using the SCOPUS and PubMed databases. International studies quantifying medical student attitudes have demonstrated neutral to positive attitudes towards older people, using various instruments. The most commonly used instruments are the Ageing Semantic Differential (ASD) and the University of California Los Angeles Geriatric Attitudes Scale, with several other measures occasionally used. All instruments used to date have inherent weaknesses. A reliable and valid instrument with which to quantify modern medical student attitudes towards older people has not yet been developed. Adaptation of the ASD for contemporary usage is recommended.

Attitudes of neurology specialists toward older adults

OBJECTIVE

Attitude of healthcare providers toward older people is very important in the aging world. Neurologists contact older adults very frequently. We aimed to investigate the attitudes of neurologists toward older adults.

MEASUREMENTS

We recorded participants age; sex; duration of clinical practice in neurology; existence of older adult relatives; and history of geriatrics education, nursing home visits, older adult patient density in their clinical practice, and participation in voluntary public activities. UCLA Geriatrics Attitude Scale was used to evaluate participants' attitudes.

RESULTS

A total of 100 neurologists participated in this study. Seventy-seven percent had positive, 3 % had neutral, and 20 % had negative attitudes. Twenty-seven percent of the participants had history of geriatrics education, and these participants tended to have a higher rate of positive attitudes. Neurologists with positive attitudes tended to be older than those with negative attitudes. Participants with history of living with older adult relatives had lower rates of positive attitudes. The most common diagnoses of the patients the participants encountered were stroke and dementia. Independent factors associated with positive attitudes were history of geriatrics education and older age. History of living with older relatives tended to have a negative effect. Most of the negative items of the attitude scale were associated with the natural course and behavior of the common diseases in neurology practice.

CONCLUSIONS

Generalization of geriatrics education may translate into a better understanding and improved care for older patients. Development of instruments and implementation of qualitative studies to assess attitudes of neurologists toward older adults are needed.