Nurses' attitudes towards older people: a systematic review

Gerontological educational interventions for student nurses: a systematic review of qualitative findings

OBJECTIVES

This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing.

METHODS

Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS

Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies.

CONCLUSIONS

Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.

Ageism and Dementia-ism in Health Care: A Proposed Framework to Guide Treatment Decisions in Frail Older Persons

Global population ageing underscores the imperative of ageism and dementia-ism in the heath care setting as there is both anecdotal and published evidence that older persons are liable to receive less than optimum evidence-based treatments on account of their age and apparent frailty. This article explores the reasons for this phenomenon and limitations of current approaches of clinical decision making. We propose a framework to guide decision making to optimize care, with a paradigm shift in redefining a default toward clinical practice guideline-recommended treatments, guided by evidence-based medicine within an ethical means-end proportionality framework, and regularly reviewed advance care plans and goals of care conversations to secure the best interests of older persons.

What motivates students to pursue a career in gerontological nursing? The cultural adaptation and validation of the Spanish version of the CMGN questionnaire

Background

Career motivation toward gerontological nursing (CMGN) has been studied by various authors. It is essential to identify the influencing factors and guarantee that undergraduate nursing degrees provide adequate social and healthcare responses to the current demand for gerontological care. Objective: In the absence of a validated instrument to measure students' career motivation in geriatric nursing in our sociocultural context, this study aimed to adapt and validate the original questionnaire Chinese CMGN. Methods: Cross-sectional data from 316 nursing students were collected in May 2021. The cultural and linguistic adaptation process was conducted in accordance with the recommendations of Ramada-Rodilla and Beaton. A committee of experts was established to assess content validity. The CMGN questionnaire consists of 20 items divided into 2 subscales: "Expectancy" (6 items) and "Values" (14 items). To determine the psychometric properties, the following analyses were carried out: content validity (Aiken's V coefficient and Pearson's coefficient of variation), internal consistency (Cronbach's α) and construct validity (confirmatory factor analysis and convergent and divergent validity). To verify the model once the parameters were estimated, we calculated the goodness-of-fit between the model and the data. Data analyses were performed using SPSS for Windows (IBM SPSS Statistics 25.0) and Analysis of Moment Structures (AMOS 27.0).

Results

A total of 316 nursing students were surveyed, of which 91.1% were women and the mean age was 21.61 ± 5.45 years (range: 18-56). The results indicate that the psychometric properties of the questionnaire were adequate in terms of content and construct validity. The internal consistency using Cronbach's alpha for both subscales was greater than 0.8. The AMOS results revealed that the final model fit statistics of CMIN/df (2.204), GFI (0.922), CFI (0.948) and RMSEA (0.062) indicated a satisfactory model fit. Finally, an original second-order model was obtained, resulting in the Spanish version of the CMGN (SV-CMGN) instrument. Conclusions: We developed a valid SV-CMGN questionnaire that is socially and culturally adapted to the Spanish context and is capable of measuring the motivation of nursing students toward a career in gerontological nursing, from the newest to the most experienced. This new version opens up the possibility of studying the phenomenon of motivation in other Spanish-speaking countries. Keywords: Gerontological nursing; Motivation; Students, nursing; Validation study; Surveys and questionnaires.

Psychometric properties of the French version of the Kogan's Attitudes toward Older People scale: A cross-sectional study conducted on Cameroonian nursing students

To determine the psychometric properties of a French version of the KOP scale on Cameroonian French-speaking nursing students.

A cross-sectional study was conducted where a self-administered questionnaire in French was given to a convenience sample of 296 nursing students registered for three different nursing programs.

The French version of the KOP scale demonstrated moderate psychometric properties. The internal consistency, indicated by the Cronbach's alpha, was moderate, while the explanatory factor analysis showed two factor loadings, which explained 58.44% of the total variance.

CONCLUSION

The French version of the KOP scale can be a useful tool for studies in French-speaking African countries to assess the degree of ageism toward older adults. It is suggested that the original KOP scale be retranslated by African translators and administered to larger French-speaking populations in other countries.

"The supreme discipline of Nursing"-A qualitative content analysis of nurses' opinions on caring for people eighty years of age and older

Introduction

Nurses often experience stress and feel under time pressure when working with older people, increasing their job dissatisfaction. Especially people 80 years of age and older often require more complex and a greater measure of care, as the risk of care dependency is higher in this age group. This study was conducted to collect nurses' experiences and opinions regarding the care of people 80 years of age and older, as well as to learn more about how nurses perceive this care.

Method

We analysed narratives collected in an Austrian nationwide, cross-sectional online study to investigate nurses' attitudes towards people 80 years of age and older and their perceptions regarding their care (N = 1197). Data were collected from May-October 2021 by using a convenience sampling method. In total, 149 participants filled in the free text field; these texts were analysed using a qualitative content analysis method.

Results

Three main themes emerged from the analysis of the nurses' narratives: (1) 'opinions on people in need of care', (2) 'reputation of nursing profession', and (3) 'criticism of current nursing practice'. Most narratives were assigned to the subthemes 'positive opinions on nursing', 'ideal image of nursing', and 'shortage of staff'.

Conclusion

Nurses considered their work with people aged 80 years and older to be meaningful and important, but they criticised working conditions which need to be improved. This could be achieved by offering further education and increasing nursing staff. Further research is needed to investigate nurses' needs and wishes regarding the care of people aged 80 years and older.

An application of the reasoned action approach to clinical students' intention toward a career in geriatrics

Guided by the reasoned action approach, this study examined select individual, information, and social factors that influence intention toward pursuing a career in geriatrics among 314 clinical medical and nursing students in Ghana. A Poisson regression showed attitude toward older persons was a significant influencing factor of intention to choose a career in geriatrics for medical students (B = 0.015, SE = 0.0048, p = 0.002) but not nursing students (B = 0.009, SE = 0.0145, p = 0.512). Personal interest was, however, a significant influencing factor for both medical and nursing students (B = 0.462, SE = 0.0592, p = 0.000) and (B = 0.015, SE = 0.0048, p = 0.002), respectively. Nursing students with moderate to strong interest were 1.6 times more likely to express an intention to specialize in geriatrics, and medical students were 1.5 times more likely to express an intention to specialize in geriatrics. The results show that the most important factor influencing geriatric career intention is students' personal interest in the field. Evidence-based interventions such as early educational and practice exposure to the field and interactions with older adults are recommended.

Translation and validation of the ageism scale for dental students in Iran (ASDS-Persian)

AIMS

A longer life and the growing population of older adults are the achievements of the 20th century. The World Health Organization considers ageism an important barrier to age-appropriate care for older adults. The aim of this study was to translate and validate the ageism scale for dental students in Iran (ASDS-Persian).

METHODS

The 27-question ASDS was translated from English into Persian (Farsi) and completed by 275 dental students from two universities in Isfahan, Iran. Principal component analysis (PCA), internal consistency reliability, and discriminant validity were estimated. Furthermore, in this study we conducted an analytical cross sectional study among dental students of Isfahan province (two universities) with the aim of proving data regarding their ageism beliefs and attitudes.

RESULTS

PCA revealed an 18-question, four-component scale with acceptable validity and reliability. The four components are 'barriers/concerns on dental treatment in older adults', 'opinions about older adults', 'practitioner's perspective,' and 'older adults' perspective'.

CONCLUSION

This preliminary validation of ASDS-Persian produced a new 18-question scale with four components with acceptable validity and reliability. This instrument could be further tested in larger samples in Farsi speaking countries.

Nursing students' knowledge and attitudes toward older adults

Nursing students, as the future healthcare workforce, hold immense potential in providing quality care to older adults and becoming advocates for promoting aging and public health, thus contributing significantly to addressing the multifaceted challenges of our aging society. Nurses' knowledge and attitudes about aging affect health care quality. Negative and unattractive representations of the social problems associated with aging contaminate nursing students' attitudes. Nursing schools are challenged to develop new curricula to prepare future nurses for the inherent complexity of an aging society. This study aims to assess the knowledge and attitudes of nursing students toward older adults and identify the variables that can influence these attitudes. Quantitative research was carried out through the application of an online survey using a cross-sectional descriptive research design. A total of 182 nursing students completed the online survey. Progression in the nursing course was statistically significant; the more students advanced, the more positive attitudes and knowledge they revealed about aging; 39% of students have daily contact with their grandparents; however, only 14.8% would like to work with older adults. Multiple linear regression revealed that the most important factor for positive attitudes and knowledge about aging was regular contact with grandparents, followed by progression in the nursing course. The students' age was not a significant factor in improving attitudes or expanding knowledge regarding older adults. In a multidimensional logic, the deepening of knowledge about aging and the socialization of students with older adults are central factors that should reinforce curricula in nursing education.

The Association of Technology-Based Ageism with Using Digital Technology in Physical Therapy for Older Persons

Integrating digital technologies in healthcare for older adults can enhance their independence and quality of life. Nevertheless, ageism among healthcare professionals impacts treatment decisions and may deprive older patients of technology-based treatment. This study explores whether technology-specific ageism influenced physiotherapists' use of technology-based healthcare with older patients. Seventy-eight physiotherapists in Luxembourg filled out an online survey. Participants filled out the Attitudes Towards Older Adults Using Technology (ATOAUT-11) scale, Expectations Regarding Aging, attitudes towards technology use in the work environment, and whether they had not offered technology-based treatment in the past because of a patient's age. Using logistic regression, negative ATOAUT was found to predict not offering technology-based treatment, such that participants with more negative attitudes (1 standard deviation) were two times more likely not to offer treatment. Positive attitudes towards using technology in the work environment were also found to be a significant predictor. All other characteristics (gender, age, experience and percentage of patients over 50) were not predictive of not offering treatment. This study demonstrates that technology-specific ageism may lead to discrimination and deprive older persons of optimal treatment. More research is needed to identify the magnitude of ageism in using technology-based treatment and develop interventions to overcome it.

Exploring the attitudes of general medical students toward older adult's care in a lower middle-income country: implications for medical education

OBJECTIVE

The motivation for this study stemmed from the growing population of older adults and the increasing demand for healthcare professionals who possess the necessary skills and knowledge to provide quality care to this demographic. By exploring the attitudes, perceptions, and beliefs of medical students towards older adult care, the study aimed to identify gaps in their training and areas where improvements can be made to better equip them for this critical aspect of healthcare.

METHOD

This study was a qualitative thematic analysis. The participants of this research were selected from among the general medicine internship students of Iran University of Medical Sciences by purposive sampling method. In-depth individual semi-structured interviews were used to collect data. Sampling continued until data saturation. The interviews were recorded, transcribed, and analyzed using a hybrid approach of inductive and deductive thematic analysis. Using this approach, the analysis of the data became more adaptable and open-ended, free from the restrictions of pre-existing theoretical frameworks. MAXQDA 22 was used to analyze qualitative data.

RESULTS

A total of 27 medical students were interviewed semi-structured, and audio files were transcribed immediately after the interview. In the process of reading the interviews carefully and separating the conceptual units into codes, 167 primary codes were obtained, and these codes were divided into five main categories under the title of root factors after constant comparison analysis. Five main themes are including discrimination in service delivery, a lack of inter-professional training, interpersonal communication skills, inadequate infrastructure and human resources, and enhancing attitudes towards older person care through experiential learning.

CONCLUSION

This study sheds light on the attitudes and perceptions of medical students toward older adult care in a lower-middle-income country. The findings reveal that there are significant gaps in their training and preparation for providing quality care to this demographic profile. The four main categories identified as root factors highlight key areas where improvements can be made in medical education. It is recommended that medical schools in low and middle-income countries consider incorporating these themes into their curricula to better equip future healthcare professionals with the necessary skills and knowledge to provide quality care to older adults.

Intervention to reduce age bias in medical students' decision making for the treatment of older women with breast cancer: A novel approach to bias training

Objectives: Despite NICE guidelines to 'treat people with invasive breast cancer, irrespective of age, with surgery and appropriate systemic therapy, rather than endocrine therapy alone', older patients receive differential treatment and experience worse outcomes. Research has evidenced the prevalence of ageism and identified the role of implicit bias in reflecting and potentially perpetuating disparities across society, including in healthcare. Yet age bias has rarely been considered as an explanatory factor in poorer outcomes for older breast cancer patients nor, consequentially, has removing age bias been considered as an approach to improving outcomes. Many organizations carry out bias training with the aim of reducing negative impacts from biased decision making, yet the few evaluations of these interventions have mostly seen small or negative effects. This study explores whether a novel intervention to address age bias leads to better quality decision making for the treatment of older women with breast cancer.Methods: An online study compared medical students' treatment recommendations for older breast cancer patients and the reasoning for their decision making before and after a novel bias training intervention. Thirty-one medical students participated in the study.Results: The results show that the bias training intervention led medical students to make better quality decisions for older breast cancer patients. The quality of decision making was measured by decreases in age-based decision making and increased efforts to include patients in decision making. These results suggest there is value in exploring whether if anti-bias training interventions could usefully be applied in other areas of practice where older patients experience poorer outcomes.Conclusions: This study evidences that bias training improves the quality of decision making by medical students in respect of older breast cancer patients. The study findings show promise that this novel approach to bias training might usefully be applied to all medical practitioners making treatment recommendations for older patients.

Evidence-based geriatric knowledge among healthcare providers in Vietnam: adaptation, validation, and pilot of the knowledge about older patients quiz

BACKGROUND

Vietnam's aging population is growing rapidly, but its health workforce's capacity to provide quality geriatric care is not clearly understood. We aimed to provide a cross-culturally relevant and validated instrument to assess evidence-based geriatric knowledge among healthcare providers in Vietnam.

METHODS

We translated the Knowledge about Older Patients Quiz from English to Vietnamese using cross-cultural adaptation methods. We validated the translated version by evaluating its relevance to the Vietnamese context, as well as its semantic and technical equivalence. We fielded the translated instrument on a pilot sample of healthcare providers in Hanoi, Vietnam.

RESULTS

The Vietnamese Knowledge about Older Patients Quiz (VKOP-Q) had excellent content validity (S-CVI/Ave) and translation equivalence (TS-CVI/Ave) of 0.94 and 0.92, respectively. The average VKOP-Q score was 54.2% (95% CI: 52.5-55.8) and ranged from 33.3 to 73.3% among 110 healthcare providers in the pilot study. Healthcare providers in the pilot study had low scores on questions related to the physiopathology of geriatric conditions, communication techniques with sensory impaired older adults, and differentiating age related changes from abnormal changes or symptoms.

CONCLUSIONS

The VKOP-Q is a validated instrument to assess geriatric knowledge among healthcare providers in Vietnam. The level of geriatric knowledge among healthcare providers in the pilot study was unsatisfactory, which supports the need for further assessment of geriatric knowledge among a nationally representative sample of healthcare providers.

'Sometimes you need an eye-opener': A qualitative study on nursing assistants' experiences of developing communication skills through an educational intervention on person-centred communication

AIM

To explore nursing assistants' (NAs') experiences of developing communication skills while participating in an educational intervention on person-centred communication.

DESIGN

A descriptive qualitative study was conducted.

METHODS

Data were collected from interviews and written assignments before, during and after an educational intervention on person-centred communication targeting NAs in home care services. The data were analysed using a phenomenological approach. A total of 25 NAs participated in the study.

RESULTS

The findings describe NAs' experiences concerning the communication skills needed for building relationships with older persons and handling emotionally challenging situations. The educational intervention increased their knowledge and awareness of the importance of communication skills and how such skills are developed and refined.

Social support and associated factors among family caregivers of older people in North-East Peninsular Malaysia

Background

The negative health results associated with the family caregivers of older people can be alleviated with social support, which is considered a valuable resource. Hence, the factors contributing to social support need to be understood.

Objective

This study aimed to evaluate the social support associated with the family caregivers of older people.

Methods

A cross-sectional study was conducted among 231 family caregivers of older people conveniently selected from two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. Data were gathered between June to December 2021 using a Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire. Descriptive statistics were used to summarize the data in frequencies and percentages. Independent t-test and one-way analysis of variance were used to examine correlations among variables.

Results

The mean scores of social support for family caregivers were significantly higher among their family (Mean ± SD; 5.44 ± 0.969) and other important people (5.25 ± 1.123) compared to their friends (4.84 ± 1.094). Caregivers' gender and duration of caregiving were significant factors associated with social support (p <0.05).

Conclusions

The family caregivers received maximum support from their family and other important people, but they were less supported by their friends. This study also observed that the perceived social support of the caregivers of older people was affected by several factors, such as gender and duration of caregiving. This finding gives nurses and other healthcare workers the basic information they need to enhance nursing interventions and promote social support among those who care for older people, which can positively impact caregiving.

Factors associated with nursing students' attitudes toward older people: A scoping review

Nursing students rate geriatric nursing poorly in career preferences, but aging populations mean more older people require access to health care. Negative attitudes held by nursing students can lead to ageism affecting the quality of care provided. The purpose of this scoping review is to summarize research findings in the published literature relating to factors associated with nursing students' attitudes toward older people, and the tools used to measure these attitudes. The Joanna Briggs Institute guide for conducting a scoping review was used. Eleven databases and search engines were searched for international peer reviewed research articles published in English between January 2000 and February 2021. Sixteen articles were included in the review. This review highlights areas for affirmative action to improve undergraduate nursing students' attitudes toward older people to prepare them to work effectively in future health care systems. Positive attitudes were associated with: senior years of study; professional values (caring, professionalism, trust); education regarding care of older adults; knowledge about aging; contact with older family members; comfort communicating with older people; and willingness to work with older people following graduation. It also identified the need for a current, nursing-specific measure of attitudes toward older people.

A scoping review of ageism towards older adults in cancer care

INTRODUCTION

Ageism towards older adults with cancer may impact treatment decisions, healthcare interactions, and shape health/psychosocial outcomes. The purpose of this review is twofold: (1) To synthesize the literature on ageism towards older adults with cancer in oncology and (2) To identify interventions that address ageism in the healthcare context applicable to oncology.

MATERIALS AND METHODS

We conducted a scoping review following Arksey and O'Malley and Levac methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted an exhaustive multi-database search, screening 30,926 titles/abstracts. Following data abstraction, we conducted tabular, narrative, and textual synthesis.

RESULTS

We extracted data on 133 papers. Most (n = 44) were expert opinions, reviews, and letters to editors highlighting the negative impacts of ageism, expressing the need for approaches addressing heterogeneity of older adults, and calling for increased clinical trial inclusion for older adults. Qualitative studies (n = 3) described healthcare professionals' perceived influence of age on treatment recommendations, whereas quantitative studies (n = 32) were inconclusive as to whether age-related bias impacted treatment recommendations/outcomes or survival. Intervention studies (n = 54) targeted ageism in pre/post-licensure healthcare professionals and reported participants' improvement in knowledge and/or attitudes towards older adults. No interventions were found that had been implemented in oncology.

DISCUSSION

Concerns relating to ageism in cancer care are consistently described in the literature. Interventions exist to address ageism; however, none have been developed or tested in oncology settings. Addressing ageism in oncology will require integration of geriatric knowledge/interventions to address conscious and unconscious ageist attitudes impacting care and outcomes. Interventions hold promise if tailored for cancer care settings. 249/250.

Investigation of Variables Affecting Attitudes of Emerging Adults Towards Older Individuals

Similar to other countries, the ratio of the older people in the total population and the number of studies in this field is increasing day by day due to the decrease in the fertility rate and the increase in life expectancy in the Turkish culture. The aim of the present study is to examine whether a number of sociodemographic variables and different sub-dimensions of empathy predict the attitudes toward older adults. A total of 143 undergraduate students, 111 (77.6%) of whom were women, who were in emerging adulthood (M. = 19.76 SD. = 1.37, range 18-24 years) were included in the study. The data was collected using a ‘Demographic Information Form’, ‘The Interpersonal Reactivity Index’, and ‘Kogan’s Attitude Toward Older People Scale’ and hierarchical regression analysis was performed. ‘Willingness to live with the elderly in the future’ (yes; β = 0.42, p < .001, no idea; β = 0.30, p < .001) and ‘being a woman’ (β = -0.19, p = .017) were associated with a more positive attitude toward older people. Moreover, when ''willingness to live with the elderly in the future' and 'being a woman' were controlled in the first step, it was found that high 'empathic concern' positively predicted the attitudes toward older adults (β = .20, p = .038). Partially consistent with the previous studies, these findings indicate that ‘gender’, ‘want to live with an older person in the future’, and ‘empathic concern’ are significantly related to the attitudes toward older adults.

Is there evidence of age bias in breast cancer health care professionals' treatment of older patients?

OBJECTIVES

Despite NICE (2009; 2018) guidelines to treat breast cancer patients 'irrespective of age', older women experience differential treatment and worse outcomes beyond that which can be explained by patient health or patient choice. Research has evidenced the prevalence of ageism and identified the role of implicit bias in reflecting and perhaps perpetuating disparities across society, including in healthcare. Yet age bias has rarely been considered as an explanatory factor in poorer outcomes for older breast cancer patients.

METHODS

This mixed methods study explored age bias amongst breast cancer HCPs through four components: 1) An implicit associations test (31 HCPs) 2) A treatment recommendations questionnaire (46 HCPs). 3) An attitudes about older patients questionnaire (31 HCPs). 4) A treatment recommendations interview (20 HCPs).

RESULTS

This study showed that breast cancer HCPs held negative implicit associations towards older women; HCPs were less likely to recommend surgery for older patients; some HCPs held assumptions that older patients are more afraid, less willing and able to be involved in decision-making, and are less willing and able to cope with being informed of a poor treatment prognosis; and conditions which disproportionately affect older patients, such as dementia, are not always well understood by breast cancer HCPs.

CONCLUSIONS

These results indicate that there are elements of age bias present amongst breast cancer HCPs. The study's findings of age-based assumptions and a poorer understanding of conditions which disproportionately affect older patients align with patterns of differential treatment towards older breast cancer patients suggesting that age bias may be, at least in part, driving differential treatment.

Nurses' perspectives on caring for and attitudes towards adults aged eighty years and older

BACKGROUND

Adults aged 80 years and older form a vulnerable group regarding perceived ageism, because they are often stereotyped as being frail and dependent. Nurses often display biased behaviour and hold negative attitudes towards this age group, due to the fact that they have frequent contact with patients who need complex care. As this frequent contact can negatively influence the quality of care, we performed this study to assess nurses' attitudes towards adults aged 80 and older and their views regarding their care, as well as to identify factors that influence attitudes.

METHODS

A cross-sectional study design was used. A convenience sample of 1179 Austrian nurses was taken, and their attitudes were measured using the Ageing Semantic Differential (ASD) Scale. Their views on caring for older adults were assessed with the Perspectives on Caring for Older People (PCOP) Scale. Multiple linear regression was used to examine factors that influence nurses' attitudes. The Ethics Committee of the Medical University of Graz (EK Number 31-320 ex 18/19) gave their ethical approval for this study.

RESULTS

Nurses display neutral to positive attitudes towards adults aged 80+ and view caring for them positively. Positive attitudes were indicated, for example, by the factors of a positive view towards the care of older patients, a higher education and a personal relationship with older adults. Negative attitudes were indicated by the factors of being female and interacting more frequently with older care receivers.

CONCLUSIONS

Although the nurses' attitudes were not negative, they should be encouraged to view this patient population more positively. Educational interventions to alter nurses' attitudes and thus to improve the quality of care are recommended. As the ASD measures some aspects of ageism, it is recommended to consider qualitative methods in future studies to obtain a deeper knowledge of ageism in nursing care.

Simulation-based holistic education in physiotherapy interns to increase empathy toward older adults and individuals with disabilities

Background

The proportion of older adults and individuals with disabilities in the general population increases each year. Thus, clinical clerkships designed for physiotherapy interns should provide more than simply knowledge and skills. For such interns to be able to handle the requirements of their future jobs, clerkships must enable them to develop empathy and positive attitudes toward patients. This study investigated the effect of simulation-based, holistic health-care education on physiotherapy interns’ empathy, attitudes, and knowledge. 

Methods

A parallel-group design. Thirty physiotherapy interns from a medical institution were enrolled as participants, with experimental and control groups each comprising 15 participants. Both groups received standard clinical training. However, the experimental group received an additional 3.5 h of simulation-based holistic health-care education. The Jefferson Scale of Empathy, Kogan’s Attitudes Toward Old People Scale, the Attitudes Towards the Elderly Scale, the Knowledge About Aging Scale, Knowledge of the Situation of Older People Scale, Perceptions of Working with Older People Scale, and Care Willingness Scale were used in a pretest and posttest.

Results

After the intervention period, we observed substantial between-group differences of 6.4 points on the Jefferson Scale of Empathy (p = 0.001), 7.7 points on Kogan’s Attitudes Toward Old People Scale (p = 0.002), 3.5 points on the Attitudes Toward the Elderly Scale (p = 0.002), 2.5 points on Knowledge About Aging (p = 0.055), 4.5 points on the Knowledge of the Situation of Older People Scale (p < 0.001), and 2.1 points on Perceptions of Working with Older People Scale (p = 0.046).

Conclusion

Simulation-based, holistic health-care education can significantly improve the empathy, knowledge, and attitudes of physiotherapy interns.

Feasibility of a telephone-delivered educational intervention for knowledge transfer of COVID-19-related information to older adults in Hong Kong: a pre-post-pilot study

Background

During the COVID-19 pandemic, educational interventions have become necessary to prevent the spread of health-related misinformation among Hong Kong older adults. The primary objective of this study was to assess the feasibility of a student-led, telephone-delivered intervention to improve COVID-19-related health knowledge among Hong Kong older adults. The secondary objective was to evaluate the impact of the intervention on the student volunteers.

Methods

Twenty-five participants aged 65 or above who were able to communicate in Cantonese and had no hearing or cognitive impairments were recruited for this longitudinal pre–post-study from a community center in Hong Kong. The pilot telephone-delivered intervention consisted of five telephone call sessions conducted by 25 student volunteers. Each participant was paired with the same volunteer throughout the intervention. The first four sessions included pre-tests that assessed the participants’ understanding of three COVID-19-related themes: medication safety, healthcare voucher scheme, and COVID-19 myth-busting. Standardized explanations of the pre-test questions were offered to participants during the phone calls. In the last session, a post-test on all the themes was conducted. The intervention’s feasibility was assessed based on (a) percentage changes in the participants’ test scores, (b) attrition rate, and (c) the acceptability of the intervention by the participants. The impact of the intervention on the student volunteers was evaluated based on a student feedback survey. There was no control group.

Results

Significant improvements in the participants’ test scores (out of 100%) for all themes were observed after the intervention: from 76 to 95.2% for medication safety, from 64.0 to 88.8% for the healthcare voucher scheme, and from 78.0 to 93.2% for COVID-19 myth-busting. The average improvement in test scores of the three themes was 18.4% (95% CI 12.2 to 24.6%). Most participants were satisfied with the program. The student feedback survey suggested that the intervention enhanced students’ communication skills and understanding of Hong Kong older adults.

Conclusion

This pilot study offers initial evidence of the potential and feasibility of student-led, telephone-delivered educational interventions for the transfer of COVID-19-related knowledge to older adults and their benefits for the student volunteers. Future studies should include larger samples and a control group.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01169-y.

Emergency department transfers from residential aged care: what can we learn from secondary qualitative analysis of Australian Royal Commission data?

OBJECTIVES

To use publicly available submissions and evidence from the Australian Royal Commission into Aged Care Quality and Safety as data for secondary qualitative analysis. By investigating the topic of emergency department transfer from the perspective of residents, family members and healthcare professionals, we aimed to identify modifiable factors to reduce transfer rates and improve quality of care.

DESIGN

The Australian Royal Commission into Aged Care Quality and Safety has made over 7000 documents publicly available. We used the documents as a large data corpus from which we extracted a data set specific to our topic using keywords. The analysis focused on submissions and hearing transcripts (including exhibits). Qualitative thematic analysis was used to interrogate the text to determine what could be learnt about transfer events from a scholarly perspective.

RESULTS

Three overarching themes were identified: shortfalls and failings, reluctance and misunderstanding, and discovery and exposure.

CONCLUSIONS

The results speak to workforce inadequacies that have been central to problems in the Australian aged care sector to date. We identified issues around clinical and pain assessment, lack of consideration to advance care directives and poor communication among all parties. We also highlighted the role that emergency departments play in identifying unmet clinical needs, substandard care and neglect. Given the inadequate clinical care available in some residential aged care facilities, transferring residents to a hospital emergency department may be making the best of a bad situation. If the objective of reducing unnecessary transfers to emergency departments is to be achieved, then access to appropriate clinical care is the first step.

Caring for the Elderly Enhances Positive Attitudes Better Than Knowledge in Nursing Students

Background and Objectives: There is a growing interest in the measurement of attitudes towards older people in healthcare professionals, as there is a need to implement interventions to improve ageist attitudes. A one group pretest–posttest study was carried out to explore the change in nursing student attitudes towards the elderly during their university careers. Materials and Method: A total of 97 nursing students were enrolled. Attitudes were analyzed using Kogan’s Attitudes Toward Old People Scale. Results: The attitude was positive from the beginning of the study, with a score of 110.06 (12.92). No differences were observed after completing the subject “Care of the elderly” (106.21 (10.77)), though a significant increase was recorded after the completion of clinical placement (142.88 (12.64)), with a large effect size (η2p = 0.754). The score of the positive items was significantly increased, but not that of the negative items, as ageist attitude was not reduced. Conclusion: The current curricular design, that includes taking the theoretical course before clinical placement in the geriatric area, increases positive attitudes in nursing students but does not reduce ageist attitudes.

Evaluation of Nurses’ Knowledge and Attitudes towards Older Adults and Associated Factors

Background:

Due to the increased risk of developing chronic diseases among older adults, their demand for health care has increased. Preparing nurses to care for the older adults is one of the most difficult challenges in nursing education.

Objective:

This study investigated nurses’ knowledge and attitudes towards older adults and demographic and occupational features that affect them.

Methods:

This cross-sectional study was conducted on 412 participants from July to October 2020. Patients were selected using a random sampling method. Three questionnaires were used: a socio-demographic form, an Older Patient in Acute Care Survey, and a Knowledge about Older Patients-Quiz.

Results:

According to the Pearson correlation test, there is a statistically significant and positive correlation between knowledge and general opinion (P = 0.000), (r = 0.271) as well as between practice experiences and general opinion (P = 0.000), (r = 0.205) of nurses about older adult’s care. There was no statistically significant relationship between knowledge and practice experiences (P = 0.857), (r = -. 009).

Conclusion:

Having a better understanding of the needs of the older adults would improve the quality of care that nurses provide to them.

Providing ambulatory healthcare for people aged 80 and over: Views and perspectives of physicians and dentists from a qualitative survey

Background

People aged 80 and over frequently face complex chronic conditions and health limitations, including oral health problems, which are primarily addressed by ambulatory (i.e., outpatient) healthcare. This demographic development is expected to affect the provision of care. However, few studies have investigated physicians’ and dentists’ views across the various medical disciplines in non-institutional settings. This study investigated how healthcare providers perceive caring for very old people, and how they feel healthcare should be designed for this patient group.

Methods

A qualitative online survey comprising nine open-ended items was conducted among physicians and dentists practicing in the ambulatory healthcare sector in North Rhine-Westphalia, Germany. Apart from child and adolescent healthcare, no medical specialties were excluded. The results were analysed using Kuckartz’ approach of structuring qualitative content analysis. A descriptive codebook was developed first. After coding all the material, recurring patterns between the topics were investigated and compared between two groups of participants, physicians and dentists.

Results

N = 77 cases were included in the analysis, from which n = 21 originated from the field of ambulatory general practice care and internal medicine, n = 19 from specialties (e.g., neurology, urology), and n = 37 from dentistry. Caring for patients aged 80 and over was perceived as challenging because of complex health conditions and treatments such as multimorbidity and polypharmacy, and patients’ cognitive and physical limitations. In characterizing good care in older age, both groups found individual care important, as well as empathetic interactions and good collaboration in networks of healthcare providers. Inadequate reimbursement and limited resources and time were the most important barriers to providing good care, while one of the most important facilitators was healthcare providers’ attitude and motivation.

Conclusions

Physicians’ and dentists’ conceptions of good healthcare are in line with the conceptualization of patient-centred care. However, the transfer in everyday care delivery is hampered by the current design of healthcare structures. Healthcare providers feel overstrained by the increasing demands placed on them. Adaptations for improvement should focus on building strong networks of cooperating health professions, especially including dental care, and local social support structures.

Curriculum, Theory, and Practice: Exploring Nurses’ and Nursing Students’ Knowledge of and Attitudes towards Caring for the Older Adults in Canada

Background

Caring for older adults is among the most challenging issue of public health and social care systems in modern societies. By enhancing the nursing curriculum, nursing students will be qualified to provide gerontology care, and they will be acknowledging and working to eliminate ageism from the health care system.

Purpose

This study explores nurses’ and nursing students’ knowledge and attitudes in caring for older adults and addresses the factors contributing to nurses’ perspectives. It also examines the nursing curriculum's contributions to nurses’ knowledge and attitudes and provides suggestions aimed at reconfiguring the nursing curriculum for comprehensive gerontology nursing care.

Methods

A mixed-method research design was utilized, and quantitative and qualitative data were collected from 90 nurses and nursing students through an online questionnaire. Data were analyzed via SPSS and NVivo 12 software programs.

Results

The results revealed that most nurses possess neutral attitudes toward caring for older patients, and their knowledge ranged from average to above-average levels. Statistical analysis revealed no statistically significant difference between gender and nurses’ attitudes or between gender and knowledge. Similarly, there was no statistically significant difference between work status and nurses’ attitudes. Results showed a statistically significant positive correlation between nurses’ attitudes and knowledge level. This study demonstrated the positive impact of the Canadian nursing curriculum on nurses’ knowledge and attitudes.

Conclusion

The current study recommends providing gerontology nursing courses as a mandatory separate course in nursing education to enhance nursing students’ knowledge and skills for high-quality gerontology nursing care.

Spotlight on Age: An Overlooked Construct in Medical Sociology

Medical sociology gives limited attention to age-a surprising observation given the aging of the population and the fact that age is among the strongest determinants of health. We examine this issue through an analysis of articles published in Journal of Health and Social Behavior (JHSB) and Sociology of Health & Illness (SHI) between 2000 and 2019. One in 10 articles focused on age or aging, with attention increasing over the period. However, the journals differed. More JHSB than SHI articles addressed it, but fewer focused on the latest life stages when frailty often appears. We discuss three dimensions of age that would enrich medical sociology: as a dimension of inequality akin to race and gender with similar health effects, as an institution interacting with the medical one, and as an identity-again, akin to race and gender-through which people process their experiences in ways that affect health.

Hospital nurses' knowledge about older patients in Turkey: a validation and comparison study

BACKGROUND

In Turkey, nursing care in hospitals has gradually included more older patients, resulting in a need for knowledgeable geriatric nurses. It is unknown, however, whether the nursing workforce is ready for this increase. Therefore, the aim of this study is to validate the Knowledge about Older Patients Quiz (KOPQ) in the Turkish language and culture, to describe Turkish hospital nurses' knowledge about older patients, and to compare levels of knowledge between Turkish and Dutch hospital nurses.

METHOD

First, the KOPQ was translated, resulting in the KOPQ-TR. Then, content validity was assessed by 10 geriatric experts using the Lynn method, a pilot test among 10 nurses was conducted, and a Rasch analysis was performed using data from 135 nurses working in two Turkish hospitals. Finally, a comparison between Turkish and Dutch nurses' levels of knowledge was performed.

RESULTS

The results of the qualitative validation (i.e., content validity by experts and nurses), model fit, item reliability and the item separation index of the KOPQ-TR proved excellent, indicating good content and construct validity. However, the Person Separation Index and Person Reliability of the Rash analysis did not meet the criteria for adequate scale and psychometric validation. The levels of knowledge among Turkish nurses were significantly lower than those of Dutch nurses.

CONCLUSIONS

The KOPQ-TR is promising for use in Turkey, although psychometric validation should be repeated using a better targeted sample with a larger ability variance to adequately assess the Person Separation Index and Person Reliability. Currently, education regarding care for older patients is not sufficiently represented in Turkish nursing curricula. However, the need to do so is evident, as the results demonstrate that knowledge deficits and an increase in older patients admitted to the hospital will eventually occur. International comparison and cooperation provides an opportunity to learn from other countries that currently face the challenge of an aging (hospital) population.

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.

Exploring nursing students' learning experiences and attitudes toward older persons in a gerontological nursing course using self-regulated online enquiry-based learning during the COVID-19 pandemic: A mixed-methods study

BACKGROUND

During the COVID-19 pandemic, universities adopted online teaching as the primary teaching and learning method. Most of the online teaching, however, has been limited to the broadcasting of asynchronous lectures and sharing of teaching materials.

OBJECTIVES

To explore undergraduate nursing students' self-regulated learning experiences, satisfaction, and attitudes toward older persons in a gerontological nursing course using online self-regulated enquiry-based learning (EBL) during the COVID-19 pandemic.

DESIGN

A mixed-methods design was adopted.

SETTING

A university in Hong Kong providing pre-registration nursing programmes.

PARTICIPANTS

155 students studying in the fourth year in a five-year Bachelor of Nursing programme participated in the quantitative study in which 18 joined the focus groups (4 groups with group size of 4-5).

METHODS

Five video-based scenarios along with two interactive online workshops, a mind-map development exercise, gamified assessments, reading materials, group discussions, and presentations were adopted in a gerontological nursing course offered in 2019-2020 to enhance the students' learning, driven by a process of enquiry. Attitudes toward older people were measured at baseline and one week after the course (post-test). Information on self-regulated learning experiences, satisfaction, and confidence were collected at post-test only. Paired t-tests and descriptive statistics were used to analyse the data. Focus groups were conducted through semi-structured interviews and transcribed verbatim for inductive content analysis.

RESULTS

A significant improvement was demonstrated in the students' attitude toward older people. The students appreciated the opportunities provided by the online EBL to apply key concepts of gerontology in the teaching and learning activities and to enhance their critical thinking skills. Three major themes were revealed from the focus group: Perception of the teaching pedagogy, Improvement of cognitive skills, and Positive and negative aspects of the learning experience.

CONCLUSIONS

The online self-regulated EBL improved the students' online learning experience in a gerontological nursing course during the pandemic and improved their attitudes toward older people.

The Effect of Integrating Service-Learning and Learning Portfolio Construction into the Curriculum of Gerontological Nursing

Background: With the rapid increase in the aging population, a greater number of older individuals will require nursing care in the future. Therefore, it is important for nurses to be willing to engage in gerontological nursing. Nursing students must increase their experience in providing care to older people during their education and must receive education that improves their attitudes toward aging; this will help provide care to the older people, develop positive attitudes toward aging, and increase their empathy and willingness to provide care to older people after graduation. Hence, studies focused on improving the attitude of nursing students toward aging are urgently required. Methods: In this mixed-method experimental study, participants were interviewed individually and observed to better understand the connection between quantitative and qualitative data. Service learning and learning portfolio constructions were integrated in the gerontological nursing curriculum of an experimental group, whereas traditional gerontological nursing curriculum was provided to a control group. Quantitative data on the nursing students were collected using the attitudes toward aging scale (ATAS) and older people behavioral intention scale (OBIS) and analyzed using descriptive and inferential statistics. Result: From the pre- to the post-test, the average ATAS and OBIS scores of the experimental group increased significantly, reaching a statistically significant level. However, the results of the control group indicated that the educational intervention does affect the attitudes toward aging and older people behaviors. A qualitative analysis revealed that educational intervention can improve the students’ attitudes toward aging and older people behavioral intention. Conclusion: Our study results showed that integrating community older people service and learning portfolio construction into the curriculum can effectively improve the attitudes of nursing students toward aging and older people’s behaviors, thus providing substantial assistance to students intending to care for the older people in the future.

Does caring lead to stigmatisation? The perception of older people among healthcare professionals and the general population: A cross-sectional study

BACKGROUND

It is well recognised that healthcare professionals are particularly at risk for developing a negative perception of older people. Indeed, in addition to receiving education centred on a biomedical view of ageing, they are constantly exposed to the most vulnerable and dependent older individuals.

AIM

The purpose of our study is to compare the perception of older people between health professionals, working in a nursing home and the general population.

METHODS

This is a cross-sectional study. The perception of older people was measured using two different instruments: the image-of-ageing question and the Aging Semantic Differential (ASD) scale. We performed t-test to compare the perception of older individuals between the general population and healthcare professionals.

RESULTS

The image-of-ageing question does not show any difference between the general population (n = 148) and healthcare professionals (n = 107). In these both groups, almost half of the words cited in reference to older individuals were negative. Concerning the ASD, results show that healthcare professionals have significantly more negative perceptions towards older individuals than the general population (with the control of age, gender and educational level).

CONCLUSION

Healthcare professionals seem to have a more negative view of older people than the general population. Their regular contact with the frailest older adults could explain this finding. Another hypothesis could be a non-optimal quality of contact in nursing homes.

IMPLICATIONS FOR PRACTICE

Such results highlight the importance to promote a more holistic view of ageing in educational programs of healthcare professional. Improving the quality of contact with nursing homes residents should be strongly considered to reduce ageism among healthcare professionals.

Willingness to care for older people and associated factors in pre-registered student nurses: A multi-country survey study

BACKGROUND

Addressing nursing students' lack of interest in providing care for the aged population is a global challenge for nursing educators. Despite global interest in student nurses' readiness for older people care, almost all the literature has been identified from single countries, predominantly with high income per capita. At present, no study has been conducted to provide evidence-based data related to this topic from a multi-country perspective.

OBJECTIVE

The study's purpose was to examine the willingness to work with older persons and associated factors among student nurses from nine countries (or regions).

DESIGN

This study utilized a correlational and cross-sectional design.

SETTINGS

This was a multi-country survey study conducted in China, Chile, Egypt, Hong Kong, India, Greece, the State of Palestine (henceforth Palestine), the Philippines, and Saudi Arabia.

PARTICIPANTS

2250 baccalaureate nursing students were recruited from 10 universities in this study.

METHODS

The survey that was used to collect data comprised four parts: socio-demographic data, attitude toward aging, older person care perception, and willingness to work with such group.

RESULTS

Respondents in five regions (including Mainland China, Greece, Hong Kong, Palestine, and Saudi Arabia) stated that older persons were the least favored group for future career choices. In comparison with mainland China, respondents in Chile, India, and the Philippines were significantly more likely to be willing to care for older patients, but those in Egypt and Greece indicated a lower tendency to choose this option. Favorable attitudes toward aging and older person care perception were significantly associated with having the willingness to provide care to gerontologic patients in the future.

CONCLUSIONS

Although attitudes toward aging and older person care perception have long been confirmed as important factors that are linked with willingness in caring for older people, this study adds that location is a more influential factor. Additional research in other countries is needed to advance the knowledge in this important area.

How does geriatric nursing education program change the knowledge, attitude and working intention among undergraduate nursing students? A systematic literature review

OBJECTIVE

This review aimed to examine the changes of knowledge, attitude and working intention in nursing students after an undergraduate geriatric nursing education.

DESIGN

A systematic review of the literature.

DATA SOURCES

Five databases which included CINAHL, MEDLINE, PubMed, Scopus and Web of Science were searched for this literature review from January 2010 to October 2020.

REVIEW METHODS

The review was registered in PROSPERO registry with registration number CRD42020215703. The review examined undergraduate nursing education programs in terms of knowledge, attitude and working intention towards geriatric care among undergraduate nursing students as outcomes. We used JBI critical appraisal tools and Mixed Methods Appraisal Tool to evaluate and assess the quality of the retrieved research papers.

RESULTS

The search yielded 19 studies included in the final review, 14 of which were quantitative studies and five were qualitative studies. Four types of education programs were identified. These were type 1, a four-year undergraduate gerontology program consisting of geriatric theory and geriatric care clinical placement; type 2, stand-alone geriatric subject and geriatric clinical placement program; type 3, integrated geriatric subject and geriatric clinical placement program; type 4, solely geriatric clinical placement program. The review found that the type 2 program demonstrated the best educational outcomes in undergraduate students.

CONCLUSIONS

This review provided the most recent literature evidence pertaining to undergraduate geriatric education program and its educational outcomes. Future research should focus on the evaluating the content of each type of geriatric education program to inform the development of undergraduate geriatric nursing education.

Collective Perceptions of Aging and Older Persons Held by Students From Eight Healthcare Professions

In order to increase the number of students entering the geriatric workforce, an understanding of factors influencing career preference and what may prevent students from pursuing geriatric careers is necessary. Using a convergent parallel mixed methods approach, the aim of this study was to provide insight for geriatric educators regarding the collective perceptions of aging and older persons held by 864 students from eight healthcare professions. Quantitative questions assessed students' attitudes (Geriatric Attitudes Scale). Student responses to four open-ended questions were assessed using conventional content analysis. Results included rich narrative examples of healthcare professions students' perceptions and understanding of the aging process, as well as myths and misconceptions of aging and older persons that can be used to inform geriatric curricula across multiple health professions training and education programs. Geriatric education is a critical avenue to correct misperceptions, quell ageism and address the current shortage in the geriatrician workforce.

Knowledge, attitude, and associated factors towards older people care among nurses working at public hospitals in West Shoa zone, Oromia region, Ethiopia

Background

Nurses’ knowledge and attitude regarding the care of older people can have an impact on patient outcomes such as reduced length of hospital stays, reduced readmission rates, and increased patient and family satisfaction. However, evidence is scarce in Ethiopia, particularly in the study area. Therefore, the study aimed to assess the knowledge, attitude, and associated factors towards the care of older people among nurses working at public hospitals in West Shoa Zone, Ethiopia.

Methods

Institutional based cross-sectional study was conducted from April1–30, 2021 among 423 nurses who were working in adult care units. Data were collected through a self-administered questionnaire. The sample was selected using simple random sampling. The logistic regression analysis model was fitted and the Adjusted Odds Ratio at 95% confidence interval was used. P-values less than or equal to 0.05 were considered statistically significant.

Results

A total of 411 nurses participated in the study with a 97.16% response rate. The mean age of the participants was 29.11 (SD ± 3.84) years. The study showed that 37.2% (95% CI: 33, 42%) of the participants had good knowledge and 45.7% (95% CI: 40.9, 50.6%) had a favorable attitude toward the care of older people. The significantly associated factors positively affected both the knowledge and the attitude of nurses. Age greater than 30 years (AOR:2.37, 95% CI: 1.18, 4.75), experience greater than 5 years (3.00: 1.21, 7.41), being BSc degree holder and above (3.57: 1.40, 9.09), lived with older people (2.14: 1.34, 3.42), and nurses working in adult intensive care unit (3.03: 1.03, 8.91) were significantly associated with knowledge. Likewise, being female (2.04: 1.33, 3.12), being BSc degree holder and above (2.77: 1.35, 5.65), lived with older people (1.59: 1.03, 2.44), and care for older people (1.63: 1.06, 2.53) were significantly associated with attitude.

Conclusion

In this study, less than half of the nurses had good knowledge and a favorable attitude towards the care of older people. Continuous professional development regarding the care of older people is important to enhance nurses’ knowledge and attitude.

Exploring gaps in positive solitude perceptions: older adults vs. gerontology professionals

OBJECTIVES

The aim of this study was to explore old persons' experiences of positive solitude (PS) and the gaps between their experience and professional caregivers' perceptions of older adults' experiences of PS. Moreover, we attempt to understand the basic mechanism that may explain these gaps.

DESIGN

A qualitative method was used.

PARTICIPANTS

Fourty-one older adults (aged 65-103 years) and 2 groups of professionals: 16 occupational therapists with a specialization in gerontology and 41 gerontology graduate students from other occupations.

MEASUREMENT

Four open-ended questions about PS were asked. The older adults described their views on PS and experiences during solitude. The two caregiver groups, who are familiar with older adults, answered the questions twice, referring once to themselves and once to older adults in general.

RESULTS

A. Gaps exist between old peoples' and caregivers' perceptions and experience of PS. B. The caregivers believe that older adults cannot easily enjoy PS. C. Caregivers believe that there are certain preconditions for older adults' experience of PS. D. Differences in attitude toward older adults between the caregiver groups were found.

CONCLUSIONS

Although old people occasionally prefer PS, culture and age bias may prevent caregivers from accepting older adults' need for PS. Practical implications include the need to raise awareness of age bias among caregiving staff, in particular regarding their acceptance of older adults' PS experiences. This may improve the staff's willingness to enable older adults to experience PS without interruption.

Older adults 'Have so Much to Teach Us': A qualitative study of BSN student perceptions when anticipating clinical in the nursing home

BACKGROUND

As the population of older adults is estimated to double by 2050, the growing demand for nurses to provide care to older adults will grow. Internationally, attitudes among nursing students towards caring for older adults range from negative to slightly positive.

OBJECTIVE

The purpose of this qualitative descriptive study was to examine undergraduate nursing students' thoughts, feelings and perspectives towards older adults residing in nursing homes prior to their clinical experience.

METHODS/RESULTS

Students enrolled in a clinical component of a course within a baccalaureate nursing programme were prompted to write a one-page reflection on their thoughts and feelings toward caring for older adults in a nursing home. Artefacts from 72 undergraduate students' were examined, and data saturation was obtained at 20 cases. Utilizing a one-time inquiry approach, we identified eight categories that emerged from the data: Range of emotions when anticipating clinical, building rewarding relationships with older adults, preparing for my nursing career, student pre-existing attitudes, providing the best care possible, relationships with grandparents, experience(s) in nursing homes and older adults 'have so much to teach us'. Two themes encompassed all the others: '[Older adults] have so much to teach us' and 'providing the best care possible'. A strong majority of students expressed enthusiasm for their upcoming clinical in a nursing home.

CONCLUSION

Students' attitudes were significantly more positive than those in prior studies. The results offer essential insight for nursing faculty who teach and design clinical experiences for undergraduate nursing students in nursing home facilities. Faculty should take account of their students' prior experiences, thoughts, and feelings to prepare them appropriately to care for older adults in their future nursing careers.

IMPLICATIONS FOR PRACTICE

Increasing staffing and retention of staff in nursing homes facilities remains a priority for stakeholders in long-term care of older adults. Nursing educators must continuously assess students' knowledge and attitudes assists to identify knowledge gaps and misconceptions, which must be addressed to teach student nurses how to provide high-quality, effective and culturally sensitive care to older adults. As students become more competent in caring for older adults, their desire to pursue a nursing career in gerontology care may increase. Early experiences of student nurses with older adults will prepare nursing students for their future career. Understanding students' thoughts and feelings will assist faculty in tailoring clinical orientation, designing clinical experiences and post-conference debriefings that address students' concerns. This research contributes to the knowledge of perceptions of nursing students and will assist to design educational experiences. Nursing educators who understand nursing students' attitudes toward caring for older persons can facilitate therapeutic interactions between nursing students and older adults. Designing experiences with these research results in mind may facilitate the development of positive attitudes towards caring for older adults.

Study of the attitudes and future intentions of nursing students towards working with older people: an observational study

BACKGROUND

Older people are increasing in the world leading to the fact that many nursing students will work in geriatric care setting. It was also reported the lack of knowledge and interest in working with older people by many nursing students. Therefore, the aim of the study is to explore the attitudes, wills, and intentions for the care of older people from nursing students.

METHODS

A sample of 383 students (mean age between 17 and 24; females: 76.2%) was divided according to the year. A questionnaire and three scales investigating the attitude for working with older persons (Kogan, Aday-Campbell, Nolan scales) were administered. Simple correlations across the three scales and the comparisons in means by year of graduation were reported.

RESULTS

Of the 383 students, 69.7% would take care of an older person, with the previous experience with older patients being the most important determinant in positive attitude of students in working with older people. The Kogan scale revealed a relatively positive attitude towards older people of the students involved; the Aday's scale a reasonable willingness to take care of the older people; the Nolan scale a fair intention. Aday's scale significantly correlated with Nolan's scale and with Kogan's scale as well as the Nolan scale correlated with the Kogan scale.

CONCLUSION

Our study suggests that the quality of care provided to older people is related to the attitudes of health professionals indicating that nursing educators should adopt effective strategies to increase and promote students' positive attitudes to older people.

Attitudes towards older adults (80 years and older): A measurement with the ageing semantic differential - A cross-sectional study of Austrian students

INTRODUCTION

The aims of the study were to investigate the four-factor structure of the German version of the Aging Semantic Differential (ASD) and to gain initial insights into the attitudes of nursing, medical and humanities students towards older people in Austria.

METHOD

A cross-sectional study design with a convenience sample was chosen.

RESULTS

The ASD was completed by 255 Austrian nursing, medicine, and humanities students, who described their attitudes towards persons who are 80 years of age and older. The applicability of the four-factor structure (instrumentality, autonomy, acceptability and integrity) of the German version was confirmed by performing a confirmatory factor analysis. The mean age of students in our sample was 23.6 years; 79% of these were female. The sample displayed negative attitudes regarding the factors of autonomy and instrumentality, but more positive attitudes regarding the factors integrity and acceptability. The attitudes of the students in the three study programmes differed, with the medical students displaying the most negative attitudes. Students who displayed positive attitudes had statistically significantly higher levels of knowledge about ageism and better possibilities to hold personal conversations with older people (80+) in the family or circle of friends.

CONCLUSION

We conclude that having more knowledge about ageism and close personal contacts to older persons can support positive attitudes towards older individuals.

Clinical Pharmacists' Knowledge of and Attitudes toward Older Adults

Background: Although pharmacy literature suggests that pharmacists have a positive attitude towards older adults, there is a paucity of studies that have measured pharmacists’ knowledge or attitudes towards older people. The purpose of our study was to assess the knowledge and attitudes of hospital pharmacists toward older adults. Methods: An electronic survey was distributed over two months to clinical hospital pharmacists across the province of Alberta, Canada. The survey was composed of two validated tools, the Palmore Facts of Aging Quiz (PFAQ) and Kogan’s Attitude toward Old People Scale (KOPS). PFAQ is scored from 0 (poor knowledge) to 25 (high knowledge) and KOPS from 34 to 204, with higher than 119 indicating a positive attitude. Results: A total of 153 pharmacists completed the survey (response rate of 24%). The mean age was 39 (SD 10.8) years; the average years practiced was 15 (SD 11), and the majority of respondents (n = 65) reported that >50% of patients in their practice were geriatrics. The mean correct responses on the PFAQ were 18.8 (SD 2.6). KOPS had a mean score of 156.8 (SD 14), with only one pharmacist score falling below 119, indicating a negative attitude. There was a statistically significant, positive correlation between attitudes and knowledge (r = 0.38, p < 0.05), as well as the increasing age of the respondents (r = 0.18, p = 0.03). The remaining measured categories (i.e., gender, years of pharmacy practice) had no significant effect. Conclusion: Clinical hospital pharmacists in Alberta have a positive attitude toward geriatric patients, as well as a satisfactory knowledge of older adults.