A comparison of nurse teachers' and student nurses' attitudes toward hospitalised older adults

Turning evidence into action using a senior friendly hospital framework and a collaborative network

The Senior Friendly Hospital Accelerating Change Together in Ontario program linked the Collaborative Network Model and the Senior Friendly Hospital Framework in a unique multi-hospital knowledge-to-practice initiative to improve care for hospitalized older adults. The design enabled teams from 78 Ontario hospitals to close a shared skills and knowledge gap while meeting the varied needs of their diverse contexts. Results suggest that this design meant to reduce unnecessary redundancy, while preserving requisite diversity, was successful in achieving its specific objectives: to build a collaborative network and increase the confidence, knowledge, and skills of its members sufficient to lead sustainable improvements in their unique hospital settings. Findings with special relevance to process improvement specialists, health system leaders, and hospital administrators and managers are discussed.

Teaching Gerontology in Transcultural Academics: A Phenomenographic Study of Thai and Swedish Nurse Educators' Conceptions of Gerontological Nursing

INTRODUCTION

There is an urgent need for registered nurses with gerontological competence within long-term care (LTC) of older adults. Despite increases of life expectancy, LTC for older adults is not emphasized in nursing curricula in neither Sweden nor Thailand. Thus, the aim was to explore conceptions on gerontological nursing (GN) among Swedish and Thai nurse educators.

METHOD

A qualitative phenomenographic method, based on open-ended interviews with five Thai and nine Swedish nurse educators was conducted.

RESULTS

The results indicate a paradox between the educators' knowledge about the implications of global aging, their hope of own aging, and LTC. The ethical responsibility of being credible and a source of inspiration in teaching about aging are focused, while GN seem to be less important.

DISCUSSION

To increase students' interest in GN, measures need to be taken within the educational arenas, where the educators' own conceptions toward GN, cultural aspects of aging, and LTC are discussed.

Cross-cultural perspectives on gerontology in nursing education - a qualitative study of nurse educators' experiences

This study focuses on nurse educators' perspectives on teaching gerontology within nursing curricula in two cultures. An increasing aging multi-cultural population with large caring needs requires not only informal elder care provided by family members, but also professional nursing staff trained in gerontology. The aim of this study was to explore how Swedish and Thai nurse educators describe the role of teaching gerontology within nursing educations in Sweden and Thailand. Method: Qualitative open-ended interviews with 13 Swedish and Thai nurse educators were conducted and analyzed with qualitative content analysis. Findings: There is a lack of gerontological nursing competence in faculty, as well as bureaucracy impeding necessary changes of curricula, together with difficulties in highlighting positive and cultural aspects of aging. Conclusions: Pedagogical strategies need to be developed by nurse educators specialized in cross-cultural gerontology to improve current and future nursing educations in both countries.

"Where would I prefer to work after graduation?" Career preferences of students attending Italian nursing schools

BACKGROUND

Worldwide, nursing students have reported a preference for working in intensive care, paediatrics, and operating theatres after graduation, disregarding psychiatry and geriatrics. Many factors can influence student choices. Educators need to know students' preferences and influencing factors in order to plan appropriate interventions to orient future nurses towards the clinical areas that are most in need of trained and motivated nurses.

OBJECTIVES

To identify career preferences and student-related factors that influence the career intentions of students attending Italian nursing schools.

DESIGN

A cross sectional design.

SETTING

The study was conducted in 14 Italian nursing schools.

PARTICIPANTS

Students enrolled on a three-year undergraduate nursing program were invited to participate.

METHODS

A questionnaire was used to collect sociodemographic data and clinical area preferences. A multivariate binary logistic regression was performed to identify the student characteristics influencing career choices.

RESULTS

1534 students were enrolled in the study. Students preferred working in paediatrics, emergency departments and operating theatres, and these preferences were consistent in all of the three years. Psychiatry and geriatrics were the clinical areas least preferred in all the three years. Age, gender, nationality, and university attended were the factors that predicted students' preferences for specific clinical areas.

CONCLUSIONS

In line with international literature, students attending Italian nursing schools expressed preferences for working in some clinical areas and to disregard others. Nursing curricula and internships need to be reviewed in terms of declared and hidden curriculum in order to enable students to view all areas of practice as equally valuable.

Where are we now in relation to determining the prevalence of ageism in this era of escalating population ageing?

Population ageing is escalating rapidly now worldwide. This is an important time to determine if ageism or discrimination against older people is of concern, such as it being prevalent and/or increasing in prevalence. Over the years, many ageism measurement tools have been developed, with research findings from their use of prime consideration then for determining the prevalence of ageism and any prevalence trends. All print and open access English-language research articles published in 1953+ that used one or more ageism measurement tools in a study were sought using the Directory of Open Access Journals and EBSCO Discovery Service. A total of 25 ageism measurement tools were identified. However, only six had been used one or more times to measure the prevalence of ageism. The identified prevalence levels varied considerably, but most investigations using small convenience samples, with limited generalizability of findings. This paper highlights the need to continue developing ageism measurement tools to estimate ageism or use other measures, such as census and population-representative polling, to assess the extent and impact of ageism. This foundational measurement is needed, as ageism could be prevalent and growing in effect.

Nursing Competence in Geriatric/Long Term Care Curriculum Development for Baccalaureate Nursing Programs: A Systematic Review

BACKGROUND

As facing the rapid growth of the elderly population, the demands for geriatric and long-term care are drastically increasing. Since one of the important strategies in preparation for long-term care system is to focus on the engagement of health care professionals, this paper applies a systematic approach to review the current geriatric and long term care courses in Bachelor of Science in Nursing (BSN) programs. This review assessed the impact of Geriatric Nursing (GN) and/or Long Term Care (LTC) courses on nursing students' knowledge, care intention and competence of Geriatric Long Term Care (GLTC) care to enable their nursing competence before graduation.

METHOD

Data related to the purpose of the study, research design, sample, curriculum content, teaching strategies, evaluation measurements and results were extracted. The methodological quality of all publications was included in the review.

RESULTS

Eighteen articles were eligible for analysis, including 16 quantitative and 2 qualitative studies. The review revealed that including geriatric and long term care content in undergraduate nursing curriculum could effectively enhance students' nursing competence.

CONCLUSION

GN and LTC curriculum development should offer established content on geriatric and long term care as a foundation to implement early learning experiences in the curriculum. Both theory and clinical practice of GLTC course can be developed to increase the nursing students' knowing on the elders and the disabled through the clinical placement.

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

AIM

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Music Therapy Training for Undergraduate Nursing Students: A Modality to Foster Interest in Gerontological Nursing

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Music Therapy Training for Undergraduate Nursing Students: A Modality to Foster Interest in Gerontological Nursing" found on pages 25-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until May 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Identify the worldwide shortage of nurses specializing in gerontological nursing. 2. Describe the results of using music therapy to create positive attitudes toward older adults. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Nursing students generally have a negative attitude toward older adults. Preparing nurses to meet the care needs of an expanding aging population is a challenge for nursing educators. The purpose of the current study was to explore whether incorporating music therapy into a practical geriatric nursing course at a nursing home cultivates positive attitudes toward older adults, raises students' willingness to work with older adults, and increases their interest in specializing in gerontological nursing after graduation. Focus groups were conducted to collect data from three participant groups (N = 20). Verbatim transcripts of audiorecorded interviews were analyzed using content analysis, which revealed four themes: (a) better appreciation and understanding of music therapy, (b) role modeling instructors' successful experience and positive attitude toward older adults, (c) changing attitudes toward older adults, and (d) improving interaction skills with older adults. Results suggested music can be integrated into a gerontological nursing course to enhance students' motivation to learn, empathize, and approach older adults. [Journal of Gerontological Nursing, 42(6), 25-31.].

The feasibility of ethnodrama as intervention to highlight late-life potential for nursing students and older adults

One barrier to the expansion of geriatric health care providers is the limited desire of nursing students to work with older adults. The purpose of this study is to evaluate the feasibility of using ethnodrama as an intervention to highlight late-life potential. Twelve baccalaureate nursing students were paired with 12 residents of an assisted living facility to complete transformative learning activities focused on the topic of late-life potential culminating in a performance of an ethnodrama developed from these data. Transcripts of initial student meetings, self-reflections, the performance, postperformance discussion, and open-ended survey questions were analyzed using in vivo and pattern coding. Older adult participants recognized and emphasized positive late-life potential, whereas students explored potential throughout the life span and reflected on its meaning in their own lives. Increasing discussion about late-life potential may alter the stigma associated with aging.

Undergraduate nurse attitudes toward older adults and perceptions of working with older adults: an analysis of measurement instruments

BACKGROUND

An undergraduate nurse's attitude toward older adults or their perception of working with older adults can influence the quality of care provided and their career choice, respectively. As such, it is important to conduct research that contributes to the evaluation of attitudes and perceptions. In the conduct of comprehensive and rigorous research, it is necessary to make the right choice of an instrument to measure outcomes. The identification of a valid and reliable instrument to suit a specific research question is a complex process.

OBJECTIVE

In order to deal with this complexity, this paper reviews instruments that have been used to measure undergraduate nurse attitudes toward older adults and their perceptions of working with older adults.

DATA SOURCES

Data were sourced from Medline, CINAHL, Healthsource/Academic Edition, PsycINFO and PubMed for the years 2008-2013.

RESULTS

Eight readily available instruments were identified and their characteristics analyzed for their purpose, number of items, design, reliability and validity. The strengths and weaknesses of each of the instruments and recent use are also discussed.

CONCLUSION

The choice of a suitable instrument is likely to be critical to the testing of intervention strategies such as curriculum activities, which target attitude improvements to enhance the quality and effectiveness of nursing care provided to older adults.

The evaluation of undergraduate nurses' attitudes, perspectives and perceptions toward older people

OBJECTIVES

This literature review was undertaken to evaluate undergraduate nurses' attitudes and perspectives toward older people and perceptions of working with older people. The objectives were to (1) identify if undergraduate nurses hold positive or negative attitudes and perspectives toward older people and perceptions of working with older people, and (2) determine if positive attitudes, perspectives and perceptions can be established, maintained and improved with curriculum activities.

DESIGN

Literature review.

DATA SOURCES

For the period 2008-2013, the literature search included an electronic database search (Medline, CINAHL, Healthsource/Academic Edition, PsycINFO and PubMed) and a hand search of reference lists of the papers included.

RESULTS AND CONCLUSIONS

The analysis of 32 studies revealed that undergraduate nurses' attitudes, perspectives and perceptions are positive and it is recommended that this be the starting point for the development of curriculum activities and future research to maintain and improve this result. Finally, the limitations of recent studies are identified and a research agenda for future studies is proposed.

Nurses' attitudes towards older people: a systematic review

BACKGROUND

The population is ageing globally. Older people are more likely to have chronic diseases and disabilities and have contact with health services. Attitudes of healthcare professionals affect the quality of care provided and individual career preferences.

AIM

To examine the international research relating to registered and student nurses' attitudes towards older people and the potential underpinning variables.

METHODS

A systematic search of 8 databases covering English and Chinese language publications since 2000 was undertaken which identified 25 papers.

FINDINGS

Reported attitudes towards older people were inconsistent with positive, negative and neutral attitudes being noted across registered and student nurses and appear to be slightly less positive since 2000. A range of variables have been examined as potential predictors of nurses' attitudes with age, gender and education level being investigated most frequently but none were consistent predictors. Preference to work with older people and knowledge of ageing appeared to be associated with positive attitudes towards older people.

CONCLUSIONS

There is a growing need for registered nurses committed to working with older people, however, there is a dearth of well designed studies which investigate both the attitudes of registered and student nurses and the associated factors, and test interventions to inform workforce strategies.

Health professionals' attitudes toward older people and older patients: a systematic review

Attitudes toward older people and older patients among healthcare professionals are of concern throughout the world, but there are no recent systematic reviews which have examined and compared the attitudes across the various healthcare professionals who provide healthcare to older people. A comprehensive literature search (2000-2011) was undertaken on electronic databases (CINAHL, MEDLINE, EMBASE, British Nursing Index, PsycINFO, Chinese Biomedical database, China Medical Academic Conference and China Academic Journal) using a combination of terms. We identified 2179 articles indexed with these terms. Initial screening was undertaken by two researchers and then checked by a third researcher. In total, the reviewers selected 117 articles which, on the basis of their abstracts, appeared to meet the criteria for inclusion. We obtained the full texts and two reviewers assessed each full text paper to further examine whether it met all the criteria. The final review identified 51 studies. Publications over the last 10 years show that attitudes towards older people and older patients range from neutral to positive among healthcare professionals and highlight the need for well-designed studies of both qualified and student healthcare professionals recruiting random samples across multiple sites and utilizing validated instruments consistently to permit comparison over time and across countries.

Iranian nursing students' perspectives regarding caring for elderly patients

The purpose of this study was to explore Iranian nursing students' perspectives regarding caring for elderly patients. A qualitative design, based on the content analysis approach, was used to collect and analyze the perspectives of 25 senior nursing students who were providing care for elderly patients in the medical and surgical wards of two teaching hospitals in Tehran, Iran. After using purposeful sampling to select the participants, semistructured interviews were held in order to collect the data. During the data analysis, two main themes and six subthemes emerged. The first theme was "the barriers to caring for elderly patients", with the subthemes of "policies and rules of the organization", "a lack of educational preparation", and "an inappropriate physical environment", and the second theme was "the facilitators to caring for elderly patients", with the subthemes of "religion and cultural norms", "role modeling", and "previous exposure to elderly patients". This study informs international audiences of the factors that influence the quality of care of elderly patients so that strategies can be devised in order to prepare nursing students to meet the physical and psychological needs of elderly patients.

Attitudes, knowledge, and interest: preparing university students to work in an aging world

BACKGROUND

The underlying goals of the present study were (i) to assess knowledge of and attitudes towards aging in a sample of Portuguese undergraduate students undertaking various degrees in health and welfare subjects, and (ii) to analyze the extent to which knowledge, attitudes and other factors were associated with interest in working with older adults.

METHODS

The study was cross-sectional in design. The sample comprised 460 Portuguese undergraduate students enrolled in degrees in nursing, social work, and psychology. They were asked to complete questionnaires and quizzes, which were analyzed using contingency tables and one way analysis of variance for inter-group comparison, and then subjected to multivariate logistic regression analysis.

RESULTS

Significant differences emerged between groups on knowledge, attitudes towards aging and interest in working with older adults, with both nursing and social work students displaying more positive attitudes, knowledge, and interest in working with older adults, when compared with psychology students. A regression analysis indicated that attitudes, knowledge, and previous formal contact were significant predictors of interest.

CONCLUSION

Interest in working with older adults was significantly related to positive attitudes, more knowledge and formal previous contact. Positive attitudes towards older adults can be promoted through interaction with faculty members and experts, knowledge acquisition about normative changes with age, and contact with healthy and impaired older adults.

Older adult mental health: Teaching senior-level baccalaureate nursing students what they need to know

Within the older adult population, certain idiosyncratic aspects of mental illness add to the challenges of helping clients manage these disorders. Older adults are more likely than younger populations to experience physiologically based comorbidities, a dynamic that further strains coping capacities. Barriers to the provision of comprehensive mental health nursing care for older adults include myths and stigmas about aging and mental health. Nurse educators are challenged to move students toward a more positive, empirically based approach to the care of older adults' mental health. In this article, background information supporting the importance of working to improve students' knowledge of and attitudes toward mental illness in older adults is provided. Specific teaching strategies in the areas of older adult mental health, dementia, and delirium are discussed. Resources to support the incorporation of these strategies into nursing curricula are described.

Nursing Students' Perceptions of Self-Determination in Elderly People

The purpose of this study was to compare nursing students' perceptions of self-determination in elderly patients before and after clinical training in long term care institutions as a part of their course in gerontological nursing. A pre- post-test design was employed. The data were collected by questionnaires completed by students at one nurse education organization college in Finland (pre-test n ± 120, response rate 95%; post-test n ± 115, response rate 91%). The students' perceptions of elderly patients' self-determination were more positive after their clinical training period concerning to what extent elderly patients are able to control their treatment and what kind of support they received from nurses to exercise their self-determination. The students' perceptions remained stable concerning how important self-determination is to elderly patients, and how willing and knowledgeable they are about using their self-determination. Ethics teaching, together with high quality clinical training placements, should be assured early during nursing studies.

Attitudes of nursing staff working with older people towards nutritional nursing care

AIM

The aim of this study was to examine attitudes of the nursing staff in geriatric care towards factors of importance for nutritional nursing care.

BACKGROUND

Studies show that nutritional risk assessment is seldom performed on older patients as routine and very few patients have a nutritional care plan. Patients in long-term care who are easy to feed are also found to be looked upon more positively than those with high feeding needs.

METHODS

A total of 252 registered nurses and nurse aids working at geriatric rehabilitation and medical care clinics and resident homes participated in the study. Attitudes were examined using the Staff Attitudes to Nutritional Nursing Care Geriatric scale. The scale includes 18 items and was designed as a one to five-point Lickert-type scale. It gives a total score and five subscales representing the dimensions 'Norms', 'Habits', 'Assessment', 'Intervention' and 'Individualization'. A higher score indicates a more positive attitude.

RESULTS

Of all nursing staff, 53% displayed a positive attitude towards factors of importance for nutritional nursing care and the rest displayed a neutral or negative attitude. The 'Intervention' dimension, dealing with nutritional problems and how to manage them, reflected the highest level of positive attitudes, which represents 71% of the nursing staff. The 'Norms' dimension had the lowest relative frequency of positive attitudes, 27%. The registered nurses held significantly more positive attitudes than the nurse aids did.

CONCLUSIONS

Nutritional issues comprise an important and time-consuming responsibility in geriatric care; however, nursing staff do not show an unequivocal positive attitude regarding this responsibility. The consequences this entails for the older patient need to be examined further. Relevance to clinical practice. Nursing staff play an important role in caring for patients who are malnourished or at risk for malnutrition. Positive attitudes might hinder the development of undernourishment or the further worsening of an already undernourished patient's condition.