Relationship Between Gerontological Nursing Education and Attitude Toward Older People

Association between ageing knowledge and willingness to care for older adults among nursing students in China: the mediating role of attitude towards older adults

Little is known about the mediating effect of attitude toward older adults on the relationship between aging knowledge and willingness to care for older adults. We applied the theory of planned behavior (TPB) and the knowledge-attitude-behavior (KAB) model as theoretical frameworks to examine the mediation effect of attitude toward older adults. Data from 388 Chinese nursing students were analyzed. The Willingness to Care for Older People (WCOP) scale, Kogan's Attitude toward Older People scale (KAOP) and Facts on Aging Quiz (FAQ) were utilized to assess willingness, attitude and aging knowledge, respectively. Data were analyzed using SPSS 22. 0 with the PROCESS macro. Bootstrap methods were used to obtain the significance of mediating effects. The study showed that aging knowledge was significantly associated with willingness to care for older adults and that attitude toward older adults mediated the association. Bootstrapping method confirmed the significance of the indirect effect of aging knowledge through attitude, accounting for 18.9% of the total willingness variance. Overall, based on the TPB and the KAB theoretical framework, our data support the notion that improving aging knowledge and attitude may contribute to improve the willingness to aged care among nursing students.

Attitudes and perceptions about ageism among nursing students: a scoping review

OBJECTIVE

to map scientific knowledge on nursing students' attitudes and perceptions regarding ageism.

METHOD

scoping review according to the recommendations of the Joanna Briggs Institute. The study question was: What are scientific evidence available on the attitudes and perceptions of nursing students regarding ageism? The search was conducted in 12 databases using the Rayyan application and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The studies were selected by two reviewers using a data extraction tool.

RESULTS

of the 4,595 files, 46 that were published between 1984 and 2022 were selected, and the quantitative method was the most used. The most commonly used instrument was the Kogan's Attitudes Toward Old People Scale. Positive, negative, mixed, neutral, and inconclusive attitudes and perceptions were identified.

CONCLUSION

attitudes and perceptions about ageism are diverse and not conclusive. Future intervention studies are recommended to detect changes in the behavior of nursing students in the face of ageism.

BACKGROUND

(1) Attitudes and perceptions about ageism are diverse and not conclusive.

BACKGROUND

(2) Importance of discussing ageism in the training of nursing students.

BACKGROUND

(3) Intervention studies to identify paradigm shifts in nursing students.

Association between spirituality and attitudes toward older adults in nursing students: a cross-sectional study

PURPOSE

This study aimed to determine the correlation between spirituality and attitudes toward older adults among nursing students.

METHODS

The study was designed as a cross-sectional study. This study was conducted with nursing students in the nursing department of a university in Eastern Turkey. The study was completed with 366 nursing students. An information form, the Spirituality Scale, and Kogan's Attitudes toward Old People Scale were used.

RESULTS

The mean score of the Spirituality Scale was 104.18 ± 18.79, and the mean score of the Kogan's Attitudes toward Old People Scale was 99.11 ± 13.57. There was a small but significant correlation between spirituality and attitudes toward older adults (r = 0.342, p < 0.01). Moreover, the results indicated that spirituality is positive and significantly predicted attitudes toward older adults (β = 0.342, t = 19.495, p < 0.01) and explained 11.7% of the variance in attitudes toward older adults.

CONCLUSIONS

A small but significant correlation was found between spirituality and attitudes toward older adults. Further study on the causal relationship between spirituality and attitudes toward older adults among nursing students is necessary.

Determinants of the intention to work in aged care: a cross-sectional study to assess gerontological nursing competencies among undergraduate nursing students

BACKGROUND

There are huge demands for aged-care workers, and undergraduate gerontological nursing education plays a critical role in providing academic and professional training.

PURPOSE

To examine relationships of characteristics, aged-care education, and gerontological nursing competencies with the intention to work in aged care.

METHODS

An online survey was distributed to undergraduate nursing students between April and June 2022 to gather characteristics, relevant aged-care education, gerontological nursing competencies, and intentions to work in aged care data. Multivariate regression analyses were conducted to identify determinants of the intention to work in aged care.

RESULTS

Students (n = 358) who were older (p < 0.001) and who were married (p < 0.001) had higher intentions to work in aged care. "Promoting mental health and psychological well-being", "Providing evidence-based dementia care", and "Enabling access to technology", were also associated with positive intentions.

CONCLUSIONS

This study provides evidence on determinants of the intention to work in aged care, particularly gerontological nursing competencies.

Adaptation and Validation of the Spanish Version of Kogan's Attitude toward Older People Scale (KAOP)

It is essential to understand the behavior and attitudes of nurses towards older people to improve clinical practice and quality of care in the gerontological sector. A clearer understanding of the attitudes that drive nurses toward the desire to work with older people would be a good starting point to encourage the development of positive and nurturing attitudes. A cross-sectional study with non-probabilistic sampling and a self-administered questionnaire was conducted among 381 nursing students of the Faculty of Nursing at the University of Castilla La-Mancha to evaluate the psychometric properties of the Spanish Version of the Kogan's Attitudes Towards Older People Scale (KAOP-S). Construct validity, internal consistency, and reliability were assessed. In total, 298 females and 83 males completed the questionnaires. Their mean age was 20.42 years. The results revealed a Cronbach's alpha coefficient of 0.75 for the scale, which is comparable with other published versions of the KAOP Scale. The results of the exploratory factor analysis established that the scale has a two-factor solution and an explained variance of 25% in the sample. The KAOP-S was found to be a reliable and valid tool with good content and construct validity for assessing nursing students' attitudes towards older people.

Influencing Nursing Student Attitudes Toward Older Adults: A Pre/Post Interventional Study

BACKGROUND

The older adult population in the US is burgeoning and nurses will be at the forefront of providing the skilled, compassionate care needed for them. Undergraduate nursing students do not commonly desire to work with older adults after graduation, likely related to negative attitudes, which can adversely impact the care provided.

AIM

To determine the effect of a course using a suite of teaching techniques designed to positively shift nursing students' attitudes toward older adults.

DESIGN

A one group pre and post-test design was used to test the effect of completion of the Nursing Care of the Older Adult course on baccalaureate undergraduate junior level nursing students' attitudes toward older people at a large University in the Midwest for two consecutive years (2019 and 2020).

METHODS

A quality assurance evaluation using a voluntary anonymous survey (Kogan's Attitude Toward Older People Instrument) on paper (2019) or online (2020) took place on the first and last day of class. Normality was assessed and the central limit theorem was applicable, therefore, independent samples t-tests were performed on the primary outcome, total score, with the primary predictor as pre vs post. This process was repeated on a 2020 cohort in the same course with a paired samples t-test, as paired subject ID's were recorded in 2020 but not in 2019. Due to the impact of the COVID-19 pandemic on all parts of academic life, no direct comparisons were made between the 2019 and 2020 samples. Course content included lectures, videos, MaskEd™ simulation, group work, case studies and clinical experiences.

RESULTS

Both cohorts had significant improvement in the total Kogan instrument score, indicating a positive change in attitudes toward older adults [2019 pre M 167.2, SD 20.3 to post M 176.9, SD 22.4, t (292.43) =3.96, p<0.001 and 2020 pre M 179.4, SD 21.3 to post M 188.1, SD 22.2, t (70) =-5.61, p<0.001].

CONCLUSION

The innovative, intentional teaching strategies incorporated into this gerontology course were effective in promoting positive attitudes toward older adults.

IMPACT STATEMENT

Providing knowledge about and interaction with older adults can positively influence nursing students' attitudes and contribute to the improvement health care outcomes for this population.

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.

Career Preferences among Nursing Students: A Cross-Sessional Study

Introduction

It is estimated that mores nurses are needed in the future, nursing students’ career preferences are important to contribute the shortage of nursing manpower in Macao. Little is known regarding the preferences for nursing students’ career preferences and related factors among nursing students.

Objective

To explore and investigate the career preferences and related factors among nursing students in Macao.

Methods

A descriptive, cross-sectional survey study design was adopted to assess career preferences and related factors among nursing students in Macao.

Results

In total, 217 nursing students completed surveys. The most favorite career preferences among nursing students were community health nursing, paediatric nursing, medical surgical nursing, and obstetric & gynecological nursing; while the least career preferences among nursing students were oncology and hospice nursing, mental health nursing, and ER nursing. Factors were related to “gender”, “education”, and “nursing is my first study preference” among Macao nursing students for career preferences.

Conclusion

The senior nursing students prefer working in community health nursing and the junior and female nursing students prefer working in pediatric nursing and obstetric and gynecological nursing. The more understandings of nursing students’ career preferences, the better nursing curriculum design and implication to promote nursing students’ intention for working in the least career preferences work.

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.

The Association Between new Nurses' Gerontological Education, Personal Attitudes Toward Older Adults, and Intentions to Work in Gerontological Care Settings in Ontario, Canada

Background

The older adult population in Canada is increasing, and many will require care within an acute geriatric unit (AGU) or long-term care facility (LTCF). However, the nursing workforce is not growing at the same pace as the population is aging. New graduate nurses may be able to fill this gap; therefore, it is important to understand their intentions of working in gerontological care settings (i.e., AGU or LTCF).

Aim

To examine if nursing education and personal attitudes toward older adults influence newly registered nurses’(RNs) intentions to work in a gerontological care setting.

Method

Nurses (n= 1,103) who registered with the College of Nurses of Ontario for the first time in 2018 were invited to complete a questionnaire.

Results

The majority of participants (n = 181) reported a positive attitude toward older adults. However, only 14% reported an intention to work in a gerontological care setting. Participants who completed multiple geriatric focused clinical placements were more likely to report an intention to work in these settings.

Conclusion

This study provides some information regarding the attitudes and intentions of newly RNs toward a career in gerontological care settings. Further research is needed to understand nurses’ intentions regarding working in AGUs or LTCFs.

Improving Nursing Student Attitudes Toward Older Adults Through the Use of Mask-Ed™ Simulation

Older adults are significant consumers of health care, yet studies find many health care students do not want to work with this population. This negative attitude can impact health outcomes. Increased exposure to older adults is linked to increased positive attitudes toward older adult care. Addressing the need for increased opportunities to interact with older adults will likely enhance these attitudes and thus improve health outcomes. In the current study, four varied Mask-Ed™ simulation activities were used in a course with a specific focus on nursing care of older adults. The Mask-Ed™ character, an older adult woman, works with students and provides opportunities for positive interactions/experiences. Students responded positively to simulation activities. Students described the experiences as helpful in increasing their confidence and comfort level with older adults. This unique experience fostered positive attitudes toward older adults among nursing students by giving them the opportunity to practice engaging with this population. [Journal of Gerontological Nursing, 47(12), 43-47.].

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.

The Moderating Role of Empathy Profiles in the Relationship Between Knowledge About Aging and Attitudes Toward Older Adults Among Nursing Students

Knowledge about aging (KA) and empathy affect nursing students' attitudes toward older adults. However, little is known about the mechanisms underlying this phenomenon from an integrated, person-centered perspective. The purposes of the present study were (1) to identify empathy profiles based on the Interpersonal Reactivity Index (IRI) among Chinese nursing students and (2) to explore whether these latent empathy profiles moderate the association between KA and attitudes toward older people. A cross-sectional survey design was used, and a battery of questionnaires - including those on demographic information, the Chinese version of Palmore's Facts on Aging Quiz (C-FAQ), the Chinese version of Kogan's Attitude Toward Older People Scale (C-KAOP), and the IRI - was filled in by 622 Chinese nursing students (M age 21.76; SD = 1.33). The mean total scores on KAOP and C-FAQ were 164.96 ± 18.32 and 10.436 ± 3.015, respectively, indicating relatively positive attitudes toward older people but low KA among Chinese nursing students. Latent profile analysis was used to identify a three-profile solution characterized by distinct levels of four dimensions of empathy, namely average empathy (AE, n = 399), high empathy (HE, n = 42), and low empathy (LE, n = 181). Subsequent linear regression analysis revealed that the LE rather than the HE profile predicted positive attitudes toward older adults. It is worth noting that the LE profile played a remarkable moderating role in associations between KA and negative attitudes toward older adults after controlling for covariant variables. Both the identification of distinct empathy profiles and the interplay between the LE profile and KA are of significance in reducing negative attitudes toward older adults among Chinese nursing students. Nursing educators should combine improving nursing students' levels of KA and fostering greater empathy to reduce negative attitudes toward older adults. Such training should give priority to nursing students with LE.

Assessing attitudes and intention to work with older adults by American and Israeli nursing students: Adapting and testing a measure

BACKGROUND

Finding workers to care for older adults in healthcare settings has become a priority, and research identifying factors influencing a nursing student's intention to make geriatrics a career choice is needed. This calls for the development of a reliable measure of students' perceptions and attitudes.

OBJECTIVES

To determine the adaptability of Carolina Opinions on Care of Older Adults (COCOA) to assess nursing students' attitudes to older adults and their intentions to work with them in two countries.

DESIGN

Cross-sectional survey.

SETTINGS

Nursing students enrolled in an introduction to gerontological nursing course in the United States and Israel.

PARTICIPANTS

A convenience sample of 231 undergraduates pursuing a Bachelor of Science in nursing in the United States (N=122) and Israel (N=109).

METHODS

Students completed the COCOA instrument and basic demographics using an electronic platform.

RESULTS

Exploratory Factor Analysis (EFA) produced five factors explaining 59% of the variation, with the majority of the items (17, 71%) loading above 0.40 on subscales from the instrument's original structure. EFA led to the elimination of one subscale (Value of Older Adults) and the creation of a new subscale (Older versus Younger Adults) with three items. The reliability scores were good to acceptable for all subscales in both Israeli and American samples (α-Cronbach 0.80 to 0.60). Confirmatory FA supported the data's fit to the 21 items of the modified COCOA instrument (CMIN/DF=1.55, CFI=0.93, IFI=0.93, RMSEA=0.05). The analysis of model equivalence for American and Israeli samples revealed significant differences only on the Experience in Caring for Older Adults subscale.

CONCLUSIONS

The modified COCOA demonstrated good construct validity and reliability and can serve as estimation of nursing students' attitudes to older adults and their intention to make geriatrics a career choice. Future studies should further evaluate its predictive validity.

Older adult care in nursing education: How have curricula been developed?

Given the rapidly growing older adult population, future nurses should increase their knowledge and skills in gerontological nursing to deliver high-quality care to older adults. The aim of this national survey (n = 40 nursing schools) was to analyse the status of gerontology education in Portuguese baccalaureate nursing programmes. Data were collected using a 51-item questionnaire about baccalaureate nursing education programmes and gerontology-related topics. Descriptive analysis was used. A total of 18 nursing schools returned the questionnaire (response rate = 45%). Results showed that 66.7% (n = 12) of nursing schools integrated gerontology content into several courses, 38.9% (n = 7) of them had stand-alone courses, and 11.1% (n = 2) of them had both options. The most significant factor inhibiting the development of the gerontological nursing curriculum was the negative image of gerontological nursing (44.4%). Gerontological-related competencies were identified in only two nursing programmes. Thirteen schools reported needing help to strengthen the gerontological content in the nursing curriculum. This study has demonstrated that gerontological content is covered in the nursing curriculum of all nursing schools. The increase of knowledge and skills in gerontological nursing and the development of a standard gerontological curriculum could contribute to enhancing gerontological nursing education and practice.

Daily life activities simulation: Improving nursing students' attitudes toward older patients

AIM

This study aims to evaluate the effects of daily life activities simulation on the attitudes of first-year nursing students toward older adults within the scope of geriatric nursing.

METHODS

The study was carried out using a pretest-posttest, quasi-experimental design. First-year undergraduate students (N = 119) of a nursing faculty constituted the study sample. The students were divided into two groups as intervention and control groups. The intervention group performed the daily life activities simulation. Data were collected by using Kogan's Attitudes Towards old People Scale (KAOP) and Positive and Negative Ageism Scale (PNAS). SPSS Ver. 22.00 software was used for statistical analysis. Chi-square test, and t test were used for comparative statistics.

RESULTS

Most of the participants were female, and mean age was 20.96 ± 3.24. Intergroup comparison of the KAOP and PNAS scores reveals a statistically significant difference between the pretest and posttest scores for the simulation group (p ˂ .05). The posttest KOAP and PNAS scores of the simulation and control groups were statistically significantly different (p ˂ .05).

CONCLUSION

Daily life activities simulation is an effective method to improve nursing students' positive attitudes toward older adults. Participant feedback from our study shows that the simulation increased empathy and awareness of geriatric nursing.