Nursing faculty and students' perspectives of how students learn to work with older people

Knowledge of aging, attitudes toward older people and willingness to engage in geriatric rehabilitation among rehabilitation students in southwestern China: a cross-sectional study

BACKGROUND

As the global elderly population rises, providing quality care for older adults is increasingly challenging. Rehabilitation technicians are crucial in this effort. Their knowledge and attitudes significantly impact care quality and their willingness to work with the elderly. While many studies have examined healthcare professionals' attitudes toward older adults, few focus on rehabilitation students. This study assesses Chinese rehabilitation students' knowledge of aging, attitudes toward older individuals, willingness to care for them, and the factors influencing these aspects.

METHODS

A sample of 890 rehabilitation students from three colleges and universities in southwestern China was investigated with a self-administered questionnaire, which included socio-demographic information, the Palmore Facts on Aging Quiz, the Kogan's Attitude towards Older People Scale and the Chinese Version of the Interpersonal Reactivity Index. Data analyses were conducted using SPSS version 25.0. Descriptive statistics were used to illustrate the demographic characteristics of the respondents. The frequency and percentage of responses was calculated. Means and standard deviations were computed for general knowledge of aging, attitudes toward older people, and empathy. Independent t-tests and one-way ANOVA assessed differences in FAQ, KAOP, and IRI-C scores between groups. Pearson's correlation examined correlations among general knowledge of aging, attitudes toward older people and empathy ability. Chi-square or Fisher's exact tests compared willingness to engage in geriatric rehabilitation across different respondent characteristics. Hierarchical multiple regression analysis explored the independent effect of different variables on attitudes toward older people.

RESULTS

The Chinese rehabilitation students from three colleges and universities in southwestern China displayed a relatively low level of knowledge about aging, but a generally positive attitude towards older people. Females had significantly more positive attitudes toward older people than males(p<0.01). The students who had previous experience of being cared for by (maternal) grandparents, living with the elderly, and taking care of the elderly showed significantly more positive attitudes toward older people (p = 0.001, 0.007 and 0.007, respectively) and a significantly stronger willingness to engage in geriatric rehabilitation(p = 0.013, <0.01 and <0.01, respectively) than those who had not had these experiences. Students with good relationships with older people had more positive attitudes toward the elderly (p < 0.01) and greater willingness to engage in geriatric rehabilitation (p < 0.01). Those with frequent contact with the elderly also showed more positive attitudes (p < 0.01) and a stronger willingness to engage in geriatric rehabilitation (p = 0.002) compared to those with less contact. Knowledge of aging and empathy ability were both significantly positively related to attitudes toward older people and both independent predictors of attitudes toward older people(r = 0.143, p<0.01 and r = 0.337, p<0.01).

CONCLUSIONS

It is crucial to prepare rehabilitation students with adequate knowledge and positive attitudes to ensure the quality of rehabilitation and care provided to older people. Educators should adopt effective strategies to promote rehabilitation students' geriatric rehabilitation knowledge and increase their positive attitudes toward older people.

Keep quiet or act? Challenges in integrating ethical theory into gerontological nursing care during students' first clinical rotation: A discussion paper

AIM

The aim of the paper is twofold: 1. To present observations based on first-year nursing students' narratives during clinical rotation in gerontological nursing care; and 2. Explore a nursing educator's reflections on these observations in relation to the didactic and ethical challenges that occurred.

BACKGROUND

The teaching of ethics is included in nurse education worldwide. Students are in their first clinical placement in residential care of older persons confronted with the moral complexities of gerontological care, where they get little possibility to share emotions and thoughts about ethically challenging nursing situations with a supervising registered nurse.

DESIGN

A critical discussion paper.

METHOD

The educator's reflections in this discussion paper are based on a narrative assignment in ethics where first-year nursing students reflect on and describe a nursing situation during their clinical rotation in the residential care of older persons.

RESULTS

Most students were acting as mere spectators in the described nursing situation where an older person, ethical standards, or evidence-based care was violated. Some students acted as advocates to the older person and intervened in the situation and a few as inspirers showing alternative ways of handling ethically challenging situations.

CONCLUSIONS

Educators in nursing programs at the undergraduate level require time for student-centered formative guidance to foster moral courage and practice. During first-year students' clinical rotation, the learning goals in long-term residential care of older persons are focused on evidence-based basic nursing care. In this, students are confronted with ethically challenging situations, where the possibility to learn from a critical reflective practice is rare. When observing situations where an older person is subjected to unethical or unsafe nursing care it is common that the students take the spectators' role, not knowing how to deal with what is observed. Some students are taking an intervening role by trying to alleviate the vulnerability of the older person. A few are showing moral courage by directly intervening when experiencing unethical or unsafe nursing care or conduct. In this the student can inspire fellow students or staff during their clinical rotation in alternative ways of handling ethically challenging situations. As older persons are the largest demographic group that nurses will experience, educators need a sound knowledge of ethics as well as gerontological care to be able to meet and nurture students' ethical reflections during clinical practice and to foster practical wisdom in nursing.

Student nurses' views on an E-Learning module on comfort, safety, and mobility with older adults: a cross-sectional study

BACKGROUND

Nursing students often receive insufficient training in older adults' care.

PURPOSE

Examine nursing students' perceptions of an e-learning module developed to enhance their knowledge about the comfort, safety, and mobility of older adults.

METHODS

A cross-sectional survey was administered to third-year baccalaureate nursing students at a Canadian university after they had completed the comfort, safety, and mobility module. The survey assessed students' perceptions of the e-learning module using four 5-pointLikert-type items. The survey also contained demographic questions and one open-ended question that invited participants to make any comments they wished. Descriptive statistics were used to summarize participants'demographic characteristics. Responses to the open-ended quesiton were summative content analyzed.

RESULTS

The survey was completed by 119 participants, who reported that the module increased their confidence, perceptions and knowledge in working with older adults. Participants also found the method of instruction to be convenient, interactive, and enjoyable.

CONCLUSIONS

Results suggest that the learning module has the potential to facilitate student nurses' learning about comfort, safety, and mobility.

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.

Characteristics Associated with Relationship-Centred and Task-Focused Mealtime Practices in Older Adult Care Settings

Purpose: To assess care home and staff characteristics associated with task-focused (TF) and relationship-centred care (RCC) mealtime practices prior to the COVID-19 pandemic.Methods: Staff working in Canadian and American care homes were invited to complete a 23-item online survey assessing their perceptions of mealtime care, with one item assessing 26 potential care practices from the Mealtime Relational Care Checklist (relationship-centred = 15; task-focused = 11) reported to occur in the home prior to the pandemic. Multivariate linear regression evaluated staff and care home characteristics associated with mealtime practices.Results: Six hundred and eighty-six respondents completed all questions used in this analysis. Mean TF and RCC mealtime practices were 4.89 ± 1.99 and 9.69 ± 2.96, respectively. Staff age was associated with TF and RCC practices with those 40-55 years reporting fewer TF and those 18-39 years reporting fewer RCC practices. Those providing direct care were more likely to report TF practices. Dissatisfaction with mealtimes was associated with more TF and fewer RCC practices. Homes that were not making changes to promote RCC pre-pandemic had more TF and fewer RCC practices. Newer care homes were associated with more RCC, while small homes (≤49 beds) had more TF practices.Conclusions: Mealtime practices are associated with staff and home factors. These factors should be considered in efforts to improve RCC practices in Canadian homes.

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.

The influence of prior work experience in aged care on nursing students' views on aged care nursing: A systematic review

BACKGROUND

Nursing students' experiences during clinical training in aged care placements is a well-studied topic. However, there is less research on the connection between nursing students' prior experiences as assistants in nursing (AIN) and their perception of aged care nursing.

AIM

The aim of this study was to identify and synthesize undergraduate nursing students' experiences as working as AIN in aged care settings.

METHOD

A systematic review was carried out by searching the CINAHL, Scopus, Medline and Medic databases, supplemented by manual searches. The searches focused on peer-reviewed scientific empirical research articles published in English, with a 10-year date limitation. The data were analysed by the qualitative content method.

RESULTS

The review identified 11 articles, which showed that nursing students' prior work experience shifts their perceptions of older adults' care. The findings were organized under four major themes. Through their employment as AIN, (1) nursing students' ability to reflect and develop skills needed in clinical work strengthened, (2) they became aware of the independent role of the nurse, (3) they feel part of the workplace community and (4) they recognized their feelings and views about aged care as a career.

CONCLUSION

Students' work experience in aged care helps them to observe aged care settings as a unique set up and nursing comprehensively from the perspective of an older adult's care needs and they can observe the dynamics of a workplace community. They can see many positive features in working in aged care and assess their experience with positive descriptions.

Nursing Students' Views on an e-Learning Activity About Health Promotion for Older Adults: A Cross-Sectional Study

PURPOSE

Nurses are graduating ill-prepared to work with older adults across care contexts. The education nursing students receive about older adults often focuses on managing illnesses rather than promoting health. To expand the education that nursing students receive regarding health promotion and older adults, we examined nursing students' perceptions of an e-learning activity on health promotion with older adults.

METHOD

We used a cross-sectional survey design. We included first-year baccalaureate nursing students (N = 260) at a Canadian university. Students were required to complete the module, but only those who wanted to participate in the study completed the survey (n = 167; response rate = 64.2%). We used a feedback survey to assess students' perceptions of the e-learning activity using four 5-point, Likert-type items. We also asked one open-ended question to solicit participants' feedback and suggestions for improving the e-learning activity. Descriptive statistics (frequency, mean [SD]) were used to summarize participants' perceptions and demographic characteristics. Content analysis was used to explore responses to the open-ended question.

RESULTS

Participants reported that the module increased their knowledge about health promotion, as well as their perceptions and confidence in working with older adults. Participants also found the method of instruction interactive and enjoyable.

CONCLUSION

Our e-learning activity on health promotion was perceived by nursing students as helpful in sensitizing them to their role in promoting health among older adults. [Journal of Gerontological Nursing, 50(3), 19-24.].

"It´s like walking in a bubble", nursing students´ perspectives on age suit simulation in a home environment - group interviews from reflection seminars

BACKGROUND

Older persons with age-related and complex health problems will increasingly depend on care provision from nurses in their own homes. However, a barrier to quality care is ageism and nursing students´ disinterest in geriatrics. In addition, nurse education often falls short in preparing students for the complexity of geriatric care. Welfare technology (WT) is progressively implemented in home care to help older persons live at home despite their health problems. However, this process is intricate and requires acceptance and digital literacy among caregivers and older persons. Despite these challenges, nurse education can address and change negative attitudes through innovative teaching methods such as age suit simulation. Therefore, the study aims to describe nursing students´ experiences of age suit simulation in a home-like environment with WT and technical aids, and will reveal their perspective on ageing and providing care to older adults.

METHODS

A qualitative explorative design using semi-structured group interviews (n=39) among nursing students. Data was analysed through reflexive thematic analysis.

RESULTS

The analysis generated three main themes; "It's like walking in a bubble", "An eye opener" and "Concerns about ageing and the current structure of geriatric care". The main themes included eight subthemes. Adapting to the sensory and physical limitations of the age suit was an immersive experience and caused feelings of frustration, loneliness and disconnection. A prominent result was a raised awareness of cognitive loss, especially impaired vision, and students felt the simulations had made them aware of the everyday challenges older persons faced. Students highlighted the importance of patience and giving enough time in care situations by being present and having a critical perspective of WT. The students were mostly negative towards their own ageing and could better relate to older persons´ vulnerability.

CONCLUSIONS

Age suit simulation was described as an embodied and eye-opening experience, raising nursing students´ awareness of older persons´ functional limitations and the consequences for dignity and independence. Coping with cognitive loss was especially difficult. Students were motivated to apply their new knowledge to clinical practice. Age suit simulation can complement geriatric education, preparing students for the complex care needs of older persons.

Education and attitudes toward geriatric care: Impact for nursing graduates and their career decisions - study protocol

The demanding and challenging nature of care for geriatric patients requires appropriate preparation of health care professionals. However, the willingness of nursing students to work in geriatric nursing care is mostly at a low level. The EAging_C project has been developed to investigate the relationship between nursing teachers' and students' attitudes towards older people and its impact on career decisions regarding working in a geriatric setting. This study uses an explanatory sequential mixed-method. The study has been conducted in a Polish academic setting in teams of geriatric nursing practical training teachers and their students. Quantitative and qualitative data have been collected in three stages. Kogan's Attitudes Towards Older People questionnaire has been used to collect quantitative data among teachers and students. By developing two questionnaires for the semi-structured interviews (one for students and one for teachers) qualitative data was collected that deepened the quantitative data collected. The investigation conducted in this project allows us to provide an insight into the issue of the unwillingness to work in a geriatric setting by nursing graduates. Based on the identified variables that are crucial to promoting work with older people, further research can be carried out based on testing the intervention.

Educational interventions to improve student nurses' knowledge, attitudes, or willingness to work with older people: a systematic review of quantitative findings

The purpose of this systematic literature review of quantitative findings was to examine the effectiveness of educational interventions to improve gerontological knowledge, attitudes, and willingness to work with older people in baccalaureate nursing students. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic literature search was conducted in five databases. Quality assessment was conducted using the Mixed-Methods Appraisal Tool. Based on inclusion and exclusion criteria, 41 papers were included in the review. The overall quality of studies included was moderate. The interventions were classified as education content, simulation or immersion experiences, clinical placement, or a combination of these pedagogical approaches. Majority of studies demonstrated improvement in knowledge and attitudes but there was a limited change in willingness to work with older people. There is insufficient evidence to make recommendations for the most effective educational intervention for enhancing bachelor of nursing students' willingness to engage in gerontological care.

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.

Fast thinking: How unconscious bias and binary language contribute to rationing of care to older persons

BACKGROUND

Binary or categorical thinking is a way of thinking in which the brain unconsciously sorts the masses of information it receives into categories. This helps us to quickly process information and keeps us safe through pattern recognition of possible threats. However, it can also be influenced by unconscious and conscious biases that inform our judgements of other people and situations.

OBJECTIVES

To examine nursing practice with older people through the lens of unconscious bias.

METHODS

In this critical analysis, using Kahneman's fast and slow thinking, we argue that nurses working with hospitalised older people often rely on thinking quickly in hectic work environments, which can contribute to unconscious and conscious bias, use of binary language to describe older persons and nursing tasks, and ultimately rationing of care.

RESULTS

Binary language describes older persons and their care simplistically as nursing tasks. A person is either heavy or light, continent or incontinent, confused or orientated. Although these descriptions are informed in part by nurses' experiences, they also reflect conscious and unconscious biases that nurses hold towards older patients or nursing tasks. We draw on explanations of fast (intuitive) and slow (analytical) to explain how nurses gravitate to thinking fast as a survival mechanism in environments where they are not supported or encouraged to think slow.

CONCLUSIONS

Nurses survival efforts in getting through the shift using fast thinking, which can be influenced by unconscious and conscious biases, can lead to use of shortcuts and the rationing of care. We believe that it is of paramount importance that nurses be encouraged and supported to think slowly and analytically in their clinical practice.

IMPLICATIONS FOR PRACTICE

Implications Nurses can engage in journaling and reflecting on their practice with older people to examine possible unconscious bias. Managers can support reflective thinking by supporting nurses through staffing models and encouraging conversations about person-centered care in unit practices.

Reducing ageism combining ageing education with clinical practice: A prospective cohort study in health sciences students

AIM

To analyse the impact of an intervention combining ageing education with clinical practice in nursing homes on a nursing cohort's negative stereotypes and prejudices towards ageing.

DESIGN

A prospective cohort study was conducted in September 2019-October 2020 in a population of health sciences students (n = 222).

METHODS

Questionnaire of Negative Stereotypes towards Aging (CENVE) and Aging Semantic Differential (DSE) were used to examine negative stereotypes and prejudices towards ageing in the nursing cohort exposed to the ageing education and practice intervention compared to a medical cohort that received no intervention. Group-by-time interaction, controlled by sex and age, for the effect of the intervention on CENVE and DSE scores was determined by mixed-design ANOVA.

RESULTS

The nursing cohort significantly reduced negative stereotypes and prejudices towards ageing when compared to the medical cohort in total (F = 26.926; p < 0.001), health factor (F = 16.812; p < 0.001), motivational and social factor (F = 11.266; p = 0.001), and character and personality factor (F = 19.202; p < 0.001) scores of CENVE scale and in DSE (F = 7.826; p = 0.006).

Improving practicing nurses' knowledge of the cognitive impairment, continence, and mobility needs of older people

OBJECTIVES

To test if two e-learning modules - one on cognitive impairment, and one on continence and mobility - in older people would improve the knowledge of nurse members from the Canadian Gerontological Nurses Association and College of Licensed Practical Nurses of Alberta.

METHODS

A pre-post-test design was used to test 88 nurses' knowledge of cognitive impairment and 105 nurses' knowledge of continence and mobility and their perceptions of how the modules contributed to their learning.

RESULTS

There was a statistically significant increase in practicing nurses' knowledge about cognitive impairment (0.68 increase), continence (2.30 increase), and its relationship to mobility. Nurses' self-report on the feedback survey demonstrated increases in knowledge, confidence, and perceptions about older people.

CONCLUSION

These results suggest the modules have strong potential to enhance practicing nurses' knowledge about cognitive impairment, continence, and mobility.

Impacts of COVID-19 pandemic on professional identity development of intern nursing students in China: A scoping review

PURPOSE

Clinical experience plays a vital role in the development of the professional identity (PI) of nursing students. China has applied a strict zero- COVID health policy in combating the COVID-19 pandemic since December 2019 and studies have been conducted in different places of China to explore PI development of nursing students during the pandemic time among the intern nursing students who are on clinical practices. This review study aims to synthesize the previous studies and provide a comprehensive picture of the impacts of the pandemic on the PI development of intern nursing students.

METHODS

Arksey and O'Malley's five-stage scoping review framework was used. Combinations of keywords were used to search relevant articles in both Chinese and English databases published from inception of the articles until the final search date (10 March 2022). The initially included articles were also appraised for their quality, and those that passed the appraisal were left for data analysis. The analytic results were cross-checked among the reviewers.

RESULT

Three themes emerged from the included studies: 1) the PI levels, 2) the impacts of personal and social factors of PL, and 3) the specific impact of the COVID-19 pandemic. The levels of students' PI ranged from 66%-80% of the total scores in PI instruments, almost the same levels as in pre-pandemic time, despite the elevated social image of nurses after the COVID-19 pandemic. There is no consensus about the impacts of most personal and social factors on students' PI across the studies. The impacts of COVID-19 on PI were both positive and negative.

CONCLUSIONS

COVID-19 epidemic exerted complicated impacts on the PI of intern nursing students. While it is necessary to address the fear of the COVID-19 pandemic among intern nursing students, the pandemic may not be an opportunistic time to enhance the students' PI.

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.

Pharmacy student attitudes towards a career in older adult care

INTRODUCTION

The United States (US) health care workforce is significantly unprepared to meet the needs of the growing older adult population. The primary purpose of this study is to examine the reasons that current pharmacy students are interested or not interested in pursuing a career or postgraduate training in geriatrics and to evaluate factors that influence this choice.

METHODS

This is a qualitative study utilizing focus groups of pharmacy students from the doctor of pharmacy (PharmD) curriculum of one public school of pharmacy in the US. Student pharmacists were invited to participate in the focus groups, and focused interviews were conducted by two postgraduate year two geriatric residents. Each discussion was audio recorded and subsequently transcribed, extracting key factors through open thematic coding.

RESULTS

Focus group participants (n = 8) most commonly identified job security, relationship value add, and past positive experiences with older adults as encouraging factors promoting interest, and inadequate geriatric exposure, emotional impact of death and dying, and heightened professional liability as discouraging factors deterring interest in a career in geriatrics.

CONCLUSIONS

Enhancing early exposure to geriatric patients and pharmacists, emphasizing common geriatric considerations in the PharmD curriculum, and increasing specialized older adult and end of life content could encourage more student pharmacists to seek careers in geriatrics.

Improving practicing nurses' knowledge and perceptions of older people: a quasi-experimental study

OBJECTIVES

This study aimed to determine if an e-learning module about understanding and communicating with older people can improve practicing nurses' ageist perceptions about older people.

METHODS

We used a quasi-experimental pre-post-test design. Participants completed a 13-item Ambivalent Ageism Scale before and after completing the Understanding and Communicating with Older People e-learning module as well as a Likert-style feedback survey with the option for written feedback on an open-ended question.

RESULTS

Pre-post-test comparisons indicated a statistically significant decrease in ageist attitudes and self-reported increases in knowledge and confidence in working with older people. Qualitative analysis of written feedback revealed that most participants felt the module enhanced their understanding of older people.

CONCLUSIONS

The e-learning activity has the potential to improve practicing nurses' knowledge and perceptions about working with older people and is likely to be associated with better patient-level outcomes.

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.

Awakening Canadians to ageism: a study protocol

Background

Making fun of growing older is considered socially acceptable, yet ageist humour reinforces negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Such stereotypes and discrimination affect the wellbeing of older people, the largest demographic of Canadians. While ageism extends throughout professions and social institutions, we expect nurses—the largest and most trusted group of healthcare professionals—to provide non-ageist care to older people. Unfortunately, nurses working with older people often embrace ageist beliefs and nursing education programs do not address sufficient anti-ageism content despite gerontological nursing standards and competencies.

Methods

To raise awareness of ageism in Canada, this quasi-experimental study will be supported by partnerships between older Canadians, advocacy organizations, and academic gerontological experts which will serve as an advisory group. The study, guided by social learning theory, will unfold in two parts. In Phase 1, we will use student nurses as a test case to determine if negative stereotypes and ageist perceptions can be addressed through three innovative e-learning activities. The activities employ gamification, videos, and simulations to: (1) provide accurate general information about older people, (2) model management of responsive behaviours in older people with cognitive impairment, and (3) dispel negative stereotypes about older people as dependent and incontinent. In Phase 2, the test case findings will be shared with the advisory group to develop a range of knowledge mobilization strategies to dispel ageism among healthcare professionals and the public. We will implement key short term strategies.

Discussion

Findings will generate knowledge on the effectiveness of the e-learning activities in improving student nurses’ perceptions about older people. The e-learning learning activities will help student nurses acquire much-needed gerontological knowledge and skills. The strength of this project is in its plan to engage a wide array of stakeholders who will mobilize the phase I findings and advocate for positive perspectives and accurate knowledge about aging—older Canadians, partner organizations (Canadian Gerontological Nurses Association, CanAge, AgeWell), and gerontological experts.

Improving student nurses' perspectives towards older people with an e-learning activity: A quasi-experimental pre-post design

BACKGROUND

Despite older people being the largest demographic accessing health care, nurses often lack knowledge about how to work with them and may hold ageist perceptions towards them. Previous research has identified the gaps in their education program and offered suggestions on what and how to fill those gaps in education related to older people. E-learning activities to fill these gaps were developed.

OBJECTIVE

The aim of this study was to determine if nursing students' perceptions about older people could be improved through an e-learning activity focused on communication and understanding older people.

METHODS

A quasi-experimental pre-post design was used to test whether the understanding and communication with older people e-learning activity improved student nurses' perceptions about older people. A feedback survey was also analyzed using descriptive statistics to understand students' perceptions of the learning activity.

RESULTS

There was a statistically significant decrease in participant's negative perceptions towards older people after completing the e-learning activity. Participants enjoyed the activity and believed that it improved their knowledge of older people, their confidence in working with older people, and their perceptions about older people.

CONCLUSIONS

The strength of the e-learning activity in this study is that the educator need not be an expert in order to use the activity in their course. In this way, knowledge about older people is facilitated despite the dearth of nurse educators with gerontological expertise. More research to test this activity in other universities is needed.

IMPLICATIONS FOR PRACTICE

Improved understanding and communicating with older people could improve person-centered-care. The flexible delivery of this learning activity could facilitate practicing nurses understanding and communication strategies if offered to them.

Factors Affecting Attitudes towards Older People in Undergraduate Nursing Students

Background: The population of older people is increasing worldwide. The social and healthcare systems need many nurses to care for the elderly. Positive attitudes increase the preference to work with older people and improve the quality of care. This study describes attitudes towards the elderly in a sample of nursing students, and analyzes the potential factors influencing these attitudes. Methods: A cross-sectional study was carried out in nursing students during the academic course 2017–2018. Kogan’s Attitude Toward Old People Scale was used to assess student attitudes towards older people. Results: The study included 377 undergraduate nursing students, of which 75.9% were women. The mean age was 22.23 (5.69) years. Attitude proved positive, with a mean Kogan’s score of 131.04 (12.66). Women had higher scores than men, with a mean difference of 7.76 (95% CI: 4.87–10.66; p < 0.001). The male sex, age ≥ 25 years, and previous experience with institutionalized older adults worsened attitudes, while studying the subject of geriatrics, each higher course within the degree, work placements in hospitals and nursing homes, and previous experience with community older adults or with older relatives favored a more positive attitude. Participants with no interest in working with older adults yielded lower scores. Conclusions: Attitudes towards the elderly among nursing students are positive. Women have a more positive attitude. Analyzing the factors that improve attitudes in nursing students is suggested, as it may contribute to improve nursing care.

Harnessing nursing to diminish ageism

BACKGROUND

The common practice of making fun of aging and older people demonstrates that ageism towards older people is socially acceptable. It is so accepted that even those of us who are aging or have moved into the 'third act' believe and fear the negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Ageism is evident in work places, family relationships, when older people purchase goods and services, in health and social institutions and extends throughout professions that work with older people.

OBJECTIVES

We explore how nurses-the largest group of healthcare professions- may be inadvertently perpetuating negative perceptions about older people in nursing practice, nursing education, and through common misconceptions about what gerontological nursing means.

METHODS

This is discussion paper using the literature.

RESULTS

We suggest that nursing education is well situated to diminish negative perspectives of ageing by incorporating theories of life-course and harmonious aging into the holistic perspective of individuals that nursing is well known for.

CONCLUSIONS

Greater understanding about the diversity of ageing and the context that have influenced older persons could encourage nurses to treat them holistically with dignity, which would ultimately improve older people's experiences. Improving older persons' experiences is like paying it forward, as we all are ageing and if we are to have a different experience when we are old, it is necessary to diminish stereotypes about ageing, and work towards inclusion of older people in social and healthcare institutions.

IMPLICATIONS FOR PRACTICE

It is important for nurses, particularly those in nursing education, to support the incorporation of a life course and harmonious view of aging in which the social, political, and environmental context of individuals are viewed as part of the difference of ageing.

Working with older people: Beginning or end of a nurse's career?

BACKGROUND

The increasing numbers of older people (age 65+) make it important to understand how to attract nurses to work with this population.

METHODS

A secondary analysis using qualitative descriptive methods was used to understand how student nurses' perceptions about older people may influence their desire to work with older people.

RESULTS

Student nurses perceive a generational divide between them and older people, regardless of practice settings. They believe working with older people is heavy work, and not high acuity, and although good to learn skills as a student, not a population they want to work with until they are close to retirement themselves.

CONCLUSIONS

It is important to enhance nursing education so that students understand the older generation, how to communicate with them and the prevalence of older people in healthcare settings, so that they are more likely to choose to work with older people.

The effect of extended contact with community-dwelling older adults on the ageist and helping attitudes of home care students: A single-blind randomised controlled trial

BACKGROUND

Ageist and helping attitudes among undergraduate homecare students are a concern for educators, healthcare professionals and home care workers due to their potential to increase the marginalisation of older people and negatively impact quality of care.

OBJECTIVES

The current study evaluated the effect of extended contact with community-dwelling older adults on the ageist and helping attitudes of home care students.

METHODS

Fifty-five students attending a public university in Turkey were randomly assigned to the intervention group (n = 27) or control group (n = 28). The intervention group received positive theoretical education and had extended contact with community-dwelling older adults, while the control group only received positive theoretical education. Before and after the intervention, the students' ageist attitudes were evaluated with Kogan's Attitudes towards Old People scale (KAOP) and helping attitudes were evaluated with the Helping Attitude Scale (HAS).

RESULTS

There were statistically significant differences between pre- and post-test mean KAOP total, positive ageism and negative ageism subscale scores in the intervention group (p < 0.05) and in KAOP negative ageism score in the control group (p < 0.05). HAS scores showed no significant post-intervention change in helping attitudes in either group.

CONCLUSION

Extended contact with community-dwelling older adults had a favourable influence on undergraduate health students' ageism attitudes. These results suggest that contact with older adults may be an effective strategy to reduce ageism but may not increase helping behaviours.

IMPLICATIONS FOR PRACTICE

Positive contact experiences with community-dwelling older adults can be used to reduce ageism in home care students.

Registered nurses' reflections on their educational preparation to work with older people

BACKGROUND

Negative perceptions about working with older people within nursing contribute to the deficit of educators with expertise to teach student nurses, and nurses graduating ill-equipped to work with the ageing population. The perceptions of nurses who have recently graduated from a nursing programme can provide insights into what they wished they knew about working with older people before they graduated.

METHODS

A qualitative descriptive study design examined recently graduated registered nurses' reflections on their education preparation to work with older people. Content and thematic analysis was used to develop the themes of first impressions and preparation to work with older people.

RESULTS

Key findings were that nurses did not recognise the importance of learning about older people until they had graduated. Only then did they realise that the ageing population was so complex and prevalent. They perceived a lack of education particularly related to working with older people with dementia and their behaviours, as well as learning how to communicate to an older population. Participants perceived that as students, it was up to them to fit in learning about working with older people without the support of faculty.

CONCLUSIONS

Faculty need to be supported in learning how to best incorporate content about older people into their curriculum. This could include the development of learning activities that dispel negative stereotypes about ageing and facilitates interest in older people, as this is the population, students are most likely to work with when they graduate.

IMPLICATIONS FOR PRACTICE

Nurses in practice may require education on working with people with dementia as it is a deficit in nursing programmes.