Ageism in nursing education: A review of the literature

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The impact of elder abuse training on subacute health providers and older adults: study protocol for a randomized control trial

BACKGROUND

Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse.

METHODS

This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers' knowledge of responding to elder abuse and older people's sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses.

DISCUSSION

This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral.

TRIAL REGISTRATION

ANZCTR, ACTRN12623000676617p . Registered 22 June 2023.

Effectiveness of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults: A systematic review and meta-analysis

AIM

This study aims to investigate the efficacy of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults.

BACKGROUND

A new approach to teaching to enhance nursing students' attitudes toward and empathy for older adults involves the use of an aging simulation suit.

DESIGN

This systematic review and meta-analysis seeks to determine the efficacy of the aged simulation suit on the attitudes and empathy of undergraduate nursing students toward older adults. This protocol for a systematic review and meta-analysis was registered as CRD 42023393879 on the PROSPERO database.

METHODS

In February-March 2023, a systematic review with meta-analysis of randomized controlled and quasi-experimental studies was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Population, Intervention, Control, Outcomes, Study Design (PICOS) structure was used for search strategy. Databases CINAHL, Cochrane Library, PubMed, PsycINFO, and Web of Science, as well as ULAKBIM, Turkish Medline, Turkiye Klinikleri, and YOK National Thesis Center, were searched for the articles. The Joanna Briggs Institute Critical Appraisal Tools were used to evaluate the methodological quality of a study and the extent to which its design, conduct, and analysis addressed the possibility of bias.

RESULTS

The meta-analyses of attitudes toward older adults included six studies (including 535 nursing students). The intervention group's attitudes toward older adults were found to be similar to those of the control group (SMD: 15.84, Z= 1.98, p= 0.05). The subgroup analyses revealed similarities between intervention group's and the control group's mean score on attitudes toward older adults (SMD: 4.85, Z=0.70, p=0.48, for RCT; SMD: 23.05, Z= 2.02, p=0.04, for quasi-experimental). Three studies (involving 207 nursing students) revealed significantly higher mean empathy score for the control group compared with the intervention group following the intervention (SMD: 7.08, Z=4.82, p=0.00001). The subgroup analyses revealed statistically significantly higher mean level of empathy for the control group compared with the intervention group was after the intervention (SMD: 7.49, Z=3.15, p=0.002, for RCT; SMD: 6.83, Z= 3.65, p=0.0003, for quasi-experimental).

CONCLUSIONS

Nursing students should be aware of older adults' feelings and experiences aging-related changes and aged simulation interventions can be a useful intervention to allow students to empathize with an older adult.

Development of Gerontological Learning Objectives to Enhance Nursing Educational Curricula

BACKGROUND

Many nursing schools are challenged to provide adequate gerontological education to students despite the enormous benefits to students' careers and society. This project developed student learning objectives to be used by nursing faculty to facilitate enriched gerontology courses and program curricula.

METHOD

The project team drafted a comprehensive list of nursing student learning objectives based on the 2020 Canadian Gerontological Nursing Association Standards of Practice and Competencies and included relevant supportive references. Subsequently, 20 gerontological nurse experts reviewed the learning objectives through a modified Delphi process via online Qualtrics surveys (two rounds).

RESULTS

A total of 176 learning objectives were rated in round one for importance, measurability, feasibility, and interpretability; these were amalgamated to 47 learning objectives for review in round two.

CONCLUSION

Thirty-three learning objectives were identified and validated that can be used by nursing schools to offer increased opportunities for gerontological learning. [J Nurs Educ. 2024;63(4):256-260.].

Gerontological nursing competencies: A scoping review

BACKGROUND

Despite decades of advocates striving to enhance gerontological content in baccalaureate nursing programs, nurses are still graduating with inadequate knowledge and skills to work with older adults. Scholars suggest that incorporating entry-to-practice gerontological competencies could be one way to improve graduating nurses' knowledge about older adults.

AIM

To examine the state of gerontological entry to practice competencies and standards for baccalaureate-prepared nurses around the world.

DESIGN

We conducted a scoping review of the literature using the Joanna Briggs Institute (JBI) framework and followed PRISMA-ScR guidelines to report findings.

METHODS

We performed searches from inception to June 20th 2022 in Medline and EMBASE via OVID, CINAHL via EBSCOhost, Scopus, and Cochrane Library via Wiley. We conducted a search on GOOGLE for grey literature. We included literature that examined 1) baccalaureate nursing programs, 2) gerontological competencies/standards, and 3) older people/adults.

RESULTS

We found 8 literature sources, 4 of which were academic papers and 4 documents describing gerontological entry-to-practice standards and competencies from national nursing associations. Gerontological competencies highlight providing person-centered care to older people and their families across many care contexts. This care includes relational and cultural competence, exhibiting professional values and screening for potential elder abuse. Scholars in two papers relayed their experiences incorporating gerontological competencies into their curricula and two studied student nurses' gerontological competency.

CONCLUSIONS

There is interest and some progress in developing and incorporating gerontological competencies in various countries but not enough. A coordinated approach to sharing information and expertise among nations is needed to develop international gerontological competencies to facilitate improved nursing care with older adults.

Implicit Bias Toward Lesbian and Gay Persons Among Nursing Students: A Correlation Study

AIM

The purpose of this study was to measure implicit bias among nursing students toward lesbian and gay (LG) persons.

BACKGROUND

Implicit bias is identified as a contributor to the health disparities experienced by LG persons. This bias has not been studied among nursing students.

METHOD

This descriptive, correlation study used the Implicit Association Test to measure implicit bias in a convenience sample of baccalaureate nursing students. Demographic information was collected to identify relevant predictor variables.

RESULTS

Implicit bias in this sample ( n = 1,348) favored straight persons over LG persons ( D -score = 0.22). Participants identifying as male ( B = 0.19), straight ( B = 0.65), other sexuality ( B = 0.33), somewhat ( B = 0.09) or very religious ( B = 0.14), or enrollment in an RN-BSN program ( B = 0.11) predicted stronger bias favoring straight persons.

CONCLUSION

Implicit bias toward LG persons among nursing students remains a challenge for educators.

Mediating effects of ageism and knowledge on the relationship between contact with older adults and attitudes toward older adults' sexuality among nursing students

BACKGROUND

Healthcare professionals often ignore sexuality in aging and avoid discussing related topics, especially in China. Nursing students, as future professionals, can address the sexuality of older adults encountered in clinical practice by establishing positive attitudes toward aging sexuality. Previous studies have demonstrated that contact has positive impacts on nursing students' attitudes toward aging sexuality. However, little is known about the mechanism underlying this relationship between contact and attitudes.

OBJECTIVES

To explore the mediating effects of ageism and knowledge on the relationship between contact and nursing students' attitudes toward aging sexuality.

DESIGN

This was a cross-sectional study.

SETTINGS

The study was conducted at a nursing school in Hefei city, China.

PARTICIPANTS AND METHODS

614 nursing students completed online-administered questionnaires measuring the level of contact with older adults, ageism, knowledge, and attitudes toward aging sexuality. Data were analyzed using SPSS and AMOS.

RESULTS

The mean scores for knowledge and attitudes toward aging sexuality were 85.70 (SD = 16.39) and 104.91 (SD = 14.88), respectively. Overall, our findings confirmed that these hypotheses were accepted. Ageism (β = -0.079, P = 0.007) and knowledge (β = -0.070, P < 0.001) mediated the relationship between contact and attitude.

CONCLUSION

Given the mediating role of ageism and knowledge in the relationship between contact and attitude, reducing ageism and enhancing knowledge are vital to changing students' attitudes, including integrating ageism and aging sexuality knowledge learning into the nursing curriculum and creating opportunities for contact with older adults. The frequency and quality of contact between nursing students and older adults can be improved by rationalizing the internship duration, tasks, and assessment objectives of placements on geriatric wards and by the role of clinical faculty role models in cultivating positive attitudes toward aging sexuality.

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

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

E-learning modules to enhance student nurses' perceptions of older people: a single group pre-post quasi-experimental study

OBJECTIVES

To examine whether e-learning activities on cognitive impairment (CI), continence and mobility (CM) and understanding and communication (UC) improve student nurses' knowledge and attitudes in the care of older adults.

METHODS

A quasi-experimental single group pre-post-test design was used. We included 299 undergraduate nursing students for the CI module, 304 for the CM module, and 313 for the UC module. We administered knowledge quizzes, Likert scales, and a feedback survey to measure student nurses' knowledge, ageist beliefs, and feedback on the modules respectively.

RESULTS

Participants demonstrated significantly more knowledge and reduced ageist attitudes following the e-learning activities.

CONCLUSIONS

Findings suggest that e-learning activities on cognitive impairment, continence and mobility, and understanding and communication improve knowledge and reduce ageist attitudes among nursing students.

Attitude towards Older People According to Sociodemographic and Educational Variables in Students of a Chilean University

Current evidence suggests that attitude towards older people may be associated with sociodemographic and educational variables; hence, a positive attitude towards older people is key when training new university professionals. However, there is little evidence of this association in Chilean university students. The objective was to analyze students from a Chilean university's attitudes towards older people, according to sociodemographic and educational variables. Analytical and cross-sectional study; 515 students from a Chilean university were consulted online about their attitude towards older people using Kogan's Attitudes towards Old People scale. Additionally, sociodemographic and educational variables were recorded. The average score for positive attitude was 70.8 (±9.7), while the negative attitude score was 68.3 (±11.6). The total score was 139.1 (±16.6). Mostly, university students perceive themselves with a low-level positive attitude (61.2%). Additionally, older university students (26-42 years old); women; Chileans; students of law, speech therapy, and occupational therapy; students in their final years of the programs; and those who had training in older people outside the university have a more positive attitude towards older people. In Conclusion, a profile of sociodemographic and educational characteristics of students with a lower and higher attitude towards older age was investigated. These results are relevant since the way of seeing the aging process could regulate the training of future professionals and consequently generate changes in dealing with older people. Young people's perception of ageing would affect the treatment and incorporation of the older people in society and the adaptation of policies in this age group.

A Model for Effective Nonverbal Communication between Nurses and Older Patients: A Grounded Theory Inquiry

Nonverbal communication is an inevitable art to be effectively mastered by nurses. Nurse nonverbal communication has many benefits when it is effective. For instance, nonverbal communication is important to convey affective and emotional information, and demonstrate respect for and build therapeutic relationships with older patients. As the older population is growing fast worldwide, effective nonverbal communication with older patients is an essential skill for nurses and will improve patients' satisfaction and the quality of care. Therefore, this article presents a model to guide effective nonverbal communication between nurses and older patients. A Grounded Theory approach guided the study. Data were collected between July 2018 and January 2020 through overt participant observations and individual interviews. Purposive and theoretical sampling were used to select 13 clinically experienced nurses, 4 nursing students, and 8 older adults. Data analysis encompassed open coding, axial coding, and selective coding. The results showed that effective nonverbal communication emerged as the co-phenomenon hinged within context and/or environment and is influenced by certain factors. This model, which is in support of person-centered communication and care, advocates for effective nonverbal communication between nurses and older patients.

Relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals

BACKGROUND

The quality of care has a significant impact on the condition of elderly patients. Many factors affect the quality of care, including ethical considerations. Ethical considerations, such as moral sensitivity, change in times of crisis. The present study was conducted to assess the relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals.

METHODS

This was a cross-sectional descriptive correlational study. The participants included 445 nurses that were selected by quota sampling method from hospitals admitting COVID-19 patients. The data were collected using the Moral Sensitivity Questionnaire (MSQ) and Quality Patient Care Scale (QUALPAC) as self-reports. We used the SPSS software v.16 for statistical analysis.

RESULTS

The total score of moral sensitivity and quality of care was 52.29 ± 16.44 and 2.83 ± 0.23, respectively. Moral sensitivity negatively correlates with psychological, social, and physical aspects (P < 0.05). Modifying autonomy, interpersonal orientation, and experiencing moral conflict predicted β = 0.10 of the psychosocial aspect of quality of care. Structural moral meaning and expressing benevolence predicted the changes in the physical dimension of quality of care (β = 0.02).

CONCLUSION

The quality of care had a significant inverse correlation with moral sensitivity. Multiple regression analysis showed that modifying autonomy, interpersonal orientation, and experiencing moral conflict could predict the psychosocial dimensions. Structuring moral meaning could predict the physical dimension. The communication aspects were not related to any of the dimensions of moral sensitivity.

Student Perceptions of Age and Ageing-An Evaluation of Swiss Dental Students Receiving Education in Gerodontology

Society is ageing and the higher number of senior citizens in the total population is a challenge for society and often perceived as a burden. Negative images of old age can lead to ageism and poorer healthcare for older people. The younger generation will have to master these demographic challenges. Therefore, their attitude towards and their perception of the older generation has to be monitored. The aim of this study is to present the images of ageing held by dental students who received education in gerodontology and to assess possible changes between different generations of students over time and separated by gender. An annual, anonymous questionnaire survey was conducted among dental students at the end of the 10th semester each year between 2008 and 2021. The questionnaire surveyed personal attitudes towards ageing, the assessment of seniors, and personal experience with seniors (images of ageing, “Aging Semantic Differential”). In addition to confirming Friedan’s phenomenon regarding the assessment of age limits, the present study was able to demonstrate a positive image of ageing in dental students, which has remained almost constant over the years. An education in gerodontology might positively influence student perceptions of age and aging.

Ageism, moral sensitivity and nursing students' intentions to work with older people - A cross-sectional study

BACKGROUND

Nursing students' intentions to work with older people are low, despite a worldwide need for gerontological nursing, with ageism being the main culprit. Romania lacks legislation to prevent and combat elder abuse in healthcare, although it is alleged to be rampant among nursing staff. There is also a lack of research on nursing students' ageism toward older people and intentions to work with them.

OBJECTIVES

Since ageism conflicts with nursing ethics, we expect moral sensitivity to lower ageism and increase intention to work with older people, while also moderating other socio-psychological influences. Because ageism and intention to work with older people are largely predicted by the same variables, we hypothesize that ageism may function as a mediator. Finally, we explore ageism among Romanian nursing students and its predictors in a culturally sensitive manner.

DESIGN

This is a cross-sectional, descriptive survey study.

SETTINGS

The study was conducted in Romania.

PARTICIPANTS AND METHODS

408 nursing students completed online-administered questionnaires measuring intention to work with older people, ageism, moral sensitivity, death and ageing anxiety, knowledge of ageing, attitudes toward own ageing and intergenerational contact. Data were analyzed with Pearson's correlations, regressions with simple slope analyses and bootstrapped mediation analyses.

RESULTS

Ageism mediated the relationships between students' intentions to work with older people and knowledge of ageing, ageing anxiety, intergenerational contact quality, attitudes toward own ageing and moral sensitivity. Moral sensitivity decreased ageism and increased intention, while moderating the influence of contact quality, death and ageing anxiety, attitudes toward own ageing and knowledge of ageing on ageism. Additionally, it moderated the influence of perceived behavioral control on intention.

CONCLUSIONS

Integrating moral sensitivity training in the nursing curricula could both decrease ageism in nursing students and increase their intention to work with older people, providing an efficient and low-cost strategy to aid students consider gerontological nursing for career advancement.

Ageism against older patients in nursing: conceptual differentiations and the role of moral sensitivity

Ageism in nursing is difficult to identify, prevent and combat. Using a mixed-method approach in two exploratory cross-sectional studies (N = 512), we brought support for a proposed conceptual difference between ageism toward older adults and ageism toward older patients which may facilitate the identification of ageism in healthcare settings. We also investigated whether nurses' moral sensitivity could buffer the negative effect of socio-cognitive factors on ageism against older patients. Our findings supported our assumption, suggesting that fostering nurses' moral sensitivity could be a promising new avenue to prevent and combat ageism in nurses, together with comprehensive gerontological education meant to decrease stereotyping and help nurses fulfill their roles of moral advocates against older patient discrimination.

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

This study utilized a correlational and cross-sectional design.

SETTINGS

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

PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

'I decided to attend to him because it's my duty': Student Nurses perception and attitude towards care of older adults

BACKGROUND AND AIM

Nurses perception and attitude towards an older patient can positively or negatively influence the quality rendered. As students under training, the views of this population needs to be sought and shaped to improve the quality of care the older patients receive. This is because life expectancy is on the rise. The study aimed to explore students' perception of ageing and their attitude towards care of the older adults.

METHODS AND MATERIALS

An exploratory descriptive design was used. Data form containing the sociodemographic attributes of the students and a semi-structured interview form developed by the researchers in line with the literature. The participants interviewed were student nurses who had been in clinical practice for at least one semester. Four focus group discussions (FGD) were held.

RESULTS

Average age of the participants was 22.30 years. An equal number of males and females (15 each) were recruited to have a balance in gender. Students expressed that they saw the older adults as their grandparents so they try to accord them respect and care. However, older adults are perceived not receptive to nurses in training. The students stated that registered nurses neglected the basic care of older adults such as diaper changes, bathing, and feeding, and would rather beckon student nurses to attend to the older adults.

CONCLUSION

Gerontology as a stand-alone course is necessary for early years of training to give an in-depth education to nursing students and instil a positive attitude towards older adult patients.

Older Adults’ Interpretation of Nurses’ Nonverbal Communication in Cameroon: A Grounded Theory Inquiry

Communication is central to nursing care. Yet, the nonverbal aspect of communication tends to be neglected or underestimated in nursing studies. Research has shown that older patients interpret nurses’ communication messages during the clinical encounter. This article conceptualizes older adults’ interpretation of and need for nonverbal communication (NVC) to enhance patient-centered communication advocated by the World Health Organization. The Corbin and Strauss (2015) inductive Grounded Theory approach was used to collect data from 3 hospital units in Cameroon using in-depth interviews with eight older adults, thirteen nurses, and four student nurses between July 2018 and January 2020. Open coding, axial coding, and selective coding were used for analysis, which reveals that interpretations of NVC can be positive or negative. It means that older adults view nurses either as angels or as difficult persons, depending on the nurses’ positive or negative NVC and behaviors. These interpretations lead to consequences ranging from a preference for some nurses to noncompliance with care. The results further show that older adults need active listening, humor, and affection from nurses. Information regarding older adults’ interpretation of and need for NVC can be used to improve curriculum content and to develop skills in and awareness of NVC with older adults. It is recommended that further research expand on effective nonverbal techniques during COVID-19 times where the meaning of facial expressions and voice inflection can be disrupted.

Conditions Influencing Effective Nurse Nonverbal Communication With Hospitalized Older Adults in Cameroon

Effective communication between nurses and patients is an important factor to quality nursing care but ineffective nonverbal communication could take a toll on health care. Therefore, understanding the factors that influence nonverbal communication between nurses and hospitalized older adults could help solve communication problems, thus improve nursing care. A sample of 13 nurses and 4 student nurses from two hospitals in Cameroon participated in the study. Data were collected using participant observations and semi-structured interviews, and analyzed using open coding and constant comparative analysis. Three categories were identified as influencing factors: nurse views of hospitalized older adults, hospitalized older adult-related factors, and nurse intrinsic factors. Effective nurses' nonverbal communication with hospitalized older adults relies mostly on nurses' intrinsic factors. Identification and nurturing of the positive nurse intrinsic factors are important to develop effective nonverbal communication skills among nurses.

Addressing Ageism and Ethnocultural Diversity With a Photo Essay Project

BACKGROUND

By 2050, the percentage of older adults in the United States will double. By 2060, nonmajority individuals will comprise nearly half of our older adult population. Therefore, nursing students must have learning experiences that prepare them to care for a diverse population of older adults when they enter practice.

METHOD

Photo-elicitation and a photo essay project was initiated in an Aging and Health in Global Communities course in which 75 students created and presented photo essays of a diverse group of older adults.

RESULTS

Through spending time with older adults to create a photo essay, students ably portrayed lives rich in meaning and ethnocultural heritage.

CONCLUSION

The natural intersection of aging and diversity that occurred in the photo essays enlightened students to the rich experience of age and the similarities and unique differences in the lives of the older people portrayed. [J Nurs Educ. 2021;60(1):44-47.].

Attitudes towards oldest-old adults (age ≥80 years): A survey and international comparison between Swedish and Austrian nursing students

BACKGROUND AND RATIONALE

Ageism in nursing, particularly regarding oldest-old adults (age ≥80 years), adversely affects patient safety and care quality. Nurse education can reduce ageist attitudes. Swedish and Austrian nursing students' attitudes towards adults age ≥80 years have not been assessed.

AIMS

To analyse attitudes towards adults age ≥80 years among nursing students from universities in Sweden and Austria.

DESIGN

A prospective cross-sectional survey including the four-factor, 26-item validated Ageing Semantic Differential scale and demographic questions.

METHODS

A pen-and-paper survey was administered to nursing students at the Medical University of Graz, Austria (May-June 2019); an online survey was conducted at the University of Gothenburg, Sweden (January-June 2020). Demographic data were analysed descriptively; means and individual item ratings were calculated for each country. Multiple logistic regression was performed for each factor of the instrument: (1) Instrumentality, (2) Autonomy, (3) Acceptability and (4) Integrity. Six independent variables were included in the regression analysis.

RESULTS

In total, 136 Austrian and 222 Swedish students responded (88% women). Compared with Austrian students, Swedish students were older and had more positive attitudes about oldest-old adults. Swedish students' median factor ratings (7-point scale) were 3.62 (Factor 1), 3.50 (Factor 2), 2.71 (Factor 3) and 3.80 (Factor 4). Austrian students' median ratings were 4.25 (Factor 1), 3.83 (Factor 2), 3.28 (Factor 3) and 4.00 (Factor 4). Regression analyses showed that the variables country, older family member/acquaintance, and age were associated with the different factors.

DISCUSSION

Compared with Austrian students, Swedish students' attitudes towards oldest-old adults were more favourable. We discussed the findings at individual, interpersonal/intergroup and societal/cultural levels and present implications for education and research.

CONCLUSIONS

Nurse education should address ageism as a multilevel phenomenon, and include the person-centred care perspective. Further research comparing nursing students' attitudes from different cultures is needed.

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.

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.

Kogan's Attitude toward Old People scale revisited: Psychometric properties and recommendations

Population ageing is one of the present and future challenges in the European context. In addition to age-related changes, negative and judicious attitudes by society are also prevalent. Therefore, there is a need for reliable instruments to evaluate attitudes toward ageing. In this vein, the present research aims to provide a reliable version of the Kogan's Attitudes toward Older People scale adapted to the Spanish context. In a sample from the academic community (N = 163), we evaluated the reliability, the psychometric properties, and the internal consistency of a version of Kogan's scale translated into Spanish. The results showed a reliable short version of the scale with adequate psychometric properties and two factors: positive and negative. Moreover, the correlates with similar measures of attitude toward older people proved external validity measures by the short scale. The implications and contributions to the geriatric population are discussed.

Evaluation of the 'Empathic Care of a Vulnerable Older Person' e-simulation

BACKGROUND

Healthcare reports have identified that the nursing care provided to frail older people is sometimes indifferent, unkind, and lacking in empathy. Compelling research indicates that these types of healthcare interactions can result in both emotional and physiological harm. Thus, there is a need for authentic learning experiences that enhance nursing students' empathy towards older people and that they can reflect upon, learn from and transfer to their real-world practice. e-Simulations provide a pragmatic way of addressing this need.

AIM

The aim of this study was to evaluate the impact of an 'Empathic Care of a Vulnerable Older Person' e-simulation on nursing students' empathy levels.

SETTING AND PARTICIPANTS

A convenience sample of first year nursing students from one university in the United Kingdom and two Australian universities was recruited for the study.

DESIGN AND ANALYSIS

A three-group pre-post study was conducted using the Comprehensive State Empathy Scale to evaluate the impact of the effectiveness of the e-simulation. Sample characteristics were summarised using descriptive statistics. Dependent t-tests and analysis of variance (ANOVA) were used to compare the changes in empathy scores pre post and differences between groups.

RESULTS

A total of 684 nursing students participated in the study; their average age was 23 years. Overall, there was a significant increase in empathy scores from pre-test to post-test. Post-hoc comparison of the three groups indicated that the e-simulation had a greater impact on the empathy levels of participants from Universities 2 and 3, compared to those from University 1.

CONCLUSION

e-Simulations using narrative methodologies that cater for learners' emotional memory appear to be an effective approach for enhancing empathy towards older people. However, further studies are needed to explore how this learning activity might inform and influence learners' future clinical practice.

Ageing as part of the curriculum for health-care professionals: A Queensland Survey

OBJECTIVES

Education affects the attitudes and abilities of health professionals regarding older people. This study examines the nature and amount of ageing-related content in programs at universities and in continuing education in Queensland for disciplines involved in the direct care of older people.

METHODS

Surveys developed for the different settings were sent to universities and health professional representative bodies.

RESULTS

Representatives from thirty (of 71) programs and 12 (of 22) professional bodies responded. Many program representatives (62%) reported ageing content was at an appropriate level. The remainder indicated it was too low. Representatives from professional bodies identified ageing was a priority (81%) and offered ageing-related education (72%). Time spent on ageing in university programs varied widely (median of 67 hours [interquartile range: 222.5]). Qualitative feedback indicated tensions existed about accreditation standards and perceptions of ageing as a specialty versus a core practice area.

CONCLUSION

Ageing-related education for health professionals requires attention to address shortcomings.