Undergraduate nursing students and the elderly: An assessment of attitudes in a Turkish university

Approximately half of the nursing students confirmed their willingness to participate in caring for older people: a systematic review and meta-analysis

BACKGROUND

Global population aging poses a significant global challenge, necessitating an increased demand for proficient caregivers specialized in elderly care. In our study, a systematic review and meta-analysis were conducted to synthesize the evidence concerning nursing students' willingness to participate in caring for older people.

METHODS

Eligibility criteria focused on cross-sectional studies involving nursing students' willingness to participate in caring for older people and were reported in English or Chinese. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WANFANG databases were searched from inception until July 24, 2022. The methodological quality assessment in the included studies was evaluated using the AHRQ instrument. The pooled effects of the nursing students' willingness to participate in caring for older people were computed using a random-effects model. Funnel plots and Egger's test were employed to evaluate publication bias. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was conducted to verify the robustness of the meta-analysis findings. All statistical tests were conducted with Stata 16.0 software.

RESULTS

A total of 68 studies of medium or high quality met the eligibility criteria, involving 30,328 nursing students. The rate of nursing students' willingness to participate in caring for older people was 49.0% (95% CI = 46-53%, I2 = 98.1%, P = 0.000). The results of meta-regression analysis showed that the following four predictor variables were significantly associated with nursing students' willingness to participate in caring for older people: experience of living with and caring for older people, nursing as their first choice and their year-level in education, respectively. Subgroup analyses for these four predictor variables revealed the following pooled estimates of nursing students' willingness: having experience of living with older people (0.54, 95% CI = 0.46-0.62) vs. no such experience (0.38, 95% CI = 0.30-0.46), having experience of caring for older people (0.55, 95% CI = 0.48-0.63) vs. no such experience (0.38, 95% CI = 0.30-0.46), nursing as their first choice (0.54, 95% CI = 0.51-0.58) vs. not their first choice (0.44, 95% CI = 0.35-0.53), being in the first year of nursing education (0.44, 95% CI = 0.34-0.55), second year (0.45, 95% CI = 0.34-0.56), and third and fourth year (0.62, 95% CI = 0.53-0.71).

CONCLUSION

The study found that approximately half of the nursing students confirmed their willingness to participate in caring for older people.The present study can serve as a resource for policymakers to increase the willingness of nursing students to participate in caring for older people.

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

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

Professional attractiveness among long-term care workers in nursing homes in China: a cross-sectional study

BACKGROUND

The population aging trend and the shortage of elderly care workers require the long-term care profession to become more attractive. However, the professional attractiveness among long-term care workers has yet to be extensively studied. This study aims to identify the factors that influence the attractiveness of the long-term care profession for nursing home (NH) care workers..

METHODS

A cross-sectional study was conducted in more than 50 NHs. Perception of professional attractiveness among long-term care workers and potential associated factors were measured using the Attractive Work Questionnaire (AWQ) and structural instruments including the Fraboni Scale of Ageism (FSA) and the Maslach Burnout Inventory (MBI). A multiple linear regression method was employed to explore the influence of potential independent variables on professional attractiveness.

RESULTS

The overall response rate was 99%. The results showed the score of professional attractiveness (185.37 ± 20.034), as well as the scores of each component (99.26 ± 11.258 for work condition, 30.13 ± 3.583 for work content, and 55.99 ± 7.074 for job satisfaction). Findings of multiple linear regression analysis indicated that age(β = 0.129, p<.05), years of work(β = 0.156, p<.05), 12-hour shifts(β = 0.185, p<.05), and training times per year(β = 0.148, p<.05) positively associated with long-term care workers perceived professional attractiveness. Whereas only ageism(β=-0.267, p<.05) significantly and negatively influenced professional attractiveness.

CONCLUSIONS

The perceived professional attractiveness of long-term care workers in NHs was acceptable. Age, years of work, shifts, training opportunities, and ageism contributed to the professional attractiveness of nursing home care workers in China. Target intervention measures should be taken to enhance the attractiveness of long-term care careers so as to avoid the shortage of long-term care workers.

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

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

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

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

CONCLUSION

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

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSION

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

BACKGROUND

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

BACKGROUND

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

BACKGROUND

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

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

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

Ageism and nursing students, past or reality?: A systematic review

OBJECTIVE

This systematic review aimed to summarise and update existing knowledge about ageism among nursing students through the following research question: what is the perception and attitudes of ageism among student nurses?

DESIGN

A systematic review of longitudinal and cross-sectional studies of ageism in nursing students was carried out.

DATA SOURCES

The literature search was conducted in the scientific databases Pubmed and Scopus in February 2021.

REVIEW METHODS

After the screening process, 22 studies meeting the selection criteria were selected; 8 more were identified after manually searching the selected paper' reference lists. A total of 30 studies were included in the review. The JBI Critical Appraisal Checklists for Analytical Cross-Sectional studies and for Cohort Studies were used to appraise the articles' quality.

RESULTS

There was large variability in the manifestation of ageism among student nurses, as well as in the instruments used for assessment. Most of the articles analysed attitudes towards old age, the majority of which were positive. Being a female student, being on the final year of study and having regular contact or cohabitation with an older adult were three of the main determinants in the expression of positive attitudes towards the elderly.

CONCLUSIONS

Our findings suggest that student nurses generally have positive attitudes towards old age, although ageist beliefs and discriminatory behaviours were identified and should be studied in greater depth. Training programs for future care professionals have a responsibility to educate from a non-stereotypical perspective based on current societal needs.

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.

Investigation of Variables Affecting Attitudes of Emerging Adults Towards Older Individuals

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

Nurses’ attitudes towards hospitalized older adults in a tertiary care setting in Ghana

Introduction

The increasing population of older adults and rapid increases in co‐morbidities globally has necessitated the need for a healthcare delivery system that meets the multifaceted needs of the growing population of older adults. Concurrent with these rising complex health needs is the importance of positive, non‐judgmental attitudes of health services providers towards older adults. Moreover, this is particularly important in the nursing profession, given nurses' significant and crucial roles in healthcare settings.

Aim

The study aimed to evaluate nurses’ attitudes towards older adults in a tertiary hospital in Ghana.

Design

It employed a descriptive cross‐sectional quantitative design.

Method

Data were collected from 160 registered adult medical and surgical ward nurses using the Ageism Attitude Scale (AAS).

Results

Findings indicated that more than half of the participants had a diploma in general nursing. None of the nurses surveyed specialized in the care of older adults, and the mean age of participants was 30.14 (3.75) (minimum 24 and maximum 42 years). Female nurses had more positive attitudes than their male counterparts. Although the surveyed nurses reported a somewhat positive attitude towards older adults, there was no correlation between nurses' education levels and positive attitudes.

Graduating nurse students' interest in older people nursing-A cross-sectional survey in six European countries

BACKGROUND

Countries vary in the number of qualified nurses employed in older adult services. Moreover, students' views of older people nursing as a career differ internationally. Studying future nurses and their career intentions for the field is warranted to meet the increased nurse workforce expectations in terms of quantity and competence.

AIM

To analyse graduating nurse students' interest in older people nursing and the factors associated with it.

METHODS

A cross-sectional multicountry survey design was applied. Data were collected between May 2018 and March 2019 from several educational institutions in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Non-probability convenience sampling was used to recruit graduating nurse students (n = 1796). The data were collected with a structured questionnaire comprising background factors and the Willingness sub-scale (six items) of the Students' Interest in Nursing Older People Scale. Data were analysed using a linear mixed model including relevant background variables.

RESULTS

Overall, students' interest in older people nursing was low (score 20.5, on a 0-100 scale). Among the studied countries, Spanish students scored the highest (38.8) and German students the lowest (3.6). Students' interest in older people nursing was associated with country (p < .001), the length of work experience (p = .006), plans for further study (p = .007), competence (p < .001) and the extent that nursing is valued by society (p < .001). The students who were most interested in older people nursing had higher self-reported competence level (p < .001).

CONCLUSION

In the studied sample of future nurse professionals, interest in older people nursing is low at a time when the field suffers from workforce shortage. As for quality workforce, it was promising that the students who considered working in the field also evaluated themselves as competent.

IMPLICATIONS FOR PRACTICE

Multidimensional actions are required to promote interest in the field, including continued development of competence in both undergraduate education and workplaces, and investing in various career pathways to envisage potential opportunities.

Attitudes Toward Older Adults and Need for Education Among Nurses and Nursing Assistants

BACKGROUND

Attitudes toward older adults and education needs could influence the quality of care provided by nurses and nursing assistants. The goal of this study is to assess attitudes toward older adults and geriatric nursing education needs among nurses and nursing assistants working at long-term care hospitals in Korea.

METHOD

Data were collected with a structured self-reported questionnaire. The study included 124 nurses and 145 nursing assistants working at six long-term care hospitals in Korea.

RESULTS

No statistically significant difference was found between the nurses and nursing assistants in their attitudes toward older adults, with both groups showing neutral attitudes. Both nurses and nursing assistants had a high need for education in health issues affecting older adults.

CONCLUSION

To improve nursing quality, a practical and systematic curriculum on older adults and their health issues is needed for nursing staff working in long-term care hospitals. [J Contin Educ Nurs. 2021;52(11):517-524.].

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Factors affecting preregistered nurses' willingness to serve in geriatric long-term care

AIM

Rapidly ageing population leads to increased demands for long-term care. Taiwan's preparation for its ageing population focuses on engaging healthcare professionals. This study explored pre-registered nurses' current knowledge, experience in geriatric long-term care (GLTC) and willingness to serve in GLTC.

DESIGN

A cross-sectional survey design and a self-developed structured questionnaire were used.

METHODS

A probability proportionate to size sampling strategy was used to collect data from students in junior college and bachelor of nursing science programmes in Taiwan in 2017. Multiple regression was adopted to predict significant factors that influence nursing students' willingness to serve in GLTC.

RESULTS

The willingness to serve in GLTC was positively correlated with their experience of living with older adults, practicum experience, taking GLTC-related courses and interest in GLTC. Willingness to serve older/disabled patients can be enhanced through school courses and practicum experiences, indicating the importance of GLTC-related courses in the training of the professional nursing workforce.

Assessing knowledge and ageist attitudes and behaviors toward older adults among undergraduate nursing students

Caring for older adults is viewed as a low prestigious profession and a less attractive career option for nursing students. Knowledge deficit is a major perceived barrier to reliving ageist attitudes and behaviors among nursing students. In the Middle East, there is limited evidence regarding ageism among nursing students. This study aimed to examine the association of nursing students' demographics and knowledge of aging with ageist attitudes and behaviors. A cross-sectional design was used to recruit a convenience sample of 290 undergraduate nursing students in Jordan. The majority of nursing students reported poor knowledge, held ageist attitudes, and expressed ageist behaviors. A significant difference was found between senior and junior nursing students in the level of knowledge about aging. Also, significant correlations were found among students' knowledge about aging and ageist attitudes and behaviors. Targeting knowledge deficit and ageist attitudes and behaviors among nursing students is crucial for optimal geriatric care.

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.

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.

Preferences of nursing and medical students for working with older adults and people with dementia: a systematic review

BACKGROUND

A current issue in workforce planning is ensuring healthcare professionals are both competent and willing to work with older adults with complex needs. This includes dementia care, which is widely recognised as a priority. Yet research suggests that working with older people is unattractive to undergraduate healthcare students.

METHODS

The aim of this systematic review and narrative synthesis is to explore the factors related to healthcare (medical and nursing) student preferences' for working with older people and people with dementia. Searches were conducted in five databases: MEDLINE, PsycINFO, CINHAL, BNI, ERIC. Screening, data extraction and quality appraisal were conducted by two independent reviewers. A narrative, data-based convergent synthesis was conducted.

RESULTS

One thousand twenty-four papers were screened (139 full texts) and 62 papers were included for a narrative synthesis. Factors were grouped into seven categories; student characteristics, experiences of students, course characteristics, career characteristics, patient characteristics, work characteristics and the theory of planned behaviour.

CONCLUSION

Health educators should review their role in cultivating student interest in working with older adults, with consideration of student preparation and the perceived value of this work. There is a lack of evidence about the career preferences of students in relation to dementia, and this warrants further research.