The psychometric properties, confirmatory factor analysis, and cut-off value for the Fraboni scale of ageism (FSA) in a sampling of healthcare workers

Beyond the stethoscope: ageism in white coats and resident physicians' preferences for elderly patient care

BACKGROUND

The global increase in life expectancy has significantly raised the elderly population. In Türkiye, the proportion of individuals aged 65 and over rose from 8.8% in 2018 to 10.2% in 2023. This demographic shift necessitates the planning of social and health services for the elderly. Ageism affects elderly health negatively and is prevalent in healthcare settings. This study aimed to determine the prevalence of ageism among resident physicians at Pamukkale University Hospital and identify factors influencing their preferences for providing healthcare to elderly patients.

METHODS

This cross-sectional study was conducted at Pamukkale University Hospital between 6 June and 16 June, 2024. A total of 448 resident physicians were selected through simple random sampling. Data were collected using a self-administered questionnaire, which included sociodemographic information, factors affecting ageism, and the Fraboni Scale of Ageism (FSA). Descriptive statistics, Chi-square tests, and logistic regression were used to evaluate factors influencing healthcare preferences.

RESULTS

The FSA score averaged 71.89 ± 7.87, indicating a 20.1% (95% CI:16.48-24.10) prevalence of age discrimination among resident physicians. Logistic regression analysis revealed that male participants (odds ratio (OR) = 1.519, P = 0.042), those with moderate to very poor perceived knowledge of elderly health (OR = 2.418, P < 0.001), and higher FSA scores (OR = 1.046, P < 0.001) were more likely to prefer not providing healthcare services to elderly patients.

CONCLUSIONS

Ageism among resident physicians is prevalent, impacting their willingness to provide care to elderly patients. Gender, perceived knowledge, and ageist attitudes influence their preferences for providing healthcare to elderly patients. Addressing these factors is crucial for improving healthcare services for the elderly.

Psychometric properties of the Fraboni scale of ageism (FSA) applied to long-term caregivers in nursing homes

BACKGROUND

The aging society has resulted in enormous demand for long-term care services. However, ageism is a common phenomenon in long-term care facilities, which not only hinders the quality of care for the recipients but also negatively influences caregivers' well-being. In this paper, we first applied the Fraboni Scale of Ageism (FSA) to evaluate its reliability and construct validity among Chinese long-term caregivers in nursing homes. This study could contribute to assessing the prevalence of ageism in Chinese long-term caregivers, prompting facilities and the government to recognize the issue of ageism and explore necessary interventions to reduce ageism in long-term caregivers.

METHODS

This is a cross-sectional study. We recruited 392 long-term caregivers using a convenience sampling strategy in nursing homes from two cities in Chinese central and northern regions. Parameters included the demographic characteristics, Cronbach's alpha coefficients, and intraclass correlation coefficient. The construct validity was conducted by exploratory factor analysis and confirmatory factor analysis.

RESULTS

The Cronbach's alpha of FSA (Chinese version) was 0.856 and ICC was 0.871. The factor analysis identified 3 principal factors, explaining 43.95% of the total variance. The 3-factor model was confirmed to fit by confirmatory factor analysis.

CONCLUSIONS

The findings confirm that the FSA is easy to use and has good psychometric properties. This study will contribute to improving the condition of ageism, thereby improving the quality of care for the elderly and retention of professional talents in the LTC system.

Attitudes toward Aging among College Students: Results from an Intergenerational Reminiscence Project

The detrimental effects of negative attitudes toward aging among younger adults extend to both older and young adults, highlighting the need for attention from academics, applied researchers, and practitioners. To improve college students' attitudes toward aging, an intergenerational reminiscence intervention was conducted. College students, who were randomized to intervention or control groups and matched with older adults, made weekly phone calls to community-dwelling older adults with cognitive impairment for ten weeks. This study investigated whether college students improved their attitudes toward aging after participating in this project. A total of 64 college student participants completed the whole intervention and all data collection. The Fraboni Scale of Ageism was used to measure attitudes toward aging and administered at three time points (pre-, mid-, and post-test). Parametric and nonparametric tests were examined to understand changes over time, and post-hoc analyses were conducted to understand timepoints in which changes occurred. The results showed that both the intervention and control groups evidenced a decrease in the majority of the ageism scale, including statistical improvements in three specific negative items, which were "Seniors are stingy and hoard money", "Seniors live in the past", and "I prefer not to spend time with seniors". Overall, the findings indicate that weekly engagement with older adults is promising in improving attitudes toward aging among college students. Implications for future research on intergenerational contacts to improve attitudes toward aging are discussed.

Quality of Gerontological Nursing and Ageism: What Factors Influence on Nurses' Ageism in South Korea?

With the aging of the population, age-related problems are emerging, which has caused age discrimination. Particularly, most nurses care for a large number of old patients in the clinical setting. Nurses' attitude toward the clients has a significant effect on the quality of nursing, so it is time to identify their perspective to the aged. The quality of nursing could greatly depend on who provides and how to provide care. If older patients meet nursing staff with an ageist perspective, whether intentionally or unintentionally, they experience negative attitudes toward them during served health care, and trust cannot be formed, resulting in a deterioration in the quality of medical services. This study aimed to identify factors influencing nurses' ageism attitudes. A total of 162 general hospital nurses completed a questionnaire consisting of the Wong and Law Emotional Intelligence Scale (WLEIS), the Contact with Elderly People (CEP), the Anxiety about Aging Scale (AAS), and the Fraboni Scale of Ageism (FSA). Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Scheffé post hoc, Pearson's correlation coefficients, and stepwise multiple regression using SPSS/WIN 26.0 program. The average score of FSA was 2.63 ± 0.36 (range 1-4); FSA showed a statistical difference according to cohabitation with an old adult in the past (t = 2.42, p = 0.017). Factors influencing FSA were the fear of old people (β = 0.34, p < 0.001) and fear of loss (β = 0.28, p < 0.001) of the AAS; and these variables explained 21.1% of FSA (F = 22.56, p < 0.001). Based on these results, the development and application of nursing education focused on intergenerational contact is needed in order to reduce the anxiety about aging and to acquire a high quality of gerontological nursing with a reduction of ageism.