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Zhe Wong GH, Kiat Yap PL. Ageism and Dementia-ism in Health Care: A Proposed Framework to Guide Treatment Decisions in Frail Older Persons. J Am Med Dir Assoc 2024; 25:105015. [PMID: 38750656 DOI: 10.1016/j.jamda.2024.105015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 05/27/2024]
Abstract
Global population ageing underscores the imperative of ageism and dementia-ism in the heath care setting as there is both anecdotal and published evidence that older persons are liable to receive less than optimum evidence-based treatments on account of their age and apparent frailty. This article explores the reasons for this phenomenon and limitations of current approaches of clinical decision making. We propose a framework to guide decision making to optimize care, with a paradigm shift in redefining a default toward clinical practice guideline-recommended treatments, guided by evidence-based medicine within an ethical means-end proportionality framework, and regularly reviewed advance care plans and goals of care conversations to secure the best interests of older persons.
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Bartrim K, Waite C, Williams LT, O'Shea MC. Allied health students' experiences of older adults in residential aged care placements: A scoping review. Nutr Diet 2024; 81:107-119. [PMID: 38057994 DOI: 10.1111/1747-0080.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/08/2023]
Abstract
AIM To explore the attitudes and experiences of allied health students working with older adults on residential aged care placements. METHOD A systematic literature search was conducted to identify studies of any design describing allied health student experience of residential aged care placements. Online databases searched to identify potentially relevant documents included Scopus, Web of Science, PubMed, CINAHL Complete (EBSCOhost) and Health and Medicine (ProQuest). Studies were excluded if residential aged care facilities or allied health professional students could not be extracted from the data. No restrictions were applied to methodological design, language, geographical location or year of publication. The Mixed Methods Appraisal Tool was used to assess methodological quality. Extracted studies were analysed to identify the study design, participant and placement characteristics, study methodology and student experience measures. Data from the included studies were analysed thematically using meta-synthesis. RESULTS Six studies (total number of participants, n = 308) met inclusion criteria, with four papers scoring a 5/5 on the Mixed Methods Appraisal Tool. Studies included undergraduate and master's students from physiotherapy (n = 3), speech language pathology (n = 2), dietetics (n = 1) and audiology (n = 1). Placement length varied from two to 15 h, between one and six residential aged care visits. Three themes were identified; (1) Opportunity to improve skills and gain confidence, (2) Development of empathy and shift in attitudes towards older adults and (3) Recognised challenges associated with older adults and residential aged care settings. CONCLUSION While the size of the evidence-base is limited, the studies were largely consistent in demonstrating an increase in positive attitudes towards older adults following residential aged care placements. Future research, innovations and planning around workforce size, preparation and motivation must be prioritised to ensure older adults receive the care they need and deserve.
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Affiliation(s)
- Karly Bartrim
- Centre for Community Health and Wellbeing and School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
| | - Cassandra Waite
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
| | - Lauren T Williams
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
| | - Marie-Claire O'Shea
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
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Kytridou V, Gkikas I, Garcia MN, Cepeda O, Hildebolt CF. A literature review of local and systemic considerations for endodontic treatments in older adults. Gerodontology 2023; 40:410-421. [PMID: 36971290 DOI: 10.1111/ger.12679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 11/17/2023]
Abstract
OBJECTIVES The aim of this literature review was to summarise the clinical important findings on the endodontic treatment outcome in older patients (≥60 years old) with pulpal/periapical disease considering local and systemic factors from a body of knowledge that is heterogeneous in methods or disciplines. BACKGROUND Due to the increasing number of older patients in the endodontic practice, and the current trend for tooth preservation, the need for clinicians to have a better understanding of age-related implications that may influence the required endodontic treatment in older adults to retain their natural dentition is indispensable. METHODS PubMed/Medline and Embase was searched by a medical librarian using specific terms based on inclusion/exclusion criteria. The reference list was hand-seached for additional relevant publications between 2005-2020. A combination of these terms was performed uing Boolean operators and MeSH terms. RESULTS Of the 1577 publications identified manually and electronically, 25 were included to be fully reviewed by the examiners. The data was derived from three systematic reviews, one systematic and meta-analysis, three case series, four prospective and 14 retrospective cohorts. Overall, there was heterogeneity in reporting as well as limitations in most studies. CONCLUSIONS The outcome of endodontic treatment (ET) either nonsurgical or surgical or combination of these is not affected by older age. ET can be the treatment of choice in older patients wiht pulpal/periapical disease. There is no evidence that older age per se affects the outcome of any type of endodontic treatment.
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Affiliation(s)
- Vasiliki Kytridou
- Section Head of Endodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Ioannis Gkikas
- Section of Oral and Maxillofacial Surgery, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Miryam Nathalia Garcia
- Applied Dental Medicine Department, Section of Periodontics, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Oscar Cepeda
- Division of Geriatric Medicine, St. Louis VA Medical Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Charles F Hildebolt
- Washington University School of Medicine, Saint Louis, Missouri, USA
- Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
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Jeyasingam N, McLean L, Mitchell L, Wand APF. Attitudes to ageing amongst health care professionals: a qualitative systematic review. Eur Geriatr Med 2023; 14:889-908. [PMID: 37553540 PMCID: PMC10587319 DOI: 10.1007/s41999-023-00841-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 07/15/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVES Older adults utilising healthcare may be vulnerable to systemic bias regarding ageing potentially affecting care. Primary aim is to systematically review the qualitative literature examining attitudes to ageing amongst health care professionals (HCPs). Secondary aim is to describe and compare attitudes to ageing between different professional groups. METHODS Studies examining attitudes to ageing of HCPs were identified using four databases. Original qualitative research with HCPs was included, excluding studies examining students alone, reviews, and grey literature. Three authors undertook standardised data extraction and quality rating for each study and thematic synthesis, with a fourth senior author reviewing. Quality appraisal followed the Attree and Milton guidelines (2006), including studies rated A-C. RESULTS Of 5869 citations, 13 met initial inclusion criteria. Synthesis of the 12 studies graded A-C followed (excluding one study rated-D). Nurses, doctors, and social workers were most frequently investigated. Identified themes included Attitudes towards older persons, The role of the older persons' family, Behaviour of HCPs towards older persons, Behaviour of older persons towards HCPs, and Definitions of an older person. An overarching theme emerged of the systemic context of attitudes to ageing. Common attitudes were found across disciplines, with doctors emphasising complexity and dependency and nurses the burden of care. CONCLUSIONS HCP's attitudes to ageing vary and are shaped by professional experiences and systemic factors. HCP attitudes may affect responses to and care of the older person. Therefore, interprofessional research, and systemic and service changes across disciplines are required to foster real and sustainable attitudinal change to support older peoples' care.
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Affiliation(s)
- Neil Jeyasingam
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Chippendale, NSW, 2006, Australia
- Mental Health Drug and Alcohol, Far West Local Health District, Broken Hill, NSW, Australia
| | - Loyola McLean
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Chippendale, NSW, 2006, Australia
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Westmead Psychotherapy Program for Complex Traumatic Disorders, Cumberland Hospital, WSLHD, North Parramatta, Australia
| | | | - Anne P F Wand
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Chippendale, NSW, 2006, Australia.
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Heath, University of New South Wales, Sydney, Australia.
- Older Peoples Mental Health, Sydney Local Health District, Sydney, Australia.
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Martín-Carbonell M, Espejo B, Castro-Melo GP, Sequeira-Daza D, Checa I. Psychometric Properties of and Measurement Invariance in the Questionnaire of Stereotypes Toward Older Adulthood in Health Care College Students and Health Professionals of Colombia: Psychometric Study. J Med Internet Res 2023; 25:e42340. [PMID: 36892936 PMCID: PMC10037170 DOI: 10.2196/42340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND In health professionals, negative stereotypes toward older adulthood have been associated with the difficulty in recognizing pathological processes and the refusal to care for older patients because of assuming that communication with them will be uncomfortable and frustrating. For these reasons, research on stereotypes in these groups has acquired growing importance. The usual strategy to identify and evaluate agist stereotypes is to use scales and questionnaires. Although multiple scales are currently used, in Latin America, the Questionnaire for the Evaluation of Negative Stereotypes Toward Older Adulthood (Cuestionario de Estereotipos Negativos sobre la Vejez [CENVE]), developed in Spain, is widely used but without evidence of construct validity in our context. In addition, although in the original version, a factorial structure of 3 factors was found, in later studies, a unifactorial structure was obtained. OBJECTIVE The objective is to study the construct validity of the CENVE in a sample of Colombian health personnel to clarify its factorial structure and concurrent validity. Likewise, the measurement invariance according to gender and age was studied. METHODS A nonprobabilistic sample of 877 Colombian health professionals and intern health students was obtained. The data were collected online using the LimeSurvey tool. To study the factor structure of the CENVE, 2 confirmatory factor analysis (CFA) models were carried out, one to test a single factor and the other to test the 3-related-factor structure. The factor measurement reliability was evaluated with the composite reliability index (CRI) and the average variance extracted (AVE). The measurement invariance was studied according to gender (men and women) and age (emerging adults, 18-29 years old, and adults, 30 years old or older). Using a structural equation model, the relationship between age and the latent CENVE total score was studied to obtain evidence of concurrent validity, since studies indicate that the younger the age, the greater the number of stereotypes. RESULTS The 1-factor structure was confirmed. The reliability results indicated that both indices show adequate values. Likewise, the existence of a strong invariance in measurement by gender and age group was verified. After contrasting the means of the groups, the results showed that men show more negative stereotypes toward old age than women. Likewise, emerging adults also showed more stereotypes than adults. We also verified that age is inversely related to the latent score of the questionnaire, such that the younger the age, the greater the stereotype. These results are in agreement with those obtained by other authors. CONCLUSIONS The CENVE shows good construct and concurrent validity, as well as good reliability, and it can be used to assess stereotypes toward older adulthood in Colombian health professionals and health sciences college students. This will allow us to better understand the effect of stereotypes on agism.
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A scoping review of ageism towards older adults in cancer care. J Geriatr Oncol 2023; 14:101385. [PMID: 36244925 DOI: 10.1016/j.jgo.2022.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/11/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Ageism towards older adults with cancer may impact treatment decisions, healthcare interactions, and shape health/psychosocial outcomes. The purpose of this review is twofold: (1) To synthesize the literature on ageism towards older adults with cancer in oncology and (2) To identify interventions that address ageism in the healthcare context applicable to oncology. MATERIALS AND METHODS We conducted a scoping review following Arksey and O'Malley and Levac methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted an exhaustive multi-database search, screening 30,926 titles/abstracts. Following data abstraction, we conducted tabular, narrative, and textual synthesis. RESULTS We extracted data on 133 papers. Most (n = 44) were expert opinions, reviews, and letters to editors highlighting the negative impacts of ageism, expressing the need for approaches addressing heterogeneity of older adults, and calling for increased clinical trial inclusion for older adults. Qualitative studies (n = 3) described healthcare professionals' perceived influence of age on treatment recommendations, whereas quantitative studies (n = 32) were inconclusive as to whether age-related bias impacted treatment recommendations/outcomes or survival. Intervention studies (n = 54) targeted ageism in pre/post-licensure healthcare professionals and reported participants' improvement in knowledge and/or attitudes towards older adults. No interventions were found that had been implemented in oncology. DISCUSSION Concerns relating to ageism in cancer care are consistently described in the literature. Interventions exist to address ageism; however, none have been developed or tested in oncology settings. Addressing ageism in oncology will require integration of geriatric knowledge/interventions to address conscious and unconscious ageist attitudes impacting care and outcomes. Interventions hold promise if tailored for cancer care settings. 249/250.
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Normative solidarity and compassion as determinants of ageism in nursing students: An analysis of mediation and moderation. Collegian 2022. [DOI: 10.1016/j.colegn.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Altın Z, Buran F. Attitudes of health professionals toward elderly patients during the COVID-19 pandemic. Aging Clin Exp Res 2022; 34:2567-2576. [PMID: 35986878 PMCID: PMC9391638 DOI: 10.1007/s40520-022-02209-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022]
Abstract
The perceptions and attitudes of health professionals toward a certain group of society are among the factors affecting the quality of health service. This study aimed to investigate the attitudes of physicians and nurses about ageism in the COVID-19 pandemic. An easy face-to-face survey was used to collect the data. It involves the questions about demographic information and geriatric perspectives, and they were taken from the University of California at Los Angeles Geriatrics Attitudes Scale (UCLA-GAS). In the study, 58.1% of participants were over 35 years old, 76.6% were women, and 50% were physicians out of 308 in total. It was found that most of the participants have worked in inpatient services and intensive care units for the longest time, where the triage issue was the most discussed topic during the pandemic. An average of 75% of the participants stated that they did not witness any ageist attitude in health care provided. In the comparative analyses conducted with the UCLA-GAS sub-dimensions, statistically significant results, which were anti-ageist and prioritized human life, were obtained. In the extraordinary periods such as pandemic, especially physicians should be able to give the treatment without feeling any social or legal concerns during their medical applications with the light of guidelines accepted scientifically, legally, and morally. Thus, health professionals will not only be away from legal concerns such as malpractice but also will not be exhausted mentally and they can provide more sufficient health service by working under these conditions.
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Zhang J, Fu Y, Zhang H, Tang T, Yin M, Shi L. Analysis of factors influencing the attitudes towards the elderly of nursing students based on empathy and end-of-life care: A cross-sectional study. Nurs Open 2022; 9:2348-2355. [PMID: 35612525 PMCID: PMC9374388 DOI: 10.1002/nop2.1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/02/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Aim This study aimed to explore the factors associated with attitudes towards the older adults among nursing students, to clarify the impact of empathy and end‐of‐life care on the attitude of the older adults, and to provide a basis for the follow‐up of education courses related to older adults care and the training of older adults care talents. Design A cross‐sectional study. Methods A cross‐sectional survey on nursing students' knowledge and attitudes towards older adults was conducted from 24 December 2020–24 February 2021. The Chinese versions of the end‐of‐life Attitudes Scale, Jefferson Empathy Scale‐Nursing Version and Kogan Attitudes Scale for the Elderly were used for this cross‐sectional study. We used the purposive sampling method to conduct a questionnaire survey on nursing students at Heilongjiang Nursing College (n = 371, effective response rate: 64.52%). Results The average score of FATCOD‐B was 99.04 (7.71), and the score of C‐JSE‐HPS was 100.67 (12.90). The total average score of nursing students' attitudes towards older adults was 139.91 (15.79). The hierarchical regression analysis showed that education (β = −.125, p = .025) and personal experience (β = −.132, p = .008) correlated negatively with attitudes towards the older adults, while the end‐of‐life care (β = .140, p = .013) and empathy (β = .285, p < .001) correlated positively with attitudes towards the older adults. Conclusions Religion, end‐of‐life care and empathy were positively correlated with nursing students' attitudes towards older adults. It is necessary to set up end‐of‐life care, empathy and education related to the older adults, and combine a variety of training forms, increasing humanistic assessments and reducing the employment pressure on nursing students by relevant departments can improve their attitudes towards the older adults.
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Affiliation(s)
- Jinchan Zhang
- Department of Medical Dispute, Maternal and Child Health Hospital, Heyuan, China
| | - Yang Fu
- School of Humanities, Harbin Medical University, Harbin, China
| | - Hongli Zhang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tianwei Tang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Mei Yin
- School of Humanities, Harbin Medical University, Harbin, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
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Crutzen C, Missotten P, Adam S, Schroyen S. Does caring lead to stigmatisation? The perception of older people among healthcare professionals and the general population: A cross-sectional study. Int J Older People Nurs 2022; 17:e12457. [PMID: 35267232 DOI: 10.1111/opn.12457] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/28/2021] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND It is well recognised that healthcare professionals are particularly at risk for developing a negative perception of older people. Indeed, in addition to receiving education centred on a biomedical view of ageing, they are constantly exposed to the most vulnerable and dependent older individuals. AIM The purpose of our study is to compare the perception of older people between health professionals, working in a nursing home and the general population. METHODS This is a cross-sectional study. The perception of older people was measured using two different instruments: the image-of-ageing question and the Aging Semantic Differential (ASD) scale. We performed t-test to compare the perception of older individuals between the general population and healthcare professionals. RESULTS The image-of-ageing question does not show any difference between the general population (n = 148) and healthcare professionals (n = 107). In these both groups, almost half of the words cited in reference to older individuals were negative. Concerning the ASD, results show that healthcare professionals have significantly more negative perceptions towards older individuals than the general population (with the control of age, gender and educational level). CONCLUSION Healthcare professionals seem to have a more negative view of older people than the general population. Their regular contact with the frailest older adults could explain this finding. Another hypothesis could be a non-optimal quality of contact in nursing homes. IMPLICATIONS FOR PRACTICE Such results highlight the importance to promote a more holistic view of ageing in educational programs of healthcare professional. Improving the quality of contact with nursing homes residents should be strongly considered to reduce ageism among healthcare professionals.
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Affiliation(s)
- Coline Crutzen
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | | | - Stéphane Adam
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - Sarah Schroyen
- Psychology of Aging Unit, University of Liège, Liège, Belgium
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Clinical Pharmacists' Knowledge of and Attitudes toward Older Adults. PHARMACY 2021; 9:pharmacy9040172. [PMID: 34698246 PMCID: PMC8544685 DOI: 10.3390/pharmacy9040172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Although pharmacy literature suggests that pharmacists have a positive attitude towards older adults, there is a paucity of studies that have measured pharmacists’ knowledge or attitudes towards older people. The purpose of our study was to assess the knowledge and attitudes of hospital pharmacists toward older adults. Methods: An electronic survey was distributed over two months to clinical hospital pharmacists across the province of Alberta, Canada. The survey was composed of two validated tools, the Palmore Facts of Aging Quiz (PFAQ) and Kogan’s Attitude toward Old People Scale (KOPS). PFAQ is scored from 0 (poor knowledge) to 25 (high knowledge) and KOPS from 34 to 204, with higher than 119 indicating a positive attitude. Results: A total of 153 pharmacists completed the survey (response rate of 24%). The mean age was 39 (SD 10.8) years; the average years practiced was 15 (SD 11), and the majority of respondents (n = 65) reported that >50% of patients in their practice were geriatrics. The mean correct responses on the PFAQ were 18.8 (SD 2.6). KOPS had a mean score of 156.8 (SD 14), with only one pharmacist score falling below 119, indicating a negative attitude. There was a statistically significant, positive correlation between attitudes and knowledge (r = 0.38, p < 0.05), as well as the increasing age of the respondents (r = 0.18, p = 0.03). The remaining measured categories (i.e., gender, years of pharmacy practice) had no significant effect. Conclusion: Clinical hospital pharmacists in Alberta have a positive attitude toward geriatric patients, as well as a satisfactory knowledge of older adults.
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Jester DJ, Hyer K, Wenders A, Andel R. Attitudes toward aging of health professions students: Implications for geriatrics education. GERONTOLOGY & GERIATRICS EDUCATION 2021; 42:589-603. [PMID: 33111652 DOI: 10.1080/02701960.2020.1835657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We compared attitudes toward aging of students from several health professions (N = 1,156: 286 medical, 275 pharmacy, 213 undergraduate nursing, 160 graduate nursing, 139 Internal Medicine residents, 49 physical therapy, and 34 physician assistant), and assessed the construct validity of the Image of Aging Scale. Physical therapy and graduate nursing students reported more positive attitudes toward aging in comparison to all other health professions (all p <.001). Differences in attitudes were not strongly affected by demographic variables, clinical exposure, desire to pursue primary care, or interest in providing care to older adults. The Image of Aging Scale yielded good internal reliability and adequate construct validity for health professions students. Health professions students' attitudes toward aging largely reflect the students' professional training, rather than student characteristics or career goals. The Image of Aging Scale is a robust measure of attitudes toward aging in health professions students and in older adults.
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Affiliation(s)
- Dylan J Jester
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Kathryn Hyer
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Anna Wenders
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Ross Andel
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
- Department of Neurology, Memory Clinic, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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13
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Derks CTAJ, Hutten-van den Elsen MMGM, Hakvoort LJ, van Mersbergen MPJ, Schuurmans MJ, Dikken J. Hospital nurses' knowledge regarding older patients: a multicenter study. BMC Nurs 2021; 20:135. [PMID: 34348725 PMCID: PMC8336409 DOI: 10.1186/s12912-021-00604-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nursing care in hospitals increasingly involves older adults. A nursing workforce able to care for the ageing population is therefore critical for ensuring quality older adult care. Gaining insight in the knowledge and attitudes of nurses regarding older patients in the Netherlands is needed to develop and increase the impact of education- and quality improvement programs which can positively influence nurses' knowledge and attitudes regarding older patients. METHODS A cross-sectional multicenter study was performed. Data was collected in ten tertiary medical teaching hospitals well spread across the Netherlands (89 wards, 2902 nurses). Knowledge levels were measured using the Knowledge about Older Patient-Quiz (KOP-Q), consisting of 30 true-false questions. Knowledge levels of registered nurses are compared with knowledge levels known from literature of first year nursing students; last year nursing students; nurses; and nurse specialist. Potential associated factors considered were: age; sex; education; experience; opinions and preferences. Opinion and preferences regarding working with older patients were measured by three questions: 1) which patient group nurses preferred to work with; 2) how nurses feel about the increase of older patients in the hospital; and 3) whether nurses find it difficult to care for older patients. RESULTS From all wards, a representative sample of 1743 registered hospital nurses working on all 89 wards participated. On all wards, a large range in knowledge levels is observed between nurses, with 37% of nurses presenting knowledge levels comparable with nursing student and 31% of nurses presenting knowledge levels comparable with nurse specialists. Knowledge is related to age (p < .001), work experiences (p < .001), preparatory secondary education (p < .001) and nurses education level (p = .012). A minority (12.5%) prefers working with older patients and most nurses do not find it difficult. CONCLUSIONS This study shows that there is a large diversity in knowledge levels of Dutch hospital nurses in every hospital, on every ward. A majority of nurses demonstrate negative opinions and preferences. This implies that older patients admitted can receive different levels of quality of care on the same day as nurses with different knowledge levels provide care during the various shifts. Findings demonstrate an urgent need for education programs with themes regarding essential care for older patients in the Netherlands.
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Affiliation(s)
| | | | | | | | - Marieke J Schuurmans
- Nursing Science, Julius Center University Medical Center/University Utrecht, Utrecht, the Netherlands
| | - Jeroen Dikken
- Faculty of Health, Nutrition & Sport & Health Innovation Centre of Expertise, The Hague University of Applied Sciences, The Hague, the Netherlands.
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Kolushev I, Punchik B, Digmi D, Haiman K, Ritsner M, Moller O, Hadad S, Samson T, Freud T, Press Y. Ageism, Aging Anxiety, and Death and Dying Anxiety Among Doctors and Nurses. Rejuvenation Res 2021; 24:366-374. [PMID: 33906418 DOI: 10.1089/rej.2020.2385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ageism is an important phenomenon that affects individuals and how society relates to older adults. It is important to evaluate ageism in the medical staff because of its potential effect on treatment for older adults. A cross-sectional study to assess the negative attitudes of doctors and nurses toward older adults was conducted using the Fraboni Scale of Ageism (FSA), a method for evaluating attitudes toward ageism in medical teams. Additional variables associated with ageism such as aging anxiety, and death and dying anxiety were also assessed. The study population included doctors and nurses working in a large university hospital or in community clinics in southern Israel. In all, 431 questionnaires were collected, 203 from the hospital (47.5%) and 224 from the community (52.5%). Of these, 216 (50.1%) were from doctors and 215 (49.9%) from nurses. The mean ageism score in the FSA was 2.8. In a linear regression model, doctors were less ageist than nurses; ageism was directly associated with aging anxiety, and dying anxiety, and was inversely associated with death anxiety. Among doctors, prominent ageist attitudes were directly associated with aging and dying anxiety, inversely associated with graduation from medical school in Israel, and death anxiety. Among nurses, prominent ageism attitudes were directly associated with dying anxiety and inversely associated with work in the hospital. Ageist attitudes were found among doctors and nurses in both the hospital and community clinics. The results emphasize the need to raise awareness of ageism in medical teams and to include this subject in professional training programs designed to reduce its prevalence.
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Affiliation(s)
- Ilona Kolushev
- Department of Family Medicine, Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Boris Punchik
- Home Care Unit, Clalit Health Services, Beer-Sheva, Israel.,Unit for Community Geriatrics, Division of Community Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dror Digmi
- Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Kristina Haiman
- Department of Family Medicine, Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Clalit Health Services, Beer-Sheva, Israel
| | - Maria Ritsner
- Department of Family Medicine, Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Clalit Health Services, Beer-Sheva, Israel
| | - Ofek Moller
- Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sarai Hadad
- Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tali Samson
- Department of Family Medicine, Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Unit for Community Geriatrics, Division of Community Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar Freud
- Department of Family Medicine, Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yan Press
- Department of Family Medicine, Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Unit for Community Geriatrics, Division of Community Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Geriatrics, Soroka University Medical Center, Beer-Sheva, Israel.,Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Punchik B, Tkacheva O, Runikhina N, Sharashkina N, Ostapenko V, Samson T, Freud T, Press Y. Ageism Among Physicians and Nurses in Russia. Rejuvenation Res 2021; 24:297-301. [PMID: 33715384 DOI: 10.1089/rej.2020.2376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The phenomenon of ageism has been studied extensively in the Western world, but there is only a small number of studies among medical staff in Russia. The aim of this study was to assess the prevalence of ageism and to identify variables that can explain ageism in a sample of physicians and nurses in Russia. This is a prospective cross-sectional study of physicians and nurses who participated in a training course in the years 2016-2018 in Russia. Data collected before the start of training included the Fraboni scale of ageism (FSA) questionnaire, and sociodemographic characteristics including age, gender, profession, professional seniority, place of work, and number of older adults treated by the study participant over the past half year. In total, 903 physicians and nurses participated in the study. The mean FSA score was 2.75 ± 0.49, which indicates a moderate degree of ageism. There was a trend to higher scores among nurses compared with physicians (2.78 ± 0.50 vs. 2.76 ± 0.48, p < 0.465). There was a weak, but statistically significant, correlation between ageism and age (r = 0.157, p < 0.0001), professional seniority (r = 0.098, p < 0.003), and the number of older adult patients treated by the participant over the prior half year (r = 0.075, p < 0.025). There were no differences in other characteristics including gender, profession, work setting, or serving as main caregiver for a family member and the magnitude of ageism. The phenomenon of ageism exists among physicians and nurses in Russia. Older participants with greater professional seniority and a larger number of older patients had stronger ageism attitudes.
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Affiliation(s)
- Boris Punchik
- Home Care Unit, Clalit Health Services, Beer-Sheva, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Olga Tkacheva
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia
| | - Nadezda Runikhina
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia.,Laboratory of Ambulatory Geriatrics, Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia
| | - Natalya Sharashkina
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia.,Laboratory of General Gerontology and Neuro-Gerontology, Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia
| | - Valentina Ostapenko
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moskow, Russia.,Department of Geriatrics, Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Tali Samson
- Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Pain and Palliative Care Unit, Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tami Freud
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yan Press
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Geriatrics, Soroka University Medical Center, Beer-Sheva, Israel.,Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Ozel Bilim I, Kutlu FY. The psychometric properties, confirmatory factor analysis, and cut-off value for the Fraboni scale of ageism (FSA) in a sampling of healthcare workers. Perspect Psychiatr Care 2021; 57:9-19. [PMID: 32314396 DOI: 10.1111/ppc.12521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/08/2020] [Accepted: 04/12/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The Fraboni scale of ageism (FSA) is one of the scales used to determine ageism, which is the expression of prejudice toward the elderly because of their age through attitudes and behaviors. The purpose of this study is to determine the psychometric properties, factor analysis, and cut-off value for the FSA in a sampling of healthcare workers. DESIGN AND METHODS The sampling of this study was conducted methodologically in a descriptive and relationship-seeking type of research and comprised 814 healthcare workers employed at a university and state hospital. FINDINGS As a result of the exploratory and confirmatory factor analyses, it was found that the FSA comprised 29 items and three subdimensions, that these three factors explain approximately 30.23% of the total variance, and that the cut-off value is 78. PRACTICE IMPLICATIONS This study determined that the Turkish adaptation of the FSA is a suitable tool to measure the ageism of healthcare workers.
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Affiliation(s)
- Irem Ozel Bilim
- Department of Mental Health and Psychiatric Nursing, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - F Yasemin Kutlu
- Department of Mental Health and Psychiatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
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McCarthy F, Winter R, Levett T. An exploration of medical student attitudes towards older persons and frailty during undergraduate training. Eur Geriatr Med 2020; 12:347-353. [PMID: 33245506 DOI: 10.1007/s41999-020-00430-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Older persons and patients with frailty constitute an ever increasing proportion of hospital patients. Improving student attitudes towards both groups is important in preparing future doctors for this demographic shift. We aimed to investigate medical student attitudes towards older persons and frailty over an entire medical school cohort. METHODS All current Brighton and Sussex Medical School students were invited to complete an online questionnaire consisting: (i) the Australian Ageing Semantic Differential (AASD), (ii) the Medical Condition Regard Scale (MCRS) with regards to frailty, (iii) a qualitative question asking participants to record three words regarding both a person over 70 years and frailty. RESULTS 187 students participated (66% female, 25.2% response rate). Participants reported positive attitudes with mean scores of 73.45/114 on the AASD and 52.4/66 on the MCRS. The most positive attitudes towards both older persons and frailty were held by year 1 students, and most negative by year 3 and year 4 students for older persons and frailty, respectively. Examining AASD subgroups, students held negative attitudes towards the instrumentality (function) of older persons (mean score: 17.6/36) with significant variation across year groups (p < 0.05), with the most negative attitudes expressed in year 3. Word clouds of qualitative responses showed that medical students consider the two concepts differently with frailty attracting more negative associations. CONCLUSION Generally medical student attitudes were positive towards older persons and frailty. However, these declined when focusing on the functionality, with word cloud analysis of attitudes revealing a dichotomy between the quantitative and qualitative data surrounding frailty.
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Affiliation(s)
- Fergus McCarthy
- Brighton and Sussex Medical School, University of Sussex, C/O BSMS Teaching Building, Brighton, BN1 9PX, East Sussex, UK.
| | - Rebecca Winter
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Tom Levett
- Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
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‘I've never given it a thought’: older men's experiences with and perceptions of ageism during interactions with physicians. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20001476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe subjective experience of ageism among older men has received little research attention. This study examines older Canadian men's experiences with and perceptions of ageism during interactions with physicians. In-depth, face-to-face interviews were conducted with 21 men aged 55 years and over. The findings indicate a seeming lack of awareness of ageism among many, and many did not believe ageism was likely to occur during patient–physician interaction. Negative stereotyping of older patients was common. A large majority of the participants reported that they had not personally experienced ageism during a medical encounter, nor were they concerned about it. Numerous rationales were proffered as explanations of why a particular participant had not experienced ageism and who was more likely to be a target.
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Chang ES, Kannoth S, Levy S, Wang SY, Lee JE, Levy BR. Global reach of ageism on older persons' health: A systematic review. PLoS One 2020; 15:e0220857. [PMID: 31940338 PMCID: PMC6961830 DOI: 10.1371/journal.pone.0220857] [Citation(s) in RCA: 260] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 07/24/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time. METHOD A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857). RESULTS Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism). CONCLUSION The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons' health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.
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Affiliation(s)
- E-Shien Chang
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Sneha Kannoth
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Samantha Levy
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Shi-Yi Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - John E. Lee
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Becca R. Levy
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
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20
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Jung SE, Lawrence J, Hermann J, McMahon A. Application of the Theory of Planned Behavior to Predict Nutrition Students' Intention to Work with Older Adults. J Nutr Gerontol Geriatr 2020; 39:44-55. [PMID: 31517572 DOI: 10.1080/21551197.2019.1664967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
As Registered Dietitian Nutritionists play an important role in providing nutrition care plans for successful aging, it is important to identify factors influencing nutrition students' intention to work with older adults. A cross-sectional study was conducted to identify significant predictors of nutrition students' intention to work with older adults by utilizing the Theory of Planned Behavior (TPB). A total of 183 students, majoring in Nutrition at a large Southern University, completed a questionnaire examining validated TPB constructs. Structural Equation Modeling with maximum likelihood was used to analyze the data. The structural model provided a good fit to the data (x2 = 44.95, df = 38, p < 0.01; RMSEA = 0.03, CFI = 0.99; TLI = 0.99. Attitude (γ = 0.49, p < 0.001) and subjective norm (γ = 0.39, p < 0.001) emerged as significant predictors of nutrition students' intention to work with older adults. Findings highlight the importance of providing dietetics curricula that provide opportunities for students to develop positive attitudes toward working with older adults. Dietetic educators should present themselves as positive role models in working with older adults, as the educators influence students' intention to work with this population.
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Affiliation(s)
- Seung Eun Jung
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
| | - Jeannine Lawrence
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
| | - Janice Hermann
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Amy McMahon
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
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21
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Even-Zohar A, Werner S. The Effect of Educational Interventions on Willingness to Work with Older Adults: A Comparison of Students of Social Work and Health Professions. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:114-132. [PMID: 31935158 DOI: 10.1080/01634372.2020.1712511] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 12/29/2019] [Accepted: 01/03/2020] [Indexed: 06/10/2023]
Abstract
The study examined the effect of an educational intervention on the willingness of Israeli social work students to work with older adults, comparing them to students of nursing, speech therapy, and physiotherapy. A sample of 187 first-year students were divided into two groups: a research group (n=83) exposed to an educational intervention on ageing, and a control group (n=104) that received no intervention of any kind. Following the intervention, ageism among social work students in the research group decreased and positive behavior toward older adults increased. No significant differences were found among students of the health professions following the intervention. In addition, ageism mediated between knowledge of ageing and willingness to work with older adults.Furthermore, the higher the students assessed the contribution of the intervention, the lower their level of ageism, the more positive their behavior toward older adults, and the more willing they were to consider a career in geriatrics. The results suggest that introducing into the curriculum a variety of learning methods aimed at increasing knowledge of ageing and familiarity with the world of older adults is likely to encourage more students of social work and other therapeutic professions to work with the older population.
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Affiliation(s)
- Ahuva Even-Zohar
- School of Social Work, Faculty of Social Sciences, Ariel University, Ariel, Israel
| | - Shoshi Werner
- Nursing Sciences, Faculty of Health sciences, Ariel University, Ariel, Israel
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22
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Scott TL, Kugelman M, Tulloch K. How medical professional students view older people with dementia: Implications for education and practice. PLoS One 2019; 14:e0225329. [PMID: 31747449 PMCID: PMC6867636 DOI: 10.1371/journal.pone.0225329] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 11/01/2019] [Indexed: 11/18/2022] Open
Abstract
Background Healthcare professionals’ attitudes to older people, and especially those living with dementia, may contribute to unsatisfactory healthcare. Despite repeated calls to address increasing need, training an adequate geriatric workforce remains an international concern. Of particular concern are the attitudes and knowledge healthcare workers may hold about people living with dementia. Students’ knowledge of dementia has been found to be low at the beginning of their university education and has shown limited improvement throughout their coursework; greater understanding of students’ attitudes to ageing and dementia, upon entry and throughout their degrees, may help inform targeted educational interventions to improve the healthcare delivered to older people. Methods This study measured knowledge of and attitudes toward dementia and ageing in an Australian university student sample (n = 183), comparing students from medical professional versus non-medical professional related fields at both undergraduate and postgraduate levels. We examined diagnostic and prognostic biases through age manipulation of a vignette describing a hypothetical patient (aged 42 or 72 years), who was experiencing symptoms that were consistent with DSM-5 criteria for both dementia and depression. Based on information provided in the vignette, student participants were asked to select a primary disorder that they would assign to the patient. Results Showed that while medical professional students held significantly more positive attitudes toward ageing than 'other' students, average attitudinal scores indicated neutrality. Medical professional students indicated a diagnostic bias toward the older vignette patient, who was more likely to be diagnosed with dementia than depression. A history of geriatric-specific training did not predict dementia knowledge; however, having prior contact with people with dementia predicted both dementia knowledge and more positive prognoses. Conclusions Overall, findings indicated medical professional students held neutral attitudes towards older people and showed deficits in knowledge of dementia. Educational interventions that introduce students to people living with dementia may improve knowledge, skills, and attitudes. All university students would benefit from education about dementia and inclusivity to reduce stereotyping and stigma.
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Affiliation(s)
- Theresa L. Scott
- School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
- * E-mail:
| | - Melissa Kugelman
- School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
| | - Kristen Tulloch
- School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
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Ghimire S, Shrestha N, Callahan KE, Nath D, Baral BK, Lekhak N, Singh DR. Undergraduate nursing students' knowledge of aging, attitudes toward and perceptions of working with older adults in Kathmandu Nepal. Int J Nurs Sci 2019; 6:204-210. [PMID: 31406893 PMCID: PMC6608660 DOI: 10.1016/j.ijnss.2019.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/06/2019] [Accepted: 03/04/2019] [Indexed: 11/06/2022] Open
Abstract
Objectives This study aims to examine Nepalese undergraduate nursing students’ knowledge of aging, attitudes towards older adults and perceptions of working with older adults, and to assess differences in these outcomes by socio-demographic characteristics as well as type of nursing program. Methods A cross-sectional study was conducted among 385 undergraduate nursing students in six nursing colleges located in the Kathmandu Valley. Knowledge of aging, attitudes toward older adults and perceptions of working with older adults were assessed using standardized tools, the Palmore Facts on Aging Quiz, Kogan's Attitudes towards Older People Scale, and Nolan's Intent to Work with Older People Questionnaire, respectively. Results The mean knowledge scores on older adults and aging were relatively low; participants scored an average of 26.9 out of 50. Scores assessing attitudes towards and perceptions of working with older adults were more favorable. Compared to students pursuing a Bachelor of Science in Nursing (BSN), students pursuing a Bachelor of Nursing (BN) had a significantly higher score on the knowledge, attitudes and perception of aging scales. Linear regression analyses showed that the students’ knowledge of aging (β = 0.55; 95% CI = 0.25–0.86) and perceptions of working with older adults (β = 0.22; 95% CI = 0.05–0.38) had a significant positive association with their attitudes toward older adults. Conclusions Undergraduate nursing students in the Kathmandu Valley of Nepal displayed a relatively low level of knowledge, but a positive attitude towards older adults, and a positive perception of working with older adults. Observed differences in knowledge, attitude, and perception scores between students in BSN and BN programs needs further investigation; closing this gap may be important for bolstering undergraduate gerontological preparation in Nepal.
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Affiliation(s)
- Saruna Ghimire
- Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal.,School of Public Health, University of Nevada, Las Vegas, USA
| | - Nitisha Shrestha
- Asian College for Advanced Studies, Purbanchal University, Lalitpur, Nepal
| | | | - Dhirendra Nath
- Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
| | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | | | - Devendra Raj Singh
- Asian College for Advanced Studies, Purbanchal University, Lalitpur, Nepal
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Venables H, Wells Y, Fetherstonhaugh D. Psychometric testing of the Older Patients in Acute Care Survey (OPACS) in Australian final year nursing students. Nurs Open 2019; 6:558-565. [PMID: 30918706 PMCID: PMC6419114 DOI: 10.1002/nop2.238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/16/2018] [Accepted: 12/10/2018] [Indexed: 11/09/2022] Open
Abstract
AIM To assess the internal reliability and validity (content and criterion) of the Older Patients in Acute Care Survey (OPACS) as a measure of nurses' knowledge, attitudes and practices regarding care of older hospitalized patients in Australia. DESIGN Cross-sectional survey. METHOD A convenience sample of final year nursing students at an Australian university in October 2014 completed the OPACS (N = 191). Internal reliability was assessed using Cronbach's alpha, content validity using exploratory factor analysis and criterion validity using correlations between the OPACS and Palmore's Facts on Aging Quiz and the Caring Efficacy Scale. RESULTS Despite good internal reliability on both OPACS subscales, exploratory factor analysis of the 36 items representing behaviours and the 50 items on knowledge and attitudes failed to load strongly on their corresponding factors. Analyses of criterion validity suggested the OPACS scales are measures of attitude.
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Affiliation(s)
- Helen Venables
- College of Science, Health and EngineeringLa Trobe UniversityMelbourneVic.Australia
| | - Yvonne Wells
- Lincoln Centre for Research on AgingLa Trobe UniversityMelbourneVic.Australia
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Abstract
Life expectancy has increased as a result of advancements in health care services; thus, maintaining healthy dentition is an important factor in overall health. Furthermore, the growing desire of elderly patients to maintain their teeth has led to an increased need for the performance of complex dental treatment in elderly patients. Root canal therapy is an essential phase of such treatments. Elderly patients may exhibit one or more systemic conditions that require special care, in addition to other changes that occur within the dentition and oral mucosa as a result of aging. These make root canal treatment in elderly patients a great challenge. The aim of this review was to characterize pathologic and physiologic changes in elderly patients that can interfere with root canal treatment procedures, as well as attitudes of elderly patients toward such treatment, guidelines and clinical considerations for management of root canal treatment in elderly patients.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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26
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Uğurlu Z, Kav S, Karahan A, Akgün Çıtak E. Correlates of Ageism Among Health Care Professionals Working With Older Adults. J Transcult Nurs 2018; 30:303-312. [DOI: 10.1177/1043659618810128] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: The changing proportion of older adults in society necessitates the need to determine the attitudes of health care professionals toward older adults. The purpose of this study was to explore attitudes of ageism and its correlates among health care professionals working with older adults. Method: This descriptive study was conducted in seven hospitals in five cities in Turkey. A total of 628 health care professionals participated in this study. The Fraboni Scale of Ageism (FSA) was used to collect data. Descriptive statistics, student’s t test, one-way analysis of variance and multivariate linear regression were used for data analysis. Results: The mean total score from the FSA was 56.9 ( SD = 8.0). Education (β = −.18, p < .001) and difficulty with the care of older adults (β = −.10, p < .05) were statistically significant predictors of the FSA score. Conclusions: The attitudes of health care professionals toward older adults were generally positive and affected by difficulty in providing care and the educational status of the health care professionals.
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Bahadir-Yilmaz E. The relationship between nursing students' professional values and their attitudes towards the elderly people: A cross-sectional study. NURSE EDUCATION TODAY 2018; 70:8-12. [PMID: 30125868 DOI: 10.1016/j.nedt.2018.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/28/2018] [Accepted: 08/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Professional values involve standards that are effective in solving problems, interacting with patients, making decisions on patient care and forming the student's attitude. Throughout the course of the nursing students' occupational education, these standards shape their attitudes, beliefs, and behaviors regarding the provision of care for individuals. OBJECTIVE The aim of this study was to determine the relationship between nursing students' professional values and their attitudes towards the elderly. DESIGN A cross-sectional research design was used in this study. SETTINGS This study was conducted at a university in the northeast of Turkey. PARTICIPANTS 2nd-year (n = 93), 3rd-year (n = 101) and 4th-year (n = 81) nursing students. METHOD The data for the study were collected using a Personal Information Form, the Nursing Professional Values Scale- Revised (NPVS-R) and the Ageism Attitude Scale (AAS). In the data analysis, independent samples t-test, ANOVA and Spearman Correlation were used. RESULTS The study found that the nursing students' average total NVPS-R score was 86.4 ± 16.2 and their average total AAS score was 82.7 ± 8.8. Furthermore, a significant correlation was observed between the professional values of the students and their attitudes towards the elderly (r = 0.407, p = 0.000). A positive, moderately strong correlation was determined between the total NPVS-R scores and the 'restricted life of elderly people' and 'positive attitudes towards elderly people' sub-scales of AAS (r = 0.418, r = 0.317, p < 0.005, respectively). CONCLUSION The present study has demonstrated that the nursing students' professional values are associated with their attitudes towards the elderly. In the light of these results, it is suggested that professional values be taught and that courses on values be added to the curriculum in order to improve the attitudes of the students towards ageism.
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Affiliation(s)
- Emel Bahadir-Yilmaz
- Giresun University, The Faculty of The Health Sciences, Department of Midwifery, 28340 Piraziz, Giresun, Turkey..
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Kalu ME, Abaraogu UO, Norman KE. Do Physiotherapy Students Demonstrate Ageist Attitude? A Scoping Review of Literature. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1440040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Ukachukwu O. Abaraogu
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Kathleen E. Norman
- Associate Professor, Physical Therapy Program, School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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Wilson MAG, Kurrle S, Wilson I. Medical student attitudes towards older people: a critical review of quantitative measures. BMC Res Notes 2018; 11:71. [PMID: 29361969 PMCID: PMC5781287 DOI: 10.1186/s13104-018-3186-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/17/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Further research into medical student attitudes towards older people is important, and requires accurate and detailed evaluative methodology. The two objectives for this paper are: (1) From the literature, to critically review instruments of measure for medical student attitudes towards older people, and (2) To recommend the most appropriate quantitative instrument for future research into medical student attitudes towards older people. RESULTS A SCOPUS and Ovid cross search was performed using the keywords Attitude and medical student and aged or older or elderly. This search was supplemented by manual searching, guided by citations in articles identified by the initial literature search, using the SCOPUS and PubMed databases. International studies quantifying medical student attitudes have demonstrated neutral to positive attitudes towards older people, using various instruments. The most commonly used instruments are the Ageing Semantic Differential (ASD) and the University of California Los Angeles Geriatric Attitudes Scale, with several other measures occasionally used. All instruments used to date have inherent weaknesses. A reliable and valid instrument with which to quantify modern medical student attitudes towards older people has not yet been developed. Adaptation of the ASD for contemporary usage is recommended.
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Affiliation(s)
- Mark A G Wilson
- Graduate Medicine, School of Medicine, University of Wollongong, PO Box 1782, Bowral, NSW, 2576, Australia.
| | - Susan Kurrle
- Health Care of Older People, Faculty of Medicine, University of Sydney, Hornsby Ku-ring-gai Health Service, Hornsby, NSW, 2077, Australia
| | - Ian Wilson
- Learning and Teaching, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Building 28 Rm 115, Wollongong, NSW, 2522, Australia
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Ageism in the Health Care System: Providers, Patients, and Systems. INTERNATIONAL PERSPECTIVES ON AGING 2018. [DOI: 10.1007/978-3-319-73820-8_13] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Lešnik A, Tomažič J. Starizem v zdravstvenih ustanovah. OBZORNIK ZDRAVSTVENE NEGE 2017. [DOI: 10.14528/snr.2017.51.4.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Starizem izhaja iz predsodkov in stereotipov o lastnostih, ki jih na podlagi kronološke starosti pripisujemo starostnikom. Namen raziskave je bil ugotoviti, ali starostniki v kliničnem okolju doživljajo starizem in v kolikšni meri jih le-ta prizadene. Metode: Opisna kvantitativna raziskava je bila izvedena v zdravstveni ustanovi na priložnostnem vzorcu 132 starostnikov, starih od 65 do 90 let. Uporabljen je bil na podlagi pregleda literature zasnovan vprašalnik z 11 vprašanji zaprtega tipa. Prisotnost starizma in stopnja prizadetosti je bila merjena s tristopenjsko številsko lestvico. Za opis vzorca in sistematičen prikaz odgovorov na raziskovalna vprašanja je bila uporabljena deskriptivna univariatna in bivariatna (hi-kvadrat test za neodvisne vzorce) analiza. Rezultati: Skupno je bilo zaznanih 319 diskriminatornih dogodkov. Od 132 anketiranih je najmanj en diskriminatorni dogodek doživelo 91 (69,0 %) starostnikov. Med slednjimi se je 40 (44,0 %) starostnikov počutilo vsaj enkrat prizadeto in 23 (25,2 %) vsaj enkrat zelo prizadeto. Pri zaznavanju prizadetosti statistično pomembne razlike med skupinami glede na spol (χ2 = 13,554, p = 0,825), izobrazbo (χ2 = 20,807, p = 0,409) in starost (χ2 =19,328, p = 0,501) nismo ugotovili. Diskusija in zaključek: Raziskava potrdi prisotnost starizma v kliničnem okolju. Ker ima starizem negativen vpliv na odnos do starostnika in kakovost njegove oskrbe, je profesionalno komunikacijo s starostniki treba uvesti v izobraževanje vseh profilov zdravstvenih delavcev.
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Schroyen S, Adam S, Marquet M, Jerusalem G, Thiel S, Giraudet AL, Missotten P. Communication of healthcare professionals: Is there ageism? Eur J Cancer Care (Engl) 2017; 27. [PMID: 28960583 DOI: 10.1111/ecc.12780] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 11/28/2022]
Abstract
Elderspeak is often used when talking to older individuals and is characterised by a slower and/or louder speech, a patronising tone, etc. A part of the reason of such communication can be found in the actual context of negative view of ageing. However, the link between view of ageing and elderspeak has never been objectively studied in oncology. Therefore, 40 healthcare professionals (physicians and medical students) record a podcast where they have to explain an endocrine therapy to two fictional patients (40- vs. 70-year old). Results show that when participants explained the treatment to the older patient, they used shorter utterances and made more repetitions. They also evoked fewer side effects such as sexual issues. Moreover, reduction in length of utterances and of word-per-minute rate was observed for older patient when participants have a positive view of ageing but for both patients when they have a negative view of ageing. In conclusion, physicians and medical students used elderspeak when they explained a treatment to older patients. Participants with a more negative view of ageing also unconsciously talked slower and made shorter utterances to a 40 -year-old patient.
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Affiliation(s)
- S Schroyen
- Psychology of Aging Unit, University of Liège, Liège, Belgium.,INSERM U1219 Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | - S Adam
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - M Marquet
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - G Jerusalem
- Department of Medical Oncology, CHU Sart-Tilman Liège and University of Liège, Liège, Belgium
| | - S Thiel
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - A-L Giraudet
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - P Missotten
- Psychology of Aging Unit, University of Liège, Liège, Belgium
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Rush KL, Hickey S, Epp S, Janke R. Nurses' attitudes towards older people care: An integrative review. J Clin Nurs 2017. [PMID: 28639384 DOI: 10.1111/jocn.13939] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. BACKGROUND Population ageing is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues. METHODS A systematic integrative review process guided the review. Cumulative Index of Nursing and Allied Health Literature and Medline databases were searched for primary research published between 2005-2017. A total of 1,690 papers were screened with 67 papers read in-depth and eight selected for this review that met the inclusion/exclusion criteria. RESULTS Nurses' held coexisting positive and negative attitudes towards generic and specific aspects of older adult care. Negative attitudes, in particular, were directed at the characteristics of older adults, their care demands or reflected in nurses' approaches to care. Across jurisdictions, work environment, education, experience and demographics emerged as influences on nurses' attitudes. CONCLUSION There is a paucity of research examining nurses' attitudes towards older adult care. The limited evidence indicates that attitudes towards older people care are complex and contradictory. Influences on nurses' attitudes need further study individually and collectively to build a strong evidence base. Interventional studies are needed as are the development of valid and reliable instruments for measuring nurses' attitudes towards older adult care. RELEVANCE TO CLINICAL PRACTICE Bolstering postgraduate gerontological preparation is critical for promoting nurses' attitudes towards older adult care. Creating age-friendly work environments, including appropriate resource allocation, is important to support older people care and facilitate positive nursing attitudes.
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Affiliation(s)
- Kathy L Rush
- School of Nursing, University of British Columbia-Okanagan, Kelowna, BC, Canada
| | - Stormee Hickey
- Kelowna General Hospital, Interior Health, Kelowna, BC, Canada
| | - Sheila Epp
- School of Nursing, University of British Columbia-Okanagan, Kelowna, BC, Canada
| | - Robert Janke
- Library, University of British Columbia-Okanagan, Kelowna, BC, Canada
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Tauber-Gilmore M, Addis G, Zahran Z, Black S, Baillie L, Procter S, Norton C. The views of older people and health professionals about dignity in acute hospital care. J Clin Nurs 2017; 27:223-234. [DOI: 10.1111/jocn.13877] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - Gulen Addis
- Faculty of Society and Health; School of Health and Social Science; Buckinghamshire New University; Uxbridge UK
| | - Zainab Zahran
- Department of Postgraduate Research; Florence Nightingale Faculty of Nursing and Midwifery; Kings College London; London UK
| | - Sally Black
- Florence Nightingale Faculty of Nursing and Midwifery; Kings College London; London UK
| | - Lesley Baillie
- Florence Nightingale Chair of Clinical Nursing Practice; School of Health and Social Care; London South Bank University; London UK
| | - Sue Procter
- Imperial College NHS Healthcare Trust; Faculty of Society and Health; School of Health and Social Science; Buckinghamshire New University; Buckinghamshire UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing and Midwifery; Kings College London; London UK
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Wilson DM, Nam MA, Murphy J, Victorino JP, Gondim EC, Low G. A critical review of published research literature reviews on nursing and healthcare ageism. J Clin Nurs 2017; 26:3881-3892. [PMID: 28295808 DOI: 10.1111/jocn.13803] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To establish how common and impactful nursing and healthcare ageism is and whether proven interventions or prevention methods exist. BACKGROUND Ageism has been a concern since 1969 when it was first introduced as a concept for social reform. As ageism has been linked to lower quality health services and reduced health care access, it is imperative that healthcare and nursing ageism is prevented or identified and reduced or eliminated. DESIGN A qualitative narrative review of published research literature reviews using a scoping design to map all published reviews was undertaken. The EBSCO Discovery Service (providing access to articles in 271 databases, including MEDLINE and CINAHL) and Directory of Open Access Journals (providing access to over 9,000 open access journals) were used to find review articles. Using predetermined inclusion and exclusion criteria, and limited by English language and peer-review publications, 12 eligible reviews were identified and information from them was systematically identified, assessed and synthesised. RESULTS The 12 reviews did not provide clear and convincing information to determine how common and impactful nursing or healthcare ageism is, nor what can best be done to prevent or address it. Although each review had value since research literature was collected and discussed on nursing or healthcare ageism, the array of literature search and analysis methods, and diversity in conclusions reached about the evidence is highly problematic. CONCLUSION Research literature reviews offering a more balanced perspective and demonstrating greater care in finding and using quality evidence are needed. RELEVANCE TO CLINICAL PRACTICE At this point in time, there is no clear understanding of how widespread and impactful nursing or healthcare ageism is, and what can best be done to prevent or address it. Nurses need to be aware that ageism may be common and impactful, and guard against it.
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Affiliation(s)
- Donna M Wilson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Mavis A Nam
- School of Nursing, University of Ghana, Legon, Ghana
| | - Jill Murphy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - João P Victorino
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Ellen C Gondim
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Gail Low
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Ben-Harush A, Shiovitz-Ezra S, Doron I, Alon S, Leibovitz A, Golander H, Haron Y, Ayalon L. Ageism among physicians, nurses, and social workers: findings from a qualitative study. Eur J Ageing 2017; 14:39-48. [PMID: 28804393 PMCID: PMC5550621 DOI: 10.1007/s10433-016-0389-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study investigated ageism among healthcare professionals in various therapeutic settings in Israel. Using a qualitative approach, the current study aimed to examine similarities and differences across healthcare disciplines. Three focus groups were conducted with physicians, nurses, and social workers. Data from each focus group were analyzed separately, and then commonalities and differences across the groups were evaluated. Three main themes relating to older adults emerged from the data. The first theme pertains to perceived difficulties that healthcare professionals experience in working with older adults and their family members; the second focuses on invisibility and discriminatory communication patterns; and the third theme relates to provision of inappropriate care to older adults. Similarities and differences across the three disciplines were found. The differences related mainly to the examples provided for manifestations of ageism in the healthcare system. Provision of inadequate treatment to older adults due to their age appeared to be the most complex theme, and is discussed at length in the Discussion. Briefly, the complexity stems from the fact that although some behaviors can be clearly described as inappropriate and undesirable, other behaviors such as avoidance of invasive medical procedures for older patients raise ethical dilemmas. Potentially, avoidance of invasive medical treatment can be perceived as compassionate care rather than as undertreatment due to ageist perceptions. A related dilemma, i.e., longevity versus quality-of-life, is also discussed in light of the finding that the balance of these two aspects changes as patients grow old.
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Affiliation(s)
- Aya Ben-Harush
- The Department of Social Work, Ruppin Academic Center, Emek Hefer, Israel
- The Early Childhood Education Program, The David Yellin Academic College of Education, Jerusalem, Israel
| | - Sharon Shiovitz-Ezra
- Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, 91905 Jerusalem, Israel
| | - Israel Doron
- Department of Gerontology, University of Haifa, 31905 Haifa, Israel
| | - Sara Alon
- ESHEL-Joint, Joint Hill, POB 3489, Jerusalem, Israel
| | - Arthur Leibovitz
- Internal Medicine-Geriatrics, Epidemiology and Prevention, Tel Aviv University, Ramat-Aviv, 69978 Tel Aviv, Israel
| | - Hava Golander
- The Department of Nursing, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, 69978 Tel Aviv, Israel
| | - Yafa Haron
- Nursing Division, Ministry of Health, Capital Towers, 39 Jermiyau St, Jerusalem, Israel
| | - Liat Ayalon
- Gabi and Louis Weisfeld School of Social Work, Faculty of Social Sciences, Bar-Ilan University, 52900 Ramat Gan, Israel
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De Biasio JC, Parkas V, Soriano RP. Longitudinal assessment of medical student attitudes toward older people. MEDICAL TEACHER 2016; 38:823-828. [PMID: 26619339 DOI: 10.3109/0142159x.2015.1112891] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Delivering adequate care to older people requires an increasing number of physicians competent in the treatment of this expanding subpopulation. Attitudes toward older adults are important as predictors of the quality of care of older people and of medical trainee likelihood to enter the geriatrics field. This study assessed the attitudes of 404 US medical students (MS) from the start of medical school to graduation using the University of California, Los Angeles (UCLA) Geriatrics Attitude Scale. It is the first study to utilize a longitudinal design to assess attitudes among students in a medical school with a longitudinal geriatrics clinical experience in the first two years and a required geriatrics clerkship in the third year. Participants' attitude scores toward older people were found to significantly decrease from 3.9 during the first two years to 3.7 during the final two. Significant differences existed between MS1 and MS3, MS1 and MS4, MS2 and MS3, and MS2 and MS4. Women and older students held significantly more positive attitudes than men and younger students. These results show that planned clinical exposures to older adults may not be sufficient to halt the decline in attitudes in medical school. A comprehensive empathy-building intervention embedded in the curriculum may better prevent this decline.
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Schroyen S, Adam S, Jerusalem G, Missotten P. Ageism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads. Clin Interv Aging 2014; 10:117-25. [PMID: 25678781 PMCID: PMC4317143 DOI: 10.2147/cia.s70942] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism). These stigmas can result in deleterious consequences for elderly people’s mental and physical health in “normal” aging. What, then, is the impact in a pathological context, such as oncology? Moreover, health care professionals’ attitudes can be tainted with ageism, thus leading to undesirable consequences for patients. To counter these stigmas, we can apply some possible interventions emerging from research on normal aging and from social psychology, such as intergenerational contact, activation of positive stereotypes, self-affirmation, and so on; these tools can improve opinions of aging among the elderly people themselves, as well as health care professionals, thus affecting patients’ mental and physical health.
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Affiliation(s)
- Sarah Schroyen
- University of Liège, Psychology of Aging Unit, Liège, Belgium
| | - Stéphane Adam
- University of Liège, Psychology of Aging Unit, Liège, Belgium
| | - Guy Jerusalem
- University of Liège, Laboratory of Medical Oncology, Liège, Belgium ; CHU Sart Tilman Liege, Department of Medical Oncology, Liège, Belgium
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Blackwood J, Sweet C, Martin A. Attitudes Toward Aging of Physical Therapists and Student Physical Therapists. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2014. [DOI: 10.3109/02703181.2014.934943] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
BACKGROUND The world's population of older people is increasing,The World Health Organization (WHO) (2013 a) defines 'elderly'as those 65 years and older. Currently there are deficits in good basic care, partially resulting from the negative attitudes of some nursing staff. METHOD This systematic review was conducted by searching the CINAHL, MEDLINE and Inter nurse databases, which produced 119 results. Three original research papers were extracted,the fourth was obtained from a reference list and the final paper was taken from the internet. RESULTS Both student and qualified nurses can portray a negative attitude towards older people, thus negatively affecting care. The reasons for these negative attitudes are numerous, although lack of knowledge of the ageing process and gerontology prevail. CONCLUSION Further research is required and in-depth interviews to establish why some nurses portray negative attitudes. Strategies need to be implemented to address these issues,so encouraging better care provision.
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Pestessy J, Feczkó J, Radó S, Bács P, Kovács E. [Experience with the management of subtalar dislocation]. J Med Internet Res 1976; 19:40-5. [PMID: 3689 PMCID: PMC10037170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 12/12/2022] Open
Abstract
In 10 and 3 years resp., material of two surgical departments - with great material - 10 cases of luxation - without fracture - occurred in the subtaler joint have been treated. All 10 patients suffered covered, subtaler dislocations. After conservative treatment all 10 patients recovered and are back at work.
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