Changing negative stereotypes regarding aging in undergraduate nursing students

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

What motivates students to pursue a career in gerontological nursing? The cultural adaptation and validation of the Spanish version of the CMGN questionnaire

Background

Career motivation toward gerontological nursing (CMGN) has been studied by various authors. It is essential to identify the influencing factors and guarantee that undergraduate nursing degrees provide adequate social and healthcare responses to the current demand for gerontological care. Objective: In the absence of a validated instrument to measure students' career motivation in geriatric nursing in our sociocultural context, this study aimed to adapt and validate the original questionnaire Chinese CMGN. Methods: Cross-sectional data from 316 nursing students were collected in May 2021. The cultural and linguistic adaptation process was conducted in accordance with the recommendations of Ramada-Rodilla and Beaton. A committee of experts was established to assess content validity. The CMGN questionnaire consists of 20 items divided into 2 subscales: "Expectancy" (6 items) and "Values" (14 items). To determine the psychometric properties, the following analyses were carried out: content validity (Aiken's V coefficient and Pearson's coefficient of variation), internal consistency (Cronbach's α) and construct validity (confirmatory factor analysis and convergent and divergent validity). To verify the model once the parameters were estimated, we calculated the goodness-of-fit between the model and the data. Data analyses were performed using SPSS for Windows (IBM SPSS Statistics 25.0) and Analysis of Moment Structures (AMOS 27.0).

Results

A total of 316 nursing students were surveyed, of which 91.1% were women and the mean age was 21.61 ± 5.45 years (range: 18-56). The results indicate that the psychometric properties of the questionnaire were adequate in terms of content and construct validity. The internal consistency using Cronbach's alpha for both subscales was greater than 0.8. The AMOS results revealed that the final model fit statistics of CMIN/df (2.204), GFI (0.922), CFI (0.948) and RMSEA (0.062) indicated a satisfactory model fit. Finally, an original second-order model was obtained, resulting in the Spanish version of the CMGN (SV-CMGN) instrument. Conclusions: We developed a valid SV-CMGN questionnaire that is socially and culturally adapted to the Spanish context and is capable of measuring the motivation of nursing students toward a career in gerontological nursing, from the newest to the most experienced. This new version opens up the possibility of studying the phenomenon of motivation in other Spanish-speaking countries. Keywords: Gerontological nursing; Motivation; Students, nursing; Validation study; Surveys and questionnaires.

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

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

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

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

CONCLUSION

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

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

AIM

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

DESIGN

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

METHODS

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

RESULTS

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

Impact of interprofessional geriatric teamwork on students' perceptions of older persons and collaborative practice

Health professions programs lack sufficient exposure to geriatric education in curricula. The Seniors Assisting in Geriatric Education (SAGE) Program exposes interprofessional (IP) teams of health professions students to older adults. To determine the impact of an interprofessional geriatric educational experience on student perceptions of team collaboration and older adults. IP teams of three or four students (n = 662) representing eight disciplines from two institutions were paired with an older adult to promote person-centered care over three semesters. Students completed two online questionnaires (pre- and post-SAGE Program, ~10 min). 136 students completed both questionnaires. Three IP collaborative practice sub-competencies under the Roles & Responsibilities and Interprofessional Communication Core Competencies increased significantly from pre- to post-SAGE Program (p ≤ 0.002). Comparison of the means for attitudes toward geriatric patients revealed statistically significant improvement in one item, Compassion (p < .002). The SAGE Program had a positive impact on IP collaborative practice and attitudes toward older people in some, but not all, areas.

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

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

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

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

[Guilt for perceiving oneself as a burden: A relevant variable associated with the psychological distress of older adults]

AIMS

To analyze the relationship between guilt for perceiving oneself as a burden and negative self-perceptions of aging, perceived control and anxious and depressive symptomatology in older people without cognitive or functional limitations.

METHODS

Participants were 351 community-dwelling people over 60 years without explicit cognitive or functional limitation. Indirect effet analysis were conducted that examined the indirect effect of negative self-perceptions of aging through 1) perceived control and anxious symptomatology and 2) perceived control and depressive symptomatology in guilt for perceiving oneself as a burden.

RESULTS

Both models showed an indirect relationship between negative self-perceptions of aging and guilt for perceiving oneself as a burden through 1) perceived control and anxious symptomatology and 2) perceived control and depressive symptomatology, explaining 26.37% of anxious symptomatology, 48.51% of depressive symptomatology and 13.73% and 14.44% of guilt for perceiving oneself as a burden, respectively.

DISCUSSION

The results obtained suggest that higher negative self-perceptions of aging is associated with a lower perception of control and greater psychological distress (anxiety and depression), and this process increases the feeling of guilt for perceiving oneself as burden to family members in older people without functional or cognitive limitations.

Caring for the Elderly Enhances Positive Attitudes Better Than Knowledge in Nursing Students

Background and Objectives: There is a growing interest in the measurement of attitudes towards older people in healthcare professionals, as there is a need to implement interventions to improve ageist attitudes. A one group pretest–posttest study was carried out to explore the change in nursing student attitudes towards the elderly during their university careers. Materials and Method: A total of 97 nursing students were enrolled. Attitudes were analyzed using Kogan’s Attitudes Toward Old People Scale. Results: The attitude was positive from the beginning of the study, with a score of 110.06 (12.92). No differences were observed after completing the subject “Care of the elderly” (106.21 (10.77)), though a significant increase was recorded after the completion of clinical placement (142.88 (12.64)), with a large effect size (η2p = 0.754). The score of the positive items was significantly increased, but not that of the negative items, as ageist attitude was not reduced. Conclusion: The current curricular design, that includes taking the theoretical course before clinical placement in the geriatric area, increases positive attitudes in nursing students but does not reduce ageist attitudes.

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

This is a cross-sectional, descriptive survey study.

SETTINGS

The study was conducted in Romania.

PARTICIPANTS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Interventions to improve attitudes toward older people in undergraduate health and social sciences students. A systematic review and meta-analysis

OBJECTIVE

To determine which interventions are the most effective in improving attitudes toward older persons in undergraduate health and social sciences students.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

A literature search was made in PubMed, EBSCO and SCOPUS and additional records were identified by manual searching. The selection criteria were studies that evaluated an intervention designed to improve positive attitudes; studies in undergraduate health and social sciences students; and studies using direct instruments to measure attitudes.

REVIEW METHODS

Two independent reviewers extracted study-level data from records using a common data collection spreadsheet. Two reviewers also assessed study quality by using the Cochrane Risk of Bias Tool. The primary outcome was the effect of an intervention upon attitudes toward older people, while the secondary outcome was the effect upon knowledge about aging and older people in those studies that had previously assessed subject attitude. The meta-analysis was carried out based on mixed statistical models.

RESULTS

The search identified 53 eligible studies published during 1982-2020, comprising 35 pre-post studies and 18 randomized clinical trials, of which 14 were included in the meta-analysis. A strongly significant effect upon attitudes was observed for empathy-based interventions (differences of standardized mean differences (d_SMD) = 1.26; 95%CI: 0.04-2.48; p = 0.04), knowledge + empathy-based interventions (d_SMD = 0.22; 95%CI: 0.05-0.39; p = 0.01), and knowledge + clinical skills-based interventions (d_SMD = 0.22; 95%CI: 0.01-0.43; p = 0.04). The overall effect was d_SMD = 0.50; 95%CI: 0.01-0.43; p = 0.004. In addition, a positive effect in terms of increased knowledge about the older was observed after knowledge + empathy-based and knowledge + clinical skills-based interventions (d_SMD = 0.24; 95%CI: 0.07-0.40; p = 0.005).

CONCLUSIONS

Interventions to improve attitudes in health and social sciences students are effective, with those based on empathy having the greatest impact. Improving attitudes among future professionals could improve the management and quality of care of older people. More rigorous and better designed studies are recommended to determine the effect of the interventions. Registered on PROSPERO ID: CRD42021220677.

TWITTABLE ABSTRACT

Ageism is present in healthcare settings. Empathy-based interventions are the most effective strategies in health and social sciences students.

How does geriatric nursing education program change the knowledge, attitude and working intention among undergraduate nursing students? A systematic literature review

OBJECTIVE

This review aimed to examine the changes of knowledge, attitude and working intention in nursing students after an undergraduate geriatric nursing education.

DESIGN

A systematic review of the literature.

DATA SOURCES

Five databases which included CINAHL, MEDLINE, PubMed, Scopus and Web of Science were searched for this literature review from January 2010 to October 2020.

REVIEW METHODS

The review was registered in PROSPERO registry with registration number CRD42020215703. The review examined undergraduate nursing education programs in terms of knowledge, attitude and working intention towards geriatric care among undergraduate nursing students as outcomes. We used JBI critical appraisal tools and Mixed Methods Appraisal Tool to evaluate and assess the quality of the retrieved research papers.

RESULTS

The search yielded 19 studies included in the final review, 14 of which were quantitative studies and five were qualitative studies. Four types of education programs were identified. These were type 1, a four-year undergraduate gerontology program consisting of geriatric theory and geriatric care clinical placement; type 2, stand-alone geriatric subject and geriatric clinical placement program; type 3, integrated geriatric subject and geriatric clinical placement program; type 4, solely geriatric clinical placement program. The review found that the type 2 program demonstrated the best educational outcomes in undergraduate students.

CONCLUSIONS

This review provided the most recent literature evidence pertaining to undergraduate geriatric education program and its educational outcomes. Future research should focus on the evaluating the content of each type of geriatric education program to inform the development of undergraduate geriatric nursing education.

Collective Perceptions of Aging and Older Persons Held by Students From Eight Healthcare Professions

In order to increase the number of students entering the geriatric workforce, an understanding of factors influencing career preference and what may prevent students from pursuing geriatric careers is necessary. Using a convergent parallel mixed methods approach, the aim of this study was to provide insight for geriatric educators regarding the collective perceptions of aging and older persons held by 864 students from eight healthcare professions. Quantitative questions assessed students' attitudes (Geriatric Attitudes Scale). Student responses to four open-ended questions were assessed using conventional content analysis. Results included rich narrative examples of healthcare professions students' perceptions and understanding of the aging process, as well as myths and misconceptions of aging and older persons that can be used to inform geriatric curricula across multiple health professions training and education programs. Geriatric education is a critical avenue to correct misperceptions, quell ageism and address the current shortage in the geriatrician workforce.

Improving Nursing Student Attitudes Toward Older Adults Through the Use of Mask-Ed™ Simulation

Older adults are significant consumers of health care, yet studies find many health care students do not want to work with this population. This negative attitude can impact health outcomes. Increased exposure to older adults is linked to increased positive attitudes toward older adult care. Addressing the need for increased opportunities to interact with older adults will likely enhance these attitudes and thus improve health outcomes. In the current study, four varied Mask-Ed™ simulation activities were used in a course with a specific focus on nursing care of older adults. The Mask-Ed™ character, an older adult woman, works with students and provides opportunities for positive interactions/experiences. Students responded positively to simulation activities. Students described the experiences as helpful in increasing their confidence and comfort level with older adults. This unique experience fostered positive attitudes toward older adults among nursing students by giving them the opportunity to practice engaging with this population. [Journal of Gerontological Nursing, 47(12), 43-47.].

Factors Affecting Attitudes towards Older People in Undergraduate Nursing Students

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

Contemplative pedagogy as a framework for education about ageism

Current education in gerontology focuses on sharing knowledge and promoting intergenerational contact in order to shift students' attitudes about aging and elders. Existing interventions, however, may be less effective in modifying students' emotional reactions and implicit ageism. Contemplative pedagogy includes practices that help students notice cognitive and emotional patterns and that may serve to reduce bias. Suggestions are made for ways to incorporate contemplative pedagogy in the gerontology classroom.

Mapping evidence of nurses' attitudes toward older adults in Africa: a scoping review protocol

BACKGROUND

Culture influences nurses' attitudes towards caring for older adults. Additionally, nursing students' perceptions and attitudes towards older adults affect their behavior, possibly their career choices and/or the quality of care provided to older adults after graduation. In the context of lower-middle-income countries with a faster growing older adults population compared to upper income countries, the improvement of the quality care, inclusive of nurses' attitudes towards older adults, is one of the strategies for strengthening nursing and midwifery in Africa. Furthermore, examining nurses and nursing students' attitudes towards older adults will answer the United Nations' call for more data to understand the needs and the status of older adults in Africa.

METHODS

This scoping review will be guided by Arksey and O'Malley's framework. The search will be performed using Scopus, PubMed databases, Academic search complete, CINAHL with full text, Education source, Health source: Nursing/Academic Edition, with words related to the topic. The reviewers will also use Google Scholar and the reference lists of the relevant articles. Primary studies and grey literature addressing the research question will be included. The search process will include a first stage where two reviewers will perform the title screening and the removal of duplicates, followed by a parallel abstract screening according to eligibility criteria. The second stage will involve the reading of full articles and the exclusion of articles, in accordance with the eligibility criteria. Data will be collated by two reviewers independently and parallel, using a predetermined data extraction form. Discrepancies will involve a third reviewer. The Mixed Methods Appraisal Tool, version 2018 will be used to assess the quality of the data of eligible articles. A narrative approach containing summary tables and graphs will facilitate synthesis.

DISCUSSION

The review will provide insight into nurses' and nursing students' attitudes towards older adults in African countries. The outcomes will guide future research, practice, and education in nursing.

The influence of ageism on stereotypical attitudes among allied health students in Japan: a group comparison design

BACKGROUND

Ageism is a serious problem in medical care. The importance of ageism-related education for students has been emphasized. To determine the most effective approach to ageism-related education for allied health students, this study examined ageism among this group of students, with the hypothesis that ageism was expressed not only toward elderly adults but also toward individuals other than elderly adults.

METHODS

A questionnaire survey was conducted among 154 allied health students in Japan. The questionnaire involved tree drawings to evaluate the drawer's personality and a measurement of the participants' ageism. There were two display conditions for tree drawing. In the elderly display condition, participants were informed that the drawer was an elderly person, and in a control condition, participants were not informed of the drawer's age. Participants were randomly assigned to each condition and were required to evaluate the drawer's personality based on 5 personality traits. After the evaluation, all participants were required to complete the Japanese short version of the Fraboni Scale of Ageism (FSA-J).

RESULTS

The participants were 123 allied health students, 61 of whom were in the elderly display condition and 62 of whom were in the control condition. Based on the mean score on the FSA-J (M = 29.80), we divided the participants into a low-FSA-J group (N = 64) and a high-FSA-J group (N = 59). There was no significant difference between the display conditions on the FSA-J score. In the high-FSA-J groups, the control condition evaluated the drawer's personality as more timid than did the elderly display condition (F = 4.26, df = 1, 119). For negligence, the high-FSA-J group evaluated the drawer's personality as more negligent than did the low-FSA-J group (F = 4.08). For broad interests, the main effects of condition and groups were significant (F = 4.23).

CONCLUSIONS

The results suggested that ageism indicated a negative evaluation not only of elderly adults but also of individuals other than elderly adults, and students with negative ageism might evaluate the elderly drawer more positively. We have discussed the possibility that negative ageism among allied health students in Japan might underlie these positive stereotypes.

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

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.

Ageism in Nursing

Stereotypes of older adults and assumptions of old age as a time of dependency and vulnerability affect not only how older adults are perceived and treated by society, but how they are treated by members of the nursing profession as well. When nurses display ageist attitudes, it can be harmful to older patients both physically and emotionally. In this review article the author describes some of the literature related to ageism in nursing, discusses how ageism can affect the quality of the care that is provided to older adult patients, and explains theories that may help explain ageism in nursing.

What about aging? Perspectives from high school teachers and students on integrating aging into the high school curriculum

Most educational programs on aging target college students in disciplines which might provide services or work with older adults, such as medicine or social work, to the exclusion of students in high school. The purpose of this study is to better understand high school students and teacher's attitudes and perceptions regarding aging. Focus groups were conducted to collect data for this study. A total of 35 teachers and 55 students participated in the study. Findings indicate that attitudes about aging are both positive and negative, however, there is a consensus among both teachers and students that incorporating aging into the high school curriculum would be beneficial. Teachers are in need of strategies to incorporate aging education into the high school curriculum, as there are many barriers. Results from this study can be used to aid in the development of educational modules designed to incorporate aging content into the curriculum.

Student nurses' career motivation toward gerontological nursing: A longitudinal study

BACKGROUND

The intensity of student nurses' motivation toward a certain career can influence their behaviors for career choice and decision making. However, little is known about the career motivation among student nurses toward gerontological nursing and their influencing factors.

OBJECTIVES

The objectives of this study were to examine student nurses' career motivation toward gerontological nursing and to explore potential predictors using Bandura's reciprocal determinism.

DESIGN

A longitudinal design was used in this study.

SETTINGS AND PARTICIPANTS

A total of 305 student nurses were recruited from six hospitals in Shandong province, and they completed the questionnaires over three stages.

METHODS

Student nurses' career motivation toward gerontological nursing, geriatrics attitudes, aging anxiety, empathy, and clinical practice environment were measured using the motivation questionnaire, the Geriatrics Attitudes Scale, the Anxiety about Aging Scale, the Interpersonal Reactivity Index, and the clinical practice environment questionnaire, respectively. Measurements were performed at the first month, fourth month, and seventh month of student nurses' clinical practice. A series of Pearson correlation, multiple linear regression, and generalized estimating equations were applied to analyze the data.

RESULTS

Among 305 student nurses, the mean scores for career motivation toward gerontological nursing over three stages were 66.11 (SD = 8.98), 67.55 (SD = 8.53) and 66.78 (SD = 9.51), sequentially. There were significant differences in scores for career motivation over time (P < 0.05) and the lowest score was observed at the first month. Geriatric attitudes, aging anxiety, empathy, clinical practice environment and stage of clinical practice were notable predictors of student nurses' career motivation toward gerontological nursing.

CONCLUSIONS

Student nurses' career motivation toward gerontological nursing needs to be improved, especially at the first month of clinical practice. Targeted interventions should cultivate positive geriatric attitudes, relieve anxiety about aging, promote empathy, and enrich the clinical practice environment to improve student nurses' career motivation toward gerontological nursing.

Perceptions of aging and ageism among Mexican physicians-in-training

INTRODUCTION

Attributing negative stereotypes to older adults (ageism) may lead to undertreatment, but little is known about the prevalence of ageism among physicians treating patients with cancer in Ibero-America. We studied stereotypes of aging among Mexican physicians-in-training.

MATERIALS AND METHODS

Physicians-in-training attending an oncology meeting answered the "Negative Attributes and Positive Potential in Old Age" survey. Ten questions assessed positive characteristics of aging (PPOA; score 1-4, higher scores represent a positive perception), and four assessed negative characteristics (NAOA; score 1-4, higher score representing a negative perception). Descriptive statistics were used to analyze the questionnaires. Participants completed the "Image-of-Aging" question by writing five words describing older adults and young individuals. Each word was rated from - 5 (negative) to + 5 (positive), and presented as word clouds.

RESULTS

One hundred physicians-in-training (median age 28.5) were included. For the PPOA scale, the mean score was 2.9 (SD 0.4), while for the NAOA scale it was 2.1 (SD 0.4). Perceptions of aging were better among women and trainees enrolled in geriatrics and/or oncology-related programs. In the "Image-of-Aging" questions, median rating of words describing older adults was - 2, compared to + 3 for young individuals (p < 0.001). Among words used to describe older adults, the most frequent was "frail/frailty" (n = 45), while "health" (n = 46) was the most frequent for younger individuals.

CONCLUSIONS

Mexican physicians-in-training showed mostly negative perceptions of aging, exemplified by the use of negative terms to describe older adults. Creating educational initiatives aimed at decreasing ageism among oncology trainees is necessary across Ibero-America.

Actitudes de estudiantes españoles de terapia ocupacional hacia las personas mayores

Introducción. La población mundial está creciendo y envejeciendo. Debido al cambio demográfico en la población, gran parte de los profesionales de ciencias de la salud trabajarán con personas mayores, aunque la mayoría de los estudiantes de estas áreas tienen poco conocimiento e interés para ocuparse de esta población.Objetivo. Analizar las actitudes hacia las personas mayores en los estudiantes del programa de Terapia Ocupacional de la Universidad de Granada en España.Materiales y métodos. Estudio descriptivo. Se utilizó la escala de actitudes hacia el adulto mayor de Kogan (KAOP), validada al español, en 109 estudiantes de Terapia Ocupacional de la Universidad de Granada.Resultados. Los estudiantes participantes manifestaron tener, de media, una actitud neutral hacia el adulto mayor (valor KAOP 143.60±11.70). No se encontraron diferencias estadísticamente significativas por género ni por año académico (p=0.804) en los datos observados.Conclusiones. La actitud observada hacia el adulto mayor entre los estudiantes de Terapia Ocupacional de la Universidad de Granada es neutral, sin diferencias por género ni por año académico. Son necesarios estudios futuros sobre la temática para esclarecer las posibles causas de esta actitud.

Impact of life stories on college students' positive and negative attitudes toward older adults

Gerontological educators are increasingly interested in reducing college students' negative, and promoting their positive, attitudes toward older adults. Over the course of a semester, students from six 4-year institutions viewed three life story videos (documentaries) of older adults and completed pre- and posttest surveys that assessed their positive (Allophilia Scale) and negative (Fraboni Scale of Ageism) attitudes. The authors assessed changes in attitudinal scales between treatment (with videos, n = 80) and control (no video, n = 40) groups. Change score analysis with 95% bias-corrected bootstrap confidence intervals estimated the effects of the documentaries on students' attitudes. The treatment group showed significant increases in kinship, engagement, and enthusiasm, and decreases in antilocution and avoidance (all ps <.05). There was no significant change in affect, comfort, or discrimination. This study demonstrated how video stories impact students' attitudes about older adults.

Ageism: we are our own worst enemy

In 1969, Butler (1969) first coined the term "ageism" to confront "prejudice by one age group toward other age groups" (pp. 243). As with other "isms," such as racism and sexism, ageism leads to bigotry and discrimination, though it is a very distinct beast in that, for the most part, other "isms" refer to those different from ourselves: distinct, mutually exclusive, and impervious groups. Conversely, age is a fluid social construct in which we are all intimately bound as we move through the lifespan, transitioning in and out of different age-groups. Unlike other "isms," individuals negotiate shifts from the "in-group" of youth to the "out-group" of old age. Yet we are all immersed, largely unconsciously, in this ubiquitous but too often unrecognized "ism" that needs to be named and challenged.