Jordanian nurses' attitudes toward older patients in acute care settings

The Association of Technology-Based Ageism with Using Digital Technology in Physical Therapy for Older Persons

Integrating digital technologies in healthcare for older adults can enhance their independence and quality of life. Nevertheless, ageism among healthcare professionals impacts treatment decisions and may deprive older patients of technology-based treatment. This study explores whether technology-specific ageism influenced physiotherapists' use of technology-based healthcare with older patients. Seventy-eight physiotherapists in Luxembourg filled out an online survey. Participants filled out the Attitudes Towards Older Adults Using Technology (ATOAUT-11) scale, Expectations Regarding Aging, attitudes towards technology use in the work environment, and whether they had not offered technology-based treatment in the past because of a patient's age. Using logistic regression, negative ATOAUT was found to predict not offering technology-based treatment, such that participants with more negative attitudes (1 standard deviation) were two times more likely not to offer treatment. Positive attitudes towards using technology in the work environment were also found to be a significant predictor. All other characteristics (gender, age, experience and percentage of patients over 50) were not predictive of not offering treatment. This study demonstrates that technology-specific ageism may lead to discrimination and deprive older persons of optimal treatment. More research is needed to identify the magnitude of ageism in using technology-based treatment and develop interventions to overcome it.

A cross-sectional study: exploring knowledge and attitude of medical and nursing students to Care for Elders in the future

Background

All societies are going through a longevity revolution. Inflating the elderly’s age group will present many challenges to the healthcare system. A better health workforce is needed to meet this demand. Little is known about the knowledge and attitude of medical and nursing students toward geriatric care in Saudi Arabia. This study aims to explore medical and nursing students’ knowledge about aging, and their attitude toward caring for older adults.

Method

A cross-sectional study using two surveys: the fact on aging quiz to assess knowledge and the UCLA geriatric attitude scale to evaluate attitudes. A total of 494 medical and nursing students from three universities in Saudi Arabia were included.

Results

Knowledge and attitude scores were 13.57/23 and 3.37/5, respectively. Findings showed that even in a country where the elderly are respected and family bonds are valued there is still much room for improvement. Moreover, there was a significant statistical difference in the knowledge and attitude scores (p < .0001) regarding the participants’ specialty. The nursing participants had higher knowledge scores, while the medical participants had better attitude scores. Overall, Spearman’s correlation coefficient between ranked knowledge and attitude scores was −.339 with a significance of p < .0001, indicating a low negative correlation between the two scores.

Conclusion

Knowledge and attitude score were fair to moderate, these findings propose enhancing learners’ education and training experiences in the care of the elderly through curricular improvements.

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

BACKGROUND AND RATIONALE

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

AIMS

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

DESIGN

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

METHODS

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

RESULTS

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

DISCUSSION

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

CONCLUSIONS

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

Using Virtual Patient Software to Improve Pharmacy Students' Knowledge of and Attitudes Toward Geriatric Patients

Objective. To evaluate the effect of using a virtual patient software program to improve pharmacy students' knowledge of and attitudes toward geriatric patients. Methods. The Virtual Patient for Geriatric Education (VIPAGE) software program was used in two Bachelor of Pharmacy (BPharm) degree programs in Brazilian universities. The virtual consultations were divided into an initial evaluation, care plan, letter of referral to another professional, and evaluation of follow-up. Each weekly session lasted two hours. Students answered questionnaires before and after using the virtual patient software relating to the following: demographics, geriatric experiences, Geriatric Attitudes Scale, and the Facts on Aging Quiz. Results. Of the 128 students who completed the baseline questionnaires, 109 students also completed the second questionnaire. The mean Geriatric Attitudes Scale score before the intervention was 3.7 (SD=0.8) and after was 3.9 (SD=0.7). Significant improvements in Geriatric Attitudes Scale scores after using the virtual patient software were seen in students who were male, whose grandparents were still alive, or whose parents were elderly, who had frequent contact with the elderly, who did not have frequent contact with the elderly, and who did not have professional contact with the elderly. The average score on geriatrics knowledge was 44.7 (SD=12.0) before completing the virtual patient consultations and 52.6 (SD=11.9) after. The mean score measuring students' lack of geriatrics knowledge was 27.3 (SD=15.8) before and 19.1 (SD=12.8) after using the software. Conclusion. Completing virtual patient consultations using the VIPAGE software positively impacted pharmacy students' geriatrics knowledge and attitudes.

Gender analysis of nurses' attitude towards care of the elderly with dementia in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria

This study assessed nurses' knowledge and attitudes by gender toward the care of elderly patients with dementia and explored gender differences in attitudes and associated factors in Obafemi Awolowo University Teaching Hospital, Ile-Ife. The study adopted a sequential explanatory mixed method design to obtain data from 100 nurses selected through a multistage sampling technique. Data analysis was done at univariate, bivariate, and multivariate levels with a significance at P < .05. Findings revealed that a majority of the nurses have good knowledge and attitudes toward the care of elderly patients with dementia. Previous experience in a specialized unit (Odd = 2.879, CI = 0.013-8.287, P = .047) was the main predictor for the nurses' attitude.

Knowledge, attitude and self-efficacy of elderly caregivers in Chinese nursing homes: a cross-sectional study in Liaoning Province

OBJECTIVE

This study aimed to investigate the perceptions of elderly caregivers in Chinese nursing homes (NHs) and associated factors with regard to knowledge, attitude about elderly and self-efficacy.

SETTING

A cross-sectional questionnaire survey was conducted in 12 NHs in Liaoning Province, China.

PARTICIPANTS

A total of 403 caregivers from 12 NHs were surveyed.

OUTCOME MEASURES

Data were collected using a self-administered questionnaire composed of the Palmore's Facts on Aging Quiz I, Kogan's Attitude Towards Old People Scale, General Self-Efficacy Scale and background characteristics of participants. An average score for knowledge, attitude and self-efficacy was calculated. Differences across groups were evaluated using Student's t-test and analysis of variance. Multivariable linear regression models were established to estimate the associated factors.

RESULTS

The participating caregivers reported a relative low score on knowledge about the elderly (10.42±2.79), attitude towards old people (127.85±14.36) and self-efficacy (27.12±4.9). Multivariable regression analysis showed that respondents who had high educational level (β=0.212, 95% CI 0.193 to 0.824), received prejob training (β=0.193, 95% CI 0.081 to 1.169) and had high job satisfaction (general satisfaction: β=0.345, 95% CI 0.223 to 1.875; very satisfied: β=0.322, 95% CI 0.210 to 1.283) gave a positive rating on knowledge. Caregivers who were employed as formal staff (β=0.155, 95% CI 0.116 to 1.670), earned a high income (β=0.214, 95% CI 0.117 to 1.461) and had an interest in working with the elderly (β=0.141, 95% CI 0.088 to 1.508) tended to develop a positive attitude towards the elderly. However, caregivers who were female (β=-0.110, 95% CI -1.751 to -0.080) and had long work experience (β=-0.130, 95% CI -1.527 to -0.110) developed negative perception. Caregivers who were older (β=0.215, 95% CI 0.139 to 1.027), received prejob training (β=0.143, 95% CI 0.113 to 1.024), had an interest in working with the elderly (β=0.154, 95% CI 0.114 to 1.015), had high job satisfaction (β=0.177, 95% CI 0.116 to 1.223) and perceived better health status for the elderly (partial disability: β=0.437, 95% CI 0.259 to 1.600; no disability: β=0.288, 95% CI 0.153 to 1.211) gave a positive rating on self-efficacy.

CONCLUSION

Knowledge about the elderly, attitude towards old people and self-efficacy of elderly caregivers in Chinese NHs were at low levels. Some targeted intervention programmes, such as conducting professional training for aged care and a performance-based payment system, should be given priority to improve these attributes.

Relationship Between Gerontological Nursing Education and Attitude Toward Older People

BACKGROUND

Nursing students' attitudes toward older people affect the quality of care provided to the aging population. Although gerontological nursing has been delivered as a stand-alone course in Macao since 2008, Macao nursing students' attitudes toward older people have not been investigated.

OBJECTIVE

The purposes of this study were 1) to explore nursing students' background information and attitudes toward older people and 2) to examine the presence of relationships between these factors and gerontological nursing education in Macao, a special administrative region of China.

METHODS

A cross-sectional survey design was adopted. Nursing students in Macao were invited to complete a questionnaire to record their demographic characteristics and gerontological nursing education and measure their attitudes toward older people using Kogan's Attitudes Toward Older People (KAOP) scale.

RESULTS

Data from 377 (83.04%) nursing students who returned the questionnaire were analyzed. The students were found to have positive attitudes toward older people, with a mean KAOP score of 168.44 ± 18.38 (mean ± standard deviation). In particular, the item with the lowest mean score was "older adults have excessive demands for love" (2.5 ± 1.2), while the item with the highest mean score was "older adults need no more love than others" (6.0 ± 1.0). The results also revealed that Macao nursing students' positive attitudes toward older people were associated with having "religion," "good experience in gerontological nursing taught course," and "good experience in clinical practice with older people," which were thus considered to be the predictors of their positive attitudes toward older people.

CONCLUSION

Religion and gerontological nursing education are associated with Macao nursing students' attitudes toward older people. A longitudinal study is needed to evaluate the gradual changes in nursing students' attitudes. Nursing students' future career choices and perceptions of gerontological nursing education should be explored in a future study.

Core elements of the interpersonal care relationship between nurses and older patients without cognitive impairment during their stay at the hospital: A mixed-methods systematic review

BACKGROUND

The fundamental importance of establishing an interpersonal care relationship for quality nursing care has been highlighted. However specific elements of the interpersonal care relationship of importance to older patients in the hospital have not been identified.

OBJECTIVES

The aim of this review was to explore and synthesise research findings regarding the elements of the interpersonal care relationship concept from the perspectives of older patients.

DESIGN

A systematic mixed-methods review.

DATA SOURCES

An extensive search was conducted up until October 2018 for articles without any publication date time limit in PubMed, Web of Science, Cochrane Database of Systematic Reviews and CINAHL.

REVIEW METHODS

Primary studies were included if they concerned patients aged 65 years or older and their perspectives on the elements of the interpersonal care relationship with nurses. Inclusion was limited to patients without cognitive impairment who were admitted to an acute hospital setting. The methodological quality of each study was assessed using the Critical Appraisal Skills Programme for qualitative studies, the Quality Assessment Tool for Quantitative Studies and the Mixed-Methods Appraisal Tool. Thematic analysis was used to structure the results of the included studies.

RESULTS

Of the 7596 studies found, 24 were included in this review. Twenty articles had a qualitative, three a quantitative and one a mixed methods design. Older patients consider dignity and respect as core values that need to be met in the interpersonal care relationship. Five core elements of the interpersonal care relationship were identified to meet these core values: elements related to caring behaviour and attitude, person-centred care, patient participation, communication and situational aspects. These core elements were structured according to three categories, identified in the literature, that determine the quality of the interpersonal care relationship: nurse-, older-patient-related elements and situational aspects.

CONCLUSIONS

The elements identified in this review can guide efforts to define the interpersonal care relationship between older patients and nurses. Nurses should be supported and motivated by education and practice to adapt their behaviour, attitudes and communication to meet older patients' expectations. Hospital management can also encourage nurses to communicate well. Investment in the current organisation of care is needed to improve nurses' work overload and presence. Further research is needed to clarify the underlying processes influencing the experience of the interpersonal care relationship from the perspectives of older patients, nurses, informal caregivers and hospital management.

Correlates of Ageism Among Health Care Professionals Working With Older Adults

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.

Health professionals' knowledge and attitudes toward older people in primary care in Saudi Arabia

Previous international studies have indicated that a range of factors influence knowledge and attitudes toward older people were education, past work experiences, and social contact with healthy older people. This article reports on the findings of a literature review in relation to attitudes toward older people among health professionals working in primary healthcare centers in Saudi Arabia. The findings of this narrative literature are reported through 5 themes: the instruments used in the selected studies to measure attitudes toward older people; the instruments used to measure knowledge on ageing; attitudes toward older people; knowledge of the care of older people; and factors that influence knowledge and attitudes toward older people. Further investigation is needed to identify the level of knowledge on ageing, attitudes toward older people, and the factors which affect health professionals’ knowledge and attitudes toward older people in primary healthcare centers in Saudi Arabia.

Attitudes of neurology specialists toward older adults

OBJECTIVE

Attitude of healthcare providers toward older people is very important in the aging world. Neurologists contact older adults very frequently. We aimed to investigate the attitudes of neurologists toward older adults.

MEASUREMENTS

We recorded participants age; sex; duration of clinical practice in neurology; existence of older adult relatives; and history of geriatrics education, nursing home visits, older adult patient density in their clinical practice, and participation in voluntary public activities. UCLA Geriatrics Attitude Scale was used to evaluate participants' attitudes.

RESULTS

A total of 100 neurologists participated in this study. Seventy-seven percent had positive, 3 % had neutral, and 20 % had negative attitudes. Twenty-seven percent of the participants had history of geriatrics education, and these participants tended to have a higher rate of positive attitudes. Neurologists with positive attitudes tended to be older than those with negative attitudes. Participants with history of living with older adult relatives had lower rates of positive attitudes. The most common diagnoses of the patients the participants encountered were stroke and dementia. Independent factors associated with positive attitudes were history of geriatrics education and older age. History of living with older relatives tended to have a negative effect. Most of the negative items of the attitude scale were associated with the natural course and behavior of the common diseases in neurology practice.

CONCLUSIONS

Generalization of geriatrics education may translate into a better understanding and improved care for older patients. Development of instruments and implementation of qualitative studies to assess attitudes of neurologists toward older adults are needed.

Emergency nurses attitudes towards older people in the emergency department: a cross-sectional study

AIM

To report nurses' attitudes towards older people in the emergency department (ED).

BACKGROUND

A nurse's attitude towards an older person can have an effect on nurses' work practices and interactions and can result in adverse outcomes for the older person.

DESIGN

A national cross-sectional survey using a previously validated instrument Older Person in Acute Care Survey (OPACS) was conducted to measure emergency nurses' attitudes towards older people in their care.

METHODS

Members of the College of Emergency Nursing Australasia (CENA) were invited to participate in the study. There were 371 (39%) completed surveys returned.

RESULTS

The OPACS survey identified that ED nurses have positive attitudes towards older people in the ED.

CONCLUSION

The implications for practice are clinically significant because positive attitudes can result in prevention of discrimination and marginalisation of the older person in the ED.

Attitudes of students of health sciences towards the older persons

OBJECTIVES

The purpose of this study was to evaluate and compare attitudes towards the elderly of Turkish students of various disciplines in health sciences at the level of associate and bachelor degree.

METHODS

685 students participated in this descriptive study. Data were collected with a questionnaire administered to the students and the Turkish version of Kogan's Attitudes Towards Old People Scale (KAOP). Statistical evaluation of the data was included in percentage, mean, median, t-test, and one-way variance analysis.

RESULTS

The average age of the students was 20.91±2.25years, and mean and median scores of KAOP for these students were 131.21±14.403 and 130, respectively. The attitudes of physiotherapy students towards older people were better than students in other health disciplines (p<0.05), and there were no differences in the attitudes of health science students towards the older persons in eastern and western cities of Turkey (p<0.05).

DISCUSSION

The attitudes of the health science professionals of tomorrow towards older people should be evaluated currently to be able to improve the provision of health care standards and to prevent possible negative beliefs and opinions in the future.

Gerontology course in the nursing undergraduate curricula

OBJECTIVE

To explores nursing faculty members' attitudes towards older people, their thoughts about gerontological nursing education.

METHOD

Five focus groups and a survey were used with nursing faculty members 132 at the three nursing schools to explore their attitudes towards the care of older people and the perceived status of gerontological nursing education. The survey was given to 132 faculty members, including 76 clinical instructors, 40 associate professors and 16 professors. The nursing faculty in general had a positive attitude toward older people (M=3.36, SD 0.25), and teachers' attitudes were higher than those of their nursing students (M=3.18, SD0.29).

RESULTS

This study results suggests that Saudi nursing curricula should include more extensive gerontology content and clinical experience with older people.

CONCLUSION

This is the first time in Saudi Arabia that research has listened to their voices and examined their commitments toward gerontology education.

Portuguese nurses' knowledge of and attitudes toward hospitalized older adults

Portugal is impacted by the rapid growth of the aging population, which has significant implications for its health care system. However, nurses have received little education focusing on the unique and complex care needs of older adults. This gap in the nurses' education has an enormous impact in their knowledge and attitudes and affects the quality of nursing care provided to older adults. A cross-sectional study was conducted among 1068 Portuguese nurses in five hospitals (northern and central region) with the following purposes: (i) explore the knowledge and attitudes of nurses about four common geriatric syndromes (pressure ulcer, incontinence, restraint use and sleep disturbance) in Portuguese hospitals; and (ii) evaluate the influence of demographic, professional and nurses' perception about hospital educational support, geriatric knowledge, and burden of caring for older adults upon geriatric nursing knowledge and attitudes. The mean knowledge and attitudes scores were 0.41 ± 0.15 and 0.40 ± 0.21, respectively (the maximum score was 1). Knowledge of nurses in Portuguese hospitals about the four geriatric syndromes (pressure ulcers, sleep disturbance, urinary incontinence and restraint use) was found inadequate. The nurses' attitudes towards caring for hospitalized older adults were generally negative. Nurses who work in academic hospitals demonstrated significantly more knowledge than nurses in hospital centers. The attitudes of nurses were significantly associated with the hospital and unit type, region, hospital educational support, staff knowledge, and perceived burden of caring for older adults. The study findings support the need for improving nurses' knowledge and attitudes towards hospitalized older adults and implementing evidence-based guidelines in their practice.

Nurses' attitudes towards older people: a systematic review

BACKGROUND

The population is ageing globally. Older people are more likely to have chronic diseases and disabilities and have contact with health services. Attitudes of healthcare professionals affect the quality of care provided and individual career preferences.

AIM

To examine the international research relating to registered and student nurses' attitudes towards older people and the potential underpinning variables.

METHODS

A systematic search of 8 databases covering English and Chinese language publications since 2000 was undertaken which identified 25 papers.

FINDINGS

Reported attitudes towards older people were inconsistent with positive, negative and neutral attitudes being noted across registered and student nurses and appear to be slightly less positive since 2000. A range of variables have been examined as potential predictors of nurses' attitudes with age, gender and education level being investigated most frequently but none were consistent predictors. Preference to work with older people and knowledge of ageing appeared to be associated with positive attitudes towards older people.

CONCLUSIONS

There is a growing need for registered nurses committed to working with older people, however, there is a dearth of well designed studies which investigate both the attitudes of registered and student nurses and the associated factors, and test interventions to inform workforce strategies.

Health professionals' attitudes toward older people and older patients: a systematic review

Attitudes toward older people and older patients among healthcare professionals are of concern throughout the world, but there are no recent systematic reviews which have examined and compared the attitudes across the various healthcare professionals who provide healthcare to older people. A comprehensive literature search (2000-2011) was undertaken on electronic databases (CINAHL, MEDLINE, EMBASE, British Nursing Index, PsycINFO, Chinese Biomedical database, China Medical Academic Conference and China Academic Journal) using a combination of terms. We identified 2179 articles indexed with these terms. Initial screening was undertaken by two researchers and then checked by a third researcher. In total, the reviewers selected 117 articles which, on the basis of their abstracts, appeared to meet the criteria for inclusion. We obtained the full texts and two reviewers assessed each full text paper to further examine whether it met all the criteria. The final review identified 51 studies. Publications over the last 10 years show that attitudes towards older people and older patients range from neutral to positive among healthcare professionals and highlight the need for well-designed studies of both qualified and student healthcare professionals recruiting random samples across multiple sites and utilizing validated instruments consistently to permit comparison over time and across countries.