What Factors May Predict Nursing Students' Knowledge and Attitude Toward Older Persons?

Sunday, 17 November 2019: 2:05 PM

Elaine B. Little, PhD, RN
Department of Nursing and Allied Health Professions, Indiana University of Pennsylvania, Indiana, PA, USA

The aging population with complex health needs is growing globally (World Health Organization, 2016). Nursing programs are challenged to educate student nurses competent and willing to meet this specific population’s needs. Research on ageism supports the presence of aging bias (Pew Research Center, 2014). Nursing education literature describes how nursing students’ attitudes on aging may affect career choices and the quality of health care provided to older adults (Coleman, 2015; Tagliareni, Cline, Mengel, McLaughlin & King, 2012).

Four out of five older persons have already been diagnosed with at least one chronic health condition, while almost half have two chronic health issues such as arthritis, cancer, diabetes, heart disease, high cholesterol, or high blood pressure, and 23-55% of current Medicare beneficiaries have five or more chronic conditions (Administration on Aging, 2013; American Geriatrics Society, 2013). The older adult population requires specialized nursing knowledge, skills, and attitudes to achieve positive outcomes and prevent serious geriatric syndromes (American Geriatrics Society, 2013; King, Roberts & Bowers, 2013; Neville, 2015; Tagliareni et al., 2012; Watman, 2015).

With the expected growth in the older adult population with multiple healthcare needs, it is crucial that nursing students be knowledgeable about, as well as willing to work with older persons upon graduation from nursing programs, to avoid a nursing crisis in gerontology. Although the care of older adults requires specialized knowledge and includes the most complex clients, students commonly ranked pediatrics, obstetrics, critical care and emergency nursing higher than geriatrics, citing preferences for healthier populations and faster paced environments (Stevens, 2011; Swanlund & Kujath, 2012). Despite many initiatives to bring care of complex, older adults to present nursing education, major gaps and conflicts in the literature remain. This study seeks to clarify some of the existing research, provide nurse educators with data to build gerontological curriculum, and potentially lead to increasing numbers of graduate nurses prepared to care for the older person population, in various health care settings. New knowledge about older person care and geriatric syndromes emerges daily, yet new research to support the relationship between geriatric knowledge and attitude is lacking in the literature (Tagliareni et al., 2012).

The researcher examined the relationship between knowledge of aging and attitude on aging in final semester nursing students following multiple, national gerontology initiatives (American Association of Colleges of Nursing & The John A. Hartford Foundation Institute for Geriatric Nursing, 2008; Institute of Medicine, 2011; Lee, Burton, Lundebjerg, 2017; National League for Nursing, 2010). The impact of demographic and educational factors on knowledge and attitude was also investigated. Understanding these relationships may facilitate the creation of nursing programs, throughout the world, better designed to attract and prepare nursing students for gerontological nursing.

Research suggests that nursing students rarely select geriatrics as their career choice (Henderson et al., 2014). According to Gross and Eshbaugh (2011), not only do nursing students need to be knowledgeable about elderly patients, but the attitudes nursing students have toward older adults is significant to the well-being of these patients. Students, in the literature, often report being unable to relate to older persons, having no desire to deal with their increased dependence, feeling a lack of gerontological knowledge, finding older adults depressed, as well as depressing, and perceiving “older person nursing care” as boring and unchallenging

This study utilized a quantitative, correlational, cross-sectional design and was guided by the Theory of Planned Behavior using the following tools: Kogan’s Attitude Toward Old People, the Palmore’s Facts on Aging, and a researcher created demographic and educational tool. Findings from the national sample of 168 final semester nursing students showed a positive correlation between knowledge of aging and attitude toward older adults, more positive attitudes, improved knowledge, and a desire to work with older adults. Other statistically significant relationships were found between race, educational degree and attitude toward older adults which may impact nursing practice, nursing education, and future gerontological research. The findings of the current study have the potential to assist nurse educators in the context of curriculum design and delivery in a variety of settings, to impact how nurses in health care practice can be influenced to behave toward older patients, and to guide subsequent research in areas of attitude and knowledge of older adults in nursing and other healthcare professionals throughout the world.

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