Attitudes Toward the Elderly Among Pre-Licensure Nursing Students

Sunday, 30 July 2017

Maria E. Mackey, DNP
School of Nursing, Diploma Program, St. Luke's University Health Network, Bethlehem, PA, USA


In the United States, the baby-boomers of yesteryear are emerging as today and tomorrow’s elderly population. Given this fact, health care is faced with the challenge of providing safe, quality, and compassionate care to this ageing population. According to the U.S. Census Bureau (2014), in 2010 the population of elderly (identified as 65 and older) accounted for 13.1% of the U.S. population. The U.S. Census Bureau (2014) projects that in the year 2030, the population of elderly in the U.S. will nearly double to 20.3%, and will sustain through 2060 with a projected elderly population of 20.9%. While projections are only estimates of what is to come and not definitive, it is important that health care providers be prepared to address the needs of this identified patient population. The ageing process leads to physiological, functional, cognitive and psychosocial changes; however, these changes do not suggest that ageing predictably leads to disability and dependence (Potter & Perry, 2013). Inevitably, with age-related changes individuals make assumptions and assign labels to the elderly population based on preconceived notions and inaccurate beliefs. As identified by the U.S. Department of Health and Human Services (2013), unrealistic perceptions of ageing can, and do, negatively impact the physical and mental health of the elderly. When living in an ageist society, health care professionals are often unaware of how stereotypes of ageing mold perceptions of the elderly. Perceptions become reality, and the only way to change perceptions is to create a new reality with increased sensitivity and improved attitudes. The purpose of this study was to investigate student nurses’ attitudes toward the elderly after receiving gerontology specific education, in a diploma nursing program, in the Northeastern United States.


With the increased number of elderly needing healthcare and concerns of ageist attitudes towards the elderly, pre-licensure student nurses need to have a better understanding of this patient population and the implications of providing biased care. Research indicates that there are multiple variables that help form attitudes about the elderly, and the positive influence of education. This study implemented a non-experimental Single Group Before-After study design. Using Kogan’s (1961) Attitudes Towards Old People (ATOP) scale, this project surveyed attitudes of pre-licensure diploma level nursing students, in a mixed rural and urban setting of the Northeastern U.S.. Surveys were conducted both before and after the completion of a seven-week gerontology specific course, guided by Miller’s (1990) Functional Consequences Theory for Promoting Wellness in Older Adults. Using an independent-samples t-test, before gerontology ATOP total scores were compared to after gerontology ATOP total scores to determine if the gerontology specific education improved student nurses’ attitudes toward the elderly.


Results of the independent-samples t-test revealed that there was no significant difference in scores for before (M = 124.88, SD = 8.47) and after (M = 123.55, SD = 9.73; t (26) = .39, p = .7, two-tailed). Mean differences were 1.34 (95% CI: -5.8 to 8.48). The magnitude of the effect on group difference in the overall mean scores was determined using eta squared and demonstrated a very small effect at η 2 = .006. The results of this project demonstrated no significant difference in scores for before and after, suggesting that the intervention of gerontology specific education had no impact as a strategy to improve student attitudes.


With no significant difference in scores for before and after surveys, the implication is that the intervention of gerontology education had no impact as a strategy to improve student attitudes. The lack of improvement may have been a result of students already having positive attitudes. Or, the results may have failed to demonstrate an improvement in student attitudes after gerontology education, because the sample size may have been too small to capture a change that may have occurred with a larger sample size. Nonetheless, this study provided a means to objectively measure student attitudes and provided objective data that may or may not be captured, in the classroom and clinical learning environments.