Design: A descriptive correlational study was adopted in this study.
Methods: Nurses who look after patients aged 65 years and older at a medical center in southern Taiwan were enrolled in the study. The demographics variables, working condition, geriatric care educational condition, geriatric care knowledge scale, attitude toward geriatric care scale and self-reported geriatric care competency scale were determined through the structured questionnaires. In addition, comprehensive geriatric assessment is used to confirm the health problems among hospitalized elderly patients. By comparing with problem lists, we determine the competencies of geriatric problem assessment in nurses and which represents the objective geriatric care competencies.
Results: A total of 170 nurses were included in the study with the mean age of 27.6 years old. Of which 73 (42.9%) nurses worked at medical wards, and 48 (28.2%) of them worked at surgical wards, and the others worked at integrated wards or geriatric ward. As to the clinical experience, less than 5 years of clinical experience was the majority (74.4%), and 5 to 10 years was the second (11.3%). The average score for geriatric care knowledge was 86.08 ±4.44, while the attitude test came back 62.44±5.28. The score of self-reported geriatric care competency was 67.74±8.84. However, in objective geriatric care competencies, only 30 (17.6%) nurses can assess the healthy problem correctly. The univariate analysis showed comfort of working environment, satisfaction of working environment, importance of working, preference of working and family support and received geriatric care continuous education were significantly associated with self-reported geriatric care competency. However, the Linear regression analysis showed only received geriatric care continuous education was significantly associated with higher self-reported geriatric care competencies. On the other hand, from the objective view of geriatric care competencies, nurses who were younger and worked in internal unit had better performances, whereas it did not showed statistical significance in logistical regression analysis.
Conclusion: To our knowledge, we are the first study to determine objective and subjective geriatric care competencies for nurses in the acute care setting. The study showed that nurses who scores high in the subjective tests included the geriatric care knowledge, attitude and geriatric care competencies tended to correspond with a low score in objective measures, only 17.6 percent of test takers could accurately identify the needs of their patients. The evidence shows that there is a huge gap between subjective perception of geriatric care competencies and the ability of geriatric care competencies in reality objectively. In addition, nurses have accepted geriatric care continuous education bring them high confidence in geriatric care does not translate to a sizable improvement in objective measures. This study urges our nursing education scholars to reconsider the structure and objective of elderly care training courses because how to shorten the gap between academic and practice will be a key point which is to improve nurses’ geriatric care competences.
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