Do Physiotherapy Students Demonstrate Ageist Attitude? A Scoping Review of Literature.

Aims: To describe attitudes of physiotherapy students toward older adults and their interest in working with them; and to identify factors that may influence physiotherapy students' attitude, knowledge and beliefs toward older adults or interest in working with them. Methods: We used the five-step scoping review approach described by Arksey and O'Malley (2005). We obtained studies published or in press between 2000 and 2016 of attitudes of physiotherapy students towards older adults either alone or among other groups. We excluded qualitative studies, opinion papers and articles focused on determining the psychometric properties of questionnaires. Two independent coders identify the major themes in the included studies. Results: Fourteen studies met criteria and were reviewed in detail. All reported that physiotherapy students have positive attitude towards older adults. Only four studies reported physiotherapy students' interest in working with older adults, of which three reported low interest and one reported moderate interest. Contact with older adults before entering physiotherapy education was the only factor that showed a consistently positive influence on attitudes toward older adults. Conclusions: Physiotherapy students do not demonstrate ageist attitude but have low interest in working with older adults.     

Student nurses' attitudes regarding older adults: Strategies for fostering improvement through academia

The increasing population of older adults is one of the main issues facing health care systems. Nurses caring for the elderly need to have a positive attitude toward older adults to provide optimal care. Yet, the literature reveals that student nurses' attitudes toward working with older adults tend to be negative. This article presents the current research on student nurses' attitudes toward caring for older adults and outlines practical suggestions for fostering positive attitudes.     

Attitudes of occupational therapists toward spirituality in practice.

OBJECTIVE: This study examined (a) occupational therapists' attitudes about spirituality in practice on the basis of whether they identified themselves as religious, (b) whether their personal definition of spirituality related to their religiousness, (c) whether their definition related to their attitude about spirituality in practice, and (d) the methods they used to address the spiritual needs of clients. METHOD: An attitude questionnaire was developed and mailed to 396 American occupational therapists. Fifty-two percent (n = 206) of the mailed questionnaires were analyzed. RESULTS: Overall, participants indicated a slightly positive attitude toward spirituality in occupational therapy practice. Participants who considered themselves to be religious indicated a more positive view toward spirituality in practice than those who did not consider themselves to be religious. Religiousness accounted for only 28% of the variance in choice of spirituality definition, indicating that additional variables account for what determines therapists' definitions of spirituality. No relationship was found between personal definition choice and attitude regarding spirituality in practice. The three methods most commonly used to address the spiritual needs of their clients were to (a) pray for a client, (b) use spiritual language or concepts with a client, and (c) discuss with clients ways that their religious beliefs were helpful. CONCLUSION: Therapists' conceptualization of spirituality and attitudes about spirituality in occupational therapy practice are quite diverse.     

A path analysis of Internet health information seeking behaviors among older adults

The Internet has emerged as an innovative tool that older adults can use to obtain health-related information. However, the relationships among predictors of Internet health information seeking behaviors (IHISB) in this population are not well understood. To fill this gap, this study examined the direct and indirect pathways of potential predictors of IHISB among older South Korean adults, using the modified Technology Acceptance Model 3. Participants were 300 older South Korean adults who had used the Internet to obtain health information within the past month. Data were collected via a self-report questionnaire and were analyzed through structural equation modeling. Two variables—prior experience and behavioral intention to use—had positive direct effects on IHISB. These findings imply that health care providers promoting IHISB among older adults should consider these individuals' prior experience with the Internet and their willingness to use the Internet as a source of health information.     

Relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults

The purpose of this study was to examine the relationships among stress, infectious illness, and religiousness/spirituality in community-dwelling older adults in the southeastern United States. Four assessment tools were completed by 82 older adults (mean age = 74, age range = 65 to 91): the Perceived Stress Scale, the Carr Infection Symptom Checklist (SCL), the Brief Multidimensional Measurement of Religiousness/Spirituality, and a demographic form. A significant correlation was found between stress and SCL scores; however, four dimensions of religiousness/spirituality moderated the relationship between stress and infection. Older adults who were unable to forgive themselves or forgive others, or feel forgiven by God, were more likely to have had an infection in the previous month. Increased infections also occurred when older participants did not feel they had religious support from their congregations. Using these findings, gerontological nurses are well positioned to deliver tailored stress management and forgiveness interventions when older adults report increased stress.     

The effects of a well older adult clinical experience on students' knowledge and attitudes

Is a planned learning experience with well older adults a positive influence on a nursing student's attitude, level of gerontological knowledge, and willingness to work with older adults after graduation? Students in a baccalaureate program were divided into treatment or control groups based on their attitudes on the Kogan's Attitude Toward Old People Scale. Knowledge was measured by the Palmore's Facts on Aging Quiz (Palmore, 1977). Half of the students were given experiences with well elderly while the other group had no experience with this population. Differences in pre- and post-test scores were compared by analysis of variance. All students, regardless of planned experience with older adults, increased their knowledge. Students who initially had negative attitudes significantly improved their attitudes regardless of the type of clinical experience. The investigation failed to support the idea that experiences with well elderly would make a difference on attitude and knowledge base. This project suggests knowledge and attitude changes are not dependent upon a particular type of clinical learning activity.     

Community-based flood disaster management for older adults in southern of Thailand: A qualitative study

ObjectiveThis study explored the approaches for community-based flood disaster management for older adults in Southern Thailand. It sought to understand community culture for supporting older adults and promoting community strength in case of flood disaster.MethodThis was a qualitative content analysis study using data from observation, in-depth interviews, secondary data, and focus group discussion. One hundred and twenty-seven people in total were selected specifically for the study, including Local Administration Organization (LAO), community leaders, public sector officers, civil groups, and older adult groups and family caregivers.ResultsThe results of this study were two main themes, focusing on 1) approaches to community-based flood disaster management for older adults as follows: eight approaches in the phase of prevention and preparedness in flood disaster management for older adults, eight approaches in the phase of response in flood disaster management for older adults, and six approaches in the phase of recovery and rehabilitation in flood disaster management for older adults; and 2) factors contributing to success in flood disaster management for older adults has four factors, including the human factor, the work factor, the data factor, and the resource factor.ConclusionThe findings showed significant roles in improving the potential and strength in community-based flood disaster management for older adults and providing suggestions for community nurses and health practice personnel involving in flood disaster management to mitigate the potential influence on older adults in the community.     

The impact of a gerontology nursing course with a service-learning component on student attitudes towards working with older adults: A mixed methods study

A growing older adult population requires educational programs which prepare nursing students to care for and increase their interest in working with this population. Faculty at a large public university developed a course specific to gerontology to address this need, including designing a service-learning intervention entitled Aging is Very Personal. The purpose of this study was to explore the impact of this course on student attitudes towards working with older adults. Using a convergent parallel mixed-methods design, 79 students completed pre-course and post-course quantitative surveys and open-ended questions using the Senses Framework survey. Quantitative data were analyzed using a paired-sample t-test. Qualitative data were analyzed using Krippendorff's method of qualitative content analysis. Participants showed statistically significant positive changes in attitudes towards working with older adults on 11 of 15 items. Qualitative findings included 5 themes: acknowledgement of preconceptions prior to course; positive shift in perceptions about older adults; growing interest in working with older adults; appreciation of gerontological nursing as a highly skilled profession; and service-learning as a valuable opportunity to form connections with older adults. A designated course in gerontology with a service-learning component can markedly improve student attitudes towards working with older adults.     

Spiritual perception, attitudes about spiritual care, and spiritual care practices among nurse practitioners

The purpose of the nonexperimental study was to examine the relationships among spiritual perception, attitudes about spiritual care, and spiritual care practices in nurse practitioners. Attitudes about providing spiritual care and spiritual care practices have been studied among nurse generalists, but little research has been conducted on nurses in advanced practice. All nurse practitioners registered by the state of Indiana were sent Reed's Spiritual Perspective Scale (SPS) and a modified version of the Nurses' Spiritual Care Perspectives Scale developed by Taylor, Highfield, and Amenta. Pearson correlation techniques were used to test for significant relationships. Statistically positive relationships were between perception of personal spirituality and 9 of the 12 spiritual care practices. Eight of the 13 items describing attitude toward providing spiritual care were statistically significant with the SPS. Implications of the findings are discussed.     

Spirituality in later life: effect on quality of life

The purpose of this study was to explore the effects of spirituality on quality of life (QOL) in older adults when age, gender, social support, and health status are controlled. A secondary analysis of data was conducted using results from a cross-sectional survey of older adults. Data were available from a convenience sample of 426 people living in British Columbia, Canada, who volunteered to complete the questionnaire. Instruments included the WHOQOL-100 and a demographic data sheet. The results show spirituality was not a significant factor contributing to QOL in this sample, and that the strongest predictors of overall QOL were social support and health satisfaction. Given difficulties in measuring spirituality and homogeneity of the sample, further research is warranted.     

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.     

What influences student nurses’ intention to work with older people? A cross-sectional study

BackgroundStudies have reported that student nurses hold positive attitudes towards older people; nevertheless, working with older people has consistently remained one of the least desired career choices among student nurses in most countries.ObjectivesThe current study aimed to assess student nurses’ intentions to work with older people and to determine the predictors of working intentions among nursing students.DesignThe study adopted a cross-sectional design.SettingsMultistage sampling was used to recruit nursing students from five states in Malaysia.ParticipantsA total of 1462 nursing students from eleven nursing education institutions participated in this study.MethodsA self-administered questionnaire was used to collect data. This study is underpinned by the Theory of Planned Behaviour. The Intent to Work with Older People Scale and Kogan Attitudes Toward Old People Scale were used to assess nursing students’ intentions and attitudes towards care of older people respectively. Researcher-developed instruments were used to assess subjective norms and perceived behavioural control among nursing students.ResultsThe present study found that nursing students in Malaysia demonstrated a moderate level of intention to work with older people, with a mean of 39.72 (±4.38). There were significant differences in effects of gender, ethnic group, academic level, type of nursing institution and setting of older person care clinical experience on intentions to work with older people. There was a moderate and positive relationship between attitudes towards older people and intentions to work with older people, as well as between perceived behavioural control and intentions to work with older people; it was found that r = 0.36 for both relationships. Attitudes, subjective norms and perceived behavioural control accounted for 19.7% of the variance in intentions to work with older people.ConclusionThe primary findings of this national study revealed that Malaysian nursing students have a moderate level of intention to work with older people. It is imperative to develop educational interventions to nurture attitudes for caring and promote stronger intentions to work with older people.     

Integrative review of spirituality in African American breast cancer survivors.

This paper reports findings of an integrative review of the literature on spirituality in AA breast cancer survivors, isolates key spiritual themes, and recommends future research. Inclusion criteria are 1994 to 2004 research studies that included AA breast cancer survivors 18 years old and older. Content analysis was used to isolate spiritual themes and spiritual domains/dimensions. Seven studies resulted that used qualitative, quantitative, and mixed methods. Themes identified were spirituality provided the strength to cope; the need to care for others and receive care; beliefs that God is the healer and in control; God assists in decision-making; and closeness to God. Spiritual domains were beliefs, functions, and social support. Future research should explore the domains/dimensions and meanings of spirituality experienced by diverse groups ofAA breast cancer survivors. Culturally appropriate, evidence-based nursing care should include spiritually based interventions that acknowledge the significance of God.     

Predictors of poststroke quality of life in older Chinese adults

Title.  Predictors of poststroke quality of life in older Chinese adults.
Aim.  This paper is a report of a study to identify the changes in poststroke quality of life and other clinical issues among older Chinese adults from 1 month to 6 months after stroke and the predictors of poststroke quality of life at 6 months.
Background.  Stroke survivors are known to suffer from prolonged and multiple impairments leading to a compromised quality of life, but few studies report early predictors for quality of life among older Chinese adults after active rehabilitation has been undertaken during the first 6 months after stroke.
Method.  A total of 214 patients with first-ever ischaemic stroke were interviewed by a research nurse at 1 month and 188 patients were interviewed again 6 months after hospital admission for stroke. Assessment of quality of life was done using the Modified Rankin Scale for Quality of Life. Changes in and relationships between quality of life and variables in five domains were explored: bio-anatomical, physical, emotional, cognitive, communicative and social support. The data were collected in 2004–2005.
Results.  Quality of life among two-thirds of participants was unchanged or lower when scores at 1 month and 6 months after stroke were compared. Length of hospital stay after admission for stroke and other 1-month factors – level of worry over current health, cognitive and self-care deficits – were identified as having independent effects on quality of life at 6 months.
Conclusion.  Clinicians need to observe for early signs of mild cognitive impairments and emotional needs of stroke survivors, as well as to consider longer-term interventions to enhance poststroke quality of life.     

A comparison of acute and long-term health-care personnel's attitudes towards older adults

Considerable variations in the quality of care older adults receive may depend much on the attitude of staff towards them. The attitudes of nurses, assistant personnel and porters towards older adults were assessed. Determinants affecting this judgement, such as age, gender, education, years in practice and care setting, were also assessed. Ninety-nine (acute) and 87 (long-term) hospital employees completed the self-report Kogan's Attitude Towards Old People scale. Significant statistical differences in negative attitudes were found between assistant personnel and nurses and between porters and nurses; these non-professionals believed that older adults were irritable, grouchy, complaining and untidy. Practice area had no influence on attitudes; attitudes were, however, significantly predicted by education levels. Findings suggest that, irrespective of setting, assistant personnel and porters possess significantly greater negative attitudes towards older adults than nursing staff. Furthermore, these negative attitudes seem to be a function of lower educational achievement. Implications for informing practice, education and policy-makers are discussed.