Attitudes and behaviors of hospital staff toward elders in an acute care setting

doi:10.1053/apnr.2002.35958

Applied Nursing Research

Volume 15, Issue 4, November 2002, Pages 227-234

https://doi.org/10.1053/apnr.2002.35958 Get rights and content

Abstract

This study was a grounded-theory approach to the social processes engaged in by elderly people while in the hospital. Staff behaviors were identified along two continua, attitude, which affected the elders' dignity and autonomy, and managing care, which affected the elders' health. Elders described the physicians' role as the director of their health care. The elders characterized the nurses' role to provide their medications and direct needs, whereas the nurses identified their role as providing education and emotional support. Implications and recommendations for practice are offered.

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Cited by (58)

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
2019, International Journal of Nursing Studies
Citation Excerpt :
Therefore the core values are presented as an introduction of the manuscript. The literature demonstrates that older patients consider dignity (Canzan et al., 2014; Chang et al., 2012; Jacelon, 2002, 2003; Maben et al., 2012; Randers and Mattiasson, 2000; Ruan and Lambert, 2008; Tauber-Gilmore et al., 2018; Webster and Bryan, 2009) and respect (Canzan et al., 2014; Jacelon, 2002, 2003; Janes and Wells, 1997; Koskenniemi et al., 2013; Lasiter and Duffy, 2013; Maben et al., 2012; Randers and Mattiasson, 2000; Ruan and Lambert, 2008; Tauber-Gilmore et al., 2018; Webster and Bryan, 2009) to be core values that need to be met in the interpersonal care relationship. This finding indicates that the elements of the interpersonal care relationship must meet these core values by providing dignity and respect to older patients.
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.
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.
A systematic mixed-methods review.
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.
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.
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.
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.
An exploration of emergency nurses’ understanding of the ageing process and knowledge of their older patient: A comparison between regional and metropolitan nurses in Australia
2018, International Emergency Nursing
The aims of the present study were to report and compare regional and metropolitan Australian ED nurses' knowledge and understanding of age related characteristics of the older person.
ED nurses, who have a duty of care to deliver best practices for managing the older person, can be challenged due to the complexities and co-morbidities associated with older person presentations in the ED. Nurses in regional areas may have limited access to continuing education programmes and limited opportunities to attend such programmes.
A cross-sectional survey using previously validated instruments (OPACS and Palmore's Facts of Ageing Quiz) was conducted to measure emergency nurses knowledge and perceptions of physical, physiologic, and age related characteristics of older people; and aspects of hospitalisation that affect older people.
Members of the College of Emergency Nursing Australasia (CENA) were invited to participate in the present study. There were 371 (39%) completed and valid surveys returned.
The OPACS results indicate that 66% of ED nurses had a basic knowledge about physical aspects and hospitalisation issues that affect older people. There were 59% correct responses for the Palmore's Facts of Ageing Quiz items measuring knowledge of physiologic and age related characteristics of older people. There were few differences between regional and metropolitan nurses.
Increased knowledge of ageing is required for emergency nurses to continue to provide adequate care to older patients presenting to the ED to avoid adverse outcomes for these people.
Attitudes of students of health sciences towards the older persons
2016, Nurse Education Today
Citation Excerpt :
Attitude is defined as a person's belief, feelings, and experiences in regard to a human, an object or a condition, which is constituted by the person's background and it influences the person's behavior or reactions (Mario et al., 2004). Many factors of care of the older persons are related to attitudes towards an older population, such as inadequate physical conditions and technical equipment in hospital, care centers or nursing homes, management problems, lack of communication with care team professionals, inadequate knowledge and skills for older person care (Adibelli and Kilic, 2012; Jacelon, 2002; Lovell, 2006). In addition to these factors, culture, age, gender, education level, experience and previous relationships with older people could be influential factors on the healthcare provider's attitudes towards the population (Hweidi and Al-Hassan, 2005; Hweidi and Al-Obeisat, 2006; Lambrinou et al., 2009; Usta et al., 2012).
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.
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.
The average age of the students was 20.91 ± 2.25 years, 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).
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.
Knowledge and attitudes of radiation therapists and undergraduate students towards older people
2015, Radiography
Rapidly changing demographics worldwide mean that there will be a significant increase in the number of older cancer patients requiring radiation therapy treatment in the coming decades. Education is regarded as a key factor in addressing attitudes towards older people among healthcare professionals and has been proven to influence the quality of care received. To our knowledge, there is only one previous study specifically in relation to radiation therapists (RTs), and this included a small sample of RTs.
The aim of this study was to investigate the knowledge and attitudes of RTs and RT students towards older people.
A cross-sectional survey design was used, consisting of: 1) demographics, 2) knowledge and 3) attitudes. Knowledge was assessed using the Facts of Aging Quiz (FAQ), while Kogan's Attitude towards Old People (KAOP) Scale was used to assess attitudes. The study population included radiation therapists (RTs) working in Ireland and undergraduate students.
Mean knowledge scores in this study were recorded as 11.82 (SD = 3.07)for RTs and 12.17 (SD = 2.55) for students out of a possible 24, i.e. 49% and 51%, respectively. Average attitude scores were documented as 126.12 (SD = 10.06) for RTs and 125.30 (SD = 10.28) for RT students, out of a possible 170 i.e. 74% for both qualified RTs and students. There were no significant differences between students and qualified RTs in relation to both knowledge and attitude scores. Only 44% of RTs stated that their undergraduate degree equipped them with the necessary skills to deal effectively with older patients.
RTs have a prominent role in the provision of care to cancer patients, the majority of whom are aged 65 and older. Provision of optimal care to older people undergoing radiotherapy will require “age attuning” of the profession, both at undergraduate and postgraduate level. The findings of this research indicate that RTs and RT students have average knowledge and very positive attitudes towards older people.
Dignity in the older critically ill adult: The family member's perspective
2014, Heart and Lung: Journal of Acute and Critical Care
Citation Excerpt :
Staff who are attentive to patients, connected, friendly, helpful, unobtrusive, and respectful enhance a patient's dignity. Staff who are inattentive, rough, harsh speaking, unfriendly or brusque, forgetful of promises or actions, slow to respond, noisy, disrespectful, and insensitive to maintaining privacy diminish patient's dignity.20 Despite this growing attention to issues of dignity, little attention has been paid to the family members' perspective.
The purpose of this study was to examine the meaning and relative importance that family members of older patients in the intensive care unit (ICU) ascribed to dignity.
Dignity is a core value of the nursing profession and of critical care nursing practice. Although there is a substantial body of research supporting the needs of family members of patients in the ICU, little is known about the needs of family members of older, critically ill patients, particularly as they relate to patient dignity.
A qualitative, descriptive approach using unstructured interviews was used. Data consisted of audio taped interviews of study participants. Data were analyzed using the constant comparative method.
Three major themes were identified including: 1) the older patient's health status and ICU experiences; 2) family roles, relationships, and goals; and 3) staff interactions with family members.
Insight into the concerns of family members related to the dignity of the older critically ill patient may be useful in guiding nurses as they provide care in what are often fast-paced, highly technical environments. Meeting well established family needs as well as attending to the unique concerns identified in this study will assist nurses in supporting the older, critically ill patient's dignity.
Nurses' attitudes towards older people: A systematic review
2013, International Journal of Nursing Studies
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.
To examine the international research relating to registered and student nurses’ attitudes towards older people and the potential underpinning variables.
A systematic search of 8 databases covering English and Chinese language publications since 2000 was undertaken which identified 25 papers.
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.
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.

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^☆: Supported in part by the Beta Zeta Chapter of Sigma Theta Tau International.

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Original ArticlesAttitudes and behaviors of hospital staff toward elders in an acute care setting☆

Abstract

Original Articles
Attitudes and behaviors of hospital staff toward elders in an acute care setting☆