Perception Knowledge and Attitude of Nursing Students towards the

Accepted Manuscript Perception Knowledge and Attitude of Nursing Students towards the Care of Older Patients Joel Olayiwola Faronbi, Olabisi Adebowale, Grace Oluwatoyin Faronbi, Oluwaseun Oluwafemi Musa, Joseph Ayamolowo PII: DOI: Reference:

S2214-1391(16)30059-2 http://dx.doi.org/10.1016/j.ijans.2017.06.004 IJANS 60

To appear in:

International Journal of Africa Nursing Sciences

Received Date: Revised Date: Accepted Date:

19 December 2016 15 June 2017 23 June 2017

Please cite this article as: J.O. Faronbi, O. Adebowale, G.O. Faronbi, O.O. Musa, J. Ayamolowo, Perception Knowledge and Attitude of Nursing Students towards the Care of Older Patients, International Journal of Africa Nursing Sciences (2017), doi: http://dx.doi.org/10.1016/j.ijans.2017.06.004

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Perception Knowledge and Attitude of Nursing Students

Title Page

Title: Perception Knowledge and Attitude of Nursing Students towards the Care of Older Patients

Running Head:


Authors:

Joel Olayiwola Faronbi, RN, PhD1*, Olabisi Adebowale1, RN, BNSc Grace Oluwatoyin Faronbi1, RN, MPH, Oluwaseun Oluwafemi Musa 1, RN, BNSc , Sunday Joseph Ayamolowo1, RN, MSc

Mailing Address:

1

Department of Nursing Science, College of Health Science, Obafemi

Awolowo University, Ile-Ife, Nigeria 2

Frail Elderly Research Support Group (FRESH),

Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden *Corresponding author

Authors’ contributions JOF and OA conceived the idea for this study, participated in the design of methodology, data collection and analysis, interpretation of data and prepared the final manuscript for publication. GOF, OOM and SJA participated in the design of the study’s methodology, interpretation of data, drafting and editing of the manuscript. All authors read and approved the final manuscript.

Key words: Ageing, attitude, knowledge, older adults, perception 1


2


Perception, Knowledge and Attitude of Nursing Students towards the Care of Older Patients

Abstract The objectives of the study were to assess the perception, knowledge, and attitude of nursing students towards old age and care of the older adults and to examine personal characteristics that could predict their attitude. Two hundred and eighty students were systematically selected from learning institutions for nursing in Ile-Ife, Nigeria. Data on perception, knowledge, and attitude were collected with the aid of a validated self-administered questionnaire. Descriptive analysis and inferential statistics were done using Statistical Package for Social Sciences. Results showed that 66.1% and 71.8% of respondents had a positive perception and attitudes towards the care of older people, respectively. It further revealed that respondents believed that nurses should be patient, cheerful and sensitive (97.2%); as well as empathetic (91.4%) when caring for the older patients. The respondents also expressed that caring for the older patients goes beyond the basic nursing care (66.1%) and 90% supported the need for a geriatric unit in the hospital. Furthermore, 60% of respondents demonstrated good knowledge of essential clinical practice in the care of older patients. There was a statistically significant association between attitude and perception (OR=1.11; p=0.002) and age category 20-25 (OR=0.45; p=0.04). However, there was no significant association between the attitude of the respondents and knowledge (χ2=4.16; df=2; p=0.125). The study concluded that the respondents have positive perception and attitude as well as good knowledge towards the care of the older adults. These should be reinforced to enhance a better clinical outcome in the care of the older adults.

Key words: Ageing, attitude, knowledge, older adults, perception

3


1. Introduction Globally, there is an increasing aging population (United Nations, 2009) and the 60+ adults comprise the fastest growing age group with significant increase in developing countries (Adebusoye, Ladipo, Owoaje, & Ogunbode, 2011). The older adult population has been estimated to be two billion by 2050 and 80% of them will be resident in developing countries (Gao, Raven, & Tang, 2007). Similarly, 5.3% of Nigeria population is over 59 year old, representing 8.8 million people (HelpAge International, 2013). For the purpose of this study, an older adult is therefore considered an individual older than 60 years The population of older adults is characterized by unique and diverse individuals who may require a variety of healthcare professionals to meet their healthcare needs. Nurses are at the forefront of providing care to the older adults. The care of older people as a specialty in nursing is rising and caring for the older people demands specific knowledge and abilities (Ferreira & Ruiz, 2012). Current demographic and health utilization trends strongly indicate a rapidly increasing demand for nurses who are well qualified to care for older adults (King, Roberts, & Bowers, 2013). Nurses’ role in the care of the older adults is multifaceted; they are provider of direct care, teaching of modifiable risk factors (e.g., healthy diet, physical activity, stress management), as a manager and as an advocate (Capezuti et al., 2012). Ferreira and Ruiz (2012) are of the opinion that there is a lack of educational training for registered nurses as well as for all other groups of nurses working with older people. This was further supported by Doherty, Mitchell, and O'Neill (2011) who reported that over the years, the healthcare provided for the older adults has been severely threatened by the negative stereotypic attitudes and misconceptions by nurses with 63% of elders expressing an unmet health need. This may lead to situation where older patients developing a negative view of nurses and nursing services in health care settings.

4


Studies on the attitudes of nursing students, staff and other health care professionals towards older people and their care have identified negative attitudes towards geriatric nursing (Alsenany, 2009; Oyetunde, Ojo, & Ojewale, 2013). Significantly, Eltantawy (2013) pointed out that in the past 30 years, nursing students have developed a bias about caring for older people, and their study showed that nurses tended to have minimal interest in working at nursing homes caring for older people; they preferred to work with children and adult patients. The quality of nursing services towards the care of the older adults is highly dependent on the preparedness of nursing students who will definitely grow up to become the geriatric care practitioners. Several scholars Adebusoye et al. (2011); Eltantawy (2013); Oyetunde et al. (2013) show that nurses' attitudes and knowledge of ageing may affect their expectations about their working lives and the ways in which they care for and approach their clients. With the increasing ageing population, and associated chronic illness as well decrease physical functionality and increase in dependency, the need for nurses with right attitude, adequate knowledge and skill will also be on the increase. To better understand the issues involved in nursing care of older adult population in Ile-Ife, Nigeria, this study assess the perception, knowledge and attitude of nursing students towards aging and health care of the older adults; and examine personal characteristics that could predict their attitude toward care of the older people. The findings of this study are expected to provide information on how to improve the quality of care of older adults who constitute a vulnerable group among health care consumers.

2. Research Methodology 2.1 Research Design and setting

5


This was a descriptive, cross-sectional study conducted in three training institutions for nurses in Ile-Ife, Nigeria. Two of these schools run a three-year basic programme that prepares students for the final professional qualifying examination for registered nurses (RN). The third institution operates a five-year baccalaureate programme leading to the award of Bachelor of Nursing Science degree (BNSc). In addition, it also prepares students for the final professional qualifying examination for registered nurses (RN). Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) serves as a training base for all the students from the three schools and provides opportunity for students to learn in real life situation as well as interact with other students. 2.2 Target Population

The participants were students in their clinical hospital practice years. The clinical year is defined as follows: Students in the 3rd, 4th and 5th year in the university based programme are regarded as Clinical 1, 2 and 3 respectively while 2nd and 3rd year students in the hospitalbased training are regarded as Clinical 1 and 2 respectively. In the first year, the baccalaureate students take general science courses while in their second year they do basic medical sciences including Anatomy, Biochemistry and Physiology and others. The clinical programme commences at the third year. Similarly, students in the hospital based programme undertake general courses, basic sciences and basic medical sciences in their first year and commence their clinical practice at the beginning of their second year. The sample included second and third year students in the diploma programme and third, fourth and final year students in the university based programme.

The sample size of 280 was derived from the total population of 334 students in the three institutions in the study. The sample size was estimated using Taro Yamane’s formula, n= N/[1+N (e) 2], where, n = sample size; N = population size; e = sampling error (usually

6


between 0.01-0.05). Sample was selected proportionately to the size of each institution using a simple random sampling. 2.3 Research Instrument Data was collected with the aid of a structured questionnaire which was adapted from three instruments namely: Kogan attitudes toward old people scale (Kogan, 1961), Students' perceptions of working with older people (Nolan, Brown, Davies, Nolan, & Keady, 2006) and Facts on Ageing Quiz-2 (Palmore, 1988) The questionnaire comprises four sections: Section A consists of demographic data, Section B contain items that elicit information on perception of respondents towards ageing and care of older people. It contains 14 items using a 4-point Likert scale ranges from strongly agree, agree, disagree to strongly disagree summed to give a total score ranging from 14 - 56 with 14 being the minimum score and 56 is the maximum score. Perception was rated as negative (14-35) and positive (36-56). Similarly, section C comprises items that elicit information on the attitude of respondents towards ageing and care of older people. It has 9 items using a 4-point Likert scale. Response ranges from strongly agree, agree, disagree to strongly disagree corresponding to 1 to 4 respectively. The section is summed up with a minimum score of 9 and the maximum score is 36. The total score for attitude was ranked as 9-23 = negative attitude and; and 24 - 36 = positive attitude. Furthermore, the final part consists of 11 items in “yes” or “no” format that assess the knowledge of ageing and care of older people. For the responses, score of 1 and 0 was given for correct and incorrect and reversed scoring was given for negative knowledge items. The minimum score was 0 and the maximum score was 11. The total score was ranked as 1- 4 = poor knowledge; 5 -7 = fair knowledge; and 8 - 11 = good knowledge.

7


2.4 Reliability and Validity of Research Instrument The validity was ensured through face and content validity by a group of experts in nursing, psychology and education. The reliability of the instrument was ascertained through a pilot study which included a different population but similar characteristics. A pilot study was conducted in School of Nursing, Osogbo using ten nursing students. The instruments yielded a correlation coefficient (r) of 0.71, it was therefore deemed suitable for use in the current study. 2.5 Ethical Consideration Permission for the study was obtained from the authority of the institutions. Ethical approval for the study was obtained from the Health Research Ethics Committee (HREC) of the Institute of Public Health (IPH), Obafemi Awolowo University, Ile-Ife, Nigeria. The respondents were also assured of confidentiality of the findings and liberty to discontinue their participation at will. In addition, informed consent was obtained from the respondents before data collection. 2.6 Procedure for Data Collection Data were collected in July 2012. A formal permission to conduct the study was obtained from the head of each institution, who also provided the class register for each of the classes and this was used as the sampling frame. The principal in conjunction with class coordinator arranged for opportunity to meet with each of the classes. The students were selected by randomly choosing the required number from the class population based on the class register. The purpose of the study was explained to the students, and they were asked to participate in the study. Consent was obtained and they were given the questionnaire. They were allowed to fill the questionnaire without any form of coercion and they returned same immediately.

8


2.7 Method of Data Analysis Data collected were analyzed with the use of Statistical Package for Social Sciences (SPSS) (v.18) using descriptive and inferential statistics. Statistical methods employed include frequency count, percentage and chi square and logistic regression. Chi square was used in testing association between attitude and knowledge and age while logistic regression was used in examining personal characteristics that could predict their attitude toward the care of the older people. 3. Results Table 1 presents the demographic characteristics of the respondents. The age of the respondents spans from 17 to 32 years with the mean of 22.98years (±2.94). As reflected on the table, 63.9% of the respondents fall within the range of 21-25 years. Majority (53.6%) were in clinical 2 and an overwhelming majority (88.9%) were female. A large majority (83.2%) of the respondents were Yorubas and most were Christians (86.1%). Table 1: Socio - Demographic Data of Respondents Frequency Age Below 20 55 21-25 179 26-30 42 Above 30 4 Total 280

Percent 19.6 63.9 15.0 1.4 100.0

Clinical 1

91

32.5

Clinical 2

150

53.6

Clinical 3

39

13.9

Total

280

100.0

Sex

Male Female Total

31 249 280

11.1 88.9 100.0

Tribe

Yoruba

233

83.2

Level of study

9


Religion

Igbo Hausa Others Total

35 4 8 280

12.5 1.4 2.9 100.0

Christianity Islam Others Total

241 38 1 280

86.1 13.6 0.4 100.0

Results of the perception of respondents towards the care of the older adults showed that majority of the respondents perceived the older adults as experienced (96.7%) and dependent (88.5%). Most (81.5%) believe that loneliness comes with aging but 66.1% disagree that misery comes with aging. Aging is seen as regression to childhood by 62.1% of the respondents who agreed and strongly agreed to the statement. 60% of the respondents disagree that it is possible to age without having diseases and 73.2% disagreed that the older adults can learn new things. Majority (80.4%) of the respondents perceive the older adults as being able to hold a sensible conversation although, 70.8% perceive the older adults as forgetful.

Furthermore, attitudes of participants towards the older adults revealed as follows: Respondents believe that nurses should be patient, cheerful and sensitive (97.2%); as well as empathetic (91.4%) when caring for the older adults. Although 78.2% of the respondents believe that working in the care of elders is interesting, 66.8% agree that it is easier to talk with younger people. Majority (89.3%) of the respondents are opposed to discrimination of older people and 86.1% believed it will be fulfilling to specialize in caring for the older adults. Respondents did not believe the nurse should be sorry for the older people. In addition, the knowledge of respondents about care of the older adults on issues such as dietary requirements, dehydration, memory and judgment, and others showed that

10


66.1% of the respondents believed that there is more to caring for the older adults than just washing, feeding and toileting; and 70% believed that basic nursing skills are inadequate in elder care. However, a vast majority, 89.3% view lapses in memory and judgment as normal changes in the older adults. Similarly, 90% of the respondents think that there is a need for an older adults care unit and a vast majority (92.9%) of the respondents only recognized moderate level of exercises as necessary for the older adults. In addition, 82.5% of the respondents recognized a situation where an elder is abused.

Table 2: Summary score of Perception, Attitude and Knowledge about Care of the Older adults among the Respondents Variables Frequency Percentage Attitude Positive attitude (24-36) 198 70.7 Negative attitude (9 -23) 82 29.3 280 100.0 Total Perception Positive perception (36-56) Negative perception (14-35) Total

185 95 280

66.1 33.9 100.0

Knowledge Good knowledge (8-11) Fair knowledge (5-7) Poor knowledge (1-4) Total

160 119 1 280

60.0 39.3 0.7 100

Table 2 revealed that majority (66.1%) of the respondents have positive perception of the older adults; 71.7% respondents have positive attitude towards the older adults and 60% of the respondents have good knowledge about the care of the older adults. Level of significance was set at p < to 0.05, two variables tested were not significant.

11


Table 3: Association between Attitude, Knowledge and Age of the Respondents about Care of the Older Adults p df χ2 Variable Attitude Knowledge Negative Positive Total Poor knowledge 0 1 1 0.125 2 4.16 Fair knowledge 40 79 119 Good knowledge 42 118 160 Total 82 198 280 Age below 20 20-25 25-30 above 30 Total

10 58 13 1 82

55 179 42 4 280

45 121 29 3 198

0.309

3

3.59

A chi square analysis was conducted to test whether there is any significant association between attitude of the respondents and their knowledge of the care of the older adults as well their age. The result revealed that the two variables tested were not significantly related to attitude (p> 0.05). Table 4. Logistic Regression Model Predicting the Attitudes of Respondents about the care of Older Adults

Attitude Perception Knowledge Age 20-25 25-30 above 30 Sex Female Tribe Igbo Hausa Others Religion Islam Others Institution

Odds Ratio

Std. Err.

Z

P>z

1.10981 1.04163

0.03720 0.05386

3.11 0.79

0.002 0.43

1.03925 0.94124

1.18518 1.15273

0.45505 0.17445 0.62075 0.33086 1 (omitted)

-2.05 -0.89

0.04 0.371

0.21465 0.21839

0.96468 1.76444

0.63657

0.30117

-0.95

0.34

0.25185

1.60902

0.98357 4.72988 0.91443

0.48193 6.22349 1.03617

-0.03 1.18 -0.08

0.973 0.238 0.937

0.37647 0.35880 0.09922

2.56969 62.35136 8.42705

1.45664 0.63740 1 (omitted)

0.86

0.39

0.61785

3.43419

12

[95% Conf. Interval]


OAUTHC SDA Clinical year Clinical 2 Clinical 3 _cons

1.60202 1.52869

0.78056 0.82815

0.97 0.78

0.333 0.433

0.61650 0.52868

4.16297 4.42025

0.29154 0.30155 0.02166

0.43868 0.46997 0.04755

-0.82 -0.77 -1.75

0.413 0.442 0.081

0.01527 0.01422 0.00029

5.56546 6.39678 1.60013

The logistic regression model was performed to assess which of the independent variables (perception, knowledge, age, sex, tribe, religion, institution and clinical year) is likely to predict negative attitude of respondents. The full model containing all predictors was statistically significant, χ2 (15, N = 275) = 33.09, p < .0044, Pseudo R2 = 0.3061. The overall multivariate model accounted for 30.6% of the variance of attitudes of respondents towards the care of the older adults. Among the variables entered into the model only perception (OR = 1.109817; p = 0.002) and age category 21-25 (OR = 0.455046; p = 0.04) were statistically significant.

4. Discussion

The majority of respondents in this study were between 21-25years and predominantly female and Christians (86.1%). Findings from this study showed that respondents have positive perception toward the older adults and their care. For example, they perceived that older adults as experienced people, who have accomplished all things (marriage, birth, duties). They also believed that sickness is not part of the normal ageing process. They reported that it is possible for an individual to go through the course of aging without a disease. This good perception displayed by respondents may be associated with the fact that the study setting is a similitude of true African society which holds the older adults in high esteem. Musaiger and D'Souza (2009) believed that the older adults are repositories of experience, memories, authority, and wisdom. Therefore, they should be treasured and protected. These findings further support the reports of Ajala (2006) which revealed that Yorubas traditionally, are people who view older adults as a source of wisdom and guidance 13


based on their varied life experiences This general attitude is however, contrasted by the work of (Celik, Kapucu, Tuna, & Akkus, 2010) who observed a negative attitude towards geriatric nursing among nursing students, staff and other health care professionals

Our finding that respondents did not believe that older adult should be stereotyped negatively is contrary to report from the United Nations (2013) which highlighted that that older people are stereotyped as weak frail and disabled. Seccombe and Ishii-Kuntz (1991) on their own opined that many of these stereotypes have no biological, sociological, or psychological evidence to support them, but they persist nonetheless. A study in the United States revealed that there is a generally a mixed perception towards the older adult, where they are stereotyped as warm (positive) and incompetent (negative) (Fiske, Cuddy, Glick, & Xu, 2002).

Respondents demonstrated a positive attitude towards the care of the older adults. This might have been due to the influence of professional development and expectation on them. King et al. (2013) suggested from their study that schools of nursing may be able to play a role in influencing how students perceive and prefer to work with older adults. The positive attitude displayed by the students further supports the findings of previous researchers Cybulski, Krajewska-Kułak, and Jamiolkowski (2015); Eltantawy (2013) that identified a favourable and positive attitude towards older adults among nursing students who participated in their study. Attitude plays a crucial role in influencing nursing professionals to work with older people.

The statistically significant relationship between perception and attitude is a reflection of the way an individual perceives ageing and older people might lead to their attitudes about caring for the older people. For example, those who perceive that sickness is not part of a normal ageing process and that it is possible for an individual to go through the course of 14


aging without disease may have a positive attitude toward promoting the health of the older adults. This will also manifest in their caring and supportive attitude towards restoring the health of the sick older adults. On the other hand, those who hold negative perceptions towards older adults may also manifest negative attitude towards caring for these old people.

Similarly, there was a significant relationship between attitude and 20-25years age category. This means that even though generally there was no significant relationship between attitude and age, there was a significant relationship between attitude and this age subgroup. This means that the attitudes of respondents in this age subgroup are likely to be predicted by their age. This is similar to the Rhodes and Pivik (2011) reported that one’s gender and age may interact to play a role in one’s perception of older adults. On the contrary, a study conducted by Capezuti et al. (2012) to examine nurses’ knowledge and attitudes towards older patients further revealed a negative attitude of nurses.

Generally, most of the respondents have a good knowledge about the care of the older adults. They recognised causes and prevention of complications when providing care to the older adults. This they viewed will improve the well-being of the older adults. The complexity of caring for older people and the necessity of special knowledge and specialisation in this field is recognized by the majority of nursing students. This good knowledge displayed by respondents supports the findings of Naylor et al. (2004) which revealed that their respondents possessed a reasonable knowledge about the care of the older adults. This is, however, contrasts with the findings of Eltantawy (2013); Montejo, Montenegro, Fernández, and Maestú (2011) which showed that their respondents lack good knowledge of aging and the older adults.

One of the factors responsible for the good knowledge of students on ageing recorded in this study might be related to sampling. This present study was limited to students in their 15


clinical years, who might have been exposed to real life situations in the care of older adults. Contrary to this, the study by Eltantawy (2013) involved all levels of students, including those in the pre-clinical years who were novice in clinical practice. Another reason for this difference might be related to curriculum issue. Eltantawy (2013) reiterated that the poor knowledge recorded in their study might be attributed to insufficient courses of gerontological nursing in the curriculum. However, in this setting, students are exposed to both theoretical and practical aspects of the care of older people at all levels of the education. This might have positively influenced their knowledge.

Further statistical analysis of this study data did not reveal any significant relationship (p < 0.05) between the attitude of the nursing students and their knowledge of ageing and the care of the older patients. The non-significant association between attitude and knowledge observed in this study may be related to differences in sampling as explained earlier. Further large scale study in this environment will likely throw more light to this.

4.1 Implications for Nurses

Gerontology nursing focuses on an integrated preparation of nurses for a more effective management o the complex problems of the ageing process and caring for older people. The increasing number of older people poses a challenge to the health care system, and especially to the nurses who are the first line of providing care to the older adult population. It is important for nurses and nursing students to be aware of their own values and attitudes towards ageing and the older adults, and examine what myths or stereotypes that influence those attitudes. Perception held by nurses and their attitude towards older adults may influence the quality of care they render since a negative attitude toward older people jeopardises the health care of older patients. There is therefore a need to inculcate positive attitudes and perceptions in nursing students who are future practitioners aiming to meet the 16


needs of the older adults. This will ensure maximal satisfaction and comfort to the older adults and this will ensure that the quality assurance of the nursing profession is unthreatened.

4.2 Limitation of the study

The main limitation of the study is related to the self-report nature of information provided through a self-administered questionnaire which is different from what might have been obtained in real life situation. Respondents were asked to complete the questionnaires in anonymous way. However, this self-report may be different from the real patients or clinical experience of students in the different hospitals. It is possible for an individual to deliberately conceal his true nature when responding to a self-report measure. Further qualitative study may provide data to better understand this topic. 4.3. Recommendations The positive attributes demonstrated by respondents in this study could be improved upon by the following recommendations: 1. Gerontological training should be introduced into nursing curricula with meaningful service-learning components in the institutions of learning, 2. It is also recommended that it may be useful to study nursing faculty members’ attitudes towards older patients since their attitudes may influence that of their students. 3. Further study especially qualitative studies should be conducted to further explore factors that influence perception and attitude towards the care of the older adult. 5. Conclusion This study has shown that the majority of participants reported positive perception and attitude towards older people and they have good knowledge in essential clinical practice 17


issues on ageing. These positive attributes should be sustained by placing more emphasis on issues affecting the wellbeing of our increasing geriatric population. This will definitely improve their competency when caring for the older adults in the various health care settings. Conflict of interest None Authors’ contributions JOF and OA conceived the idea for this study, participated in the design of methodology, data collection and analysis, interpretation of data and prepared the final manuscript for publication. GOF, OOM and SJA participated in the design of the study’s methodology, interpretation of data, drafting and editing of the manuscript. All authors read and approved the final manuscript.

Acknowledgements We appreciate the valuable contributions of Fabio Zicker on earlier versions of the manuscript.

References Reeferences Adebusoye, L. A., Ladipo, M. M., Owoaje, E. T., & Ogunbode, A. M. (2011). Morbidity pattern amongst elderly patients presenting at a primary care clinic in Nigeria. African Journal of Primary Health Care & Family Medicine, 3(1), 6 pages. Ajala, A. S. (2006). The changing perception of aging in Yoruba culture and its implications on the health of the elderly. Anthropologist, 8(3), 181-188. Alsenany, S. (2009). Student nurses’ attitudes and knowledge towards the care of older people in Saudi Arabia. Generation Rev. Newsl. Br. Geriatrics Soc. Capezuti, E., Boltz, M., Cline, D., Dickson, V. V., Rosenberg, M. C., Wagner, L., . . . Nigolian, C. (2012). Nurses Improving Care for Healthsystem Elders–a model for optimising the geriatric nursing practice environment. Journal of Clinical Nursing, 21(21-22), 3117-3125. Celik, S. S., Kapucu, S., Tuna, Z., & Akkus, Y. (2010). Views and attitudes of nursing students towards ageing and older patients. Australian Journal of Advanced Nursing, The, 27(4), 24. Cybulski, M., Krajewska-Kułak, E., & Jamiolkowski, J. (2015). Perception of the elderly by junior high school students and university students in Poland. Polish Ministry of Science and Higher Education value: 6, 93. Doherty, M., Mitchell, E. A., & O'Neill, S. (2011). Attitudes of healthcare workers towards older people in a rural population: A survey using the Kogan Scale. Nursing Research and Practice, 2011. Eltantawy, S. H. A. E. (2013). Relation between Nursing Students’ Knowledge of Aging and Attitude towards Elderly People and Their Will and Intent to Work with the Elderly. Relation, 4(27). Ferreira, V. M., & Ruiz, T. (2012). Community health workers' attitudes and beliefs toward the elderly. Revista de Saúde Pública, 46(5), 843-849.

18


Fiske, S. T., Cuddy, A. J., Glick, P., & Xu, J. (2002). A model of (often mixed) stereotype content: competence and warmth respectively follow from perceived status and competition. Journal of personality and social psychology, 82(6), 878. Gao, J., Raven, J. H., & Tang, S. (2007). Hospitalisation among the elderly in urban China. Health policy, 84(2), 210-219. HelpAge International. (2013). Global AgeWatch rank: AgeWatch report card: Nigeria. Retrieved from King, B. J., Roberts, T. J., & Bowers, B. J. (2013). Nursing student attitudes toward and preferences for working with older adults. Gerontology & geriatrics education, 34(3), 272-291. Kogan, N. (1961). Attitudes toward old people: the development of a scale and an examination of correlates. The Journal of Abnormal and Social Psychology, 62(1), 44. Montejo, P., Montenegro, M., Fernández, M. A., & Maestú, F. (2011). Subjective memory complaints in the elderly: prevalence and influence of temporal orientation, depression and quality of life in a population-based study in the city of Madrid. Aging & mental health, 15(1), 85-96. Musaiger, A. O., & D'Souza, R. (2009). Role of age and gender in the perception of aging: a community-based survey in Kuwait. Archives of gerontology and geriatrics, 48(1), 50-57. Naylor, M. D., Brooten, D. A., Campbell, R. L., Maislin, G., McCauley, K. M., & Schwartz, J. S. (2004). Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. Journal of the American Geriatrics Society, 52(5), 675-684. Nolan, M., Brown, J., Davies, S., Nolan, J., & Keady, J. (2006). The Senses Framework: improving care for older people through a relationship-centred approach. Getting Research into Practice (GRiP) Report No 2. Oyetunde, M. O., Ojo, O. O., & Ojewale, L. Y. (2013). Nurses' attitude towards the care of the elderly: Implications for gerontological nursing training. Journal of Nursing Education and Practice, 3(7), 150. Palmore, E. B. (1988). The facts on aging quiz: A handbook of uses and results: Springer Publishing Co. Rhodes, N., & Pivik, K. (2011). Age and gender differences in risky driving: The roles of positive affect and risk perception. Accident Analysis & Prevention, 43(3), 923-931. Seccombe, K., & Ishii-Kuntz, M. (1991). Perceptions of problems associated with aging: Comparisons among four older age cohorts. The Gerontologist, 31(4), 527-533. United Nations. (2009). Department of Economic Social Affairs, Population Division, World Population Prospects: The 2008 Revision, Highlights, Working Paper No. ESA/P/WP.210 United Nations. (2013). World population prospects: 1988. Population newsletter/issued by the Population Division of the Department of Economic and Social Affairs, United Nations(45), 1.

19


Tables for Perception of Ageing Table 1: Socio - Demographic Data of Respondents Variables Frequency Age Below 20 55 21-25 179 26-30 42 Above 30 4 Total 280

Percent 19.6 63.9 15.0 1.4 100.0

Clinical 1

91

32.5

Clinical 2

150

53.6

Clinical 3

39

13.9

Total

280

100.0

Sex

Male Female Total

31 249 280

11.1 88.9 100.0

Tribe

Yoruba Igbo Hausa Others Total

233 35 4 8 280

83.2 12.5 1.4 2.9 100.0

Religion

Christianity Islam Others Total

241 38 1 280

86.1 13.6 0.4 100.0

Level of study

20


Table 2: Summary score of Perception, Attitude and Knowledge about Care of the Older adults among the Respondents Variables Frequency Percentage Attitude Positive attitude (24-36) 198 70.7 Negative attitude (9 -23) 82 29.3 280 100.0 Total Perception Positive perception (36-56) Negative perception (14-35) Total

185 95 280

66.1 33.9 100.0

Knowledge Good knowledge (8-11) Fair knowledge (5-7) Poor knowledge (1-4) Total

160 119 1 280

60.0 39.3 0.7 100

Table 3: Association between Attitude, Knowledge and Age of the Respondents about Care of the Older Adults 21


Variable Knowledge Poor knowledge Fair knowledge Good knowledge Total Age below 20 20-25 25-30 above 30 Total

Negative 0 40 42 82

Attitude Positive 1 79 118 198

10 58 13 1 82

Total 1 119 160 280

55 179 42 4 280

45 121 29 3 198

p

df

χ2

0.125

2

4.16

3

3.59

0.309

Table 4. Logistic Regression Model Predicting the Attitudes of Respondents about the care of Older Adults Attitude Perception Knowledge Age 20-25 25-30 above 30 Sex Female Tribe Igbo Hausa Others Religion Islam Others Institution OAUTHC SDA Clinical year Clinical 2 Clinical 3 _cons

Odds Ratio

Std. Err.

Z

P>z

1.10981 1.04163

0.03720 0.05386

3.11 0.79

0.002 0.43

1.03925 0.94124

1.18518 1.15273

0.45505 0.17445 0.62075 0.33086 1 (omitted)

-2.05 -0.89

0.04 0.371

0.21465 0.21839

0.96468 1.76444

0.63657

0.30117

-0.95

0.34

0.25185

1.60902

0.98357 4.72988 0.91443

0.48193 6.22349 1.03617

-0.03 1.18 -0.08

0.973 0.238 0.937

0.37647 0.35880 0.09922

2.56969 62.35136 8.42705

1.45664 0.63740 1 (omitted)

0.86

0.39

0.61785

3.43419

1.60202 1.52869

0.78056 0.82815

0.97 0.78

0.333 0.433

0.61650 0.52868

4.16297 4.42025

0.29154 0.30155 0.02166

0.43868 0.46997 0.04755

-0.82 -0.77 -1.75

0.413 0.442 0.081

0.01527 0.01422 0.00029

5.56546 6.39678 1.60013

22

[95% Conf. Interval]