Nurses' general attitudes and caregiving-specific perceptions toward the oldest-old: A nationwide survey

Background: Despite the growing population of older adults worldwide, nurses may harbor negative attitudes to-ward older patients that might risk patient safety. Most studies have investigated general attitudes toward older adults. Only a few have focused on nurses' perceptions of caring for older patients, and there has been little focus on the oldest-old (aged >= 80 years), an age group that is particularly affected by negative attitudes. Emerging models to combat this issue suggest that education about aging and interaction with older adults are key factors. These models have primarily been evaluated using students, not healthcare professionals.Objective: To examine if and to what extent education (training and education about working with older people) and interaction (professional and personal contact with older adults) are associated with nurses' general atti-tudes toward older persons and their perceptions of caring for older patients (aged >= 80 years).Design: A cross-sectional survey study. Participants: A nationwide sample of 2294 Swedish registered nurses with background characteristics reflective of the national nursing population. Methods: Emails with study information and survey links were distributed via the Swedish Association of Health Pro-fessionals' registry. The survey contained one instrument that measures general attitudes toward older adults and one that measures perceptions of caring for older patients. Following the Positive Education about Aging and Contact Ex-periences model, items about participants' education and their professional and personal interaction with the oldest -old adults were also included. Descriptive and comparative analyses were conducted. Multiple regression models used general attitudes and caregiving-specific perceptions as dependent variables in each model. Results: Nurses' general attitudes and caregiving-specific perceptions were correlated. Regression analyses revealed that the education and interaction variables were independently associated with gen-eral attitudes and caregiving-specific perceptions, but these associations followed different directions. An older family member/close friend, extensive work experience, and working primarily in administration were in-dependently associated with more positive general attitudes toward the oldest-old adults. Working in home care or assisted living, having education in geriatrics/gerontology, and frequent interaction with older patients were associ-ated with less favorable general attitudes but more positive perceptions of caring for the oldest-old patients.Conclusions: Our results highlight the complex relationship between nurses' general attitudes and their caregiving-specific perceptions toward the oldest-old persons. Education in geriatrics/gerontology and interaction with older adults are warranted to improve nurses' caregiving-specific perceptions. Appropriate scales that consider this com-plexity beyond general attitudes are needed to capture caregiving-specific and contextual perceptions.(c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

Research shows that education and interaction with older adults significantly influence nurses' attitudes towards older people and their perceptions of caring for older patients. Having an older family member, extensive work experience, and working in administrative positions are associated with more positive attitudes, while working in home care or assisted living, having education in geriatrics/gerontology, and frequent interaction with older patients are associated with less favorable general attitudes but more positive perceptions of caring for the oldest-old patients.