The older population is increasing as life expectancy in many African countries also rises. In the year 2000, the life expectancy of Ghana was 56.99 years. Nineteen years down the line, it increased to 65.66 years. Improved technology and the health care system is believed to account for this. With an increase in the number of the elderly in our community, health providers must be equipped to cater for their needs (Ploeg et al., 2019, Lim et al., 2017). This population is very vulnerable and access health care frequently because of their changing needs.
Ageing comes with its complications such as increased dependence, loss of self-reliance and diminished physical and mental capacity or functioning (de Lange, 2020, Gbeasor-Komlanvi et al., 2020). For example, chronic disease and disabilities are highly associated with older people and therefore they visit the health facility more often (Agyemang-Duah et al., 2020, Lartey et al., 2020).
In Ghana, older adults are nursed in general wards together with young and middle-aged adults after diagnosis has been classified as a medical or surgical case. Nurses are the main carers of the older population when they visit the hospital. It is said that individual beliefs and values influence how we perceive and act towards the older population. Some researchers are of the view that an individuals age, gender, education, living/spending time with an old person, areas of application and professional socializing can influence attitudes towards the aged (Rababa et al., 2020, Abozeid, 2015). The attitude of nurses and other healthcare professionals affect the preferences and the care provided (Baes et al., 2020, Liu et al., 2013).
Geriatric patients value respect which comes in the form of listening attentively, reassuring them, giving accurate answers, helping with their basic activities of daily living, responding promptly to their pain and helping them to manage time effectively (Keutchafo et al., 2021, Koskenniemi et al., 2012). Pennbrant, Berg, & Fohlin Johansson, (2019) indicated that diabetic patients expect to be provided with support and encouragement, monitoring their blood glucose, good nutritional support as well as adequate education about their condition. This calls for an increase in knowledge about their health condition and the needed support. Additionally, nurses need to understand the changes that older adults undergo concerning their physical health, psychological health, social health as well as environmental health. Knowing this makes the nurse better equipped to understand older adult patients. When these expectations are not met, there is a negative impact on their diet, personal hygiene, their social life as well as free will to move about (Tuominen, Leino-Kilpi, & Suhonen, 2014).
Before a nurse can execute effective care to the older adult, they must be fit emotionally as well. This when not dealt with may affect the quality of care provided (Ericson-Lidman & Strandberg, 2013). According to Hanson, (2014) it is common among nurses to show a negative attitude towards older adults. Factors such as gender, age of nurse, educational level are postulated to affect the attitude of nurses towards the older adult. Female gender and advanced age affect attitudes positively (Faronbi, Adebowale, Faronbi, Musa, & Ayamolowo, 2017). The educational level also plays a vital role in the attitude of nurses towards older adults. Higher University learning has been associated with improved care of older adults (Doherty, Mitchell, & O’Neill, 2011).
Liu, Norman and While (2013), postulate that the personal decision to work in the geriatric unit and adequate knowledge positively influence nurses’ attitudes.
A cross-sectional study conducted in Cameroon showed that nursing students had a positive attitude but poor knowledge of older adults (Keutchafo, & Kerr, 2020). According to Manjavong et al., (2019) patients wished to know more about their illness but nurses focused on relieving symptoms. They pay less attention to important issues of older adult health and much attention is given to irrelevant issues. Hence, this lack of knowledge creates the perception that ageing is a disability (Forsell et al., 2011).
Studies have shown that misconceptions about older adults and the ageing process could influence negatively one’s attitude towards this population (Rababa et al., 2020, Sinan et al., 2021). The socio-cultural make-up of Ghanaians is such that older adults are to be revered however some individuals label them as ‘witches’’. Studies have been done in Ghana, on the management of pain in older adults (Adams, Varaei, & Jalalinia, 2020), their utilisation of health services (Adatara, & Amooba, 2020), intention to specialize in geriatric care (Karikari, 2020) among nurses or nursing students. However, none has been done on the knowledge and attitude of nurses (with diploma admitted to a degree program) towards the care of older adults. These are a special group because they are practising nurses with a minimum of two working experience.
The assumption is that having nursed, lived or living with older adults could affect the attitude of nurses towards them. It is necessary to assess the attitude of these nurses who take care of older adults in various health settings. This is expected to also direct the education of student nurses during gerontology. To cope with the current situation and provide quality care to older adults, this current study assesses the knowledge and attitude of nurses towards older adults.
This quantitative study was carried out using a descriptive cross-sectional study design.
The study population was selected from the first private university in Ghana. The study was conducted at a Ghanaian University which was established in 1979 by the West Africa Union Mission of the Seventh-Day Adventist Church. The baccalaureate nursing programme of the institution commenced in September 2007. Currently, the School of Nursing runs the BSc. Nursing program for both practising nurses and senior high school leavers. The university is located at Oyibi, 31 km from the city of Accra, and 13 km from Adenta, a suburb of Accra. This setting was chosen because diploma holding nurses from various hospitals within and outside the region, come to study for a degree here and also by convenience for geographic closeness to the authors.
Participants were second and third-year diploma nurses who were enrolled in the BSc. Nursing program. Nurses with a diploma are admitted to the second year of the degree program. These nurses work in various hospitals and clinics in the Greater Accra region of Ghana. Those in the fourth year were excluded because they had been taught an introduction to gerontological nursing in the current semester which is seen to be an advantage to them. Foreign nationals not practising in Ghana were also excluded from the study. A convenience sampling technique was used to select nurses in their classrooms. Convenience sampling is a type of non-probability sampling technique in which members of the target population are selected based on their availability, accessibility and readiness to voluntarily participate in a study. The diploma nurses were informed by the first author about the details of the study and their consent sought for participation after a lecture. A research assistant distributed the questionnaires to students who were available and willing.
Yamane (1967) formula with a level of precision of 0.05 was used to determine the sample size for the study. With a total population (N) of 51, the sample size was calculated.
Sample size = N = 45.23
In all, forty-five (45) questionnaires were distributed to the practising nurses in the second and third years, and forty (40) were returned. Which accounts for an 88% response rate.
The questionnaire is divided into three sections. Section A was for demographic data, Section B had 25 questions to assess their knowledge using the Facts about ageing quiz and Section C assessed their attitude towards older people.
Palmore, 1977, Palmore, 1981, Palmore, 1988 Facts on Ageing Quiz 1 (FAQ1) was used to measure knowledge. This is a self‐report measurement tool with 25 true/false questions related to a person’s knowledge of ageing. The FAQ1 was designed to measure normal ageing changes such as a decline in the senses, taking longer to learn new things, and seldom reporting boredom. The instrument also measures common misconceptions about ageing (e.g. most older people are pretty much alike). The score of false responses was recorded as a “0″ while true answers were scored “1.” The total score of the FAQ1 ranges from 0 to 25, with a lower total score indicating a lower level of knowledge.
The tool used for the assessment of the attitudes towards the elderly was the KAOP scale (Kogan’s Attitudes toward Old People Scale) first used in 1961 by N. Kogan (Kogan, 1961). KAOP scale is an instrument used to measure stereotypes of the aged and people’s image of older adults. It has 17 positive items and 17 negative items. Kogan’s attitude toward old people scale consists of 3 domains: personal appearance, resemblance, and the nature of interpersonal relations across age generations. The distribution of questionnaires was done before the presentation began. Participants were allowed 30 min to complete and submit the questionnaires. The individuals who were included in the study were informed of the objective of the study, their verbal and written consent was received, and the questionnaires were completed individually. The completed questionnaire was coded and analyzed using a statistical package for social sciences (SPSS) version 22.
Institutional Review Board (IRB) approval (37MH-IRB IPN 58/2019) was granted by the 37 Military hospital Review Board. Written informed consent was obtained from the participants before data collection. Confidentiality and anonymity were maintained as nurses were asked not to indicate their names on the questionnaires.
After obtaining IRB approval, the researchers met with the Dean of the School of Nursing to discuss the study procedure, eligibility criteria, and time/date for questionnaire administration. WhatsApp messages were sent to the platforms of year 2 and year 3 nursing students to invite registered nurses to participate in the study. On the selected date (25th July 2019) the first author visited classrooms of year 2 and 3 and gave details about the study. Signed consent forms were obtained from the eligible nurses who agreed to participate. The first author was available during the consent procedure to answer any questions the nurses might have. The research assistant study questionnaires to the nurses and demonstrated how to complete them. The researchers asked the nurses to devote only 30 min of their time to complete the questionnaire. The nurses were asked to drop the completed questionnaire package in a designated box located at the entrance of the Deans office. Completed questionnaires were picked up the following day. Data collection was from 25th July to 8th August 2019.
The data were analysed for the socio-demographic data profiles of 40 participants of the study. The distribution of nurses according to their knowledge and attitude toward elderly people was explored. Table 1 shows the sociodemographic characteristics of the studied participants, the findings revealed that the age ranged from 20 years to 45 years. Almost all (81.0%) of the study subjects were female, more than half of the sample (55.0%) were married, and 72.5% of the study sample had<5 years of clinical experience. Whiles 15% had between 6 and 10 years of experience. More than two-thirds (84%) of the study sample have lived with older people. Concerning the highest level of education, all were at the diploma level. When asked how many of the study samples are taking care of an older person at home, 85% responded in the affirmative. All participants were currently working in the medical unit of their facility.
Read more: https://www.sciencedirect.com/science/article/pii/S2214139122000208: Nurses knowledge and attitude towards care of older patients.