Nurses knowledge and attitude towards care of older patients: A cross-sectional study

    Abstract

    The older adult population is very vulnerable and access health care frequently because of their changing needs. Additionally, 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. This study aims to assess the knowledge and attitude of nurses towards older adults. The knowledge and attitude of nurses towards the care of older adults has not been studied in Ghana. Hence a survey study was conducted among 40 nurses who had enrolled on a Bachelor of Nursing program using the Fact on Aging Quiz 1, and Kogan’s Attitudes toward Old People Scale from 25th July to 8th August 2019. Results of the study show that even in a country with reverence for older adults and recognised family bonds, poor knowledge and attitudes of nurses toward older adults can affect the quality of health care provided. These findings have implications for nursing education, and clinical practice. Changes across these sectors based on the findings may contribute to improving the quality of health care older adults receive.

    1. Background

    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., 2019Lim 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, 2020Gbeasor-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., 2020Lartey 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., 2020Abozeid, 2015). The attitude of nurses and other healthcare professionals affect the preferences and the care provided (Baes et al., 2020Liu 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., 2021Koskenniemi 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., 2020Sinan 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.Read more here: https://www.sciencedirect.com/science/article/pii/S2214139122000208