Attitudes towards oldest‐old adults (age ≥80 years): A survey and international comparison between Swedish and Austrian nursing students

Abstract

Background and rationale Ageism in nursing, particularly regarding oldest‐old adults (age ≥80 years), adversely affects patient safety and care quality. Nurse education can reduce ageist attitudes. Swedish and Austrian nursing students’ attitudes towards adults age ≥80 years have not been assessed. Aims To analyse attitudes towards adults age ≥80 years among nursing students from universities in Sweden and Austria. Design A prospective cross‐sectional survey including the four‐factor, 26‐item validated Ageing Semantic Differential scale and demographic questions. Methods A pen‐and‐paper survey was administered to nursing students at the Medical University of Graz, Austria (May–June 2019); an online survey was conducted at the University of Gothenburg, Sweden (January–June 2020). Demographic data were analysed descriptively; means and individual item ratings were calculated for each country. Multiple logistic regression was performed for each factor of the instrument: (1) Instrumentality, (2) Autonomy, (3) Acceptability and (4) Integrity. Six independent variables were included in the regression analysis. Results In total, 136 Austrian and 222 Swedish students responded (88% women). Compared with Austrian students, Swedish students were older and had more positive attitudes about oldest‐old adults. Swedish students’ median factor ratings (7‐point scale) were 3.62 (Factor 1), 3.50 (Factor 2), 2.71 (Factor 3) and 3.80 (Factor 4). Austrian students’ median ratings were 4.25 (Factor 1), 3.83 (Factor 2), 3.28 (Factor 3) and 4.00 (Factor 4). Regression analyses showed that the variables country, older family member/acquaintance, and age were associated with the different factors. Discussion Compared with Austrian students, Swedish students’ attitudes towards oldest‐old adults were more favourable. We discussed the findings at individual, interpersonal/intergroup and societal/cultural levels and present implications for education and research. Conclusions Nurse education should address ageism as a multilevel phenomenon, and include the person‐centred care perspective. Further research comparing nursing students’ attitudes from different cultures is needed.

Attitudes towards older adults (80 years and older): A measurement with the ageing semantic differential ‐ A cross‐sectional study of Austrian students

“…Interestingly, the items concerning dependency (independent/dependent, self‐reliant/dependent) showed high mean values in both studies. This result supports the assumption that especially individuals over 80 are viewed as dependent (Heckemann et al, 2021). We chose this special age group by following the recommendation of Kydd et al (2020), who used the defined age group especially for research purposes.…”

Nurses' perspectives on caring for and attitudes towards adults aged eighty years and older

“…As measured with the Fabroni Scale of Ageism (FSA), 89.9% of Jordanian nurses held negative attitudes towards older adults [16]. The Ageing Semantic Differential (ASD) Scale was used to assess nursing students' attitudes towards adults aged 80 years and older in Austria [17,18] and Sweden [17]. In Austria, the nursing, medicine and humanities students displayed slightly negative attitudes towards older adults [18], while in Sweden the nursing students displayed more positive attitudes than Austrian nursing students [17].…”

“…The reason for these differences is not completely clear, but some studies show indications that the nurses' or nursing students' attitudes towards older adults are influenced by their age [15,17], work experience and setting [15], level of nursing education, having older adults in the family [14], personal relationship with older adults and the knowledge of ageism [18] and culture [19].…”

The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data

“…These old and very old patients have thus become a focus of research; it is now a consensus that chronological age alone is not a suitable criterion for assessing the prognosis of critically ill ICU patients [ 7 ]. Away from clinical trials, "ageism" is a common problem [ 8 , 9 ]. For this reason, alternative concepts focusing on frailty rather than age alone have been developed.…”