Journal of Gerontological Nursing

Improving Students' Attitudes Toward Aging

Gerry Chamberland; Betty Rawls; Carla Powell; Mary Jo Roberts

Abstract

The 1971 White House Council on Aging called for nurses to assume leadership roles in dealing with the problems of aging.1 Curriculum patterns of schools of nursing have not traditionally responded to the needs of the geriatric population in our society by providing positive experiences in geriatrics for nursing students. In an attempt to deal with this problem, steps have been taken to integrate geriatric nursing content into the ASN curriculum at Troy State University.

The authors had previously researched attitudes toward the aged among society as a whole and among nursing students. The attitudes were generally negative.2-10 With this in mind, four hours of classroom content were set aside for exploration of attitudes toward the aged and to teach some psychosocial adaptations of normal aging in our society. In addition, it was decided to utilize the nursing homes as clinical facilities for Fundamentals of Nursing, the first quarter of the nursing sequence.

In order to evaluate the curriculum, the TuckmanLorge "Old People's Questionnaire"11 was utilized asa pre- and post-test at the beginning and end of the quarter to determine attitude change. At the end of the first Fundamentals' class, the authors were surprised to be confronted with the fact that on the posttest there was an increase rather than a decrease in negative attitudes of students toward the aged.

The authors attributed this negative change to placing of students in a nursing home situation in order to learn basic nursing skills. We felt we had unintentionally contributed toward the rape of a sound geriatric program. As recommended by the American Nurses' Association, it was decided that the student in pursuit of the study of the geriatric client should first observe and interview the relatively well client living in his/her own home or in a complex specifically developed for the elderly, after having been exposed in the classroom to the normal physiological and psychological processes of aging. The students could then assist in screening programs set up for degenerative diseases such as hypertension, diabetes, and emphysema, and assist in appropriate health teaching. Only after such an introduction to the "normal aged,' combined with an introduction to the contribution! made to literature, science, and the arts by relatively elderly people, should the student progress to caring for the geriatric client in an acute or long-term care facility.

We had planned to initiate these changes with the next Fundamentals' class; however, the severe time limitations imposed by the ASN program militated against these recommendations and necessitated returning to the nursing home for clinical experience with this class also.

In order to effect some positive changes within our time limitations, it was decided to initiate a nursing home group project that would entail student initiative and creativity. The students were taught some of the basic principles of behavior modification, remotivation group therapy and sensory stimulation, including reality orientation. These principles formed the basis for the group projects which the students developed, Τ wo of the day rooms in the nursing homes were turned over to the students. Each clinical group was responsible for their own project and a maximum of 40 points was given to each group for their efforts. Evaluation was accomplished the final day of the quarter by having "judging" with the groups assigning a certain number of points to one another, as well as the instructor assigning points.

The authors were gratified to learn that, even with the imposed curriculum and time limitations, the second group of students demonstrated an increase in positive attitudes toward the aged. We attribute this increase to the student-initiated projects. After evaluating this experience, the…

The 1971 White House Council on Aging called for nurses to assume leadership roles in dealing with the problems of aging.1 Curriculum patterns of schools of nursing have not traditionally responded to the needs of the geriatric population in our society by providing positive experiences in geriatrics for nursing students. In an attempt to deal with this problem, steps have been taken to integrate geriatric nursing content into the ASN curriculum at Troy State University.

The authors had previously researched attitudes toward the aged among society as a whole and among nursing students. The attitudes were generally negative.2-10 With this in mind, four hours of classroom content were set aside for exploration of attitudes toward the aged and to teach some psychosocial adaptations of normal aging in our society. In addition, it was decided to utilize the nursing homes as clinical facilities for Fundamentals of Nursing, the first quarter of the nursing sequence.

In order to evaluate the curriculum, the TuckmanLorge "Old People's Questionnaire"11 was utilized asa pre- and post-test at the beginning and end of the quarter to determine attitude change. At the end of the first Fundamentals' class, the authors were surprised to be confronted with the fact that on the posttest there was an increase rather than a decrease in negative attitudes of students toward the aged.

The authors attributed this negative change to placing of students in a nursing home situation in order to learn basic nursing skills. We felt we had unintentionally contributed toward the rape of a sound geriatric program. As recommended by the American Nurses' Association, it was decided that the student in pursuit of the study of the geriatric client should first observe and interview the relatively well client living in his/her own home or in a complex specifically developed for the elderly, after having been exposed in the classroom to the normal physiological and psychological processes of aging. The students could then assist in screening programs set up for degenerative diseases such as hypertension, diabetes, and emphysema, and assist in appropriate health teaching. Only after such an introduction to the "normal aged,' combined with an introduction to the contribution! made to literature, science, and the arts by relatively elderly people, should the student progress to caring for the geriatric client in an acute or long-term care facility.

We had planned to initiate these changes with the next Fundamentals' class; however, the severe time limitations imposed by the ASN program militated against these recommendations and necessitated returning to the nursing home for clinical experience with this class also.

In order to effect some positive changes within our time limitations, it was decided to initiate a nursing home group project that would entail student initiative and creativity. The students were taught some of the basic principles of behavior modification, remotivation group therapy and sensory stimulation, including reality orientation. These principles formed the basis for the group projects which the students developed, Τ wo of the day rooms in the nursing homes were turned over to the students. Each clinical group was responsible for their own project and a maximum of 40 points was given to each group for their efforts. Evaluation was accomplished the final day of the quarter by having "judging" with the groups assigning a certain number of points to one another, as well as the instructor assigning points.

The authors were gratified to learn that, even with the imposed curriculum and time limitations, the second group of students demonstrated an increase in positive attitudes toward the aged. We attribute this increase to the student-initiated projects. After evaluating this experience, the following recommendations were made for the next group of Fundamentals students:

1. To involve at least one nursing assistant and/or LPN in the sensory stimulation/remotivation projects;

2. To begin the projects on the very first day of clinical experience;

3. To assign a specific group of residents with a range of limitations to each student group so projects can be tailored to a detailed assessment of the specific resident group's needs;

4. To develop a checklist of detailed criteria for assigning points to the projects so that judging can be more objective; and

5. To collaborate more closely with the nursing home activity directors to ensure continuation of the projects after students leave.

The authors intend to continue the study of determining the best means of improving students' attitudes toward the aged by utilizing more refined research techniques in both associate degree and baccalaureate degree nursing programs.

Principles of behavior modification, remotivation group therapy, sensory stimulation, including reality orientation formed the basis for group projects developed by students in the day rooms of two nursing homes.

Principles of behavior modification, remotivation group therapy, sensory stimulation, including reality orientation formed the basis for group projects developed by students in the day rooms of two nursing homes.

Principles of behavior modification, remotivation group therapy, sensory stimulation, including reality orientation formed the basis for group projects developed by students in the day rooms of two nursing homes.

Principles of behavior modification, remotivation group therapy, sensory stimulation, including reality orientation formed the basis for group projects developed by students in the day rooms of two nursing homes.

References

  • 1. Toward a National Policy on Aging. Proceedings of the 1971 White House Conference on Aging. Vol II. Nov. 28-Drr 2: Washington DC:' US Gov't Printing Office.
  • 2. Brown II: Nurses' attitudes toward the aged and their care. {Annual report to Gerontological Branch. USPHS, Contract No. PH 108-64-122) June 30th, 1966 to July 1st, 1967. U.S. Gov't Printing Office: 1967.
  • 3. Campbell ME: Study of the attitudes of nursing personnel toward the geriatric patient. Nurs Res 20(2), 1971.
  • 4. DeLora JR. Moses DV: Specialty preferences and characteristics of nursing student in baccalaureate programs. Nurs Res 18:137144, 1969.
  • 5. Gillis Sr M: Attitudes of nursing personnel toward the aged. Nurs Res 2216: 1973.
  • 6. Gunter LM: Students attitudes toward geriatric nursing. Nurs Outlook 19:466-69. 1971.
  • 7. McTavish DG: Perceptions of old people: a review of research methodologies and findings. Gerontologist 2(4), 1971.
  • 8. Powell Carla: Comparing the effectiveness of a formal communication versus an interpersonal involvement in improving the attitudes of sophomore baccalaureate nursing students toxvard the aged. Unpublished Research Paper, University of Alabama in Birmingham, 1974.
  • 9. Spence D. Feigenbaum ?: Medical students' attitudes toward the geriatric patient. J Am Geriatric Soc, Vol 16. 1968.
  • 10. Williams BJ: A comparative study of nursing students' attitudes and perceptions concerning the aged. University of Alabama in Birmingham, 1971.
  • 11. Axelrod S, Eisdorfer C: Attitudes toward old people: an empirical analysis of the stimulus. Group Validity of the Tuckman-Lorge Questionnaire. J Gerontological Nurs 16:7580, 1971.

10.3928/0098-9134-19780101-11

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