Dietetic Students’ Attitudes to and Knowledge of Working with Older People
Across the world, people are living longer but not necessarily healthier lives. Healthcare professionals will need to be prepared to work with older people, recognising that, at all stages of the lifespan, attention to nutrition and other health behaviours can impact positively on wellbeing. This study examined the attitudes, knowledge and future career preferences of pre-registration dietetic students in the United Kingdom towards working with older people. A questionnaire, based on the validated Palmore Facts on Aging Quiz and adapted to a UK population, was sent to the fifteen universities which provide dietetic courses in the UK approved by the Health and Care Professions Council (HCPC). Responses were received from thirteen universities, and, of the estimated 1250 students, 285 questionnaires were completed (response rate 23%) with the predominant demographic being 91% female, and 86% undergraduate degree type. The mean knowledge score was higher in postgraduate vs. undergraduate students (69.6% vs. 65.2%; p<0.011). A weak positive correlation (rs = 0.155) was found between number of placement weeks carried out and knowledge score (p <0.01). Care of the elderly was the least preferred of five specialities, and 65-plus was the fourth preferred age group out of five. A greater focus should be placed on the delivery of aging education and placement experiences in dietetic courses to increase the number of graduate dietetic students who have positive work preferences towards older adults.
Age UK. (2018). Later life in the United Kingdom April 2018. Retrieved February, 22 2019, from https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/later_life_uk_factsheet.pdf
Alzheimer’s Society. (2009). Counting the cost: Caring for people with dementia on hospital wards. https://www.alzheimers.org.uk/sites/default/files/2018-05/Counting_the_cost_report.pdf
Aoki, Y., & Davies, S. (2002). Survey of continuing professional education within nursing homes. British Journal of Nursing, 11(13), 902–912. https://doi.org/10.12968/bjon.2002.11.13.10449
Aud, M. A., Bostick, J. E., Marek, K. D., & McDaniel, R. W. (2006). Introducing baccalaureate student nurses to gerontological nursing. Journal of Professional Nursing, 22(2), 73–78. https://doi.org/10.1016/j.profnurs.2006.01.005
Boswell, S. S. (2012). ‘Old people are cranky’: Helping professional trainees’ knowledge, attitudes, aging anxiety, and interest in working with older adults. Educational Gerontology, 38(7), 465-472. https://doi.org/10.1080/03601277.2011.559864
Breytspraak, L., & Badura, L. (2015). Facts on aging quiz (revised; based on Palmore 1977; 1981). University of Missouri-Kansas City. Retrieved October, 1 2018, from https://aging.umkc.edu/quiz/
Bridges, J., Nicholson, C., Maben, J., Pope, C., Flatley, M, Wilkinson, C., Meyer, J., & Tziggli, M. (2012). Capacity for care: Meta-ethnography of acute care nurses' experiences of the nurse-patient relationship. Journal of Advanced Nursing, 69(4), 760–772. https://doi.org/10.1111/jan.12050
British Dietetic Association. (2019). What is a dietitian? https://www.bda.uk.com/about-dietetics/what-is-dietitian.html
Brown, J., Nolan, M., Davies, S., Nolan, J., & Keady, J. (2008). Transforming students’ views of gerontological nursing: Realising the potential of ‘enriched’ environments of learning and care: A multi-method longitudinal study. International Journal of Nursing Studies, 45(8), 1214–1232. https://doi.org/10.1016/j.ijnurstu.2007.07.002
Carmel, S., Cwikel, J., & Galinsky, D. (1992). Changes in knowledge, attitudes, and work preferences following courses in gerontology among medical, nursing, and social work students. Educational Gerontology, 18(4), 329–342. https://doi.org/10.1080/0360127920180403
Coffey, A., Buckley, C., Gaidys, U., Sasoni, J., Arola, M., Delmente-Hartmane, D., Corvo, E., Auer, S., Petersen-Ewert, C., & Tyrrell, M. (2015). Beliefs of students about growing older and perceptions of working in gerontology. Nursing Older People, 27(1), 33–37. https://doi.org/10.7748/nop.27.1.33.e648
Cornwell, J. (2012). The care of frail older people with complex needs: Time for a revolution. The King’s Fund. https://www.kingsfund.org.uk/publications/care-frail-older-people-complex-needs-time-revolution
Department of Health. (2009). Living well with dementia: A national dementia strategy. https://www.gov.uk/government/publications/living-well-with-dementia-a-national-dementia-strategy
Department of Health. (2015). Prime Minister’s challenge on dementia 2020. https://www.gov.uk/government/publications/prime-ministers-challenge-on-dementia-2020
Department of Health and Social Care. (2011). Common core principles for supporting people with dementia: A guide to training the social care and health workforce. https://www.gov.uk/government/publications/common-core-principles-for-supporting-people-with-dementia
Ellis, G., Whitehead, M. A., Robinson, D., O’ Neill, D., & Langhorne, P. (2011). Comprehensive geriatric assessment for older adults admitted to hospital: Meta-analysis of randomised controlled trials, BMJ, 343, d6553. https://doi.org/10.1136/bmj.d6553
Fagerberg, I., & Engström, G. (2012). Care of the old—A matter of ethics, organization and relationships. International Journal of Qualitative Studies on Health and Well-being, 7(1), 9684. https://doi.org/10.3402/qhw.v7i0.9684
Featherstone, K., Northcott, A., Bridges, J., Harrison Denning, K., Harden, J., Bale, S., Hopkinson, J., Tope, R., Hillman, A., & King, M. (2018). Summary results: An evidence based investigation examining the care people living with dementia receive following an acute hospital admission. Stories of Dementia. http://www.storiesofdementia.com/2018/04/research-report.html
Gallagher, S., Bennett, K. M., & Halford, J. C. G. (2006). A comparison of acute and long‐term health‐care personnel’s attitudes towards older adults. International Journal of Nursing Practice, 12(5), 273–279. https://doi.org/10.1111/j.1440-172X.2006.00582.x
Goncalves, D. C. (2009). From loving grandma to working with older adults: Promoting positive attitudes towards aging. Educational Gerontology, 35(3), 202–225. https://doi.org/10.1080/03601270802466884
Gutheil, I., Heyman, J. C., & Chernesky, R. H. (2009). Graduate social work students’ interest in working with older adults. Social Work Education, 28(1), 54–64. https://doi.org/10.1080/02615470802028116
Happell, B., & Brooker, J. (2001). Who will look after my grandmother? Attitudes of student nurses toward the care of older adults. Journal of Gerontological Nursing, 27(12), 12–17. https://doi.org/10.3928/0098-9134-20011201-07
Henderson, J., Xiao, L., Siegloff, L., Kelton, M., & Paterson, J. (2008). ‘Older people have lived their lives’: First year nursing students’ attitudes towards older people. Contemporary Nurse, 30(1), 32–45. https://doi.org/10.5172/conu.6126.96.36.199
Hobbs, C., Dean, C.M., Higgs, J., & Adamson, B. (2006). Physiotherapy students’ attitudes towards and knowledge of older people. Australian Journal of Physiotherapy, 52(2), 115–119. https://doi.org/10.1016/S0004-9514(06)70046-0
Jacelon, C. S. (2002). Attitudes and behaviors of hospital staff toward elders in an acute care setting. Applied Nursing Research, 15(4), 227–234. https://doi.org/10.1053/apnr.2002.35958
Joint Committee on Human Rights. (2007). The human rights of older people in healthcare: Eighteenth Report of Session 2006–07: Volume I - Report and Formal Minutes. HL Paper 156-I, HC 378, House of Lords/House of Commons Joint Committee on Human Rights.
Kaempfer, D., Wellman N. S., & Himburg, S. P. (2002). Dietetic students’ low knowledge, attitudes, and work preferences toward older adults indicate need for improved education about aging. Journal of the Academy of Nutrition and Dietetics, 102(2), 197–202. https://doi.org/10.1016/S0002-8223(02)90048-9
Kim, J., Lee J., & Sims, O. T. (2017). The productive aging concept and social work students’ perceptions toward an older population. Journal of Social Service Research, 43(2), 149–155. https://doi.org/10.1080/01488376.2016.1202878
King, B. J., Roberts, T. J., & Bowers, B. J. (2013). Nursing student attitudes toward and preferences for working with older adults. Gerontology & Geriatrics Education, 34(3), 272–291. https://doi.org/10.1080/02701960.2012.718012
Kosberg, J. I. (1983). The importance of attitudes on the interaction between health care providers and geriatric populations. Social Gerontology: Interdisciplinary Topics in Gerontology, 17, 132–143. https://doi.org/10.1159/000407927
Kydd, A., Engström, G., Touhy, T. A., Newman, D., Skela-Savič, B., Touzery, S. H., Zurc, J., Galatsch, M., Ito, M., & Fagerberg, I. (2014). Attitudes of nurses and student nurses towards working with older people and to gerontological nursing as a career in Germany, Scotland, Slovenia, Sweden, Japan and the United States. International Journal of Nursing Education, 6(2), 177–185. http://dx.doi.org/10.5958/0974-9357.2014.00630.8
Kydd, A., & Wild, D. (2013). Attitudes towards caring for older people: Literature review and methodology. Nursing Older People, 25(3), 22–27. https://doi.org/10.7748/Nop2013.04.25.3.22.E769
Lee, S. -Y., Hoerr, S. L., Weatherspoon, L., & Schiffman, R. F. (2008). Nutrition students improve attitudes after a guided experiential assignment with older adults. Journal of Nutrition Education and Behavior, 40(5), 279–287. https://doi.org/10.1016/j.jneb.2007.09.011
Lin, X., Bryant, C., & Boldero, J. (2011). Measures for assessing student attitudes toward older people. Educational Gerontology, 37(1), 12–26. https://doi.org/10.1080/03601270903534796
Liu, Y. –E., Norman, I. J., & While, A. E. (2013). Nurses’ attitudes towards older people: A systematic review. International Journal of Nursing Studies, 50(9), 1271–1282. https://doi.org/10.1016/j.ijnurstu.2012.11.021
Lordly, D., & Taper, J. (2008). Assumptions lead to the devaluation of dietitian roles in long-term care practice environments. Journal of Allied Health, 37(2), 78–81. https://www.ingentaconnect.com/content/asahp/jah/2008/00000037/00000002/art00004
Mackenzie, M., & Newman, E. (2017). Preparing the dietetic workforce of the future: Developing innovative placements in social care settings. International Journal of Practice-based Learning in Health and Social Care, 5(1), 65–76. DOI: 10.18552/ijpblhsc.v5i1.389. https://publications.coventry.ac.uk/index.php/pblh/article/view/389
Masciadrelli, B. P. (2014). ‘I learned that the aging population isn’t that much different from me’: The final outcomes of a Gero-Ed BEL Project. Journal of Gerontological Social Work, 57(1), 24–36. https://doi.org/10.1080/01634372.2013.854855
Mason, S. E., & Sanders, G. R. (2004). Social work student attitudes on working with older clients. Journal of Gerontological Social Work, 42(3–4), 61–75. https://doi.org/10.1300/J083v42n03_05
McKinlay, A., & Cowan, S. (2006). ‘If you're frail you've had it’: A theory of planned behavior study of student nurses' attitudes towards working with older patients. Journal of Applied Social Psychology, 36(4), 900–917. https://doi.org/10.1111/j.0021-9029.2006.00048.x
McLafferty, I., & Morrison, F. (2004). Attitudes towards hospitalized older adults. Journal of Advanced Nursing, 47(4), 446–453. https://doi.org/10.1111/j.1365-2648.2004.03122.x
O’Connor, A., Cahill, M., & McKay, E. A. (2012). Revisiting 1:1 and 2:1 clinical placement models: Student and clinical educator perspectives. Australian Occupational Therapy Journal, 59(4), 276–283. https://doi.org/10.1111/j.1440-1630.2012.01025.x
Office for National Statistics. (2017). Overview of the UK population: July 2017. https://www.ons.gov.uk/Peoplepopulationandcommunity/Populationandmigration/Populationestimates/Articles/Overviewoftheukpopulation/July2017
Palmore, E. B. (1977). Facts on aging: A short quiz. The Gerontologist, 17(4), 315–320. https://doi.org/10.1093/geront/17.4.315
Palmore, E. B. (1981). The facts on aging quiz: Part two. The Gerontologist, 21(4), 431–437. https://doi.org/10.1093/geront/21.4.431
Palmore, E. B. (1998). Facts on aging quiz (2nd ed.). Springer.
Pensions Advisory Service. (2017, December 6). The new state pension set to increase from April 2017. https://www.pensionsadvisoryservice.org.uk/news/the-new-state-pension-set-to-increase-from-april-2017
Roqué, M., Salvà, A., & Vellas, B. (2013). Malnutrition in community-dwelling adults with dementia (NutriAlz Trial). Journal of Nutrition, Health and Aging, 17, 295–299. https://doi.org/10.1007/s12603-012-0401-9
Royal College of Psychiatrists (2005). Who cares wins: Improving the outcome for older people admitted to the general hospital. Royal College of Psychiatrists.
Saka, B., Kaya, O., Ozturk, G. B., Erten, N., & Karan, M. A. (2010). Malnutrition in the elderly and its relationship with other geriatric syndromes. Clinical Nutrition, 29(6), 745–748. https://doi.org/10.1016/j.clnu.2010.04.006
Samra, R., Griffiths, A., Cox, T., Conroy, S., & Knight, A. (2013). Changes in medical student and doctor attitudes toward older adults after an intervention: A systematic review. Journal of the American Geriatrics Society, 61(7), 1188–1196. https://doi.org/10.1111/jgs.12312
Stevens, J.A. (2011). Student nurses’ career preferences for working with older people: A replicated longitudinal survey. International Journal of Nursing Studies, 48(8), 944–951. https://doi.org/10.1016/j.ijnurstu.2011.01.004
United Nations. (2017). World population prospects: The 2017 revision – key findings and advance tables, ESA/P/WP/248. United Nations Department of Economic and Social Affairs, Population Division. https://www.un.org/development/desa/publications/world-population-prospects-the-2017-revision.html
United Nations Population Fund (UNFPA). (2012). Aging in the twenty-first century: A celebration and a challenge. United Nations Population Fund & HelpAge International. https://www.unfpa.org/publications/ageing-twenty-first-century
Weiss, I. (2005). Interest in working with the elderly: A cross-national study of graduating social work students. Journal of Social Work Education, 41(3), 379–391. https://doi.org/10.5175/JSWE.2005.200300342
Wells, Y., Foreman, P., Gething, L., & Petralia, W. (2004). Nurses’ attitudes towards aging and older adults. Journal of Gerontological Nursing, 30(9), 5–9. https://doi.org/10.3928/0098-9134-20040901-04
World Health Organisation (WHO). (2011). Global health and aging. National Institute on Aging and National Institutes of Health. https://www.who.int/ageing/publications/global_health.pdf
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