An exploration of the attitudes, knowledge, willingness and future intentions to work with older people among Saudi nursing students in baccalaureate nursing schools in Saudi Arabia.

摘要

The kingdom of Saudi Arabia, like the rest of the world, has a growing older populationudwith urgent health care needs. However little prior research has been undertaken on thisudtopic. In the light of this, the aim of this study was to explore the attitudes, knowledge,udwillingness and intentions to work with older people among nursing students, and toudconsider the effects of clinical nursing practice on such factors in the first year and theudfinal (pre-registration) year of training in three major university hospitals. The study wasudunderpinned by the theory of planned behaviour (Fishbein and Ajzen, 1975) which wasudused as a conceptual framework to explore the relationships between attitudes, subjectiveudnorms, perceived behavioural control and behavioural intentions amongst 566 nursingudstudents. The study used a mixed methods design comprising of surveys with the nursingudstudents and 132 faculty members and three focus groups with faculty members to exploreudtheir feelings about gerontological education in-depth. The questionnaires contained audrange of previously validated instruments including Kogan's Attitude Towards OlderudPeople scale, Palmore's Facts on Ageing Quiz, a measure of students' willingness to workudwith older people and a measure of their perceived intention to work with them. Openendedudquestions were also included. Data were analysed using both multivariate statisticsudand content analysis.udThe results provided some interesting and important insights into the complex factorsudpotentially shaping students intentions to work with older people. For example the 566udnursing students who participated in this study displayed a lack of basic knowledge of theudphysical and behavioural aspects of ageing but held largely positive attitudes towards olderudpeople. Despite such positive attitudes a majority of the participants indicated that theyudwould prefer not to work with older people after graduation, although those students whoudindicated that they would prefer to work with them had the most positive attitudes and theudstrongest willingness and intent to take care of older people. The data also highlight theudpotential of clinical training experience with older adults to improve the previous variablesud(attitudes, willingness and intentions). The qualitative data from both students and teachersudhighlighted a range of complex factors that in part explained some of the quantitativeudfindings. These related to the influence of subjective norms and perceived control.udTherefore at a cultural level Saudi students are exposed to strong positive norms in relationudto older people but on entering training may be exposed to negative professional norms asudto the status and desirability of gerontological nursing as a career. This, together withudstudents' limited perceived control due to inadequate preparation for practice offerudpotential explanations as to the disparity between attitudes and behavioural intentions.Theudqualitative data also highlight the need for greater attention to the preparation of nursingudstudents, with the provision of integrated skills and knowledge on the care of older people.udThe study also provides a limited critique of the theory of planned behaviour, which whilstudsupported in part cannot account fully for the complex cultural and professional factorsudshaping students future career intentions. The thesis, the first of its kind undertaken inudSaudi Arabia, concludes with some reflections and suggestions for further research and theudactions needed if the preparation of students to work with older people is to improve in theudfuture.