Abstract
Backgroundstudies have sought to identify the possible determinants of medical students’ and doctors’ attitudes towards older patients by examining relationships with a variety of factors: demographic, educational/training, exposure to older people, personality/cognitive and job/career factors. This review collates and synthesises these findings.Methodsan electronic search of 10 databases was performed (ABI/Inform, ASSIA, British Nursing Index, CINAHL, Informa Health, Medline, PsycINFO, Science Direct, Scopus, and Web of Science) through to 7 February 2017.Resultsthe main search identified 2,332 articles; 37 studies met the eligibility criteria set. All included studies analysed self-reported attitudes based on correlational analyses or difference testing, therefore causation could not be determined. However, self-reported positive attitudes towards older patients were related to: (i) intrinsic motivation for studying medicine, (ii) increased preference for working with older patients and (iii) good previous relationships with older people. Additionally, more positive attitudes were also reported in those with higher knowledge scores but these may relate to the use of a knowledge assessment which is an indirect measure of attitudes (i.e. Palmore's Facts on Aging Quizzes). Four out of the five high quality studies included in this review reported more positive attitudes in females compared to males.Conclusionthis article identifies factors associated with medical students’ and doctors’ positive attitudes towards older patients. Future research could bring greater clarity to the relationship between knowledge and attitudes by using a knowledge measure which is distinct from attitudes and also measures knowledge that is relevant to clinical care.
Highlights
The rapidly ageing population has been associated with a growth in the number of older people with frailty and complex comorbidities who present to healthcare services
A recent review identified that knowledge-based interventions are unsuccessful at improving attitudes towards older patients [4] and, the factors underpinning positive attitudes towards older patients have been systematically reviewed for nurses [5], no similar work has been done to collate the findings for medical students and doctors
Ten of 11 studies found that respondents reporting greater levels of interest in geriatric medicine or preference to work with older patients had more positive attitudes toward older patients [12, 18, 24, 26,27,28, 35, 37, 41, 42]
Summary
The rapidly ageing population has been associated with a growth in the number of older people with frailty and complex comorbidities who present to healthcare services. To meet this challenge, all doctors need to possess the necessary knowledge, skills and behaviours to care for older patients [1]. A recent review identified that knowledge-based interventions are unsuccessful at improving attitudes towards older patients [4] and, the factors underpinning positive attitudes towards older patients have been systematically reviewed for nurses [5], no similar work has been done to collate the findings for medical students and doctors. Identifying the factors associated with attitudes may help in the future design and delivery of interventions to foster positive attitudes, in order to ensure the medical workforce are adequately prepared to care for the growing number of older patients
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