WHAT FACTORS ARE RELATED TO MEDICAL STUDENTS’ AND DOCTORS’ ATTITUDES TOWARD OLDER PATIENTS?

Abstract

Background: Studies have sought to determine the possible precursors to medical students’ and doctors’ positive or negative attitudes towards older patients by examining associations with a variety of demographic, educational/training, and job/career factors. A review is now needed to explore the quality of these studies and to synthesize findings. Methods: A systematic review on the worldwide English language literature was conducted. Ten databases were explored (including Medline, PsychInfo and Science Direct) from database inception to December 2015 using a systematic search strategy. Quality was assessed and reported. Results: The search identified 2332 articles; 37 studies met the eligibility criteria. Students’ year in medical school, doctors’ years of practice or seniority, participants’ age and ethnicity did not appear to demonstrate relationships with (positive or negative) attitudes towards older patients. Ten studies reported that female medical students and/or doctors reported significantly more positive attitudes towards older patients than their male counterparts, although 18 studies found no differences. No studies reported more positive attitudes scores for males than females. Interest in working in older patient settings and reporting a high level of intrinsic motivation for choosing medicine as a career were both associated with positive attitudes towards older patients. Eight of 11 studies found more positive attitudes were reported by those who demonstrated higher levels of knowledge about ageing but this apparent relationship is questioned here due to methodological issues identified in the quality assessment stage pertaining to the knowledge measures employed. Reliability and validity of the attitude measures, that were employed, were examined. Conclusions: This article has identified factors associated with medical students’ and doctors’ positive attitudes towards older patients, as well as factors which have been extensively studied but failed to demonstrate meaningful relationships with attitudes. This is the first study to identify that the relationship between attitudes and knowledge about ageing may be a methodological artefact. Future research can build on the relationships identified here and should employ appropriate measures of attitudes with demonstrated reliability and validity.