Elsevier

Nurse Education Today

Volume 39, April 2016, Pages 170-175
Nurse Education Today

Anxiety and categorisation effects in student nurses' attitudes towards young and older patients: A dual pathway model

https://doi.org/10.1016/j.nedt.2016.01.023Get rights and content

Highlights

  • Student nurses had more negative attitudes towards older patients compared to young patients.

  • Student nurses experienced more anxiety in caring for young patients compared to older patients.

  • Anxiety in caring for young patients resulted in more negative attitudes towards these patients.

Summary

Background

Student nurses often have a negative attitude towards older patients due to negative stereotypes, which may explain their reluctance to work in geriatric care.

Objectives

The aim of this study was to investigate a dual effect (direct and indirect via anxiety) of patients' age on student nurses' attitudes towards their patients.

Design

Quantitative survey study with 2 between-subjects conditions (patient age: young patients vs. older patients; both n's = 52).

Setting

Two schools for higher vocational education in the Netherlands.

Participants

104 student nurses between the ages of 16–30 in the third or fourth year of their nursing education (Mage = 21.58, SD = 2.22; 93 women).

Results

Attitudes towards older patients were more negative than those towards young patients. Older patients also elicited less anxiety compared to young patients, and anxiety had a weaker relationship with attitudes towards older patients than attitudes towards younger patients. Attitudes towards younger patients, but not towards older patients, were depressed by anxiety.

Conclusions

Older patients generate more negative attitudes among student nurses, but can also improve attitudes indirectly by lowering intergroup anxiety. Older people may be therefore be especially suitable as a patient group to receive care from young nurses in training, who can mature in their profession without being anxious over making a wrong impression.

Section snippets

Age as a Social Category

Age is an important dimension on which we categorise others as well as ourselves (North and Fiske, 2012). In fact, age has been proposed as the most important dimension of interpersonal categorisation (Jönson, 2013). Although multiple stereotypes of older people exist which become salient in different contexts, overall attitudes towards older people tend to be negative (Adams-Price and Morse, 2009, Jönson, 2013). In fact, Liu et al. (2013) argued that healthcare professionals are particularly

Intergroup Anxiety

One variable that could further affect nurses' attitudes towards their patients is intergroup anxiety. Intergroup anxiety is a type of anxiety that people experience when anticipating or engaging in intergroup interaction (Stephan, 2014, Stephan and Stephan, 1985). It refers to negative outcome expectancies - e.g., fear of negative evaluations, or fear of being misunderstood (Bousfield and Hutchison, 2010, Vorauer et al., 2000). Research has shown that intergroup anxiety leads to more negative

Nursing Education in the Netherlands

This study was conducted among a sample of student nurses in the Netherlands. These students were enrolled in a school for higher vocational education, which prepares students during a four-year educational programme for a professional career as a nurse. The education combines theory with practical experience acquired during various internships, which start in the second year of the programme. Students are qualified upon completion to work in all EU member states in, e.g., psychiatric or mental

Participants

A total of 108 student nurses participated in this study. Although there is no universally agreed boundary to define ‘young’ students, in this study we used an age range of 16–30. As a result, four people were omitted from further analyses (aged 32, 43, 44, and 48)1, leaving 104 students as the final sample (Mage = 21.58, SD = 2.22; 93 women).

Design

We employed a between-subjects design with two

Manipulation Check

The reported (estimated) age of the patient was analysed in an analyses of variance with experimental condition (patient age) as independent variable. A significant effect indicated that the manipulation was successful, F(1, 101) = 1950.96, p < .001, ηp2 = .95. Participants in the young patient condition indicated thinking of a much younger person (M = 22.60, SD = 4.26) than those in the older patient condition (M = 79.57, SD = 8.25). Moreover, the mean age of these patients fell clearly within the intended

Discussion

The aim of this study was to investigate a dual pathway model to explain the effect of patients' age on student nurses' attitudes towards their patients. Based on the fact that older patients constitute a double outgroup whereas young patients share the same age category with student nurses, we expected and found that attitudes towards older patients were more negative than those towards young patients. However, also as expected, older patients were found to elicit less anxiety compared to

Conclusion

Young student nurses generally have more negative attitudes towards older patients than towards younger patients. A reluctance to work with older patients is therefore a growing concern in geriatric care. The current study, however, showed that there is hope yet. Although student nurses are expected to be somewhat anxious in dealing with patients due to their relative inexperience, they showed less anxiety towards older patients compared to younger patients. As such, older people may be

References (25)

  • N. Hopkins et al.

    Helping to improve the group stereotype: On the strategic dimension of prosocial behavior

    Personal. Soc. Psychol. Bull.

    (2007)
  • M.J. Hornsey et al.

    “It's OK if we say it, but you can't”: responses to intergroup and intragroup criticism

    Eur. J. Soc. Psychol.

    (2002)
  • Cited by (4)

    • Proactive personality and career adaptability: The role of thriving at work

      2017, Journal of Vocational Behavior
      Citation Excerpt :

      These results suggested that it would be legitimate to examine these three variables as separate constructs. Following prior research (e.g., Jiang, 2016a; van Leeuwen, Oosterhuis, & Ruyter, 2016; Vincze & Harwood, 2014), hypotheses were tested employing hierarchical regression analyses in SPSS, combined with Hayes' (2013) PROCESS macro for the moderated mediation. Hayes' PROCESS Model 74 integrates a mediation relationship with a moderation effect of the predictor on the second stage of the mediation pathway.

    • Student Nurses' Perceptions about Older People

      2019, International Journal of Nursing Education Scholarship
    • Empowering leadership and employee performance: A mediating role of thriving at work

      2018, International Journal of Asian Business and Information Management
    View full text