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J Public Health
DOI 10.1007/s10389-017-0849-5
ORIGINAL ARTICLE
The attitudes of healthcare professionals in a state hospital
towards ageism
Hatice Pekince 1 & Hakime Aslan 2
&
Behice Erci 1 & Ümmühan Aktürk 1
Received: 6 July 2017 / Accepted: 20 September 2017
# Springer-Verlag GmbH Germany 2017
Abstract
Aim This study will be important in terms of determining
whether or not there is ageism in terms of healthcare professionals in Turkey and being a reference for the future studies.
Methods This study was conducted to examine the attitudes
of the healthcare professionals on ageism. The population of
this descriptive study consisted of 242 healthcare professionals in Bingöl State Hospital. The data were collected by
the researchers between January 2012 and February 2012. The
information form including the descriptive characteristics of
the healthcare professionals and the Ageism Attitude Scale
(AAS) were used to collect the data. Percentage, mean, t test,
and one-way analysis of variance (ANOVA) were used to
assess the data.
Results In the study, the average age of the healthcare professionals was 29.75 ± 6.3, 79.3% were female, 59.9% were
married, 53.3% had children, and 24.8% of those with children had only one child. Sixty-four percent of the healthcare
professionals were nurses, 43.0% had an associate degree, and
82.2% had nuclear families, and 87.6% had no elderly family
* Hakime Aslan
hakime.aslan@inonu.edu.tr
Hatice Pekince
hatturk23@hotmail.com
Behice Erci
behicerci@hotmail.com
Ümmühan Aktürk
ummuhan_akturk@hotmail.com
1
Department of Public Health Nursing, School of Health, Inonu
University, 44280 Malatya, Turkey
2
Department of Nursing, School of Health, Inonu University,
44280 Malatya, Turkey
members living with them. The AAS mean score of the
healthcare professionals was 68.58 ± 5.6.
Conclusions When the titles and education of healthcare professionals were compared with the scale scores, the difference
between them was not found to be statistically significant
(p = 0.15, p = 0.859).
Keywords Elderly . Ageism . Healthcare professional
Introduction
Aging is a natural process in which the individual experiences
physical, mental and social losses and regressions (Güler and
Akın 2006). The age group of 65 years and over is defined as
elderly, and according to TSI data, 8.3% of the world population was elderly in 2014. The percentage of elderly population
in Turkey in 2013 was 7.7%, and in 2015 the percentage was
8.0% (Tiros Space Information 2015); thus, even though the
percentage of elderly in Turkey is below the world average,
that percentage is increasing. TSI analyses state that the expected percentage of the elderly will continue to increase to a
percentage of 10.2% in 2023 (Tiros Space Information 2014).
The World Health Organization (WHO) and other scientists classify the ages between 65 and 74 years as early old age,
the ages between 75 and 84 years as middle old age and the
ages of 85 years and over as advanced old age (Tumerdem
2006). The United Nations states that if 8–10% of the total
population of a country are old (65 years and over), then the
population of the country is old; if this rate exceeds 10%, the
country population is very old. Using the UN classification,
the population of Turkey entered the old class as of 2015 and
will have a very old population in 2023.
Each country has a different approach to the elderly. The
social status of elderly people is higher in countries like Japan
J Public Health
that stick to their traditions and show positive attitudes toward
old people; however, the view point towards elderly people in
countries like Turkey has started to change especially in the
cities with the transition from a patriarchal family structure,
with a positive and respectful attitude toward the elderly, to a
nuclear family structure, with a negative and disrespectful
attitude (Ozdemir and Bilgili 2014).
The issues of aging and the problems arising from
aging are becoming more important as the world learns
to prolong human life, thus increasing the elderly population (Buken and Buken 2003). Ageism is the main
problem among many problems relating to aging.
According to Vefikuluçay, ageism is a multidimensional
term that includes showing a different attitude to a person, approaching the person with prejudice or treating
the person differently just because he or she is old
(Vefikuluçay 2008). Elderly discrimination is manifested
in positive and negative attitudes. Positive attitudes of
elderly people, kindness, wisdom, trustworthiness, feelings of freedom and happiness can be considered as
positive attitudes. Perceptions like the assumption of
continuous illness, age-related incapacity, physical and
mental disorders due to aging, isolation from society
and depression can be expressed as negative attitudes
(Ozdemir 2009). Ageism is often more negative than
positive. The socio-cultural structures of societies can
make elder care in healthcare services an undesirable
field of study (Adıbelli et al. 2014). Ageism is seen in
the healthcare field because elderly people get sick more
often, apply to health facilities more frequently and
have long-term hospitalizations. Healthcare professionals
discriminate by not giving enough importance to elderly
people, preferring to serve young people, not using explanatory expressions when acquiring information, associating disease with aging, and neglecting treatment
(Akdemir et al. 2007; Dozois 2006). In another study
conducted by Vefikuluçay, the main areas where attitudes about ageism occurred were in working areas,
family life, social life, sexual life, and healthcare systems; exposure to ageism depended on physical, mental,
and psychological insufficiency along with aging
(Vefikuluçay 2008). Such discrimination causes the elderly individual to feel insufficient, weak, tired and isolated from others (Turkish Academy of Sciences 2003).
There has been a widespread incidence of ageism in recent
years where healthcare services are provided (Akdemir et al.
2007); however, a review of the literature reveals that most of
the studies on ageism in Turkey have been conducted on nursing students, and there are not many studies on those working
in healthcare services. Therefore, this study will be an important step in determining whether there is ageism among
healthcare professionals in Turkey, and this analysis will provide a reference for future studies.
Material and method
Type of the study
This descriptive study was conducted between January 2012
and February 2012.
Population and sample of the study
The population of the study consisted of 337 healthcare professionals in Bingöl State Hospital. A total of 242 healthcare
professionals were reached in the study; this was because
some of the healthcare professionals were on leave and some
did not want to participate in the study during the data collection process.
Data collection tools
An information form including the descriptive characteristics
of healthcare professionals and the Ageism Attitude Scale
(AAS),which was developed by Vefikuluçay in 2008 and
whose validity and reliability studies were made by her, were
used to collect the data.
Descriptive information form The form developed by the
researchers had 11 questions including age, gender, marital
status, presence and number of children, educational status,
family structure, the status of having elderly in the family,
affinity level, and the study year.
Ageism Attitude Scale (AAS)
The AAS is a 5-point Likert-type scale evaluating the ageism
with 23 items and three subscales including restricting life of
the elderly, positive ageism, and negative ageism. The
validity-reliability study of the scale developed by
Vefikuluçay was used (Vefikuluçay 2008). The total internal
consistency coefficient (Cronbach’s) of the scale was found to
be 0.80. In this study, Cronbach’s alpha internal consistency
coefficient was determined as 0.77. The AAS subscales include questions about the following:
1. Restricting life of the elderly (1,5,12,14,17,19,21,22,23)
2. Positive ageism (2,4,6,7,8,9,13,20)
3. Negative ageism (3,10,11,15,16,18).
If there is strong agreement with the items in subscales 1
and 2, it is evaluated as 5 points, agreeing is 4 points, undecided is 3 points, disagree is 2 points and strongly disagree is 1
point, while the negative responses of the 3rd subscale are
scored inversely.
J Public Health
Data collection
The questionnaire was applied by the researchers to the
healthcare professionals in the hospital, where the study was
conducted, between January 2012 and February 2012. Before
the data collection form was filled, verbal consent of the
healthcare professionals was obtained. It took approximately
10–20 min to complete a questionnaire.
Variables of the study
Table 1 Demographic
characteristics of healthcare
professionals
Demographic
characteristics
Data assessment
The data were analyzed by using SPSS 17 packaged software.
Percentage, mean, t test and one way analysis of variance
(ANOVA) were used to assess the data.
The ethical principles of the study
Ethical approval was obtained from the Malatya Clinical
Trials Ethics Committee in order to conduct the study
(Ethical Council number 2012/25). Before starting the study,
written permission was obtained from the head physician of
the Bingöl Provincial State Hospital. Before filling the data
collection form, verbal consent of healthcare professionals
were obtained and they were informed that participation is
voluntary and that they can withdraw from the study at any
time.
Results
According to Table 1, the average age of the healthcare professionals included in the study was 29.75 ± 6.3, 38% were in
the age range of 30–35 years, 64% were nurses, 79.3% were
female, 59.9% were married, 53.3% had children and 46.5%
of those with children had one children, 43.0% had an associate degree, 82.2% had a nuclear family structure, 87.6% had
no elderly living with them and 38.4% had been working for
1–5 years.
According to Table 2, it was determined that the AAS total
score of the healthcare professionals was 68.58 ± 5.6, the
score of the subscale Restricting life of the elderly was
21.33 ± 3.6, the score of the subscale Positive ageism was
30.45 ± 3.9, and score of the subscale Negative ageism was
16.79 ± 3.0.
According to Table 3, it was found that there was a statistically significant difference between healthcare professionals’ age groups and the subscale ‘Restricting life of the
%
Age
18–23 age
40
16.5
24–29 age
58
24.0
30–35 age
36–42 age
92
52
38.0
21.5
155
64.0
Job
Nurse
Midwife
While the healthcare professionals’ demographic characteristics were the dependent variable of the study, the ageism attitude was the independent variable.
n
Other
(laboratory,
X-ray and
anesthesia
technician)
Gender
Female
Male
Marital status
Married
Single
(divorced)
Is there a child?
Yes
28
11.6
59
24.4
192
79.3
50
20.7
145
97
59.9
40.1
129
53.3
No
113
Number of children
1 child
60
2 children
55
3 and over
14
46.7
46.5
42.6
10.9
Education status
High school
Associate
License
Graduate
47
104
83
8
19.4
43.0
34.3
3.3
199
33
82.2
13.6
10
4.1
30
212
12.4
87.6
93
74
22
53
38.4
30.6
9.1
21.9
Family structure
Nuclear family
Extended
family
Fragmented
family
Is there an elderly
person living
in the house?
Yes
No
Year of study
1–5 years
6–10 years
11–15 years
16 and over
J Public Health
Table 2 Mean scores of healthcare professionals from the AAS and its
subscales. Min minimum, Max maximum
Subscales
n
Min
Max
Mean ± SS
Restricting life
242
14
29
21.33 ± 3.6
Positive ageism
242
14
39
30.45 ± 3.9
Negative ageism
AAS total score
242
242
7
54
26
80
16.79 ± 3.0
68.58 ± 5.6
elderly’ (p < 0.05) and restricting life scores of young professionals were positively higher. It was determined in the study
that there was no significant correlation between age groups
and the AAS total score, negative ageism and positive ageism
subscales (p > 0.05); however, young professionals had more
positive ageism towards elderly people.
It was determined in the study that there was a statistically
significant difference between the Restricting life of the elderly and Negative ageism subscales and gender (p < 0.05) and
female professionals’ Restricting life of the elderly and
Negative ageism scores were positively higher. In the study,
it was found that there was no significant correlation between
the healthcare professionals’ gender and AAS total score and
the Positive ageism subscale score (p > 0.05); however, women had more positive ageism towards elderly.
In the study, it was found that there was a statistically significant difference between the healthcare professionals’ occupation status and AAS total score and Positive ageism subscale score (p < 0.05) and AAS total score and Positive ageism
score of midwives were positively higher. It was determined
in the study that there was no significant correlation between
occupation status of healthcare professional and Restricting
life of the elderly and Negative ageism subscales (p > 0.05)
but midwives had more positive ageism towards the elderly.
It was found in the study that there was a statistically significant difference between their marital status and AAS total
score and Restricting life of the elderly subscale score
(p < 0.05) and married professionals had positively higher
level of AAS total score and Restricting life of the elderly
score. In the study, it was determined that there was no significant correlation between the marital status of healthcare professionals and Positive ageism and Negative ageism subscales
(p > 0.05) but married professionals had more positive ageism
against the elderly.
In the study, it was determined that there was no significant
correlation between the status of the healthcare professionals
to have children and AAS total score, Positive ageism subscale, Negative ageism subscale, and Restricting life of the
elderly subscale (p > 0.05) but the professionals with children
had more positive ageism towards the elderly.
In the study, a statistically significant difference was found
between the number of children healthcare professionals and
AAS total score (p < 0.05) and those with a single child had
positively higher AAS total score. In the study, it was found
that there was no significant correlation between the number
of children of the professionals and Positive ageism, Negative
ageism, and Restricting life of the elderly subscales (p > 0.05)
but those with a single child had more positive ageism towards
the elderly.
In the study, it was determined that there was a significant
difference between the educational levels of the healthcare
professionals and AAS total score, Positive ageism,
Negative ageism, and Restricting life of the elderly subscales
(p < 0.05) and with higher educational level, they had more
positive ageism towards the elderly.
In the study, it was determined that there was a significant
difference between the family structure of the healthcare professionals and Positive ageism subscale (p < 0.05) and those
with extended family structure had more positive ageism than
those who had nuclear and broken family structures. In the
study, it was determined that there was no significant correlation between the family structures of the professionals and the
AAS total score, Negative ageism and Restricting life of the
elderly subscales (p > 0.05) but those with extended family
structure had more positive ageism towards the elderly compared to those having nuclear and broken family structures.
There was, however, a significant difference between the
presence of an elderly person living at home and the AAS total
score and the Positive ageism subscale (p < 0.05) and those
living with an elderly person in his/her home had more positive ageism than those who did not. In the study, it was found
that there was no significant correlation between the presence
of an elderly person living at home and Negative ageism and
Restricting life of the elderly subscales (p > 0.05); however,
those living with an elderly person at home had more positive
ageism than those who do not.
In the study, it was determined that there was a significant
difference between the working year of healthcare professionals and Restricting life of the elderly subscale (p < 0.05)
and as the working year increased, the professionals had more
negative ageism towards the elderly. In the study, there was no
significant correlation between the working year of the professionals and the AAS total score, Positive ageism and
Negative ageism subscales (p > 0.05); however as the working
year increased, the professionals had more negative ageism
towards the elderly.
Discussion
It was found in the present study that healthcare professionals
working in a state hospital had positive attitudes towards elderly people. One of the areas where negative effects of ageism are seen is the general healthcare system—it is reported
that health care providers may prefer to focus on acute health
J Public Health
Table 3 Comparison of ageism
attitude scale scores of healthcare
professionals in terms of sociodemographic characteristics
Demographic characteristics
n
Restricting
life
Positive
ageism
Negative
ageism
AAS total
score
Age
18–23 age
40
22.86 ± 3.7
31.03 ± 4.4
17.75 ± 4.2
69.48 ± 8.0
24–29 age
30–35 age
58
92
21.86 ± 3.1
20.82 ± 3.7
30.73 ± 5.3
30.10 ± 4.2
17.12 ± 3.7
17.02 ± 3.7
69.08 ± 8.3
67.86 ± 8.3
36–42 age
52
p
19.67 ± 4.0
29.77 ± 4.8
16.65 ± 2.8
67.48 ± 7.9
F = 8.178
p = 0.000
F = 0.802
p = 0.494
F = 0.684
p = 0.563
F = 0.864
p = 0.461
Gender
Female
192
22.66 ± 3.3
30.49 ± 3.8
17.11 ± 3.0
68.59 ± 5.7
Male
50
20.98 ± 3.6
29.69 ± 4.6
15.56 ± 2.8
67.89 ± 5.0
t = −2.976
p = 0.003
t = 0.307
p = 0.759
t = 3.262
p = 0.001
t = 0.88
p = 0.930
p
Job
Nurse
Midwife
155
28
21.10 ± 3.7
22.58 ± 3.2
29.97 ± 4.8
33.07 ± 2.7
16.91 ± 3.0
18.52 ± 3.7
68.72 ± 7.5
72.96 ± 5.2
Other (laboratory, X-ray and
anesthesia technician)
59
21.83 ± 3.6
31.03 ± 4.4
17.06 ± 3.5
69.61 ± 7.4
KW = 5.580
p = 0.116
KW = 10.476
p = 0.002
KW = 2.652
p = 0.224
KW = 5.016
p = 0.033
145
21.71 ± 3.7
30.66 ± 4.2
16.80 ± 2.8
69.17 ± 5.2
97
20.76 ± 3.3
t = 2.017
p = 0.045
30.14 ± 3.5
t = 0.989
p = 0.324
16.78 ± 3.4
t = 0.58
p = 0.954
67.69 ± 5.9
t = 2.036
p = 0.043
129
21.52 ± 3.7
30.44 ± 3.9
16.87 ± 2.9
68.65 ± 5.3
113
21.10 ± 3.4
t = 0.906
p = 0.366
30.37 ± 4.0
t = −0.439
p = 0.661
16.72 ± 3.2
t = −0.121
p = 0.904
68.50 ± 5.9
p
Marital status
Married
Single (divorced)
p
Is there a child?
Yes
No
p
t = 0.203
p = 0.840
Number of children
1 child
2 children
3 and over
60
55
14
21.80 ± 3.7
21.58 ± 3.6
19.57 ± 4.6
KW = 5.580
p = 0.061
30.58 ± 3.4
30.16 ± 3.4
26.92 ± 8.1
KW = 0.495
p = 0.781
16.61 ± 3.3
16.45 ± 3.1
16.28 ± 3.4
KW = 0.011
p = 0.995
68.56 ± 5.4
67.93 ± 5.2
61.85 ± 3.1
KW = 8.800
p = 0.012
Education status
High school
Associate
License
Graduate
47
104
83
8
20.40 ± 3.7
21.04 ± 3.8
22.82 ± 3.3
23.87 ± 4.0
29.21 ± 6.1
29.90 ± 4.0
31.48 ± 4.2
33.37 ± 2.7
16.23 ± 3.6
16.23 ± .9
18.02 ± 3.7
22.87 ± 3.4
66.80 ± 7.0
67.56 ± 8.5
72.16 ± 6.9
77.00 ± 3.2
KW = 16.052
p= 0.000
KW = 7.478
p = 0.024
KW = 10.886
p = 0.004
KW = 22.478
p = 0.000
30.30 ± 4.7
31.62 ± 3.5
27.00 ± 5.3
KW = 8.457
p = 0.015
17.06 ± 3.5
17.18 ± 3.8
15.30 ± 3.8
KW = 2.822
p = 0.244
68.63 ± 8.1
70.56 ± 7.4
62.90 ± 6.9
KW = 6.018
p = 0.049
p
p
Family structure
Nuclear family
Extended family
Fragmented family
p
199
33
10
21.54 ± 3.9
21.94 ± 3.2
20.60 ± 3.1
KW = 1.553
p = 0.460
Is there an elderly person living in the house?
J Public Health
Table 3 (continued)
Demographic characteristics
n
Restricting
life
Positive
ageism
Negative
ageism
AAS total
score
Yes
30
22.43 ± 3.2
32.16 ± 3.4
17.73 ± 3.9
71.76 ± 5.2
No
212
21.51 ± 3.8
t = 1.232
30.16 ± 4.7
t = 2.223
16.95 ± 3.6
t = 1.088
68.07 ± 5.9
t = 2.032
p = 0.219
p = 0.027
p = 0.278
p = 0.021
p
Year of study
1–5 years
93
23.59 ± 3.5
31.12 ± 4.4
17.49 ± 4.0
69.48 ± 7.8
6–10 years
74
22.22 ± 3.5
31.05 ± 4.3
17.09 ± 3.7
69.31 ± 7.8
11–15 years
16 and over
22
53
21.33 ± 3.9
20.64 ± 3.9
31.00 ± 3.7
28.00 ± 7.3
16.58 ± 3.5
16.04 ± 2.8
68.62 ± 8.5
67.43 ± 9.2
KW = 10.675
p = 0.014
KW = 2.395
p = 0.495
KW = 2.675
p = 0.445
KW = 1.435
p = 0.697
p
problems of young patients rather than dealing with chronic
problems of the elderly (Cilingiroğlu and Demirel 2004). In all
societies, attitudes towards elderly are generally positive, negative and mixed but the tendency of being negative is higher.
Attitudes of healthcare professionals include all three
(Akdemir et al. 2007).
Additionally, it was determined that the healthcare professionals had a positive perception of elderly people (Table 2).
The results of the present study are also compatible with other
related literature results (Unalan et al. 2012; Soyuer et al.
2010; Güven et al. 2012; Koç et al. 2013).
The study also indicated that young professionals had more
positive ageism towards the elderly. The AAS total score and
the subscale mean scores of young healthcare professionals
were higher, the difference between the Restricting life of the
elderly subscale and age was significant but there was no
significant correlation between the other subscales and age
(Table 3). In the study conducted by Köse et al. (2015) on
students studying in different departments of the health field,
they found that the average age of the students was 22 and
there was no significant difference between the ages of the
students and their attitudes towards the elderly (Köse et al.
2015). Again, in the study by Ucun et al., it was determined
that even though the average age of the students had a negative correlation with total AAS scores as well as Negative and
Positive ageism mean scores, it had a positive correlation with
Restricting life of the elderly scores; the difference between
them was not statistically significant. (Ucun et al. 2015). The
healthcare professionals of a more advanced age had more
negative attitudes concerning ageism than young ones, which
was thought to be associated with fatigue, exhaustion and
increased workload.
The study also showed that women had more positive ageism towards the elderly—their AAS and subscale mean scores
were higher than men’s scores. A statistically significant difference was determined between the Gender and Restricting
life of the elderly and Negative ageism subscales (Table 3). In
Güven et al.’s study, they determined that female students had
more positive attitudes towards elderly people and there was a
statistically significant difference between with the groups in
terms of the Restricting life of the elderly subscale (Güven
et al. 2012). Although no significant difference between gender and AAS scores was found in many studies in literature, it
was determined that female students had more positive ageism
than males (Güven et al. 2012; Koç et al. 2013; Köse et al.
2015; Unsar et al. 2015). This significant difference in the
present study was thought to be caused by the traditional
care-giving role of women in Turkish culture.
Also found in the present study was that there was a statistically significant difference between the occupation status of
healthcare professionals and the AAS total score and Positive
ageism subscales (p < 0.05) and the midwives’ AAS total
score and positive ageism scores were positively higher. In
the present study, healthcare professionals were found to have
a positive attitude towards the elderly (Table 3). Similar to the
present study, Ünalan et al. found in their study that nurses had
positive attitudes towards the elderly (Unalan et al. 2012). In
addition, there are also studies indicating that general attitudes
among nurses working with elderly people tended to be negative (Courtney et al. 2000). It was determined in the present
study that attitudes of healthcare professionals against ageism
were positive and especially midwives’ attitudes were better.
It is thought that working with elderly people less can be
effective for midwives to have higher mean scores.
In this study, it was determined that there was a significant
correlation between the marital status and ageism (p < 0.05)
and married professionals’ AAS total and Restricting life of
the elderly subscale scores were higher positively (Table 3). In
Bulut’s postgraduate thesis, it was found that married surgical
nurses had more positive attitudes towards ageism; however,
the difference between them was not significant (Bulut 2015).
In the literature studies, investigating the nurses’ attitudes towards elderly people, marital status is found not to affect the
attitude towards the elderly (Aşiret et al. 2015; Aktürk and
J Public Health
Aylaz 2016). In the present study, the fact that married participants spent more time with elderly individuals and were involved in their care was thought to likely assist in developing a
positive attitude.
Another aspect determined in the study was that the professionals with children had more positive ageism towards the
elderly. It was determined that there was a statistically significant difference between ageism and the number of children
the healthcare professionals have (p < 0.05), also the AAS
total score of those with a single child was positively higher.
It was determined that those who had a single child had more
positive ageism and as the number of children increased, the
positive attitude decreased. It was thought that increasing care
burden with an increased number of child may affect ageism
attitude negatively (Table 3).
Additionally the study revealed that as the educational level
increased, professionals had more positive ageism towards the
elderly. A significant difference was determined between the
educational level and the AAS total score, positive ageism,
negative ageism and restricting life of the elderly subscales
(p < 0.05) (Table 3). In Bulut’s postgraduate thesis, the AAS
total score, restricting life of the elderly mean score and negative ageism mean score were determined to be significantly
higher in surgical nurses with an undergraduate and graduate
level of education compared to those who had a lower educational level (Bulut 2015). In the study by Yılmaz and Ozkan
(2010), the fourth-year students were determined as having a
more positive attitude towards the elderly (Yılmaz and Ozkan
2010). In the study conducted by Hughes et al. (2007) to
evaluate the attitudes of medical students towards the elderly,
they were determined to have more positive attitudes compared to the first-year students (Hughes et al. 2007). In the
studies in the literature, it is similarly shown that there is a
positive correlation with educational level and the positive
attitudes of nurses towards the elderly (Hughes et al. 2007;
Lambrinou et al. 2009; Furlan et al. 2009; Karlin et al. 2006;
Bleijenberg et al. 2012). It was thought that healthcare professionals with a higher educational level exhibited more positive
attitudes towards ageism as a result of the fact that they have
more information and experience about the old age.
Since the family types in the societies affect perspectives
regarding the elderly, family type can be effective on attitudes
towards ageism. In the present study, it was determined that
healthcare professionals with an extended family structure had
more positive attitudes towards ageism compared to the professionals with nuclear and broken family structure and the
difference between the family structure and the AAS total
score and the Positive ageism subscale was significant
(p < 0.05)(Table 3). In Göçer’s study, positive attitudes of
the individuals living in extended families towards the elderly
were also determined to be higher than the individuals living
in nuclear families (Göçer 2012). It was found in Bulut’s study
that surgical nurses with an extended family structure had
more positive attitudes towards ageism, and also the mean
score obtained by surgical nurses with an extended family
structure from the Negative ageism subscale was also found
to be significantly higher (Bulut 2015). Spending more time
with the elderly and seeing their positive sides can be effective
in developing more positive attitudes towards ageism, also
they are expected to give pregnancy and paternity care and
the education content is organized accordingly (Gözüm and
Tan 2003). The attitudes of the elderly working with the elderly may have been positive.
It was found in the present study that the professionals
living with an elderly person in their home had more positive
ageism compared to those who did not and there was a significant difference between the presence of an elderly person
living in the same home and the AAS total score and the
Positive ageism subscale (p < 0.05; Table 3). It was determined in Ünsar et al.’s study that students sharing their home
with elderly people aged 65 years and over had a more positive perspective towards the elderly—their Restricting life of
the elderly subscale mean scores and their Positive ageism
subscale mean scores were significantly higher. In addition,
AAS score of the students living with elderly people aged
65 years and over in the same home were found to be higher
than those who did not live with them in the same house
(Unsar et al. 2015). The fact that healthcare professionals living with elderly people in the same house understand them
better is thought to be associated with the fact that they benefit
from the experiences of old people and they see positive sides
of aging.
When examining the ageism attitudes of the healthcare
professionals in terms of the working year, those who had a
working period of 1–5 years had more positive attitudes than
those who worked for longer time of period. It was determined
that there was a significant difference between the working
year of healthcare professionals and the Restricting life of
the elderly subscale (p < 0.05) and they had more negative
ageism as the working year increased (Table 3). According to
Söderhamn et al., nurses who have less clinical experiences
exhibit more negative attitudes towards ageism compared to
the nurses who have more clinical experiences (Söderhamn
et al. 2001). It was thought that as the working period increased, attitudes towards ageism changed negatively with
the effect of fatigue.
Conclusions and recommendations
The present study revealed that healthcare professionals, in
particular midwives, had positive attitudes towards the elderly.
Healthcare professionals who were young, female, married,
had undergraduate and graduate educational levels, had an
extended family structure, had a working period of 1–5 years
J Public Health
and lived with an elderly person were determined to have
more positive attitudes towards the elderly.
Old age is a period where physical and certain mental illnesses emerge more frequently, and it requires a certain effort
for the individual to deal with these illnesses, to be willing to
seek treatment when necessary, and to remain present under
whatever the pervading conditions are, with a sense of survival and a desire to live and maintain a certain quality of life.
Therefore, there is a need to establish infrastructures with
comprehensive policies, information and appropriate equipment so that the regional and central administrations can work
together on behalf of both the family and the institution.
Healthcare professionals should be informed about aging
and the period of aging, and awareness raising principals
about this subject should be made available via in-service
trainings. In addition, it is recommended to improve the working conditions of healthcare professionals in order to provide a
more qualified healthcare to elderly people, enhance job satisfaction of healthcare professionals and reduce burnout.
Acknowledgements This research received no specific grant from any
funding agency in the public, commercial, or not-for-profit sector. Ethical
approval was obtained from the Malatya Clinical Trials Ethics Committee
in order to conduct the study (Ethical Council number 2012/25).
Funding Information The financial support for this study was provided
by the investigators themselves.
Compliance with ethical standards
Conflict of interest The authors hereby disclose no financial and personal relationships with other individuals or organizations who could
inappropriately influence this work.
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