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PERCEPTION OF HEALTH STUDENTS ABOUT OLDER ADULTS IN BRAZIL

2011; Wiley; Volume: 59; Issue: 8 Linguagem: Inglês

10.1111/j.1532-5415.2011.03516.x

1532-5415

André Filipe Junqueira dos Santos, Carolina Bisinoto Borges, Lídia Kelsin Fung, Mayra Zanetti, Pedro Kallas Curiati, Vanessa Meirelles Pereira Danzini, Euro de Barros Couto Júnior, Paulo Sérgio Panse Silveira, Luiz Eugênio Garcez Leme,

Retirement, Disability, and Employment

To the Editor: To provide better care for the growing elderly population, it is necessary to assess future health professionals' perceptions of this population starting from the time of their graduation. With this in mind, in 1995, the World Health Organization (WHO) and the International Federation of Medical Students (IFMSA) began a global study called Teaching Geriatrics in Medical Education (TeGeME). In its first part (TeGeME I),1 the existence of resources for the teaching of geriatrics in several countries was analyzed, followed by TeGeME II, which evaluated medical students' attitudes toward older adults through the analyses of four variables: sex, previous contact with senior citizens, exposure to aging-related disciplines, and interest in the fields of geriatrics and gerontology. Some adjustments were made to the original protocol to expand the numbers of participants. A cross-sectional study was conducted with medical students and students from other healthcare-related disciplines (nursing, physiotherapy, speech therapy, occupational therapy, psychology, nutrition) and a control group (science of physical activity, social work, and leisure and tourism). Questionnaires were given to students who were undergraduate students and were willing to participate in the study and sign a consent form. Data were collected by responding to an Internet-based questionnaire, extracted from the TeGeME II study. A nonparametric statistics test was necessary because the three groups did not follow a normal distribution, according to the Kolmogorov-Smirnov test, and the results were obtained using SPSS version 17.0 (SPSS, Inc., Chicago, IL). Two thousand two hundred seventy questionnaires were collected in eight cities from different regions of Brazil. Because the number of questionnaires filled by medical students was much higher than that of the other groups, they were reduced randomly for the purpose of statistical analysis; 1,489 questionnaires (998 women, 491 men, 16 unknown) were divided into medical students (n=584, 39.2%), other health areas (n=584, 39.2%), and a control group (n=321, 21.6%). There was a greater prevalence of negative perceptions about older adults from medical students (Table 1). Further analyses showed that this negative perception is mostly attributable to male students. Neither “have lived with elderly people” nor “exposure to geriatrics disciplines at the undergraduate level” had any influence on this result. Positive perception was found among students who intended to specialize in geriatrics and gerontology. Medical students differed from students from other health areas based on gender (there are more women in other health areas) and intention to work with elderly people (44% of medical students vs 52% of other health area students). All groups differed on having lived with the elderly (77% of medical students and 73% of other health area students, and 63% of students from the control group did not have this experience) and having undertaken geriatrics or gerontology training (36% of medical students, 38% of other health areas, and 12% in the control group had training). Despite these differences in group compositions, we found association between gender and intention to work with the elderly: 42% of men were interested in geriatrics/gerontology while 51% of women had the same intention (chi-square, p = 0.001), but no other associations were found between complementary variables. It is interesting to emphasize that it includes training in geriatrics/gerontology, which did not reveal influence on the decision to work with the elderly. Unlike in the original protocol, not only medical students, but also students from other health-related areas were studied,2 and it was attempted to obtain a broader understanding of students' attitudes, because elderly care is often multidisciplinary. Within the three groups, 48% of future professionals intended to work with older adults, although it is worrisome that students interested in working with older adults and who, presumably, have a more-positive perception of them were not sufficient to counterbalance the negative perception that appears on several items shared by the other 52% participants. An association between sex and “intention to work with older adults” strengthens this finding, and a possible explanation for these results could be the short time involved in training in geriatrics and gerontology. These results suggest that, in Brazil,3 contact between medical students and older adults through geriatrics and gerontology classes is not enough. The need for extended courses with practice and usage of new pedagogical instruments,4 such as extracurricular activities,5, 6 is urgent and might optimize education in the treatment of and health promotion for older adults. The goal is to improve undergraduates' basic concepts, preparing them to treat older adults in all areas and to modify the negative view that society has about this growing population. This study shows that university students in health-related areas lack a positive image of older adults, despite lectures on aging in their curriculum, indicating that geriatrics and gerontology training should be restructured. This should provide not only knowledge and skills in the area, but also a new view on the aging process.7 The goal would be a change in attitudes, reflecting a review of the education, culture, and values through timely interventions during contact with older adults.8 In addition, this questionnaire should be used as a monitoring tool of the effect of interventions on the teaching of geriatrics and gerontology. The authors would like to thank the Brazilian Society of Geriatrics Gerontology, São Paulo, and all students from the disciplines of geriatrics and gerontology who actively took part in this project and contributed daily and voluntarily for the expansion and strengthening of geriatrics and gerontology in Brazil: Adriana I Un Huang, Aghata Teixeira Silva, Aline Vial Cobello, Ana Beatrice Torres Carvalho, Ana Carolina Araújo Oliveira, Ana Cristina da Silva Fernandes, Ana Paula de Oliveira Marques, Ana Paula de Souza Oliveira, Anne Grazielle Lima Bindá, Bárbara Araújo Oliveira, Blenda Sousa Carli Rodrigues, Bruna Danielle de Menezes, Carolina Burgarelli Testa, Caroline Monteiro Conceição, Cristiane Andrade da Costa, Christyanne Maria Rodrigues Barreto de Assis, Daniela Teles da Silva, Danielle Figueredo da Silva, Danielle Florêncio dos Santos, Darlene Mara dos Santos Tavares, Debora Lee Vianna Paulo, Denise Cristina de Oliveira Ferreira, Diego Adão F. Silva, Edna Corrêa Moreira, Elder Lanzani Freitas, Erika Kiyomi Yuyama, Fábia Helena Muniz, Fernanda Gasparini, Fernanda Santucci, Giovanna Arcaro de Lima, Gustavo Ferrão, Hugo Moura de Albuquerque Melo, João Augusto Hidalgo Barros Abomorad, Karen Christine Albuquerque Moreira, Karoline Bento Ribeiro, Leila Fortes, Lilian César Salgado Boaventura, Liliane Ramos Costa, Li Men Zhao, Lorena Rodrigues Netto, Lucas Certain, Lucília Rocha Lopes, Maria de Fátima Nunes Marucci, Maria Lucia Buziqui Piruzeli, Maria Monique Silva Oliveira, Mariana Leme Gomes, Mariani Mendes Madisson, Marisa Accioly Rodrigues da Costa Domingues, Marcos Alexandre Frota, Marta Nagai Coelho, Mayra Jacuviske Venegas, Maysa Seabra Cendoroglo, Mirella Carla de Melo Mendonça, Natália Sanchez Oliveira, Natalia Waldmann Okai, Natasha Casteli Bonfim, Nayara Paula Fernandes Martins, Nelisa Sandrini Alves Maciel, Paula Caroline O. Souza, Paulo André de Lacerda Alves, Raphael Valadão Dadalto, Raquel Aparecida Casarotto, Rebeca Matos Velez de Andrade Lima, Renata Borges Facury, Renato Lírio Morelato, Ricardo Ramiris Silva Gasperazzo, Silmara Rondon, Simone da Silva Henriques, Tiffany Moukbel Chaim, Valdeci de Oliveira Santos Rigolin, Vanessa Bezerra de Lima, Wagner Vicente de Morais Silva, Wilson Jacob Filho. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Author Contributions : All authors contributed equally to the data collection, analyses, and conclusion of this study. Sponsor's Role: This study had no sponsor support.