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Nu sing Open. 2023;10:3854–3861.wileyonlinelib a y.com/jou nal/nop2
1 | INTRODUCTION
The wo ld's popula ion is ageing apidly, and he p opo ion o
people aged ≥65 yea s is expec ed o inc ease om 9.3% in 2020
o 16.0% in 2050 (Uni ed Na ions, 2020). Despi e ou g owing
ageing popula ion and he many con ibu ions made by olde
people, nega i e a i udes owa ds his popula ion a e s ill com-
mon (Ab ams & Swi , 2012). Robe Bu le was he i s o de ine
and con ex ualize he e m “ageism” and desc ibed i as a se o
s e eo ypes (cogni i e componen ), p ejudices (a ec i e compo-
nen ) and disc imina ions (beha iou al componen ) agains people
because o hei age, which a e e lec ed h ough beha iou s such
Recei ed: 22 Ma ch 2022
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Re ised: 29 No embe 2022
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Accep ed: 5 Feb ua y 2023
DOI: 10.1002/nop2.1643
RESEARCH ARTICLE
Reducing ageism combining ageing educa ion wi h clinical
p ac ice: A p ospec i e coho s udy in heal h sciences
s uden s
Ba i ze San- Ma ín- Gamboa1 | Idoia Za azquin2 | Ainhoa Fe nandez- A u xa1 |
Sil ia Cepeda- Miguel1 | Bo ja Doncel- Ga cía1,3,4 | Idoia Imaz- A ambu u1 |
Amaia I azus a1 | Ana B. F aile- Be múdez1
This is an open access a icle unde he e ms o he C ea i e Commons A ibu ion License, which pe mi s use, dis ibu ion and ep oduc ion in any medium,
p o ided he o iginal wo k is p ope ly ci ed.
© 2023 The Au ho s. Nu sing Open published by John Wiley & Sons L d.
1Depa men o Nu sing I, Facul y o
Medicine and Nu sing, Uni e si y o he
Basque Coun y, Leioa, Bizkaia, Spain
2Depa men o Nu sing II, Facul y o
Medicine and Nu sing, Uni e si y o he
Basque Coun y, Donos ia, Spain
3OSI Bilbao- Basu o, Osakide za Basque
Heal h Se ice, Bilbao, Bizkaia, Spain
4Bioc uces, Bizkaia Heal h Resea ch
Ins i u e, Ba akaldo, Spain
Co espondence
Ana B. F aile- Be múdez, Depa men
o Nu sing I, Facul y o Medicine and
Nu sing; Uni e si y o he Basque
Coun y, B° Sa iena s/n, 48940 Leioa,
Bizkaia, Spain.
Email: anabelen. [email protected]
Abs ac
Aim: To analyse he impac o an in e en ion combining ageing educa ion wi h clini-
cal p ac ice in nu sing homes on a nu sing coho 's nega i e s e eo ypes and p eju-
dices owa ds ageing.
Design: A p ospec i e coho s udy was conduc ed in Sep embe 2019– Oc obe
2020 in a popula ion o heal h sciences s uden s (n = 222).
Me hods: Ques ionnai e o Nega i e S e eo ypes owa ds Aging (CENVE) and Aging
Seman ic Di e en ial (DSE) we e used o examine nega i e s e eo ypes and p eju-
dices owa ds ageing in he nu sing coho exposed o he ageing educa ion and
p ac ice in e en ion compa ed o a medical coho ha ecei ed no in e en ion.
G oup- by- ime in e ac ion, con olled by sex and age, o he e ec o he in e en-
ion on CENVE and DSE sco es was de e mined by mixed- design ANOVA.
Resul s: The nu sing coho signi ican ly educed nega i e s e eo ypes and p ejudices
owa ds ageing when compa ed o he medical coho in o al (F = 26.926; p < 0.001),
heal h ac o (F = 16.812; p < 0.001), mo i a ional and social ac o (F = 11.266;
p = 0.001), and cha ac e and pe sonali y ac o (F = 19.202; p < 0.001) sco es o
CENVE scale and in DSE (F = 7.826; p = 0.006).
KEYWORDS
ageism, nu sing s uden s, p ejudices, s e eo ypes
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SAN-MARTÍN-GAMBOA e al.
as con emp , dislike and indi e ence and can place ageing adul s
in ulne able si ua ions (Bu le , 1969).
The co ona i us disease 2019 (COVID- 19) pandemic has high-
ligh ed ageism in socie y (B a o- Segal & Villa , 2020). Al hough
COVID- 19 a ec s all age g oups, mos dea hs occu in olde pop-
ula ions and in hose wi h p e ious heal h condi ions o ail y
(G asselli e al., 2020; Hewi e al., 2020; Richa dson e al., 2020).
Thus, olde people a e a he o e on as a isk g oup and a ulne -
able popula ion, in luencing how hey a e iewed. In his con ex ,
many s udies ha e wa ned o he po en ial o inc eased ageism and
disc imina ion agains olde people du ing he COVID- 19 pandemic
(Ehni & Wahl, 2020; F ase e al., 2020; Ga cía- Sole e al., 2020).
The Wo ld Heal h O ganiza ion's ecen Global Repo on Ageism
(Wo ld Heal h O ganiza ion, 2021) s a es ha comba ing ageism is
one o he ou ac ion a eas o he Decade o Heal hy Ageing (2021–
2030) (Dixon, 2021).
2 | BACKGROUND
S udies ha e shown ha heal h sciences s uden s can pos-
sess nega i e s e eo ypes o old age (Du an- Badillo e al., 2016;
Rello e al., 2018; Sequei a & Sil a Jiménez, 2016), al hough
con adic o y da a exis (Leon e al., 2015; Özdemi & Bilgili, 2016).
O no e, s udies examining hese s e eo ypes we e c oss- sec ional
and only e ealed he ela ionship be ween di e en a iables a a
pa icula ime, making i di icul o pe o m mo e in- dep h analy-
ses. Fu he , alida ed ques ionnai es we e no always used, and
di e en componen s o ageism we e no consis en ly explo ed.
When ageis a i udes appea in heal h p o essionals, hey nega-
i ely a ec he heal h o olde people because such a i udes lead
o disc imina o y beha iou s, including inadequa e heal h com-
munica ion wi h he pa ien and amily, unde diagnosis, lack o
ea men , exclusion om esea ch and denial o access o heal h
se ices and ea men (Chang e al., 2020; F anco e al., 2010;
Kagan & Melendez- To es, 2015; Mak is e al., 2015). I is he e-
o e impo an o implemen ac ions o educe hese nega i e s e-
eo ypes and p ejudices in heal h science ainees.
Se e al s udies ha e obse ed ha educa ion abou ageing may
be e ec i e in changing a i udes owa ds ageing in heal h sciences
s uden s (Bas an e al., 2012; Rodge s & Gilmou , 2011; Sa abia-
Cobo & Cas anedo- P ei e , 2015; Wu ele & Ma uyama, 2013), ye
ew s udies ha e used con ol g oups o assess he e ec s o such
educa ional in e en ions (Leung e al., 2012; Lucche i e al., 2017).
Con ac wi h olde people is ecommended o dec ease nega i e
a i udes owa ds ageing (Bu nes e al., 2019; Sum e al., 2016).
Howe e , o heal h science s uden s, con ac wi h olde people
o en occu s du ing clinical p ac ice, and exposu e is usually wi h
ail olde adul s, which may inc ease he isk o de eloping ageis
a i udes (Giles e al., 2002).
The e o e, ou goal was o analyse he impac o combining
ageing educa ion wi h clinical p ac ice in nu sing homes on a nu s-
ing coho 's nega i e s e eo ypes and p ejudices owa ds ageing
and compa e ou comes wi h a medical coho ha did no ecei e
he educa ional in e en ion. We hypo hesized ha his s a -
egy would educe nega i e s e eo ypes and p ejudices owa ds
ageing.
2.1 | Resea ch ques ion
Could an educa ional in e en ion in ol ing ageing educa ion and
clinical p ac ice in nu sing homes in luence on a nu sing coho 's
nega i e s e eo ypes and p ejudices owa ds ageing?
3 | THE STUDY
3.1 | Design
A p ospec i e coho s udy was used o his s udy.
3.2 | Pa icipan s
The s udy was conduc ed in Sep embe 2019– Oc obe 2020 a
he Facul y o Medicine and Nu sing, Uni e si y o he Basque
Coun y, Spain. Fo he nu sing coho , in Sep embe 2019 we e-
c ui ed 132 nu sing s uden s a he beginning o hei second yea
o he Nu sing Deg ee p og am who ook a cou se wi h con en
pe inen o he ca e o olde people and who we e conduc ing
clinical p ac ice in nu sing homes o he i s ime. The medi-
cal coho consis ed o 128 medical s uden s a he beginning o
hei second yea o he Medical Deg ee p og am. These s uden s
we e no p esen ed wi h educa ional con en ele an o he ca e
o olde people and did no conduc clinical p ac ice du ing he
academic yea . The inal sample consis ed o 113 nu sing s uden s
and 109 medical s uden s who comple ed he ques ionnai es a
he beginning and end o he s udy.
3.3 | P ocedu e
The nu sing coho was exposed o an educa ional in e en ion
consis ing o ins uc ional and clinical componen s du ing he
2019– 2020 academic yea . The ins uc ional componen was
p o ided du ing he second yea o he Nu sing Deg ee p og am
and included con en pe inen o ge on ology and he ca e o
olde people. The COVID- 19 pandemic led o home con inemen
o he Spanish popula ion in Ma ch– Ap il 2020, bu Uni e si y
o he Basque Coun y s uden s con inued a ending online, and
he cou se ended in May 2020 (Legido- Quigley e al., 2020). The
clinical componen was a ou - week clinical p ac ice (35 hou s
pe week) in nu sing homes pe o med in he second yea o
he Nu sing Deg ee p og am du ing No embe 2019– Feb ua y
2020. The medical coho did no s udy any subjec s ela ed
20541058, 2023, 6, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1002/nop2.1643 by Uni e sidad Del Pais Vasco, Wiley Online Lib a y on [01/07/2024]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
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SAN-MARTÍN-GAMBOA e al.
o ageing and did no do any clinical p ac ice in he cu en o
p e ious academic yea .
Nu sing and medical s uden s we e in i ed o se e al in o ma-
ion sessions, which in oduced he objec i e o he p ojec , esol ed
doub s and eques ed hei collabo a ion. All s uden s in e es ed in
pa icipa ing olun a ily signed in o med consen o ms and com-
ple ed he ques ionnai es.
3.4 | Ma e ials
We used an ad hoc sel - adminis e ed ques ionnai e and collec ed
sociodemog aphic in o ma ion, including age, sex, ma i al s a-
us, numbe o amily membe s and pa en s' educa ion le el. The
Ques ionnai e o Nega i e S e eo ypes owa ds Aging (CENVE)
was used o examine he cogni i e dimension o ageism (how we
hink) (Blanca e al., 2005). This ques ionnai e consis s o 15 s a e-
men s ega ding he cha ac e is ics o olde pe sons, wi h esponses
anging om 1 (s ongly disag ee) o 4 (s ongly ag ee); he e o e,
possible sco es ange 15– 60, wi h highe sco es indica ing highe
nega i e s e eo ypes. This ques ionnai e explo es h ee ac o s:
heal h ac o , mo i a ional and social ac o , and cha ac e and pe -
sonali y ac o . CENVE shows good psychome ic p ope ies wi h a
C onbach's alpha o 0.89 and is he mos widely used ins umen in
Spanish- speaking coun ies (Menéndez Ál a ez- Da de e al., 2016;
Rosell e al., 2020).
The Aging Seman ic Di e en ial (DSE) was used o examine p ej-
udices owa ds ageing [i.e., a ec i e dimension o ageism (how we
eel)] and has an op imal le el o eliabili y and high i em co ela ion
wi h a C onbach's alpha o 0.91 (Villa Posada, 1997). This ques ion-
nai e includes 18 pai s o opposing adjec i es ha can be used o
desc ibe he ageing p ocess. Each wo d pai is a ed on a 7- poin
scale, possible sco es ange 18– 126 and lowe sco es e lec mo e
nega i e p ejudices.
3.5 | Analysis
S a is ical analysis was pe o med using he IBM SPSS S a is ics .26
s a is ical so wa e package (SPSS Inc., Chicago, IL). Quan i a i e
da a we e exp essed as means (M) wi h s anda d de ia ions (SD)
and ca ego ical da a as equency coun s (n) and pe cen ages (%).
Quan i a i e a iables we e checked o no mali y o dis ibu ion
using he Ko mogo o – Smi no es . Di e ences o baseline cha -
ac e is ics be ween nu sing and medical coho s we e compa ed by
he independen s uden - es o quan i a i e a iables and wi h
he chi- squa ed es o ca ego ical a iables. E ec sizes o hose
es s we e calcula ed by Cohen's d and C ame 's V espec i ely.
Di e ences in he e olu ion o CENVE and DSE sco es be ween
bo h g oups we e de e mined by mixed- design ANOVA. G oup- by-
ime e ec con olled by sex and age was calcula ed. E ec size was
de e mined by pa ial e a- squa ed. p- alue <0.05 was conside ed
s a is ically signi ican .
4 | RESULTS
Sociodemog aphic cha ac e is ics o he inal sample (n = 222) a e
shown in Table 1. Signi ican di e ences exis ed been nu sing and
medical coho s. The nu sing coho was olde ( = 3504, p = 0.001)
and included mo e women (Χ2 = 6.453, p = 0.011). The nu sing co-
ho also had ewe amily membe s ( = −2.376, p = 0.019) and sig-
ni ican ly di e en educa ion le els o bo h pa en s (Χ2 = 16.563,
p = 0.001 and Χ2 = 18.697, p < 0.001, espec i ely). Howe e , no di -
e ences we e obse ed in baseline CENVE o al sco e ( = −0.060,
p = 0.990) and DSE sco e ( = 1.514, p = 0.167).
When analysing he e ec o he in e en ion on nega i e s e-
eo ypes and p ejudices owa ds ageing (Table 2), CENVE o al sco e
o he nu sing coho be o e in e en ion (M = 32.3, SD = 5.4) was
signi ican ly highe han a e in e en ion (M = 26.5, SD = 6.0), in-
dica ing a s a is ically signi ican dec ease in nega i e s e eo ypes
owa ds ageing (F = 111.52, p < 0.001). Signi ican dec eases we e
also obse ed in CENVE ac o s in he nu sing coho : heal h ac o
(F = 62.524, p < 0.001), mo i a ional and social ac o (F = 60.425;
p < 0.001), and cha ac e and pe sonali y ac o (F = 77.270, p < 0.001).
In addi ion, DSE sco e be o e in e en ion (M = 59.8, SD = 31.1) was
signi ican ly lowe han a e in e en ion (M = 81.1, SD = 13.1), indi-
ca ing a s a is ically signi ican dec ease in p ejudices owa ds ageing
(F = 36.98, p < 0.001). The e we e no s a is ically signi ican di e -
ences in be o e- and a e - in e en ion CENVE (F = 0.01, p = 0.917)
and DSE (F = 0.06, p = 0.601) sco es in he medical coho . The mixed
ANOVA also e ealed ha nu sing coho imp o ed mo e han medi-
cal coho when analysing g oup- by- ime in e ac ion o CENVE o al
sco e (F = 26.926, p < 0.001) and all he CENVE ac o s; heal h ac-
o (F = 16.812, p < 0.001), mo i a ional and social ac o (F = 11.266,
p = 0.001), and CENVE cha ac e and pe sonali y ac o (F = 19.202,
p < 0.001). DSE sco e showed a highe imp o emen in nu sing coho
compa ing o medical coho (F = 7.826, p = 0.006).
Rega ding co a ia es, he e was no signi ican age- by- ime in e -
ac ion. Howe e , sex- by- ime in e ac ion was signi ican o CENVE
heal h ac o (F = 4.901, p = 0.028), mo i a ional and social ac o
(F = 4.344, p = 0.038) and o al sco e (F = 7.035, p = 0.009) as women
showed a g ea e imp o emen han men did.
5 | DISCUSSION
We aimed o de e mine he impac o combining ageing educa ion
wi h clinical p ac ice in nu sing homes on a nu sing coho 's nega i e
s e eo ypes and p ejudices owa ds ageing and compa ed ou comes
wi h a medical coho . Ou esul s suppo he hypo hesis ha com-
bining didac ic educa ion and clinical p ac ice wi h olde indi iduals
signi ican ly educes nega i e s e eo ypes and p ejudices abou age-
ing in nu sing s uden s.
Se e al s udies ha e conduc ed educa ional in e en ions
o imp o e a i udes o heal h science s uden s owa ds olde
people (Bas an e al., 2012; Hwang e al., 2013; Rodge s &
Gilmou , 2011; Sa abia- Cobo & Cas anedo- P ei e , 2015; Wu ele
20541058, 2023, 6, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1002/nop2.1643 by Uni e sidad Del Pais Vasco, Wiley Online Lib a y on [01/07/2024]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
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SAN-MARTÍN-GAMBOA e al.
& Ma uyama, 2013). Va ious educa ional in e en ions in ge ia ics
ha e he po en ial o imp o e s uden skills, knowledge and a i-
udes in ge ia ic medicine (Tullo e al., 2010). Fu he , pedagogical
in e en ions designed o inc ease knowledge o ageing also can
imp o e a i udes owa ds olde adul s (Chonody, 2015). Howe e ,
p e ious s udies examining how such in e en ions impac nega i e
s e eo ypes owa ds olde indi iduals a y conside ably in bo h he
me hodology and he ques ionnai es used. In addi ion, hese s ud-
ies had limi a ions, alida ed ques ionnai es we e no always used,
he ob ained esul s we e no always signi ican , and many s udies
lacked a con ol g oup.
Con ol g oups ha e been used in ew s udies assessing he e -
ec s o educa ional in e en ions on changing a i udes owa ds
ageing in heal h sciences s uden s. In medical ainees, in compa -
ison o a con ol g oup ecei ing no in e en ion, implemen a ion o
wo educa ional s a egies has shown di e en ou comes in e ms o
a i udes, empa hy and knowledge ha depend on he s a egy used
(Lucche i e al., 2017). Howe e , ha s udy did no ocus on nega-
i e s e eo ypes and p ejudices owa ds ageing and only conduc ed
an educa ional in e en ion.
In addi ion, explo a ion o he long- e m e ec o a 10- week
se ice- lea ning p ojec , whe e one olde adul and one s uden
me o 1– 2 h pe week, on medical and nu sing s uden s' knowl-
edge o ageing and a i udes owa ds olde adul s demons a ed
inc eased knowledge and educed nega i e a i udes immedia ely
a e in e en ion (Leung e al., 2012). Howe e , 1 mon h a e he
TABLE 1 Baseline cha ac e is ics o he s udy popula ion by g oup.
Ca ego ical a iables
Nu sing coho ,
n = 113
Medical coho ,
n = 109 C ame ´s VΧ2d p- Value
Sex, n (%)
Women 95 (84.1) 76 (69.7) 0.170 6.453 10.011
Men 18 (15.9) 33 (30.3)
Ma i al s a us, n (%)
Ma ied 4 (3.5) 2 (1.8) 0.164 5.831 30.176
Single 88 (77.9) 98 (89.9)
Sepa a ed/di o ced 1 (0.9) 0 (0)
O he 16 (14.2) 7 (6.4)
No answe /don´ know 4 (3.5) 2 (1.8)
Mo he educa ion le el, n (%)
No s udies 1 (0.9) 1 (0.9) 0.274 16.563 30.001
P ima y 18 (15.9) 7 (6.4)
Seconda y 39 (34.5) 21 (19.3)
Highe educa ion 52 (46.0) 80 (73.4)
No answe /don´ know 3 (2.7) 0 (0)
Fa he educa ion le el, n (%)
P ima y 25 (22.1) 6 (5.5) 0.294 18.697 2<0.001
Seconda y 45 (39.8) 38 (34.9)
Highe educa ion 38 (33,6) 64 (58.7)
No answe /don´ know 5 (4.4) 1 (0.9)
Quan i a i e a iables
Nu sing coho
n = 113
Medical coho
n = 109 Cohen´s d d p- Value
Age, M (SD)20.6 (4.49) 19.1 (0.96) 0.473 3.504 218 0.001
Family membe s, M (SD)3.8 (0.77) 4.1 (0.77) - 0.324 - 2.376 213 0.019
CENVE M (SD)
To al sco e p e- in e en ion 32.3 (5.42) 32.3 (5.42) - 0.008 - 0.060 221 0.990
Heal h ac o 10.5 (2.33) 10.7 (2.42) - 0.063 - 0.474 221 0.636
Mo i a ional and social ac o 10.7 (2.32) 10.8 (2.24) - 0.044 - 0.331 221 0.741
Cha ac e and pe sonali y ac o 11.0 (2.39) 10.8 (2.37) 0.088 0.653 221 0.514
DSE M (SD)
To al sco e p e- in e en ion 74.1 (11.50) 71.8 (13.69) - 0.016 1.514 220 0.167
Abb e ia ions: CENVE, Ques ionnai e o Nega i e S e eo ypes abou Aging; d , deg ee eedom; DSE, Ques ionnai e Seman ic Di e en ial o Aging;
M, mean; n, equency; SD, s anda d de ia ion; , s uden ´s - s a is ic; Χ2, Chi- squa e alue.
20541058, 2023, 6, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1002/nop2.1643 by Uni e sidad Del Pais Vasco, Wiley Online Lib a y on [01/07/2024]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
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SAN-MARTÍN-GAMBOA e al.
TABLE 2 E olu ion o CENVE and DSE sco es o nu sing and medical coho s.
Nu sing coho , n = 113 Medical coho , n = 109 G o u p - b y - i m e e e c
P e - e s Pos - es
Type III
sum o
squa es d F
Wi hin
g oup
p- Value
Pa ial
e a-
squa e P e - e s Pos - es
Type III
sum o
squa es d F
Wi hin
g oup
p- Value
Pa ial
e a-
squa e
Type III
sum o
squa es d Fp- alue
Pa ial
e a-
squa e
Va iable M (SD)M (SD)M (SD)M (SD)
CENVE
To al sco e 32.3 (5.4) 26.5 (6.0) 1857.98 1111.518 < 0.001 0.499 32.3 (5.4) 32.4 (5.8) 0.11 10.008 0.931 < 0.001 418.17 126.926 <0.001 0.111
Heal h ac o 10.5 (2.3) 8.7 (2.4) 193.30 162.524 < 0.001 0.358 10.7 (2.4) 10.7 (2.5) 0.04 10.013 0.908 < 0.001 50.24 116.812 <0.001 0.073
Mo i a ional
and social
ac o
10.7 (2.3) 9.0 (2.3) 173.47 160.425 < 0.001 0.350 10.8 (2.2) 10.7 (2.5) 1.02 10.361 0.549 0.003 31.92 111.266 0.001 0.050
Cha ac e and
Pe sonali y
ac o
11.0 (2.4) 8.9 (2.4) 256.99 177.270 < 0.001 0.408 10.8 (2.4) 11.1 (2.5) 1.82 10.611 0.436 0.006 60.43 119.202 <0.001 0.082
DSE
To al sco e 59.8 (31.1) 81.1 (13.1) 2685.14 136.985 < 0.001 0.248 71.6 (13.8) 71.4 (13.0) 4.13 10.057 0.811 < 0.001 557.0 0 17.826 0.006 0.035
No e: G oup- by- ime e ec was con olled by sex and age.
Abb e ia ions: CENVE, Ques ionnai e o Nega i e S e eo ypes abou Aging; d , deg ee eedom; DSE, Ques ionnai e Seman ic Di e en ial o Aging; F, mixed ANOVA s a is ics; M, mean; SD, s anda d
de ia ion.
20541058, 2023, 6, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1002/nop2.1643 by Uni e sidad Del Pais Vasco, Wiley Online Lib a y on [01/07/2024]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
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SAN-MARTÍN-GAMBOA e al.
in e en ion, all g oups showed a dec ease in posi i e a i udes
owa ds olde adul s. Cu iously, he nu sing s uden in e en ion
g oup showed a g ea e dec ease han he nu sing s uden con ol
g oup wi h no in e en ion, sugges ing ha he knowledge and a -
i ude gains a e limi ed (Leung e al., 2012). In he cu en s udy, he
in e en ion was conduc ed du ing Sep embe 2019– May 2020, and
he second da a collec ion ook place 4– 5 mon hs a e in e en ion,
in Sep embe – Oc obe 2020. The e o e, combining ageing educa-
ion wi h clinical p ac ice in nu sing homes may be a iable s a egy
o main ain imp o emen s in a i udes o e ime.
Recen s udies buil on he Posi i e Educa ion abou Aging
and Con ac Expe iences (PEACE) model (Le y, 2016) ha e ound
imp o emen s in a i udes owa ds ageing in unde g adua es
h ough posi i e in e gene a ional con ac (Ly le e al., 2021; Ly le
& Le y, 2019), an app oach ha has been suppo ed by o he s ud-
ies (Bu nes e al., 2019; Sum e al., 2016), bu hese s udies we e
no ca ied ou in nu sing s uden s. Posi i e in e gene a ional con-
ac may be an e ec i e s a egy because exposu e o only sick and
ail olde adul s may place heal h p o essionals a g ea e isk o
de eloping age- disc imina o y a i udes (Giles e al., 2002). In addi-
ion, conduc ing clinical p ac ices in di e en acili ies has a ious
e ec s on s uden s' a i udes and beha iou s owa ds olde people
(Hwang e al., 2013). In he cu en s udy, he e was con ac be ween
s uden s and olde people h ough a ou - week clinical p ac ice in
nu sing homes, bu he clinical p ac ice was complemen ed wi h
a cou se on ge on ology and educa ional con en pe inen o he
ca e o olde people. P e ious s udies ha e concluded ha ageing
educa ion is impo an (Wille s e al., 2017) and highligh ed ha
cu icula need o be ca e ully planned o b eak down nega i e pe -
cep ions (Dahlke e al., 2020; Leung e al., 2012), and pe haps “be
deli e ed by expe ge on ological nu ses o inspi e unde g adua e
nu sing s uden s o ca e o olde adul s” (Ne ille e al., 2013). A
li e a u e e iew concluded ha “ ele an p epa a ion and suppo
allows s uden s o engage in en iched lea ning expe iences, deli e
quali y ca e, and de elop posi i e a i udes in ca ing o olde people
in hei p o essional p ac ice” (Koh, 2012). Educa ion on ageing is im-
po an , bu cu icula mus ensu e ha such educa ion is e ec i e in
educing ageism. Conside ing he lack o in e en ions ha apply he
me hodology p oposed in he cu en s udy, linking clinical p ac ice
wi h educa ion abou ageing may be key o dec easing bo h nega i e
s e eo ypes and p ejudices in heal h sciences s uden s.
5.1 | Limi a ions
One o he limi a ions o his s udy is ha he COVID- 19 pandemic
occu ed du ing ou s udy, in he 2019– 2020 academic yea . I is pos-
sible ha he pandemic in luenced nega i e s e eo ypes and p eju-
dices o heal h sciences s uden s a he Uni e si y o he Basque
Coun y. Se e al s udies indica e ha ageism has inc eased (Ehni &
Wahl, 2020; F ase e al., 2020), bu o he s show ha he pandemic
has p omo ed in e gene a ional solida i y (P e i ali e al., 2020;
Ve aecke & Meisne , 2020). Thus, he imp o emen in ou nu sing
coho could be due o he pandemic; howe e , he medical coho
did no show any changes in a i udes owa ds ageing, indica ing ha
he obse ed posi i e changes we e associa ed wi h he in e en ion
and no he pandemic. Ano he limi a ion was ha he wo g oups
had di e en sociodemog aphic cha ac e is ics. The e o e, he e-
sul s we e no en i ely ee o bias. Howe e , he baseline le els o
s e eo ypes and p ejudices abou ageing we e simila in bo h g oups.
This s udy has impo an s eng hs. To he bes o ou knowl-
edge, his s udy is he i s o analyse bo h nega i e s e eo ypes and
p ejudice owa ds ageing in heal h sciences s uden s; ha is, ou
s udy explo es ageism om i s cogni i e and a ec i e componen s
using alida ed ques ionnai es. Ou s udy has an inno a i e, longi u-
dinal design, whe e he in e en ion consis s o a combina ion o di-
dac ic educa ion abou ageing and clinical p ac ice in nu sing homes,
as well as use o a con ol compa ison g oup. Ou indings highligh
he impo ance o implemen ing ac ions aimed a educing ageism
by a ge ing heal h sciences s uden educa ion and aining. This
could imp o e he quali y o ca e p o ided o he ageing popula ion.
5.2 | Implica ions o nu sing educa ion
Conside ing ha comba ing ageism is one o he ou ac ion a eas
o he Decade o Heal hy Ageing (2021– 2030), educa o s ha e he
esponsibili y o implemen and analyse speci ic ac ions o educe
ageism among nu sing s uden s o ensu e high quali y o ca e p o-
ided o he ageing. These s uden s will be dedica ed o ca e in hei
u u e p o essional li es, and o a g ea ex en , his ca e will be di-
ec ed owa ds olde people. I is essen ial o implemen ac ions o
educe ageism among nu sing and heal h science s uden s, because
wi hou in e en ion he e is no imp o emen , and disc imina o y
beha iou s owa ds olde people may be main ained.
6 | CONCLUSION
Analysing possible disc imina ion agains olde people and iden i y-
ing e ec i e in e en ions a e o i al impo ance, especially in p o-
essions ha wo k di ec ly wi h ageing popula ions, such as heal h
p o essionals. Ou esul s sugges ha an in e en ion combining
ageing educa ion wi h clinical p ac ice in nu sing homes can signi i-
can ly educe nega i e s e eo ypes and p ejudices abou ageing in
nu sing s uden s. These obse ed cogni i e and a ec i e changes
could lead o beha iou al changes, which could imp o e he quali y
o ca e p o ided o olde people. These esul s will bene i nu sing
s uden s, u u e heal h p o essionals, olde people and socie y and
se e as a ounda ion o u he esea ch aimed a de eloping mo e
inclusi e in e en ions and educa ion o bo h nu sing and heal h
sciences s udies.
AUTHOR CONTRIBUTIONS
Ba i ze San- Ma ín- Gamboa: Concep ualiza ion, In es iga ion,
W i ing – e iew & edi ing, Da a cu a ion. Idoia Za azquin:
20541058, 2023, 6, Downloaded om h ps://onlinelib a y.wiley.com/doi/10.1002/nop2.1643 by Uni e sidad Del Pais Vasco, Wiley Online Lib a y on [01/07/2024]. See he Te ms and Condi ions (h ps://onlinelib a y.wiley.com/ e ms-and-condi ions) on Wiley Online Lib a y o ules o use; OA a icles a e go e ned by he applicable C ea i e Commons License
3860
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SAN-MARTÍN-GAMBOA e al.
Concep ualiza ion, In es iga ion, W i ing – e iew & edi ing. Ainhoa
Fe nández- A u xa: Me hodology, So wa e, Valida ion, Fo mal anal-
ysis. Sil ia Cepeda- Miguel: In es iga ion, Da a cu a ion, W i ing – e-
iew & edi ing. Bo ja Doncel- Ga cía: Concep ualiza ion, In es iga ion,
W i ing – e iew & edi ing. Idoia Imaz- A ambu u: In es iga ion,
Resou ces. Amaia I azus a: Concep ualiza ion, Funding acquisi-
ion, Visualiza ion. Ana Belén F aile- Be múdez: Concep ualiza ion,
P ojec adminis a ion, W i ing – o iginal d a , Supe ision.
ACKNO WLE DGE MENTS
Open Access unding p o ided by Uni e si y o he Basque Coun y.
The au ho s since ely hank he olun ee s o pa icipa ing in his
s udy.
FUNDING INFORMATION
This esea ch ecei ed no speci ic g an om any unding agency in
he public, comme cial o no - o - p o i sec o s.
CONFLICT OF INTEREST STATEMENT
The au ho s epo no con lic o in e es .
DATA AVAILABILITY STATEMENT
Da a a ailable on eques due o p i acy/e hical es ic ions
RESEARCH ETHICS COMMITTEE APPROVAL
The s udy was conduc ed in acco dance wi h he Decla a ion o
Helsinki and was app o ed by he Commi ee on E hics in Resea ch
o he Uni e si y o he Basque Coun y (Code M10/2019/143MR1).
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