Background to the study
With the global trend towards an increasingly ageing population, health care professionals (HCPs) are considered to be at risk of developing ageist attitudes. This may arise due to their exposure to disproportionate percentage of ill or dependent older people. This rapidly increasingly ageing population with their declining health poses a great challenge to the health care professionals. The obvious implication of this is that healthcare professionals need to have appropriate attitude to play significant roles in responding to healthcare supports and needs of the elderly patients. Recent researches demonstrate that the world population is rapidly ageing. For instance, according to the Central Agency for Public Mobilization and Statistics (2010), the number of elderly in Egypt was 3.3 million, that is 4.2% of the total population and this percentage is expected to increase to 8% by the year 2030. World Health Organization (WHO, 2012) reported that between 2000 and 2050, the proportion of those over 60 years worldwide will double from about 11% to 22%. It further inferred that the absolute number of persons aged 60 years and above is expected to increase from 605 million to 2 billion over the same period. As a result, Okafor (2010) asserted that HCPs are to ensure adequate well-being of individuals, including the aged. The aged care should comprise of physical, mental/emotional and social healthcare dimensions, without discriminating and stigmatizing attitude and behaviour by HCPs. Kapungwe, Cooper, Meyeya, Mwanza, Mwape, Sikwese and Lund (2011) reported that there are widespread stigmatizing and discriminatory attitudes among health care professionals towards mental illness and those with emotional related cases, especially the aged whose population is rapidly increasing.
This increasing elderly population with its physical, social and emotional health implications increases the demands on the HCPs in the hospitals, especially general and university teaching hospitals. According to Okafor (2010), health care professionals are very important health workers with obligation of disease prevention, treatment, rehabilitation and preservation of health. This responsibility poses great challenges to HCPs. Hassan (2013) explained that HCPs must be prepared to meet the healthcare challenges of the rapidly increasing segments of population including the elderly. As a result, acquisition of proper gerontological knowledge and holding positive attitude are relevant for health care professionals for proper management of the elderly patients. However, when attitude of HCPs relates to the aged patients, it is called attitude towards the aged patients attending the hospital.
Health Care Professionals’ attitude towards the aged patients seems to depend on their perception of life, type of orientation received and attitude inculcated during training, among other factors. Obioha (2004) defined attitude as a state of readiness organized through experiences upon individuals’ response to all objects and situations. This is because every attitude, positive or negative, acceptable or unacceptable, is formed for a purpose. Each attitude serves some functions to individual, group or society that holds it, particularly when it translates to behaviour. Ademuwugan and Adekunle (2002) stated that attitude is a set of effective reactions towards an object that predisposes the individual to behave in a certain manner towards the object. This is in line with Pearson (2001) who affirmed that attitudes are the opinions and feelings that people usually have about something. This means that individuals’ behaviours or actions are triggered off by attitude towards the object. An attitude is a hypothetical construct that represents an individual’s degree of like or dislike for an object or item. Attitudes are generally positive or negative views of a person about a place, thing or event. In this study, attitude is perceived as a set of effective reactions, opinions and feelings that healthcare professionals hold towards the aged attending university teaching hospitals in Enugu State. This means that attitude is formed either positively or negatively when one comes in contact with the attitude object, in this case HCPs attitudes towards the aged patients, which are also referred to as elderly or older patients in the study.
Healthcare professionals (HCPs), according to Park (2007) are group of practitioners who render healthcare services to different categories of persons including the elderly for the purpose of prevention of diseases or infections, treatment, promotion, maintenance and restoration of health. Probably, as a result of the challenges associated with their roles, Alsenanry (2007) pointed out that in the past 30 years, HCPs have developed stereotypes and misconceptions about old people, and students in the areas of health care professions tended to have minimal interest in working at old people’s wards. He further observed that they preferred to work with children and adult patients. In this study, HCPs are individuals or group of people such as doctors, nurses, medical laboratory scientists, physiotherapists, pharmacists who are well trained in the field of health to render adequate healthcare services to ensure optimum well-being of the young, the ageing and aged. Therefore, attitude of health care professionals in the context of this study is perceived as a set of effective reactions, opinions and feelings that health care professionals hold towards the aged attending the university teaching hospitals in Enugu State.
According to World Health Organization (WHO, 2012), ageing is the process of growing old, while the aged are generally referred to as old people or elderly people among the population groups. They are those who have reached an advanced age of 60 and over. The way the aged are perceived varies across cultures. In traditional primitive culture, elderly people command respect because their memories are storehouses where cultures and traditions are kept and retrieved. In some contemporary societies, following the discovery of information technology, the elderly people are less revered giving rise to ageism.
Ageism has become a global issue that demands urgent attention. Ageism, according to Mandy, Mitchell and O’Neil (2013) is a systematic stereotyping of discrimination against people because they are old. Ageism is perpetuated by the portrayal of older people as frail, ill, physically declining, suffering mental deterioration, poor and dependent. This societal notion may influence the attitudes of health care professionals towards the elderly patients depending on their orientation and background. Roush (2003) affirmed that ageing is a natural process consisting of irreversible biological change that occurs in all living things with the passage of time, which eventually leads to death. This means that ageing process brings about the wearing down of organs in the body as well as the functions of the brain in the ageing individual. Though, there are individual differences in the rate of ageing, with time most people respond almost the same way to ageing. In most people, the hair turns white and becomes sparse, the skin loses moisture and elasticity and becomes more and more wrinkled. Changes in skeletal structure cause people to become shorter in there sixties and above. Samuel (2006) summarized the ageing process as a period of decline physically and psychologically. It can only be delayed but it must surely come with its signs and symptoms. In this study, ageing is referred to as a natural process which involves biological, mental, social, and physiological growth and development, followed by decline which occur in people as they live towards death. The aged patients in the context of this study are perceived as all those who have attained an advanced age of 60 and above who seek medicare at University Teaching Hospitals in Enugu State.
Ageing process predisposes the aged to numerous physical, social and mental health problems and increases their contact with HCPs who may display positive or negative attitude towards them, depending on the background and characteristics of the HCP. This study is therefore poised to determine the attitudes of HCPs towards the care of aged patients attending University Teaching Hospitals in Enugu State. In order to properly determine the attitudes of these HCPs, this study needs to be rooted in some theories.