Skip to main content

Advertisement

SpringerLink
Log in

The Effects of Clinical Experience on Early Career Psychiatrists’ Beliefs and Attitudes Towards Older Psychiatric Patients

  • Brief Report
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Although literature has documented widespread negative and stereotypical attitudes held by healthcare professionals towards the older adults, there is a current paucity of research about the perspective of psychiatrists. We aimed to identify the attitudes of Tunisian early career psychiatrists towards the older adults. This was a cross-sectional study conducted among 71 early career psychiatrists. Data were collected through anonymous online surveys. A series of 4 point Likert-type questions ("strongly agree", "somewhat agree", "somewhat disagree", "strongly disagree") asked participants about their beliefs about older patients, the characteristics of the psychiatric care of an older person and emotions related to caring for older patients. Psychiatrists agreed that the older patient: is frail and vulnerable in 64.8% of cases, does not trust his psychiatrist in 28% of cases, has problems of communication in 36.6% of the cases and shows hostile or aggressive behavior in 5.6% of the cases. A multivariate binary logistic regression analysis found that clinical experience would play an independent role in predicting the following beliefs and attitudes of early career psychiatrists towards older patients: the belief that the older patient often has perceptual disorders that he is fragile and vulnerable, that he often requires polypharmacy, and that his management exposes the psychiatrist to painful emotional experiences. Given the population aging, early career psychiatrists need to be equipped with skills to fulfil significant roles in responding to future health and support needs. Integrating clinical training in psychogeriatrics into the psychiatric curriculum is strongly recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Aradilla-Herrero, A., Tomás-Sábado, J., & Gómez-Benito, J. (2012–2013). Death attitudes and emotional intelligence in nursing students. OMEGA, 66, 39–55.

  • Asiret, G. D., Kaymaz, T. T., Copur, E. O., & Akyar, I. (2017). Ageism attitude towards elderly: Young perspective. International Journal of Caring Sciences, 10(2), 819–827.

    Google Scholar 

  • Bagri, A. S., & Tiberius, R. (2010). Medical student perspectives on geriatrics and geriatric education. Journal of the American Geriatrics Society, 58(10), 1994–1999.

    Article  PubMed  Google Scholar 

  • Braun, M., Gordon, D., & Uziely, B. (2010). Associations between oncology nurses’ attitudes toward death and caring for dying patients. Oncology Nursing Forum, 37(1), E43–49.

    Article  PubMed  Google Scholar 

  • Daouas, F., Ben, A. A., Nabli, A. T., & Mtiraoui, A. (2002). Les attitudes professionnelles humaines des médecins de la région sanitaire de Sousse (Tunisie). Santé Publique, 2(14), 135–145.

    Article  Google Scholar 

  • Evers, C., Ploeg, J., & Kaasalainen, S. (2011). Case study of the attitudes and values of nursing students toward caring for older adults. Journal of Nursing Education, 50(7), 404–409.

    Article  PubMed  Google Scholar 

  • Fekih-Romdhane, F., Ouanes, S., & Melki, W. (2014). La qualité du sommeil chez les résidents sans syndrome démentiel vivant en institution gériatrique. Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, 12(1), 85–93.

    Article  PubMed  Google Scholar 

  • Fekih-Romdhane, F., Mhedhbi, N., Ben Ali, S., & Cheour, M. (2019). Sleep quality in caregivers of older patients with schizophrenia spectrum and bipolar disorders: A case-control study. Clinical Gerontologist, 23, 1–12.

    Article  Google Scholar 

  • Gething, L., Fethney, J., McKee, K., Persson, L. O., Goff, M., Churchward, M., et al. (2004). Validation of the reactions to ageing questionnaire: Assessing similarities across several countaries. Journal of Gerontological Nursing, 30, 47–54.

    Article  PubMed  Google Scholar 

  • Henderson, J., Xiao, L., Siegloff, L., Kelton, M., & Paterson, J. (2008). 'Older people have lived their lives': First year nursing students' attitudes towards older people. Contemporary Nurse, 30(1), 32–45.

    Article  PubMed  Google Scholar 

  • Higgins, I., Van Der Riet, P., Slater, L., & Peek, C. (2007). The negative attitudes of nurses towards older patients in the acute hospital setting: A qualitative descriptive study. Contemporary Nurse, 26(2), 225–237.

    Article  PubMed  Google Scholar 

  • Holroyd, A., Dahlke, S., Fehr, C., Jung, P., & Hunter, A. (2009). Attitudes toward aging: Implications for a caring profession. Journal of Nursing Education, 48(7), 374–380.

    Article  PubMed  Google Scholar 

  • Iranmanesh, S., Dargahi, H., & Abbaszadeh, A. (2008). Attitudes of Iranian nurses toward caring for dying patients. Palliative & Supportive Care, 6(4), 363–369.

    Article  Google Scholar 

  • Kent, B., Anderson, N. E., & Owens, R. G. (2012). Nurses’ early experiences with patient death: The results of an on-line survey of registered nurses in New Zealand. International Journal of Nursing Studies, 49, 1255–1265.

    Article  PubMed  Google Scholar 

  • Lange, M., Thom, B., & Kline, N. E. (2008). Assessing nurses’ attitudes toward death and caring for dying patients in a comprehensive cancer center. Oncology Nursing Forum, 35, 955–959.

    Article  PubMed  Google Scholar 

  • Leung, S., LoGiudice, D., Schwarz, J., & Brand, C. (2011). Hospital doctors’ attitudes towards older people. Internal Medicine Journal, 41(4), 308–314.

    Article  CAS  PubMed  Google Scholar 

  • Lui, N. L., & Wong, C. H. (2009). Junior doctors' attitudes towards older adults and its correlates in a tertiary-care public hospital. Annals, Academy of Medicine, Singapore, 38(2), 125–129.

    Google Scholar 

  • Liu, Y., Norman, I. J., & While, A. E. (2013). Nurses’ attitudes towards older people: A systematic review. International Journal of Nursing Studies, 50(9), 1271–1282.

    Article  PubMed  Google Scholar 

  • Macknight, C., & Powell, C. (2001). The effect of a home visit on first year medical students’ attitudes towards older adults. Geriatrics Today: Journal of the Canadian Geriatrics Society, 4, 182–185.

    Google Scholar 

  • Matsui, M., & Braun, K. (2010). Nurses’ and care workers’ attitudes toward death and caring for dying older adults. International Journal of Palliative Nursing, 16(12), 593–598.

    Article  PubMed  Google Scholar 

  • Mental Health Action Plan 2013–2020 [Internet] Geneva, Switzerland: World Health Organization, 2013.

  • Mitchell, E. A., & McCance, T. (2012). Nurse–patient encounters in the hospital ward, from the perspectives of older persons: An analysis using the authentic consciousness framework. International Journal of Older People Nursing, 7, 95–104.

    Article  PubMed  Google Scholar 

  • Nilsson, A., Lindkvist, M., Rasmussen, B. H., & Edvardsson, D. (2012). Staff attitudes towards older patients with cognitive impairment: Need for improvements in acute care. Journal of Nursing Management, 20(5), 640–647.

    Article  PubMed  Google Scholar 

  • Oliver, D., & Burns, E. (2016). Geriatric medicine and geriatricians in the UK: How they relate to acute and general internal medicine and what the future might hold? Future HealthCare Journal, 3(1), 49–54.

    Google Scholar 

  • Ragan, A. M., & Bowen, A. M. (2001). Improving attitudes regarding the elderly population: The effects of information and reinforcement for change. Gerontologist, 41(4), 511–515.

    Article  CAS  PubMed  Google Scholar 

  • Sharan, P., Levav, I., Olifson, S., de Francisco, A., Saxena, S. (Eds.). (2007). Research capacity for mental health in low- and middle-income countries: Results of a mapping project. Geneva: World Health Organization & Global Forum for Health Research.

  • Sharif Nia, H., Lehto, R. H., Ebadi, A., & Peyrovi, H. (2016). Death anxiety among nurses and health care professionals: A review article. International Journal of Community Based Nursing- Midwifery, 4(1), 2–10.

    Google Scholar 

  • Samra, R., Griffiths, A., Cox, T., Conroy, S., & Knight, A. (2013). Changes in medical student and doctor attitudes toward older adults after an intervention: A systematic review. Journal of the American Geriatrics Society, 61(7), 1188–1196.

    Article  PubMed  PubMed Central  Google Scholar 

  • Samra, R., Griffiths, A., Cox, T., Conroy, S., John, A. G., & Gladman, R. F. (2015). Medical students’ and doctors’ attitudes towards older patients and their care in hospital settings: A conceptualisation. Age and Ageing, 44, 776–783.

    Article  PubMed  PubMed Central  Google Scholar 

  • Samra, R., Cox, T., Gordon, A. L., Conroy, S. P., Lucassen, M. F. G., & Griffiths, A. (2017). Factors related to medical students’ and doctors’ attitudes towards older patients: A systematic review. Age and Ageing, 46, 911–919.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sinoff, G. (2017). Thanatophobia (death anxiety) in the elderly: The problem of the child’s inability to assess their own parent’s death anxiety state. Frontiers in Medicine (Lausanne), 4, 11.

    Google Scholar 

  • Tiwari, S. C., Tripathi, R. K., Kumar, A., Kar, A. M., Singh, R., Kohli, V. K., et al. (2014). Prevalence of psychiatric morbidity among urban elderlies: Lucknow elderly study. Indian Journal of Psychiatry, 56(2), 154–160.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tullo, E. S., Spencer, J., & Allan, L. (2010). Systematic review: Helping the young to understand the old. Teaching interventions in geriatrics to improve the knowledge, skills, and attitudes of undergraduate medical students. Journal of the American Geriatrics Society, 58, 1987–1993.

    Article  PubMed  Google Scholar 

  • Williams, B., Anderson, M. C., & Day, R. (2007). Undergraduate nursing students' knowledge of and attitudes toward aging: Comparison of context-based learning and a traditional program. Journal of Nursing Education, 46(3), 115–120.

    Article  PubMed  Google Scholar 

  • Zarin, D. A., Peterson, B. D., Suarez, A., & Pincus, H. A. (1997). Practice settings and sources of patient-care income of psychiatrists in early, mid, and late career. Psychiatric Services, 48(10), 1261.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

All authors declare that they received no source of funding for this study.

Author information

Authors and Affiliations

  1. Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia

    Feten Fekih-Romdhane, Salma Tira, Nada Ghazouani, Sana Ben Ali & Majda Cheour

  2. Department of Psychiatry “E”, Razi Hospital, 1 Rue des Orangers, Manouba, Tunisia

    Feten Fekih-Romdhane, Salma Tira, Nada Ghazouani, Sana Ben Ali & Majda Cheour

Authors
  1. Feten Fekih-Romdhane
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Salma Tira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nada Ghazouani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sana Ben Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Majda Cheour
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Feten Fekih-Romdhane.

Ethics declarations

Conflict of interest

All authors declare that they have no conflicts of interest to disclose.

Ethical Approval

This manuscript complies to the Ethical Rules applicable for Community Mental Health Journal.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix 1 Early Career Psychiatrists’ Beliefs and Attitudes Towards Older Psychiatric Patients

Appendix 1 Early Career Psychiatrists’ Beliefs and Attitudes Towards Older Psychiatric Patients

I am inviting you to participate in a research study about the beliefs and attitudes towards older psychiatric patients in Tunisia. This survey will be used to better understand the attitude of early career psychiatrists towards the older adults in all its affective, cognitive as well as behavioral dimensions and to evaluate the impact of clinical experience in psychogeriatrics on the psychiatrist knowledge and attitude. The research team will use this information to inform the study design.

  • You will be asked to complete a short survey/questionnaire about your demographic information and beliefs and attitudes towards older patients.

  • You are invited because we are targeting early career psychiatrists practicing in Tunisia.

  • The estimated time to complete this survey is approximately 15–20 min.

  • This survey will be completely anonymous, and we will not be tracking responders.

If you have any questions about this questionnaire or require additional information concerning the study, do not hesitate to contact me: Dr. Feten Fekih-Romdhane feten.fekih@gmail.com.

Section 1

What is your age ?

……..

You are ? (select one).

  • Male

  • Female

What is your marital status ? (select one).

  • Single

  • Maried

  • Divorced/Separated

  • Widower

How many children do you have ? (select one).

  • 0

  • 1

  • 2

  • 3

  • 4

  • 5 or more

What is your place of residence ? (select one).

  • Urban

  • Rural

What is your highest professional degree? (select one).

  • Associate Professor

  • Assistant Professor

  • Specialist

  • Resident

How many years of clinical experience in psychiatry do you have ?

……..

How many older patients do you have in consultation per month ?

……..

Have you had any clinical experience in psychogeriatrics ? (select one).

  • Yes

  • No

Have you had any training or sufficient knowledge in psychogeriatrics ? (select one).

  • Yes

  • No

Are you interested in working in psychogeriatrics ? (select one).

  • Yes

  • No

Section 2

Please indicate how much you agree or disagree with the following statements by selecting the appropriate choice (select one per row).

Beliefs Toward Older Psychiatric Patients

figure a

Characteristics of the Psychiatric Care of an Older Person

figure b

Feelings and Perceived Burden Related to Caring for Older Patients

figure c

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fekih-Romdhane, F., Tira, S., Ghazouani, N. et al. The Effects of Clinical Experience on Early Career Psychiatrists’ Beliefs and Attitudes Towards Older Psychiatric Patients. Community Ment Health J 56, 1344–1353 (2020). https://doi.org/10.1007/s10597-020-00571-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-020-00571-1

Keywords

Search

Navigation