FACTORS INFLUENCING GERIATRIC SPECIALIZATION INTENTION. A CROSSSECTIONAL STUDY OF CLINICAL MEDICAL AND NURSING STUDENTS IN GHANA

Thesis (Ph.D.) - Indiana University, School of Public Health/University Graduate School, 2020Background: The population of older persons in Ghana is increasing. Yet, the exact number of practicing health professionals with geriatric-related expertise to provide skilled services to the aging population in the country is unknown. Our understanding of future health providers’ consideration of a career in geriatrics and attitudes toward geriatric patients is also very limited. Aim: The overarching purpose of this dissertation was to closely examine the intrapersonal and interpersonal factors associated with intention to choose a geriatric -related career among clinical medical and nursing students in a public institution in Ghana. Specifically, two related substudies were explored in this dissertation. The first sub-study examined the association between attitudes, personal interest, past experiences, mentoring opportunities, demographic characteristics, and intention to select a geriatric specialty among clinical medical and nursing students. The second sub-study assessed (a) differences in the attitudes of final year clinical medical and nursing students towards older persons; and (b) the relationship between the quality of students’ experiences with older persons and their attitudes. Method: Medical and nursing students undergoing clinical training at the Komfo Anokye Teaching Hospital in Kumasi, Ghana, voluntarily participated in this cross-sectional study. The survey was administered online via Qualtrics. Sub-study 1: Data were analyzed using Poisson multiple regression (N=314). For medical students, personal interest was the best predictor of intention to specialize in geriatrics (B =.462, S.E = .0592, p = .000). After adjusting for other variables in the model, medical students with moderate to strong interest were 1.6 more likely to express an intention to specialize in geriatrics compared to those with low to minimal interest. For nursing students, personal interest was the sole significant predictor of intention to specialize in geriatrics (B=.456, S.E = .1386, p = .001). After adjusting for other variables in the model, nursing students with moderate to strong interest were 1.6 times more likely to express an intention to specialize in geriatrics compared to those with low to minimal interest. Sub-study 2: Data analysis involved two-sample t-tests and a one-way ANOVA (N=135). Overall, most participants (82.2%) held positive attitudes towards older persons. Medical students had significantly more positive attitudes toward older persons (3.50 ± 0.44) than nursing students (3.26 ± 0.38) (t [133] = 3.257, p = .001). The association between students’ attitudes and the quality of their experiences with older persons was significant (F [2, 132] = 7.062, p = .001). Students whose experiences with older persons were negative had the least positive attitudes. Conclusion: Interventions geared towards increasing geriatric-oriented healthcare providers in Ghana should focus on enhancing students’ interests and cultivating positive attitudes towards older patients through both clinical and community-based exposures