Attitudes of undergraduate nursing students toward caring for older adults: a cross-sectional study from Limpopo Province, South Africa

Abstract

BACKGROUND: Attitudes of nursing students toward older adults are a critical determinant of the quality of geriatric care they will provide upon graduation. In South Africa, nursing education does not sufficiently incorporate dedicated gerontological nursing content. This study aimed to assess the attitudes of undergraduate nursing students toward caring for older adults within a South African nursing training context. METHODS: A quantitative cross-sectional study was conducted among 246 undergraduate nursing students at a historically disadvantaged institution in Limpopo Province, South Africa, using stratified random sampling. Data were collected online via Google Forms using Kogan's Attitudes toward Old People scale (KAOP) and a demographic questionnaire. Data were analysed using descriptive statistics, independent samples t-test, one-way ANOVA, chi-square test, and binary logistic regression using SPSS version 29.0. RESULTS: A total of 246 undergraduate nursing students completed the survey. The majority of students (54.9%) demonstrated slightly positive attitudes toward older adults, with a mean KAOP total score of 142.70 (SD = 13.02). Age group and gender were identified as significant independent predictors of attitudes. Compared with students aged 18-20 years, those aged 21-23 years (AOR = 0.361, 95% CI = 0.201-0.648, p < 0.001) and 24-26 years (AOR = 0.171, 95% CI = 0.070-0.419, p < 0.001) had significantly lower odds of demonstrating strongly positive attitudes toward older adults. Male students demonstrated higher odds of holding strongly positive attitudes compared to female students (AOR = 0.438, 95% CI = 0.249-0.772, p = 0.004). Year of study, previous experience with older adults, and intention to work with older adults were not significantly associated with attitudes (all p > 0.05). CONCLUSION: Positive attitudes toward older adult care are not uniformly held among undergraduate nursing students enrolled in a South African nursing education programme, and attitudinal formation is driven by age and gender rather than academic progression or clinical exposure alone. Systematic integration of gerontological nursing content within the R174 curriculum is recommended to address attitudinal deficits and promote equitable geriatric care in South Africa.