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Chapter 2: Literature Review
concluded that there may be a difference between nurses’ negative feelings about the
structural context of work and their more positive feelings about individual older
people with whom they work. It may be argued that retrospective opinions or
perspectives may not accurately report the present reality of a phenomenon.
More recently, Doherty, Mitchell and O’Neill (2011) measured the attitudes of
healthcare workers towards older people in a rural Irish population. Their aim was to
explore the attitudes held by nurses, healthcare assistants, ward managers, student
nurses and public health nurses who were on duty in a 24-hour designated data
collection period. Three hundred and three questionnaires requiring demographic
information and completion of the Kogan Attitudes towards Old People scale (KOP)
were administered and 190 were returned, yielding a response rate of 62.2%. The
researchers found that there was no significant difference in attitude scores measured
across gender, job title, length of service in current role, or workplace setting.
However, they did detect differences in scores for university graduates when
compared with those who had not attained a university qualification. Those with
university education held more positive attitudes. They found no difference in
attitudes between those working in different care environments. Public health nurses
had the most positive attitudes. The researchers acknowledged the public criticism of
the KOP scale (its age and its lack of focus on context) but argued that it is still used
extensively and has high reliability ratings.
2.3.8 Section Summary
This section has discussed the issues in residential care for older people as reported
in the literature. It revealed that an organisation’s approach to care is central to
positive resident experiences of care. It also revealed that staff, residents and
residents’ families often have contradictory perceptions of care and that
gerontological nurse expertise is key to enhancing residents’ autonomy and quality of
life. The studies presented in this section suggest that nursing leaders need to
promote professional knowledge and practice regarding relationship building, client-
centredness and autonomy if nurses and clients are to be empowered. It is also
suggested that there are powerful connections between structure, process and
outcomes in an organisation’s approach to care and that these ultimately affect a
resident’s autonomy. Family members were recognised as having important