Attitude of Nurses on Care of Older Adults and Factors Influencing on It Among the Nurses Working at Teaching Hospital Jaffna

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M. Hazeem, M. K.I. Mathusnka, L. Kamalarupan, K. Thanujanan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8901998/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Background It important to give more emphasis on elderly care since population is ageing. Nurses play a vital role in caring the elderly. This study aimed to assess the attitude of nurses on caring the older adults and the factors influence it among the nurses who are working at the Teaching Hospital, Jaffna. Methods This hospital-based, descriptive, cross-sectional study was conducted among 216 nursing officers at Teaching Hospital Jaffna from May 2023 to August 2024. A pre-designed and validated self-administered questionnaire was used to collect data. SPSS 25 software was used for data analysis. Descriptive analysis was used to assessed nurses' attitudes, and the Chi-Squared test was used identified the association of socio demographic factors and the attitude of nurses. Results A total of 232 nurses were recruited for the study, with a response rate of 93.1%. Participants' ages ranged from 25 to 57 years old. The majority were female (70.4%). Nearly half identified as Sri Lankan Tamil (52.8%) and Hindus (47.7%). Over half (63.9%) had less than five years of experience. More than three quarter were diploma holders (78.2%).Nurses with a positive attitude 90.3%, while those with a negative attitude account for 9.7%, based on a 50% cutoff value. The mean attitude score is 29.46. A statistically significant relationship (p < 0.05) was found between attitude and current ward/unit, and higher education qualifications. Conclusions This study demonstrated variations in nurses’ attitudes toward caring for older adults. The majority (90.3%) showed a positive attitude towards elderly care. Nurses may need frequent updates on caring for older adults; relevant wards and units should take appropriate measures to ensure nurses maintain a proper attitude toward this aspect of care. Attitude Care of older adults Nurses Teaching Hospital Jaffna INTRODUCTION The population of the elderly is increasing in all countries of the World. This is attributed to be one of the major achievements of mankind in the modern era [ 1 ]. Older adults are more likely to experience multiple chronic health conditions, have issues related to poly-pharmacy, require additional supports to complete activities of daily living, and compared to their younger counterparts, use health care services more frequently [ 2 ]. In Sri Lanka, the increasing population of older adults presents a significant challenge to the healthcare sector in meeting their needs. Nurses play a vital role in caring for the elderly requiring medical attention [ 3 ] However, nurses face obstacles in providing care to geriatric patients due to limited physical facilities and technical equipment in hospitals, care-related issues arising from patients' physical limitations, administrative problems, and communication difficulties with patients, their families, or caregivers [ 4 ]. These challenges can influence nurses' attitudes toward caring for older adults. Various factors can impact one’s attitude. The quality of care nurses provide is linked to their attitudes toward older adults. Personal experiences with the elderly or education can affect nurses' attitudes, having both positive and negative effects [ 5 ]. Research shows that many factors can influence a nurse’s attitude toward older adults. Research shows that many factors can influence a nurse's attitude toward older adults. These are divided into demographic factors, attitude of nurses towards older adults while caring for them, attitude of nurses to maintain the patient’s rights, and attitude of the nurses to communication with older adults. Demographic factors include age, gender, ethnicity, religion, work unit [ 6 ], work experience [ 1 ] and higher education qualifications. In many healthcare settings, their workload and shortages significantly impact the care provided to older adults. This can affect the quality of patient care. There are no specialized government hospitals for the elderly in the Northern Province. The Jaffna Teaching Hospital serves the entire general population across all age groups. Additionally, the current setup does not include a dedicated ward for geriatric patients. Elderly patients are treated in the same wards as adults. The nurses working in these wards at Jaffna Teaching Hospital are not specifically trained to care for geriatrics. This creates a challenge for the nurses when managing geriatric patients. This study primarily focuses on assess attitude of nurses on care of older adults and the factors influencing on it among the nurses working at Teaching Hospital Jaffna. Nurses' attitudes will be affected by caring for older adults, patient rights, communication with patients, and demographic factors. METHODS Study sample and procedures. This was a hospital-based descriptive cross-sectional study. The Teaching Hospital in Jaffna is located in the Northern Province of Sri Lanka. The study was conducted in selected wards where older adults are generally admitted for care. A total of 26 wards and 10 units were included in the study. A total of 449 nurses were recruited for the study from these selected wards and units at Teaching Hospital Jaffna, and those on maternity leave and long-term leave were excluded. The sample size of the study was estimated by using the Daniel’s formula N=Z 2 p (1-p)/d 2 . The proportion value (p-value) taken as 0.162, based on the attitude level of nurses from previous study done in Sri Lanka [ 3 ] as 16.2%. The estimated sample size is 232.The nurses’ list and their total numbers for each ward and unit were obtained from Matron Office of Teaching hospital, Jaffna. The samples were recruited for the study by using simple random sampling method. The proportional samples were calculated based on the total population in each ward and unit, Ethical approval was obtained from the Ethics Review Committee of Faculty of Medicine University of Jaffna. The study information was clearly communicated to participants, and written informed consent was obtained before data collection. Measurement A self-administered questionnaire was used to gather data. The questionnaire was developed by researchers based on specific objectives and previous literature. The questionnaire has two sections: Section 01 - Socio-demographic factors and Section 02 –attitude of nurses towards older adults while caring for them, attitude of nurses to maintain the patient’s rights and attitude of the nurses related to communication, which includes a total of 35 statements. A pretest was conducted among ten nurses at Base Hospital Tellippali. No any changes were made to the questionnaire after the pretest. Data was collected from nurses in selected wards and units at Teaching Hospital Jaffna. Data collection was carried out without disrupting their routines or privacy. Written consent was obtained from the participants after providing a clear explanation of the study. They were encouraged to ask questions or express doubts the study, and those questions were answered by the researchers. Participants consumed approximately 25–30 minutes to complete the questionnaire. The completed questionnaires were collected from the participants on the same day. Statistical analysis The data was entered and analyzed using IBM SPSS version 25.0 (Statistical Package for the Social Sciences) based on the research problems, objectives, and variables. The participants' attitude toward older adult care was categorized as either positive or negative based on their total scores for Section II. There are 35 questions. If they agree with positive attitude statements and disagree with negative attitude statements, they earn 1 point for each correct response. Each incorrect response receives 0 points. The total score is converted into a percentage. If the percentage exceeds 50%, it indicates a positive attitude, while less than 50% indicates a negative attitude among nurses caring for older adults. The data were analyzed using means, standard deviations. Descriptive analysis was used to assessed nurses' attitudes, and the Chi-Squared test was used identified the association of socio demographic factors. RESULTS Socio-demographic characteristics Out of 232 participants, the response rate was 93.1% (N = 216). Participants' ages ranged from 25 to 57 years, with a mean age of 31.65 years (SD = 6.232). Most of them (54.2%) were under 30 year old. More than two-thirds being female (70.4%). Nearly half identified as Sri Lankan Tamil (52.8%) and Hindus (47.7%). Among the total participants, (18.1%) worked in medical wards. Regarding experience, over half (63.9%) had less than five years of experience. The majority were diploma (78.2%), while (19.9%) had a degree, and (1.9%) held post-diploma qualifications. Attitude of nurses towards older adults while caring for them The participants were given two options, for each statement, namely: agree, and disagree. Majority of them (88%) were expressed that they were satisfied while caring older adults. Half of the participants had an opinion that, care for younger adults and children to be prioritized than older adults. However, this was considered as negative attitude, as it is not ethically appropriate to prioritize care based on age. Almost all the participants (96.8% felt that it was essential to provide quality care to older patients. Additionally, except 19%, others agreed that quality care remains important even for the older adults in end of life or the patients with disorientation condition. Nearly one quarter of the population expressed a negative attitude that, they felt irritable while caring older adults with cognitive impairment. They also displayed empathy and compassion towards the patients, which in turn reflects in making good decisions during critical conditions. The distribution of responses regarding attitudes while caring for older adults is presented in Table 1 . Table 1 Attitude of nurses about older adults while caring them Statement about attitude Frequency (N) and Percentage (%) Agree N (%) Disagree N (%) I satisfied while caring the older adults 190 (88%) 26 (12%) In my opinion, prioritized care to be given to the children and younger adults than older adults. 108 (50%) 108 (50%) In my opinion, prioritized care to be given as per the need of the patient. 189 (87.5%) 27(12.5%) In my opinion, it is essential to provide a quality nursing care to all the older adults. 209 (96.8%) 7(3.2%) In my opinion, it is not essential to provide a quality nursing care to the older adults, since they are in end of life. 42(19.4%) 174(80.6%) In my opinion, quality nursing care to be given the older adult, even the come with disorientation condition. 175(81%) 41(19%) I feel that, it is very irritable to care the older adults who is with any cognitive impairment. 52(24.1%) 164(75.9%) I feel emotionally connected to older adult patients under my care. 190(88%) 26(12%) I believe that interdisciplinary collaboration is important in delivering comprehensive care to older adult patients 189(87.5%) 27(12.5%) I feel empathy and companionate while caring older adults. 201(93.1%) 15(6.9%) I feel that, we have to make good decisions when older adult patients are in critical condition. 207(95.8%) 9(4.2%) I feel that, caring the older adults is annoying for me 30(13.9%) 186(86.1%) Attitude of nurses to maintain the patient’s rights (dignity, privacy, individuality, confidentiality, respect, minimal disturbing, on decision making) Almost all of them (99.5%) agreed that older adults should be treated with dignity and respect. Maintain privacy and confidentiality are the fundamental rights for everyone. Many of them (92.1%) agreed that it is important to maintain their personal information confidentially. Many of them (80.1%) understand older adults also may have shyness when touching the body parts or exposing it and they recognized the importance of maintaining privacy for older adults while caring for them (88%). Many of them (82.9%) having the right concepts that considering only the basic needs of the older adults are not sufficient, it is also important to look the personal hygiene and grooming (83.8%) of the older adult patients. Majority of them (88%) recognized that alleviate the pain is also essential to consider for the older adults, since it may cause many adverse outcome such as disturbed sleep, depression, anxiety etc. Most of the participants (85.2%) understand the importance of obtaining consent from older patients, whether in general or for specific procedures. They also focus on providing individualized care for them (81.5%). One’s personal belongings are valuable for them even if it is not in good condition, that concept many of them have (87%). The detailed responses regarding attitudes toward maintaining patients’ rights are presented in Table 2 . Table 2 Attitude of nurses to maintain the patient’s rights (dignity, privacy, individuality, confidentiality, respect, minimal disturbing, on decision making) Statement about attitude Frequency (N) and Percentage (%) Agree N (%) Disagree N (%) In my opinion, older adults should be treated with dignity and respectful. 215 (99.5%) 1 (0.5%) I believe that providing independence and autonomy is important in caring for older adult patients. 188(87%) 28(13%) I feel that it is important to provide individualized care to the older adult patients. 176(81.5%) 40(18.5%) My opinion is, normally older adults do not have any shyness when touching the body parts or exposing it. 43(19.9%) 173(80.1%) My opinion is, it is not important to maintain privacy with cloths or screen while caring the older adults 26(12%) 190(88%) My opinion is we do not worry much about their cultural aspects of the older adults while caring them. 37(17.1%) 179(82.9%) I feel that it is not important to consider the personal hygiene and grooming of the older adult patients. 35(16.2%) 181(83.8%) I feel that it is enough to consider only the basic needs of the older adults 37(17.1%) 179(82.9%) In my opinion, we should be very careful on giving medications to older adults 197(91.2%) 19(8.8%) In my opinion, it is not that much importance to follow the five rights while caring the older adult patients. 27(12.5%) 189(87.5%) It is not important to maintain their personal information confidentially. 17(7.9%) 199(92.1%) It is not important to get written consent for the older adults while doing any special procedures. 32(14.8%) 184(85.2%) It is not necessary to consider the pain of the older adults 26(12%) 190(88%) I feel, it is essential to do the nursing measures to older adults without disturbing their rest and sleep. 187(86.6%) 29(13.4%) I feel that, if any belongings of elder adults are not in good condition, it can be discarded without their permission to make the ward clean. 28(13%) 118(87%) Attitude of the nurses related to communication with older adults Nearly 70% of the nurses stated that, they felt comfortable while communicating with elders. However, 43.5% of them stated, it is very stressful to communicate with older adults who is with any sensory alterations. Majority (88%) realized that, nurses should listen carefully and patiently while communicating with the older adults. Also, majority (96.3%) believe that barriers of communication with older adults shall be break by using various techniques of communication. Even though 56.9% have idea that if there any barriers on communicating with older adults, it is only option to communicate about the older patient with their relatives or caregivers only. More than 90% of participants (93.1%) agreed that providing thorough explanations about discharge planning to patients and families is essential when caring for older adults. Majority of the participants (92.6%) were conscious that, they never use physical or verbal abuses while caring them. The distribution of responses regarding communication with older adults is presented in Table 3 . Table 3 Attitude of the nurses related to communication with older adults Statement about attitude Frequency (N) and Percentage (%) Agree N (%) Disagree N (%) I feel comfortable while communicating with older adult patients. 152(70.4%) 64(29.6%) I feel that, it is very stressful to communicate with older adults who is having any sensory alterations. 94(43.5%) 122(56.5%) I feel, nurses have to listen carefully and patiently whatever they communicate about their conditions. 190(88%) 26(12%) In my opinion, nurses should use the various techniques to minimize the barriers to communication with the older adult patients 208(96.3%) 8(3.7%) I feel that if there any barriers on communicating with older adults, it is only option to communicate about the older patient with their relatives or caregivers only. 123(56.9%) 93(43.1%) I felt that, it is important to provide thorough explanation about discharge planning with patient and families 201(93.1%) 15(6.9%) I feel that, it is not important to get opinion from older adult patients or relatives while caring. 45(20.8%) 171(79.2%) I am very much conscious that, we never do any physical or verbal abuses while caring them. 200(92.6%) 16(7.4%) Distribution of attitude score of the study population (N = 216) After analyzing the data, the predetermined cutoff was set at 50%. The attitude scores were then categorized into positive and negative attitudes. In the present study, 90.3% (N = 195) of nurses displayed a positive attitude, while 9.7% (N = 21) showed a negative attitude toward older adults' care. Relationship between socio demographic factors and nurses' attitudes toward caring for older adults at Teaching Hospital Jaffna There is no statistical significance between age and attitude. Most male (89.1%) and female (90.8%) participants had more positive attitudes than negative ones. In this study, gender had no significant association (p = 0.696) with the attitude level of the participants. Positive attitudes were recorded in the majority of participants belonging to ethnic groups such as Sri Lankan Tamils (86.8%), Sinhalese, and Sri Lankan Moors (94.1%). Here, Sinhalese and Sri Lankan Moors were combined into one category because only two participants responded from the Moors group. Additionally, ethnicity (p = 0.072) did not significantly influence the attitude levels. With regards to religion, participants from groups identified as “Hindu,” “Buddhist,” and “Christian and Islam” showed positive attitudes of 85.4%, 95.7%, and 90.0%, respectively. We combined Christian and Islam into one category because few participants responded under each. In this study, religion had no significant association (p = 0.053) with attitude levels. When examining the relationship between attitude and care of older adults in relation to the wards and units where participants currently work, we categorized medical wards, surgical wards, and Intensive Care Units & Accident and Traumatic Intensive Care Units as three categories, as older adults are mainly treated in these units. The remaining wards and units were grouped under other categories. In this study, the current ward/unit showed a significant association (p = 0.033) with attitude levels.. Looking at work experience groups, participants with “below 5 years” and “5 years and above” of experience showed positive attitudes of 89.1% and 92.3%, respectively. We combined the 5–10 years and above 10 years categories into a single “5 years and above” category because few participants responded from each group. Work experience did not significantly impact attitude level of the participants (p = 0.449). A positive attitude was observed in most participants from higher education groups, specifically the Diploma (87.6%) and Post-Diploma and Degree (100%) groups. Here, Post-Diploma and Degree were combined into one category because few participants responded in each. The highest educational qualification of the nurses (p = 0.011) was found to have a statically significant association with the participants’ attitude. The association between socio-demographic factors and nurses’ attitudes toward caring for older adults is presented in Table 4 . Table 4 Relationship between socio-demographic factors and nurses' attitudes towards caring for older adults at Teaching Hospital Jaffna Socio-demographic Factors Category Level of Attitude Statistical Result Positive attitude N (%) Negative attitude N (%) Age Below 30 years 105(89.7%) 12(10.3%) X 2 = 0.083 df = 1 p value = 0.773 30 and above 30 years 90(90.9%) 9(9.1%) Gender Male 57(89.1%) 7(10.9%) X 2 = 0.153 df = 1 p value = 0.696 Female 138(90.8%) 14(9.2%) Ethnicity Sri Lankan Tamil 99(86.8%) 15(13.2%) X 2 = 3.247 df = 1 p value = 0.072 Sinhalese and Sri Lankan Moors 96(94.1%) 6(5.9%) Religion Hindu 88(85.4%) 15(14.6%) X 2 = 5.866 df = 2 p value = 0.053 Buddhist 89(95.7%) 4(4.3%) Christian and Islam 18(90.0%) 2(10.0%) Currently working ward/unit Medical wards 31(79.5%) 8(20.5%) X 2 = 8.739 df = 3 p value = 0.033 Surgical wards 31(88.6%) 4(11.4%) Intensive Care Unit and Accident and Traumatic Intensive Care Unit 28(100%) 0(0.0%) Other wards and units 105(92.1%) 9(7.9%) Working experience Below 5 years 123(89.1%) 15(10.9%) X 2 = 0.573 df = 1 p value = 0.449 5 years and above 5 years 72(92.3%) 6(7.7%) Higher education qualification Diploma 148(87.6%) 21(12.4%) X 2 = 6.469 df = 1 p value = 0.011 Post diploma and Degree 47(100%) 0(0.0%) DISCUSSION In this study, 90.3% of nurses have positive attitudes toward the care of older adults. A similar study conducted by the University of British Columbia, based on an integrative review of papers published between 2005 and 2017, found that nurses held both positive and negative attitudes toward various aspects of older adult care. In an extensive survey study, 89.7% of nurses reported positive attitudes toward working with older people [ 2 ]. Also, 54% nurses prioritized their care over younger patients, but in our study their prioritized children, younger adults and older adults equally. According to numerous studies [ 7 , 8 , 9 ]. Respondents' socio demographic traits including age, sex were linked to their attitudes toward the care of elderly patients. Their level of education, experience, educational institutions, and work units/wards were also found to influence nurses' attitudes about caring for elderly patients [ 1 , 2 ]. A study conducted in China revealed a direct correlation between nurses' attitudes and expertise and their approach to elderly patient care [ 10 ]. Other factors affecting nursing care for senior patients include education, experience, and training in elder care [ 11 ].Among the socio-demographic factors, it was observed that most participants were under 30 year’s old, female, and held a diploma. Educational level was significantly associated with nurses' attitude. Similar studies in Turkey and Israel showed that the 20–29 age group had the highest participation, with two-thirds being female and that there was no significant association between gender (p = 0.26) and attitude level [ 6 , 12 ]. While caring for older patients, most nurses can empathize and strive to provide quality care. However, they don’t just prioritize this group because of age. In a study at the University of British Columbia, 54% of nurses prioritized caring for younger patients over others [ 2 ]. Almost all participants (99.5%) agreed that older adults should be treated with dignity and respect and in another study they reported that 80% of nurses showed respect toward older adult patients [ 2 ]. Privacy is a basic right for everyone. Most of them recognized the importance of protecting privacy for older adults when caring for them (88%). Pain can lead to negative outcomes such as depression, anxiety, sleep disturbances, and more, making it crucial to relieve older adults' pain. Most nurse (88%) had a positive view on this matter. In the study, we also observed that good communication is essential to provide ‘genuine care’. Effective communication improves when nurses demonstrate real concern and care for their patients through proper touch, tone, eye contact, empathy, and lively conversation [ 13 ]. The discharge planning explanation protocol should be maintained by all nurses for patients and their families when they are leaving the hospital; in this case, the majority (93.1%) of nurses follow it effectively. A University of British Columbia study revealed that three-quarters of nurses reported involvement in discharge planning for patients [ 2 ]. A study by Dahlke found that nurses' attitudes toward caring for older people are influenced by their previous experience and cultural factors. Besides prior work placement experiences, the supervisor's knowledge and attitude, as well as perceptions of ageing in the work environment, are important factors [ 14 , 15 , 16 ]. The increasing elderly population presents a significant health risk due to physical, physiological, and social challenges. The quality of care for older patients could decline because of nurses' insufficient knowledge, negative attitudes, and practices. Although the study made its best effort with good methodology, there were some limitations. Lack of time and willingness among nurses made it difficult to collect data for this study. Attitude was assessed with a closed-ended questionnaire; these answer options may have provided cues to participants. CONCLUSION In this study, most participants (90.3%) demonstrated a positive attitude toward caring for older adults, while 9.7% showed a negative attitude. The nurses' average attitude score was 29.46, with a standard deviation of 5.234. Attitude was significantly associated with the current ward or unit (p = 0.033) and higher educational levels (p = 0.011). It is recommended that an in-service training program be offered to all nurses to help maintain effective performance and support ongoing education with formal teaching and demonstrations for caring for older adults. Abbreviations 1. THJ Teaching Hospital Jaffna 2. SPSS Statistical Package of Social Science Declarations Ethics approval and consent to participate Ethical clearance was obtained from the Ethics Review Committee, Faculty of Medicine, University of Jaffna, Sri Lanka (Approval No: 160th ERC-07; approved on 27 June 2024). Written informed consent was obtained from all participants prior to data collection. Participation was voluntary, and confidentiality and anonymity were assured. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interest The authors declare that they have no competing interests. Funding This research was self-funded by the authors. No external funding was received. Authors' contributions A.M. Hazeem conceptualized and designed the study and drafted the manuscript. A.M. Hazeem and M.K.I. Mathushanka conducted data collection, data entry, and statistical analysis. L.Kamalarupan and K. Thanujanan supervised the study and critically reviewed the manuscript for important intellectual content. All authors read and approved the final manuscript. Acknowledgements The authors express their sincere gratitude to the Dean, Faculty of Allied Health Sciences, University of Jaffna, and the Head, Department of Nursing, for their support. We also thank the Director and administrative staff of Teaching Hospital Jaffna, including the Chief Matrons and In-Charge Nursing Officers, for facilitating this study. We extend our appreciation to all nurses who participated in this research. Authors’ information A.M.Hazeem (Corresponding Author) Bsc.Hons in Nursing University of Jaffna. Jaffna. Sri Lanka. [email protected] M.K.I.Mathushanka (Co- Author) Bsc.Hons in Nursing University of Jaffna Jaffna. Sri Lanka. [email protected] L.Kamalarupan (Supervisor) B.Sc., M.Phil. (Nursing), Senior Lecturer in Nursing, Department of Nursing, Faculty of Allied Health Sciences, University of Jaffna. Jaffna. Sri Lanka. [email protected] K. Thanujanan (Supervisor) Nursing Officer, In- Charge, CANE hospice, Uduvil, Chunnakam. Jaffna. Sri Lanka. [email protected] References Oyetunde MO, Ojo OO, Ojewale LY. Nurses’ attitude towards the care of the elderly: implications for gerontological nursing training. Int J Nurs Midwifery. 2013;5(1):1–5. Rush KL, Hickey S, Epp S, Janke R. Nurses' attitudes towards older people care: An integrative review. J Clin Nurs. 2017;26(23–24):4105–16. Rathnayake S, Athukorala Y, Siop S. Attitudes toward and willingness to work with older people among undergraduate nursing students in a public university in Sri Lanka: a cross-sectional study. Nurse Educ Today. 2016;36:439–44. Miyata C, Arai H. Professional Behaviors of Nurses in Geriatric Health Services Facility in Japan. Adv Aging Res. 2019;8(6):129–38. 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Baccalaureate nursing students' knowledge of and attitudes toward older adults. J Gerontol Nurs. 2015;41(7):46–56. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 16 Mar, 2026 Reviews received at journal 13 Mar, 2026 Reviewers agreed at journal 09 Mar, 2026 Reviews received at journal 01 Mar, 2026 Reviewers agreed at journal 26 Feb, 2026 Reviewers agreed at journal 24 Feb, 2026 Reviewers agreed at journal 24 Feb, 2026 Reviewers agreed at journal 24 Feb, 2026 Reviewers invited by journal 24 Feb, 2026 Editor invited by journal 23 Feb, 2026 Editor assigned by journal 20 Feb, 2026 Submission checks completed at journal 20 Feb, 2026 First submitted to journal 17 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8901998","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596515537,"identity":"a91b422e-e503-4e5d-8635-4bfeb59a803a","order_by":0,"name":"A. M. Hazeem","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIiWNgGAWjYBACAwglIcfP3tj44AOQycZOnBYLY8mew4cNZ4C0MBOnpSJxw420NGkeEJuQFnP24w8ffMyRSNxw5oyBtM2vbfJ8zAyMHz7m4NZi2ZOQbDhzm4TxzOM9Bsa5fbcN25gZmCVnbsPjsAMJx6R5t0nI9gFtSc7tuc0I1MLGzItPy/mH7b//bpNgbLiRY3DYsue2PWEtN5LZmBm3SShOuJGW2Mzw43YiEVqeMUv2Av0CCmTG3obbyW3MjM34/XI+/eGHn9vqQFHZ/uPHn9u289ubD374iEcLKmBsA5MNxKoHgT+kKB4Fo2AUjIKRAgDIaliiCOKwJwAAAABJRU5ErkJggg==","orcid":"","institution":"University of Jaffna","correspondingAuthor":true,"prefix":"","firstName":"A.","middleName":"M.","lastName":"Hazeem","suffix":""},{"id":596515538,"identity":"f4d551cd-4e23-46ad-a7ea-ea5fda7e2c48","order_by":1,"name":"M. K.I. Mathusnka","email":"","orcid":"","institution":"University of Jaffna","correspondingAuthor":false,"prefix":"","firstName":"M.","middleName":"K.I.","lastName":"Mathusnka","suffix":""},{"id":596515539,"identity":"40da23ae-5b54-4a9e-842c-a8de27bceda6","order_by":2,"name":"L. Kamalarupan","email":"","orcid":"","institution":"University of Jaffna","correspondingAuthor":false,"prefix":"","firstName":"L.","middleName":"","lastName":"Kamalarupan","suffix":""},{"id":596515542,"identity":"291417f7-cfe9-4f25-8798-a812200da2f3","order_by":3,"name":"K. Thanujanan","email":"","orcid":"","institution":"CANE hospice","correspondingAuthor":false,"prefix":"","firstName":"K.","middleName":"","lastName":"Thanujanan","suffix":""}],"badges":[],"createdAt":"2026-02-17 14:25:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8901998/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8901998/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103506609,"identity":"803a8c25-cd31-4c09-9cf4-06df98b834c0","added_by":"auto","created_at":"2026-02-26 13:38:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1173170,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8901998/v1/ca56b879-3aea-4b9c-b93d-996105afd7ca.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eAttitude of Nurses on Care of Older Adults and Factors Influencing on It Among the Nurses Working at Teaching Hospital Jaffna\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe population of the elderly is increasing in all countries of the World. This is attributed to be one of the major achievements of mankind in the modern era [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Older adults are more likely to experience multiple chronic health conditions, have issues related to poly-pharmacy, require additional supports to complete activities of daily living, and compared to their younger counterparts, use health care services more frequently [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In Sri Lanka, the increasing population of older adults presents a significant challenge to the healthcare sector in meeting their needs. Nurses play a vital role in caring for the elderly requiring medical attention [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] However, nurses face obstacles in providing care to geriatric patients due to limited physical facilities and technical equipment in hospitals, care-related issues arising from patients' physical limitations, administrative problems, and communication difficulties with patients, their families, or caregivers [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. These challenges can influence nurses' attitudes toward caring for older adults. Various factors can impact one\u0026rsquo;s attitude. The quality of care nurses provide is linked to their attitudes toward older adults. Personal experiences with the elderly or education can affect nurses' attitudes, having both positive and negative effects [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Research shows that many factors can influence a nurse\u0026rsquo;s attitude toward older adults. Research shows that many factors can influence a nurse's attitude toward older adults. These are divided into demographic factors, attitude of nurses towards older adults while caring for them, attitude of nurses to maintain the patient\u0026rsquo;s rights, and attitude of the nurses to communication with older adults. Demographic factors include age, gender, ethnicity, religion, work unit [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], work experience [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] and higher education qualifications. In many healthcare settings, their workload and shortages significantly impact the care provided to older adults. This can affect the quality of patient care. There are no specialized government hospitals for the elderly in the Northern Province. The Jaffna Teaching Hospital serves the entire general population across all age groups. Additionally, the current setup does not include a dedicated ward for geriatric patients. Elderly patients are treated in the same wards as adults. The nurses working in these wards at Jaffna Teaching Hospital are not specifically trained to care for geriatrics. This creates a challenge for the nurses when managing geriatric patients.\u003c/p\u003e \u003cp\u003eThis study primarily focuses on assess attitude of nurses on care of older adults and the factors influencing on it among the nurses working at Teaching Hospital Jaffna. Nurses' attitudes will be affected by caring for older adults, patient rights, communication with patients, and demographic factors.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e \u003cb\u003eStudy sample and procedures.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis was a hospital-based descriptive cross-sectional study. The Teaching Hospital in Jaffna is located in the Northern Province of Sri Lanka. The study was conducted in selected wards where older adults are generally admitted for care. A total of 26 wards and 10 units were included in the study. A total of 449 nurses were recruited for the study from these selected wards and units at Teaching Hospital Jaffna, and those on maternity leave and long-term leave were excluded. The sample size of the study was estimated by using the Daniel\u0026rsquo;s formula N=Z\u003csup\u003e2\u003c/sup\u003ep (1-p)/d\u003csup\u003e2\u003c/sup\u003e. The proportion value (p-value) taken as 0.162, based on the attitude level of nurses from previous study done in Sri Lanka [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] as 16.2%. The estimated sample size is 232.The nurses\u0026rsquo; list and their total numbers for each ward and unit were obtained from Matron Office of Teaching hospital, Jaffna. The samples were recruited for the study by using simple random sampling method. The proportional samples were calculated based on the total population in each ward and unit,\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e was obtained from the Ethics Review Committee of Faculty of Medicine University of Jaffna. The study information was clearly communicated to participants, and written informed consent was obtained before data collection.\u003c/p\u003e \u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eMeasurement\u003c/h2\u003e \u003cp\u003eA self-administered questionnaire was used to gather data. The questionnaire was developed by researchers based on specific objectives and previous literature. The questionnaire has two sections: Section 01 - Socio-demographic factors and Section 02 \u0026ndash;attitude of nurses towards older adults while caring for them, attitude of nurses to maintain the patient\u0026rsquo;s rights and attitude of the nurses related to communication, which includes a total of 35 statements.\u003c/p\u003e \u003cp\u003eA pretest was conducted among ten nurses at Base Hospital Tellippali. No any changes were made to the questionnaire after the pretest.\u003c/p\u003e \u003cp\u003eData was collected from nurses in selected wards and units at Teaching Hospital Jaffna. Data collection was carried out without disrupting their routines or privacy. Written consent was obtained from the participants after providing a clear explanation of the study. They were encouraged to ask questions or express doubts the study, and those questions were answered by the researchers. Participants consumed approximately 25\u0026ndash;30 minutes to complete the questionnaire. The completed questionnaires were collected from the participants on the same day.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe data was entered and analyzed using IBM SPSS version 25.0 (Statistical Package for the Social Sciences) based on the research problems, objectives, and variables. The participants' attitude toward older adult care was categorized as either positive or negative based on their total scores for Section II. There are 35 questions. If they agree with positive attitude statements and disagree with negative attitude statements, they earn 1 point for each correct response. Each incorrect response receives 0 points. The total score is converted into a percentage. If the percentage exceeds 50%, it indicates a positive attitude, while less than 50% indicates a negative attitude among nurses caring for older adults. The data were analyzed using means, standard deviations. Descriptive analysis was used to assessed nurses' attitudes, and the Chi-Squared test was used identified the association of socio demographic factors.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic characteristics\u003c/h2\u003e \u003cp\u003eOut of 232 participants, the response rate was 93.1% (N\u0026thinsp;=\u0026thinsp;216). Participants' ages ranged from 25 to 57 years, with a mean age of 31.65 years (SD\u0026thinsp;=\u0026thinsp;6.232). Most of them (54.2%) were under 30 year old. More than two-thirds being female (70.4%). Nearly half identified as Sri Lankan Tamil (52.8%) and Hindus (47.7%). Among the total participants, (18.1%) worked in medical wards. Regarding experience, over half (63.9%) had less than five years of experience. The majority were diploma (78.2%), while (19.9%) had a degree, and (1.9%) held post-diploma qualifications.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAttitude of nurses towards older adults while caring for them\u003c/h3\u003e\n\u003cp\u003eThe participants were given two options, for each statement, namely: agree, and disagree. Majority of them (88%) were expressed that they were satisfied while caring older adults. Half of the participants had an opinion that, care for younger adults and children to be prioritized than older adults. However, this was considered as negative attitude, as it is not ethically appropriate to prioritize care based on age. Almost all the participants (96.8% felt that it was essential to provide quality care to older patients. Additionally, except 19%, others agreed that quality care remains important even for the older adults in end of life or the patients with disorientation condition. Nearly one quarter of the population expressed a negative attitude that, they felt irritable while caring older adults with cognitive impairment. They also displayed empathy and compassion towards the patients, which in turn reflects in making good decisions during critical conditions. The distribution of responses regarding attitudes while caring for older adults is presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eAttitude of nurses about older adults while caring them\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatement about attitude\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFrequency (N) and\u003c/p\u003e \u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003ePercentage (%)\u003c/span\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree N (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDisagree N\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI satisfied while caring the older adults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e190 (88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (12%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, prioritized care to be given to the children and younger adults than older adults.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e108 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108 (50%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, prioritized care to be given as per the need of the patient.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e189 (87.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(12.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, it is essential to provide a quality nursing care to all the older adults.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e209 (96.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(3.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, it is not essential to provide a quality nursing care to the older adults, since they are in end of life.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42(19.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e174(80.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, quality nursing care to be given the older adult, even the come with disorientation condition.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e175(81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(19%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that, it is very irritable to care the older adults who is with any cognitive impairment.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52(24.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e164(75.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel emotionally connected to older adult patients under my care.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e190(88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(12%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI believe that interdisciplinary collaboration is important in delivering comprehensive care to older adult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e189(87.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(12.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel empathy and companionate while caring older adults.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e201(93.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(6.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that, we have to make good decisions when older adult patients are in critical condition.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e207(95.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(4.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that, caring the older adults is annoying for me\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30(13.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e186(86.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eAttitude of nurses to maintain the patient\u0026rsquo;s rights (dignity, privacy, individuality, confidentiality, respect, minimal disturbing, on decision making)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAlmost all of them (99.5%) agreed that older adults should be treated with dignity and respect. Maintain privacy and confidentiality are the fundamental rights for everyone. Many of them (92.1%) agreed that it is important to maintain their personal information confidentially. Many of them (80.1%) understand older adults also may have shyness when touching the body parts or exposing it and they recognized the importance of maintaining privacy for older adults while caring for them (88%). Many of them (82.9%) having the right concepts that considering only the basic needs of the older adults are not sufficient, it is also important to look the personal hygiene and grooming (83.8%) of the older adult patients. Majority of them (88%) recognized that alleviate the pain is also essential to consider for the older adults, since it may cause many adverse outcome such as disturbed sleep, depression, anxiety etc. Most of the participants (85.2%) understand the importance of obtaining consent from older patients, whether in general or for specific procedures. They also focus on providing individualized care for them (81.5%). One\u0026rsquo;s personal belongings are valuable for them even if it is not in good condition, that concept many of them have (87%). The detailed responses regarding attitudes toward maintaining patients\u0026rsquo; rights are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eAttitude of nurses to maintain the patient\u0026rsquo;s rights (dignity, privacy, individuality, confidentiality, respect, minimal disturbing, on decision making)\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStatement about attitude\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFrequency (N) and Percentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAgree N (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eDisagree N (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, older adults should be treated with dignity and respectful.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e215 (99.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI believe that providing independence and autonomy is important in caring for older adult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e188(87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28(13%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that it is important to provide individualized care to the older adult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e176(81.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40(18.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMy opinion is, normally older adults do not have any shyness when touching the body parts or exposing it.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43(19.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e173(80.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMy opinion is, it is not important to maintain privacy with cloths or screen while caring the older adults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e190(88%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMy opinion is we do not worry much about their cultural aspects of the older adults while caring them.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37(17.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e179(82.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that it is not important to consider the personal hygiene and grooming of the older adult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e181(83.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that it is enough to consider only the basic needs of the older adults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37(17.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e179(82.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, we should be very careful on giving medications to older adults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e197(91.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(8.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, it is not that much importance to follow the five rights while caring the older adult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27(12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e189(87.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt is not important to maintain their personal information confidentially.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17(7.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e199(92.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt is not important to get written consent for the older adults while doing any special procedures.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(14.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e184(85.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt is not necessary to consider the pain of the older adults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e190(88%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel, it is essential to do the nursing measures to older adults without disturbing their rest and sleep.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e187(86.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(13.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that, if any belongings of elder adults are not in good condition, it can be discarded without their permission to make the ward clean.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28(13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118(87%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eAttitude of the nurses related to communication with older adults\u003c/h2\u003e \u003cp\u003eNearly 70% of the nurses stated that, they felt comfortable while communicating with elders. However, 43.5% of them stated, it is very stressful to communicate with older adults who is with any sensory alterations. Majority (88%) realized that, nurses should listen carefully and patiently while communicating with the older adults. Also, majority (96.3%) believe that barriers of communication with older adults shall be break by using various techniques of communication. Even though 56.9% have idea that if there any barriers on communicating with older adults, it is only option to communicate about the older patient with their relatives or caregivers only. More than 90% of participants (93.1%) agreed that providing thorough explanations about discharge planning to patients and families is essential when caring for older adults. Majority of the participants (92.6%) were conscious that, they never use physical or verbal abuses while caring them. The distribution of responses regarding communication with older adults is presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eAttitude of the nurses related to communication with older adults\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStatement about attitude\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFrequency (N) and Percentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAgree N (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eDisagree N (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel comfortable while communicating with older adult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152(70.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64(29.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that, it is very stressful to communicate with older adults who is having any sensory alterations.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94(43.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e122(56.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel, nurses have to listen carefully and patiently whatever they communicate about their conditions.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e190(88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(12%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn my opinion, nurses should use the various techniques to minimize the barriers to communication with the older adult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e208(96.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(3.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that if there any barriers on communicating with older adults, it is only option to communicate about the older patient with their relatives or caregivers only.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123(56.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93(43.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI felt that, it is important to provide thorough explanation about discharge planning with patient and families\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e201(93.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(6.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel that, it is not important to get opinion from older adult patients or relatives while caring.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45(20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e171(79.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI am very much conscious that, we never do any physical or verbal abuses while caring them.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200(92.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(7.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDistribution of attitude score of the study population (N = 216)\u003c/h3\u003e\n\u003cp\u003eAfter analyzing the data, the predetermined cutoff was set at 50%. The attitude scores were then categorized into positive and negative attitudes. In the present study, 90.3% (N\u0026thinsp;=\u0026thinsp;195) of nurses displayed a positive attitude, while 9.7% (N\u0026thinsp;=\u0026thinsp;21) showed a negative attitude toward older adults' care.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRelationship between socio demographic factors and nurses' attitudes toward caring for older adults at Teaching Hospital Jaffna\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThere is no statistical significance between age and attitude. Most male (89.1%) and female (90.8%) participants had more positive attitudes than negative ones. In this study, gender had no significant association (p\u0026thinsp;=\u0026thinsp;0.696) with the attitude level of the participants. Positive attitudes were recorded in the majority of participants belonging to ethnic groups such as Sri Lankan Tamils (86.8%), Sinhalese, and Sri Lankan Moors (94.1%). Here, Sinhalese and Sri Lankan Moors were combined into one category because only two participants responded from the Moors group. Additionally, ethnicity (p\u0026thinsp;=\u0026thinsp;0.072) did not significantly influence the attitude levels. With regards to religion, participants from groups identified as \u0026ldquo;Hindu,\u0026rdquo; \u0026ldquo;Buddhist,\u0026rdquo; and \u0026ldquo;Christian and Islam\u0026rdquo; showed positive attitudes of 85.4%, 95.7%, and 90.0%, respectively. We combined Christian and Islam into one category because few participants responded under each. In this study, religion had no significant association (p\u0026thinsp;=\u0026thinsp;0.053) with attitude levels. When examining the relationship between attitude and care of older adults in relation to the wards and units where participants currently work, we categorized medical wards, surgical wards, and Intensive Care Units \u0026amp; Accident and Traumatic Intensive Care Units as three categories, as older adults are mainly treated in these units. The remaining wards and units were grouped under other categories. In this study, the current ward/unit showed a significant association (p\u0026thinsp;=\u0026thinsp;0.033) with attitude levels.. Looking at work experience groups, participants with \u0026ldquo;below 5 years\u0026rdquo; and \u0026ldquo;5 years and above\u0026rdquo; of experience showed positive attitudes of 89.1% and 92.3%, respectively. We combined the 5\u0026ndash;10 years and above 10 years categories into a single \u0026ldquo;5 years and above\u0026rdquo; category because few participants responded from each group. Work experience did not significantly impact attitude level of the participants (p\u0026thinsp;=\u0026thinsp;0.449). A positive attitude was observed in most participants from higher education groups, specifically the Diploma (87.6%) and Post-Diploma and Degree (100%) groups. Here, Post-Diploma and Degree were combined into one category because few participants responded in each. The highest educational qualification of the nurses (p\u0026thinsp;=\u0026thinsp;0.011) was found to have a statically significant association with the participants\u0026rsquo; attitude. The association between socio-demographic factors and nurses\u0026rsquo; attitudes toward caring for older adults is presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eRelationship between socio-demographic factors and nurses' attitudes towards caring for older adults at Teaching Hospital Jaffna\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSocio-demographic Factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLevel of Attitude\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStatistical Result\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePositive attitude\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNegative attitude\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105(89.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12(10.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e= 0.083\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003cp\u003ep value\u0026thinsp;=\u0026thinsp;0.773\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 and above 30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90(90.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9(9.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57(89.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7(10.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e= 0.153\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003cp\u003ep value\u0026thinsp;=\u0026thinsp;0.696\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e138(90.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14(9.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSri Lankan Tamil\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99(86.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15(13.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e= 3.247\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003cp\u003ep value\u0026thinsp;=\u0026thinsp;0.072\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSinhalese and Sri\u003c/p\u003e \u003cp\u003eLankan Moors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(94.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6(5.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHindu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88(85.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15(14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e= 5.866\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003cp\u003ep value\u0026thinsp;=\u0026thinsp;0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBuddhist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89(95.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4(4.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChristian and Islam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(90.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2(10.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eCurrently working ward/unit\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical wards\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31(79.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8(20.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e= 8.739\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e \u003cp\u003ep value\u0026thinsp;=\u0026thinsp;0.033\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical wards\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31(88.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4(11.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntensive Care Unit and Accident and\u003c/p\u003e \u003cp\u003eTraumatic Intensive Care Unit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0(0.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther wards and units\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105(92.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9(7.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eWorking experience\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123(89.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15(10.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e= 0.573\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003cp\u003ep value\u0026thinsp;=\u0026thinsp;0.449\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 years and above 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72(92.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6(7.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eHigher education qualification\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e148(87.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21(12.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e= 6.469\u003c/p\u003e \u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003cp\u003ep value\u0026thinsp;=\u0026thinsp;0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePost diploma and Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0(0.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn this study, 90.3% of nurses have positive attitudes toward the care of older adults. A similar study conducted by the University of British Columbia, based on an integrative review of papers published between 2005 and 2017, found that nurses held both positive and negative attitudes toward various aspects of older adult care. In an extensive survey study, 89.7% of nurses reported positive attitudes toward working with older people [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Also, 54% nurses prioritized their care over younger patients, but in our study their prioritized children, younger adults and older adults equally. According to numerous studies [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Respondents' socio demographic traits including age, sex were linked to their attitudes toward the care of elderly patients. Their level of education, experience, educational institutions, and work units/wards were also found to influence nurses' attitudes about caring for elderly patients [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. A study conducted in China revealed a direct correlation between nurses' attitudes and expertise and their approach to elderly patient care [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Other factors affecting nursing care for senior patients include education, experience, and training in elder care [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].Among the socio-demographic factors, it was observed that most participants were under 30 year\u0026rsquo;s old, female, and held a diploma. Educational level was significantly associated with nurses' attitude. Similar studies in Turkey and Israel showed that the 20\u0026ndash;29 age group had the highest participation, with two-thirds being female and that there was no significant association between gender (p\u0026thinsp;=\u0026thinsp;0.26) and attitude level [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. While caring for older patients, most nurses can empathize and strive to provide quality care. However, they don\u0026rsquo;t just prioritize this group because of age. In a study at the University of British Columbia, 54% of nurses prioritized caring for younger patients over others [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Almost all participants (99.5%) agreed that older adults should be treated with dignity and respect and in another study they reported that 80% of nurses showed respect toward older adult patients [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePrivacy is a basic right for everyone. Most of them recognized the importance of protecting privacy for older adults when caring for them (88%). Pain can lead to negative outcomes such as depression, anxiety, sleep disturbances, and more, making it crucial to relieve older adults' pain. Most nurse (88%) had a positive view on this matter.\u003c/p\u003e \u003cp\u003e In the study, we also observed that good communication is essential to provide \u0026lsquo;genuine care\u0026rsquo;. Effective communication improves when nurses demonstrate real concern and care for their patients through proper touch, tone, eye contact, empathy, and lively conversation [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The discharge planning explanation protocol should be maintained by all nurses for patients and their families when they are leaving the hospital; in this case, the majority (93.1%) of nurses follow it effectively. A University of British Columbia study revealed that three-quarters of nurses reported involvement in discharge planning for patients [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA study by Dahlke found that nurses' attitudes toward caring for older people are influenced by their previous experience and cultural factors. Besides prior work placement experiences, the supervisor's knowledge and attitude, as well as perceptions of ageing in the work environment, are important factors [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The increasing elderly population presents a significant health risk due to physical, physiological, and social challenges. The quality of care for older patients could decline because of nurses' insufficient knowledge, negative attitudes, and practices.\u003c/p\u003e \u003cp\u003eAlthough the study made its best effort with good methodology, there were some limitations. Lack of time and willingness among nurses made it difficult to collect data for this study. Attitude was assessed with a closed-ended questionnaire; these answer options may have provided cues to participants.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn this study, most participants (90.3%) demonstrated a positive attitude toward caring for older adults, while 9.7% showed a negative attitude. The nurses' average attitude score was 29.46, with a standard deviation of 5.234. Attitude was significantly associated with the current ward or unit (p\u0026thinsp;=\u0026thinsp;0.033) and higher educational levels (p\u0026thinsp;=\u0026thinsp;0.011). It is recommended that an in-service training program be offered to all nurses to help maintain effective performance and support ongoing education with formal teaching and demonstrations for caring for older adults.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e1. THJ\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTeaching Hospital Jaffna\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e2. SPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package of Social Science\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from the Ethics Review Committee, Faculty of Medicine, University of Jaffna, Sri Lanka (Approval No: 160th ERC-07; approved on 27 June 2024). Written informed consent was obtained from all participants prior to data collection. Participation was voluntary, and confidentiality and anonymity were assured.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was self-funded by the authors. No external funding was received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.M. Hazeem conceptualized and designed the study and drafted the manuscript. A.M. Hazeem and M.K.I. Mathushanka conducted data collection, data entry, and statistical analysis. L.Kamalarupan and K. Thanujanan supervised the study and critically reviewed the manuscript for important intellectual content. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors express their sincere gratitude to the Dean, Faculty of Allied Health Sciences, University of Jaffna, and the Head, Department of Nursing, for their support. We also thank the Director and administrative staff of Teaching Hospital Jaffna, including the Chief Matrons and In-Charge Nursing Officers, for facilitating this study. We extend our appreciation to all nurses who participated in this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; information\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.M.Hazeem (Corresponding Author)\u003c/p\u003e\n\u003cp\u003eBsc.Hons in Nursing\u003c/p\u003e\n\u003cp\u003eUniversity of Jaffna.\u003c/p\u003e\n\u003cp\u003eJaffna.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSri Lanka.\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eM.K.I.Mathushanka (Co- Author)\u003c/p\u003e\n\u003cp\u003eBsc.Hons in Nursing\u003c/p\u003e\n\u003cp\u003eUniversity of Jaffna\u003c/p\u003e\n\u003cp\u003eJaffna.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSri Lanka.\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eL.Kamalarupan (Supervisor)\u003c/p\u003e\n\u003cp\u003eB.Sc., M.Phil. (Nursing),\u003c/p\u003e\n\u003cp\u003eSenior Lecturer in Nursing,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDepartment of Nursing,\u003c/p\u003e\n\u003cp\u003eFaculty of Allied Health Sciences,\u003c/p\u003e\n\u003cp\u003eUniversity of Jaffna.\u003c/p\u003e\n\u003cp\u003eJaffna.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSri Lanka.\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eK. Thanujanan\u0026nbsp;(Supervisor)\u003c/p\u003e\n\u003cp\u003eNursing Officer, In- Charge,\u003c/p\u003e\n\u003cp\u003eCANE hospice,\u003c/p\u003e\n\u003cp\u003eUduvil,\u003c/p\u003e\n\u003cp\u003eChunnakam.\u003c/p\u003e\n\u003cp\u003eJaffna.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSri Lanka.\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOyetunde MO, Ojo OO, Ojewale LY. Nurses\u0026rsquo; attitude towards the care of the elderly: implications for gerontological nursing training. Int J Nurs Midwifery. 2013;5(1):1\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRush KL, Hickey S, Epp S, Janke R. Nurses' attitudes towards older people care: An integrative review. J Clin Nurs. 2017;26(23\u0026ndash;24):4105\u0026ndash;16.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRathnayake S, Athukorala Y, Siop S. Attitudes toward and willingness to work with older people among undergraduate nursing students in a public university in Sri Lanka: a cross-sectional study. Nurse Educ Today. 2016;36:439\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiyata C, Arai H. Professional Behaviors of Nurses in Geriatric Health Services Facility in Japan. Adv Aging Res. 2019;8(6):129\u0026ndash;38.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhagi BR, Maharjan SA, Bajracharya SL, Upadhyay R, Shrestha KB. Attitude of nurses towards care of elderly people in teaching hospitals of Kathmandu Valley. Birat J Health Sci. 2020;5(2):1022\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTopaz M, Doron I. Nurses' attitudes toward older patients in acute care in Israel. Online J Issues Nurs. 2013;18(2):9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Ouml;zdemir \u0026Ouml;, Bilgili N. Attitudes of Turkish nursing students related to ageism. J Nurs Res. 2016;24(3):211\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNilsson A, Lindkvist M, Rasmussen BH, Edvardsson D. Staff attitudes towards older patients with cognitive impairment: need for improvements in acute care. J Nurs Manag. 2012;20(5):640\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMansouri Arani M, Aazami S, Azami M, Borji M. Assessing attitudes toward elderly among nurses working in the city of Ilam. Int J Nurs Sci. 2017;4(3):311\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu X, Zheng J, Liu K, Baggs JG, Liu J, Wu Y, You L. Associations of nurse education level and nurse staffing with patient experiences of hospital care: a cross-sectional study in China. Res Nurs Health. 2019;42(3):234\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoreira WC, de Carvalho ARB, Lago EC, Amorim FCM, de Alencar DC, Almeida CAPL. Training of nursing students in integrated care for the elderly. Rev Bras Geriatr Gerontol. 2018;21(2):186\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdibelli D, Kılı\u0026ccedil; D. Difficulties experienced by nurses in older patient care and their attitudes toward the older patients. Nurse Educ Today. 2013;33(9):1074\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTay LH, Hegney DG, Ang E. Factors affecting effective communication between registered nurses and adult cancer patients in an inpatient setting: a systematic review. Int J Evid Based Healthc. 2011;9(2):151\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDinkins CS. Socrates Cafe for older adults: intergenerational connectedness through facilitated conversation. J Psychosoc Nurs Ment Health Serv. 2019;57:11\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHahn SJ. So we basically let them struggle: Student perceptions of challenges in intergenerational service-learning. J Intergenerational Relationships. 2020;18(1):1\u0026ndash;15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMattos MK, Jiang Y, Seaman JB, Nilsen ML, Chasens ER, Novosel LM. Baccalaureate nursing students' knowledge of and attitudes toward older adults. J Gerontol Nurs. 2015;41(7):46\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Attitude, Care of older adults, Nurses, Teaching Hospital Jaffna","lastPublishedDoi":"10.21203/rs.3.rs-8901998/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8901998/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eIt important to give more emphasis on elderly care since population is ageing. Nurses play a vital role in caring the elderly. This study aimed to assess the attitude of nurses on caring the older adults and the factors influence it among the nurses who are working at the Teaching Hospital, Jaffna.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis hospital-based, descriptive, cross-sectional study was conducted among 216 nursing officers at Teaching Hospital Jaffna from May 2023 to August 2024. A pre-designed and validated self-administered questionnaire was used to collect data. SPSS 25 software was used for data analysis. Descriptive analysis was used to assessed nurses' attitudes, and the Chi-Squared test was used identified the association of socio demographic factors and the attitude of nurses.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 232 nurses were recruited for the study, with a response rate of 93.1%. Participants' ages ranged from 25 to 57 years old. The majority were female (70.4%). Nearly half identified as Sri Lankan Tamil (52.8%) and Hindus (47.7%). Over half (63.9%) had less than five years of experience. More than three quarter were diploma holders (78.2%).Nurses with a positive attitude 90.3%, while those with a negative attitude account for 9.7%, based on a 50% cutoff value. The mean attitude score is 29.46. A statistically significant relationship (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) was found between attitude and current ward/unit, and higher education qualifications.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis study demonstrated variations in nurses\u0026rsquo; attitudes toward caring for older adults. The majority (90.3%) showed a positive attitude towards elderly care. Nurses may need frequent updates on caring for older adults; relevant wards and units should take appropriate measures to ensure nurses maintain a proper attitude toward this aspect of care.\u003c/p\u003e","manuscriptTitle":"Attitude of Nurses on Care of Older Adults and Factors Influencing on It Among the Nurses Working at Teaching Hospital Jaffna","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-25 04:48:40","doi":"10.21203/rs.3.rs-8901998/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-16T08:40:31+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-13T08:42:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180273268766951944652302438143652106312","date":"2026-03-09T05:41:20+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-02T04:39:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11391702035351924483796495734811173475","date":"2026-02-27T03:30:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"139920058065796343321174414418273891069","date":"2026-02-25T02:42:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"208787040521037607604916638924783012412","date":"2026-02-24T23:39:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"128798288322545781044364278738150725634","date":"2026-02-24T20:07:07+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-24T19:59:12+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-23T10:23:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-20T11:42:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-20T11:41:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2026-02-17T14:17:37+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"571ec04c-8616-4d8c-886c-a5aefb8d9764","owner":[],"postedDate":"February 25th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-18T16:53:31+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-25 04:48:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8901998","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8901998","identity":"rs-8901998","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}