A descriptive survey of personality traits, social characteristics, and stereotype attitudes toward the aged

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Title:
A descriptive survey of personality traits, social characteristics, and stereotype attitudes toward the aged in three types of nurses giving care to the aged in nursing homes
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xi, 112 leaves : ; 28 cm.
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Burge, Janet Marie, 1939-
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Nurses and nursing -- Psychological aspects -- Florida   ( lcsh )
Geriatric nursing   ( lcsh )
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Thesis:
Thesis--University of Florida.
Bibliography:
Includes bibliographical references (leaves 108-111).
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by Janet Marie Burge.
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Typescript.
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Vita.

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A DESCRIPTIVE SURVEY OF PERSONALITY TRAITS, SOCIAL
CHARACTERISTICS, AND STEREOTYPE ATTITUDES TOWARD THE
AGED IN THREE TYPES OF NURSES GIVING
CARE TO THE AGED IN NURSING HOMES












By

JANET MARIE BURGE


A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL OF
THE UNIVERSITY OF FLORIDA
IN PARTIAL FULFULLMENT OF THE REQUIREMENTS FOR THE
DEGREE OF DOCTOR OF PHILOSOPHY










UNIVERSITY OF FLORIDA
1976





































1976


JANET MARIE BURGE

ALL RIGHTS RESERVED















ACKNOWLEDGEMENTS


The writer expresses sincere appreciation to

Dr. Robert L. Curran, her major advisor, for his guidance

throughout the entire period of doctoral study. His support

will not soon be forgotten nor his ability to keep the

writer "on task".

Appreciation is extended also to Dr. Vynce A Hines

for his support in assisting with the statistical analysis

for the study. Dr. Hines once said, "Doing the dissertation

will do one of two things for you. It will either confirm

your suspicions that you hate statistics or you will find

you have a real liking for it." He will be pleased to

know that the writer experienced the latter.

The writer is especially grateful to Dr. Hal G. Lewis

for the knowledge he shared in the classroom. His ability

to stimulate the deepest of thoughts is reflective of his

being the master teacher.

A very special thank you is sincerely extended to

Dr. Otto von Mering, who exposed the writer to the whole

world of Anthropology. Without the encounter her life

would have been incomplete.

A special mention should be given Miss Jackie Sessions

who gave many hours and frustrating moments to the typing

of this dissertation.









To the author's friend, Miss Sallye Brown, for her

moral support throughout the entire academic development,

a heartfelt thank you.

Finally, deep appreciation and love are expressed to

the writer's parents and sister, without whose under-

standing and encouragement, the completion of this

dissertation would not have been possible.


iii

















TABLE OF CONTENTS


ACKNOWLEDGEMENTS . .

LIST OF TABLES . .


ABSTRACT .


CHAPTER

I. INTRODUCTION .


Statement of the Problem
Need for the Study .
Questions. .
Definitions. .
Limitations of the Study .
Conceptual Framework .

II. REVIEW OF LITERATURE .


Introduction . .
Old People, Nursing Homes,
and Nurses . .
Geriatrics as a Field of
Specialization ..
Some Personality Characteristics
Nurse Specialization Groups .
Variables Related to Attitudes
Toward the Aged. .
Attitudes of Other Geriatrically
Pertinent Professions Toward
the Aged . .
Attitudes of Nurse Groups
Toward the Aged. .
Summary. . .

III. METHODOLOGY. . .

Sample . .
Instrumentation. .
Gordon Personal Profile. .
Tuckman-Lorge Attitude
Questionnaire. .


. 14

. 15


. 17


21

. 24
. 27

29


Page
. ii


. vi


S . ix


2
4
5
7
9
. 1
. 2
. 4
. 5
. 7
. 9

. 12










CHAPTER
Biographical Questionnaire .
Pilot Administration .
Design of the Study. .
Collection of the Data .. ..
Hypotheses . .
Data Analysis. .

IV. PRESENTATION AND ANALYSIS OF DATA.


Section I


Analysis for Statistical


Significance . .
Section II. Simple Percentage
Comparisons. . .

V. SUMMARY, PROCEDURES, RESULTS,
CONCLUSIONS, SIGNIFICANCE OF THE
STUDY, AND RECOMMENDATIONS FOR
FUTURE RESEARCH. . .

Summary. . .
Procedures . .
Results. . .
Conclusions . .
Personality Testing. .
Variables Related to Selection of
Geriatrics as an Area of
Specialization .
Variables Related to Stereotype
Attitudes . .
Significance of the Study .. .
Recommendation for Future Research


. 49

S. 71




S. 75

. 75
. 76
. 77
. 84
. 84


S. 85

. 86
. 88
. 89


APPENDIX A.

APPENDIX B.


APPENDIX C.

BIBLIOGRAPHY.


GORDON PERSONAL PROFILE .


TUCKMAN-LORGE ATTITUDE
QUESTIONNAIRE . .

BIOGRAPHICAL QUESTIONNAIRE .


BIOGRAPHICAL SKETCH. .


Page
. 38
. 39
. 39
. 41
. 43
. 45

. 49


S. 97

S. 104

S. 108


. 112
















LIST OF TABLES


TABLE Page

I. Institutions, Number of Subjects
Per Institution in Three Groups Tested
and Percent of Subjects Participating
Per Institution . 31

II. Number, Age Range and Mean Age of Three
Groups Tested ... . 31

III. Race of Subjects in Three Groups
Tested . .. .. 32

IV. Sex of Subjects in Three Groups
Tested .. . 32

V. Religious Preference of Subjects
in Three Groups Tested. . ... 32

VI. Terminal Educational Levels of
Subjects in Three Groups Tested .. 33

VII. Number and Type of Educational Programs
Completed by Registered Nurse Subjects
Tested in the Study .. 34

VIII. Analysis of Variance for Four Personality
Traits by Type of Nurse . .. 50

IX. Chi Square and Frequency Distribution of
Registered Nurses Scoring "Above Average"
and "Average and Below" on Four
Personality Traits .. 52

X. Chi Square and Frequency Distribution
of Licensed Practical Nurses Scoring
"Above Average" and "Average and Below"
on Four Personality Traits. . 53

XI. Chi Square and Frequency Distribution
of Nursing Assistants Scoring "Above
Average" and "Average and Below" on
Four Personality Traits .. 54











XII. Correlation of the Number of "Yes"
Responses on the Tuckman-Lorge
Attitude Questionnaire with Mean
Scores on Ascendancy, Responsibility
Emotional Stability, and Sociability. 56

XIII. Chi Square and Frequency Distribution
for Subjects Living with the Aged and
Selecting Geriatrics and Subjects
Living with the Aged and Selecting
Other Areas of Specialization 57

XIV. Chi Square and Frequency Distribution
of Preference for Geriatrics By
Age of Nurses .. . 58

XV. Chi Square and Frequency Distribution
of Preference for Different Age Groupings
of Patients by Age of Registered Nurses 59

XVI. Chi Square and Frequency Distribution
of Preference for Different Age Groupings
of Patients by Age of Licensed
Practical Nurses. . ... 60

XVII. Chi Square and Frequency Distribution
of Preference for Different Age Groupings
of Patients by Age of Nursing
Assistants. . .. 62

XVIII. t Test for Analysis of Number of "Yes"
Responses on the Tuckman-Lorge Attitude
Questionnaire by Race, Sex, and
Religion ...... ... ... 63

XIX. t Test for Number of "Yes" Responses
on the Tuckman-Lorge Attitude
Questionnaire by Degree and Nondegree
Educational Programs for Registered
Nurses. . . .. 65

XX. Analysis of Variance of Mean "Yes"
Responses on the Tuckman-Lorge Attitude
Questionnaire by Type of Nurse and
and by Satisfaction or Dissatisfaction
of Working with the Aged. ... 66

XXI. Analysis of Variance of Mean "Yes"
Responses on the Tuckman-Lorge
Attitude Questionnaire by Type of Nurse
and by Percent of Time Spent in Working
with the Aged ..... .... 68


vii


TABLE


Page









TABLE Page

XXII. Analysis of Variance of Mean "Yes"
Responses on the Tuckman-Lorge Attitude
Questionnaire by Type of Nurse and
by Age of Nurse . 69

XXIII. Percent Tabulation of Nurses' Age
When Having Lived with the Aged and the
Rating of the Experience. ... 72

XXIV. Percent Tabulation of Nurses' Age
When Having Lived with the Aged and the
Effect the Living Experience Had on
Selecting Work With the Aged. .. ... 73

XXV. Percent Tabulation of Nurses' Rating
of the Living Experience with the Aged
and the Effect the Experience Had on
Selecting Work with the Aged. .. 73

XXVI. Percent Tabulation of "No" Responses
To Item 23 of the Biographical
Questionnaire by Type of Nurse. 74

XXVII. Type of Responses to Item 25 of the
Biographical Questionnaire and
Percent of Subjects Responding .. 74


viii















Abstract of Dissertation Presented to the Graduate
Council of the University of Florida in Partial
Fulfillment of the Requirements for the Degree of
Doctor of Philosophy



A DESCRIPTIVE SURVEY OF PERSONALITY TRAITS, SOCIAL
CHARACTERISTICS, AND STEREOTYPE ATTITUDES TOWARD THE
AGED IN THREE TYPES OF NURSES GIVING
CARE TO THE AGED IN NURSING HOMES

By

Janet Marie Burge

August, 1976

Chairman, Dr. Robert L. Curran
Major Department: Foundations of Education


The purpose of this investigation was to determine

(1) the personality traits in three types of nurses working

with the aged in nursing homes; (2) the social character-

istics of the nurses; and (3) the stereotype attitudes

toward the aged of the nurses.

The population was composed of 110 nurses working in

nursing homes in Tallahassee and Jacksonville, Florida.

Three types of nurses composed the population and were

(1) 30 registered nurses, (2) 30 licensed practical nurses,

and (3) 50 nursing assistants.

The instruments used for the study were the Gordon

Personal Profile, the Tuckman-Lorge Attitude Questionnaire,

and a Biographical Questionnaire developed by the

investigator.









The study tested twelve null hypotheses through

Pearson product-moment correlations, t-tests, analysis of

variance, and chi squares. All hypotheses were tested at

the .05 level of confidence. The testing of the hypotheses

revealed the following:

1. Each of the three types of nurses (registered

nurses, licensed practical nurses, and nursing assistants)

varied significantly in scoring "above average" and

"average and below" on the four personality traits of

ascendancy, responsibility, emotional stability, and

sociability. Without exception, each of the three types of

nurses scored significantly "average and below" on ascen-

dancy and sociability and "above average" on responsibility.

The scores on emotional stability were not statistically

different among the three types of nurses.

2. There was no statistically significant relationship

between the scores on each of the four personality traits

of ascendancy, responsibility, emotional stability, and

sociability and the degree of stereotype attitudes toward

the aged.

3. The nurses who had lived with the aged selected

geriatrics in preference to surgery and pediatrics to a

significant degree but not in preference to psychiatric,

medical, rehabilitation, maternity, or public health

nursing.

4. Preference for geriatrics did not differ signifi-

cantly by age of nurses.









5. Preference for working with different age groups

of patients did not differ significantly by age of nurses.

6. Black nurses were more stereotyped in their

attitudes toward the aged than white nurses.

7. The degree of stereotype attitudes toward the aged

in nurses did not vary significantly by nurses' age, sex,

religion, satisfaction or dissatisfaction in working with

the aged, percentage of time estimated in working with the

aged, and number of years worked with the aged.

8. Type of educational programs for registered nurses

was not found to be significantly different when related to

degree of stereotype attitudes toward the aged.

9. Type of nurse was significantly different when

related to degree of stereotype attitudes toward the aged.

Registered nurses held less stereotype attitudes toward the

aged than licensed practical nurses and nursing assistants.

There was no significant difference between licensed

practical nurses and nursing assistants in their stereotype

attitudes toward the aged.
















Chairman
xi















CHAPTER I
INTRODUCTION

Statement of the Problem

The purpose of this study is to identify significantly

interrelating personality traits, social characteristics,

and stereotype attitudes toward the aged of professional

and nonprofessional nurses who have selected working with

the aged as an occupational choice.

In the last decade, nursing has undergone significant

changes in relation to practitioners going from a generali-

zation function to a specialization function. Examples of

some of these new specializations are (1) the neurology

specialist, (2) the oncology specialist, and (3) the inde-

pendent practitioner, a nurse who, in some states, may open

a practice independent of a physician, hospital, or

sponsoring organization. With this transition having taken

place within the profession, it becomes easier for the pro-

fession to identify areas where nurses are not electing to

go as practitioners. As a result, the profession is also

able partially to explain why the care in some of the

specialization areas may not be meeting the minimum

expections of the general public.

One of the areas where specialization is not occurring

to meet the needs and demands is geriatric nursing.







2

Randall (1965) has stated that among health professionals,

nurses should have the keenest interest in nursing home care.

He accounts for this claim by implying that in nursing homes,

nursing care is the primary service, while in hospitals,

nursing is subsidiary. Yet, in spite of this, there are few

nurses actively seeking employment in these types of insti-

tutions.

Why are nurses not going into the area of geriatric

specialization? Is it because it takes an individual with

a certain type of personality to work most effectively in

the area of geriatrics? Is it possible that the attitudes

toward the aged are so negatively stereotyped that nurses

do not elect to be associated with that area of nursing?

Are there, to date, still unidentified factors which may

prevent nurses from working with the aged? One way of

finding at least partial answers to some of these questions

is to look at those personality traits, social character-

istics, and attitudes of people who do elect to go into the

area of geriatrics. This study, therefore, proposed to

take a closer and more scrutinizing look at the employees

who are currently engaged in geriatric specialization.


Need for the Study

This study was motivated by a recognition of the

growing need for nursing personnel to choose geriatrics as

a field of specialization. The proportion of elderly

people in our population increases steadily, but the







3

proportion of nursing personnel who wish to engage in this

area of practice, and who are prepared to do so, does not.

Prevailing stereotypes of old age are negative and

are often stronger among health personnel who work closely

with older people (Gunter, 1971). In order for those in

academia to assist in promoting more positive attitudes in

student nurses and practitioners of nursing, a precise

identification of these attitudes must assume a higher

priority than it has in the past. To date, only five

studies by nurse researchers have concerned themselves

primarily with attempting to explore the area of attitudes

of nurses toward the aged (Brown, 1967; Campbell, 1971;

Gunter, 1971; Delora and Moses, 1969; Gillis, 1973).

Along with the need for identification of attitudes of

nurses currently working in institutions for the aged, a

profile of personality traits is needed. Personality traits

have been identified in other nurse specialization groups

but not in the area of geriatrics. This type of data would

assist employers in nursing homes to screen for more ef-

fective employees, a custom which is currently practiced

by most professions to some degree. Personality testing in

nursing has been essentially limited to students and used

generally as criteria for admission to schools of nursing.

If personality traits have been identified for such nurse

specialization groups as medical, surgical, and psychiatric

nurses as Lentz and Michaels (1959) and Navran and

Stauffacher (1957) have indicated in their research, what







4

prevents the same type of research in the area of

geriatrics?

None of the studies reviewed reflect any personality

testing of nurses who are currently working with the aged in

nursing homes. One of the unique aspects of this study is

to identify four personality traits in the nurses who are

currently working with the aged. The personality traits of

ascendancy, responsibility, emotional stability, and

sociability will be measured in this study. These per-

sonality traits were selected for measurement because they

have been identified as significant in the daily functioning

of normal persons.


Questions

The statement of the problem and need for the study

generated the following questions:

1. Are there different personality traits found among
nurses who select working with the aged compared to nurses
working in other areas of specialization?

2. Do these basic personality traits vary signifi-
cantly among registered nurses, licensed practical nurses,
and nursing assistants?

3. If the personality traits do vary significantly
among registered nurses, licensed practical nurses and
nursing assistants, which nursing group generally possesses
the traits which could best be utilized in giving care to
the aged in nursing homes?

4. Is there a relationship between a nurse's previous
positive or negative experiences with aged parents, rel-
atives, or friends (other than his/her current employment)
and selecting this type of work?

5. What are the satisfaction and/or dissatisfaction
self-reports of professionals and nonprofessionals currently
giving care to the aged?









6. Are the satisfaction and/or dissatisfaction self-
reports related to the stereotype attitudes toward the
aged, as measured by the Tuckman-Lorge Attitude Questionnaire?

7. Are the majority of nurses currently working in
nursing homes there by preference for a field of speciali-
zation in geriatrics or are they working in nursing homes
but prefer other fields of specialization?

8. Do older nurses hold more positive or negative
attitudes toward the aged as compared with younger nurses?

9. Is there any correlation between the self-reported
amount of time spent in working with the aged and nurses'
stereotype attitudes toward them?

10. What relationship, if any, do sex, race, and
religious preferences of nurses have to stereotype attitudes
toward the aged?


Definitions

1. Professional Nurse: refers to a Registered
Nurse (RN); one who has successfully com-
pleted a course of study, ranging from two
to four years in length, and has licensure
to practice as such.

2. Nonprofessional Nurse: refers to nurses in
two distinct categories, namely; (1) the
licensed practical nurse (LPN), and (2) the
nursing assistant (NA).

3. Licensed Practical Nurse (LPN): refers to
nurses who have completed a course of study
ranging from twelve to eighteen months in
length, and has licensure to practice as
such. It refers also to licensed
vocational nurse (LVN).

4. Nursing Assistant (NA): refers to those
individuals who usually have not completed
any type of formal nursing education.
Education for this individual often takes
place in agencies under the guidance of
inservice departments and, therefore, is
variable in quality and quantity of
education required to practice. No
license is required.









5. Nursing Home: a facility which provides
some level of nursing care. For purposes
of the study, nursing homes are those
which participate in the Medicare
(Title XVIII) and Medicaid (Title XIX)
programs.

6. Skilled Nursing Facility: refers to those
facilities which provide room, board,
laundry services, some assistance in
personal matters (dressing, feeding, and
ambulating), plus nursing services and
procedures which require training, skill,
and judgment above "those the untrained
person possesses" (Burger and Garvin,
1968).

7. Attitude: the beginning, or potential
initiation of some composite act or other;
a social act in which, along with other
individuals, the individual taking the
given attitude is involved or implicated
(Strauss, 1956).

8. Ascendancy: that personality trait in an
individual which reflects the ability to
be verbally ascendant, who adopts an active
role in the group, who is self-assured and
assertive in relationships with others,
and who tends to make independent decisions
(Gordon, 1963).

9. Responsibility: that personality trait in
an individual which reflects the capabi-
lity of sticking to any job assigned them,
who is persevering and determined, and
who can be relied on (Gordon, 1963).

10. Emotional Stability: that personality
trait in an individual which reflects
that they are well-balanced, emotionally
stable, and relatively free from
anxieties and nervous tension (Gordon,
1963).

11. Sociability: that personality trait in
an individual which reflects an interest
to be with and work with people and who is
gregarious and sociable (Gordon, 1963).

12. Satisfaction-Dissatisfaction Scale: a
self-rating scale used by subjects in
the study to classify their feelings







7

in working with the aged. Three categories
were used for the scale: (1) satisfying
(positive), (2) mixed (having both
positive and negative aspects), and
(3) dissatisfying (negative).

13. Stimulus-Group Validity: a variety of
construct validity. For the purposes
of the study the stereotype attitude
scores on the Tuckman-Lorge Attitude
Questionnaire show a positive correlation
to the age of the group to which the
statements are referred, i.e., to people
past the age of 70 (Axelrod and
Eisdorfer, 1961).

14. Experiences with the Aged: having lived
with, having been reared or cared for by,
or having been responsible for the care
of an aged person.


Limitations of the Study

1. The geographical areas used for the study,

Jacksonville and Tallahassee, Florida, essentially reflected

the more urban rather than rural attitudes toward the aged

and therefore do not provide comparative data which are

sometimes attributed to size of cities, towns, or communities.

At best, these data could only be applied to other cities

of similar size after refinement to fit those cases.

2. Some of the information obtained on the Biographical

Questionnaire was subjective. For example, a subject may

have reported that he lived with an aged grandmother at the

age of eight years but he may not be able to say that this

experience did or did not actually precipitate or inhibit

his selection of his current job of working with the aged.

It was assumed, by the investigator, that the subject's

self-report of this experience can be classified as positive,







8

mixed, or negative, and may have provided some explanation

for the current attitudes toward the aged.

3. A source of error identified was the effects of

history on the results of the study. Because of the current

inflationary situation in the United States, consideration

must be given when interpreting the data to the possibility

that subjects selected this type of agency to work in out

of financial need rather than as a preference for speciali-

zation in geriatrics.

4. The mood and/or degree of cooperativeness of the

administrative personnel at the time the study was conducted

must be considered. The data were collected between

November 23, 1975, and January 15, 1976, at a time when the

state of Florida was investigating many of the nursing homes

for violation of standards of care and medicare/medicaid

claims. As a result of this sensitiveness on the part of

nursing home administrators, it was difficult to determine

if any overt suggestions were given to subjects on how the

three instruments were to be answered prior to the actual

testing and to rule out the possibility of such pressure.

5. The study is primarily a descriptive survey. It is

not an experimental study. Accordingly, significance of the

results is associational in nature and is not predictive.

Any attempt to be predictive would be presumptive.


6. Nursing home nursing is only one of several kinds

of geriatric nursing contexts and the results of this







9

study are as much relative to such contextual differences

as to "history".


Conceptual Framework

Several theories were considered for use as a frame-

work for the study but were eliminated because of their

strong focus on nonrational behavior in man rather than

rational behavior. Sigmund Freud's psychoanalytic theory

focuses essentially on the development of rational behavior

in man being dependent upon success at various stages of

infancy and childhood. If an infant or child does not

progress satisfactorily to and through various phases, his

behavior is explained away in terms of fixation. Also, his

theory does not take into account the effect of society

upon behavior other than one's immediate family.

The interpersonal theory of Harry Stack Sullivan was

also considered as a framework for the study but eliminated.

Sullivan's theory introduces the idea that society has some

effect on an individual's behavior but this is not a strong

component in the theory. The emphasis, given by Sullivan

is more on explaining the one to one relationships of an

individual with another, rather than the more broad effect

that society might have on behavior.

Neither of the two theories described above gives an

adequate theoretical base for behavior. It is the belief of

the investigator that rational behavior cannot be totally

explained away by what successfully happens to one as an







10

infant or child. Neither can it be explained totally by the

interactions of one individual with another. As a result of

these beliefs, George Herbert Mead's concept of "social

behaviorism" was selected as the framework for the study

because it provides the basis for explaining an individual's

acts (behavior) as being part of the larger communal (society)

acts (Strauss, 1956).

Mead's concept of individual behavior, the Self, which

is composed of a symbolic transaction among the "I", "Me",

and "the Other", is retained in the idea that an individual

is an active agent rather than a passive recipient of ex-

ternal stimuli. His central thesis is that the Self is

controlled by the social environment and that man does not

become a self except via symbolic transaction with the en-

vironment (Strauss, 1956 and Mead, 1934).

In order to have social behavior, there must be human

communication. This communication must have a common

meaning to a group and to the individuals in that group.

Methods of communication are established within a group

and certain social conduct is then determined and controlled

by the group (Strauss, 1956).

The principle of social control is a strong component

in Mead's theory. The principle presupposes that an indivi-

dual assumes the same attitude toward himself that the

community of others assume toward him (Mead, 1934). It

also carried the connotation that a person takes a certain

attitude in each situation and issue (Strauss, 1956). As







11
these attitudes are translated into behavior, they solicit

certain responses from others which one then adjusts his

conduct to. There are many such series of responses in

the community where one lives and they become the "insti-

tutions" by which one governs his actions (Strauss, 1956).

Mead's theory of social behaviorism has application to

and for the present study. In relation to stereotype atti-

tudes, consideration will be given to identifying the group

or groups of people currently reflecting what the attitudes

are toward the aged within a selected group of nurses.















CHAPTER II
REVIEW OF LITERATURE

Introduction

The purposes of this chapter are to review pertinent

studies concerning attitudes of nurses toward the aged, to

identify variables which are related to these attitudes,

and to identify known personality traits found in different

specialization groups of nurses.

In the review of the literature, a large gap was dis-

covered in respect to data related to nurses working with

the aged in nursing homes. For the most part, the review

included in this chapter reflects data that only indirectly

are related to the study.

The chapter is divided into seven sections. The first

deals with old people, nursing homes, and nurses. The

second deals with geriatrics as a field of specialization.

The third deals with personality traits in nurse speciali-

zation groups. The fourth deals with variables related to

attitudes toward the aged. The fifth deals with attitudes

of other professions toward the aged. The sixth deals with

attitudes of nurse groups toward the aged. Section seven

concludes the chapter with a summary of the findings in the

review of the literature.







13

Old People, Nursing Homes, and Nurses

More than 20 million Americans are over 65 years of age

(U.S. Department of Commerce, Bureau of Census, 1973).

Currently, this age group represents ten percent of the

total population and is predicted to rise to fifteen percent

by 1980 (Leaf, 1973).

In the United States in the early sixties there were

approximately 29,000 nursing homes, and less than half, or

approximately 14,000 of these facilities offered any kind of

skilled nursing care under the direction of a registered

nurse or licensed practical nurse (Burger and Garvin, 1968).

According to a USPHS survey in 1964, the ratio of registered

nurses to residents in all nursing homes was 1 to 34. The

registered nurse group represented only six percent of the

total full-time employees who were performing nursing duties

in these facilities (USPHS, 1966). Schonfield (1973) esti-

mated that in 1969 there were well over 300,000 personnel

employed in work with the aged, of whom no more than 25

percent has received any formal training for doing so. These

figures give strong evidence to the claim that the majority

of care being given to the aged in nursing homes is being

given by nonprofessionals.

Today, the figures have not changed drastically. In

1975, a critical report on the nursing home industry was

issued by the U.S. Department of Health, Education, and

Welfare. Some of the findings were (1) there are more than

three times as many nursing homes (23,000) in the U.S. as







14

hospitals (6,630), and (2) of the 815,000 registered nurses

in the U.S., only 56,235 work in nursing homes (U.S. Dept.

of HEW, 1965).

Nursing homes in the United States are being closely

looked at by the American public. It appears that the

public is no longer willing to let nursing homes remain as

"human dumping grounds" for the unwanted elderly whose only

means of discharge is the death certificate, as Tivin (1971)

has so dramatically indicated.


Geriatrics as a Field of Specialization

Considerable research has been directed at determining

why people select nursing as an occupation per se, but little

has been done to explain their preferences for specialization

within the broad area. Delora and Moses (1969) used a

questionnaire to obtain data from all nursing students in one

school on their nursing specialty preferences. The most

positive interest was expressed for the obstetric and

pediatric areas; the least positive was for nursing in the

geriatric area. As to age, children and young adults were

rated as the most desired patients and those over sixty as

least desired. Further, the adjectives used to describe

geriatric nursing were lowest in plus attributes and highest

in negative attributes as indicated by choice of such words

as depressing, dull, and slow.

A three-year project directed by Brown (1967) con-

cerned with "An Exloration of Nurses' Attitudes Toward







15

Caring for the Aged" indicated that nursing personnel prefer

younger persons and younger patients to old people and old

patients. In her study Brown also found that a large per-

centage of the nursing personnel associated the idea of

age with the concept of a person with some degree of illness

requiring nursing care. The nursing personnel tested also

revealed that the concept of aged persons carried conno-

tations of dependency, inactivity, and isolation. The

results of the study strongly indicated the need for further

study to determine (1) what connotations nursing personnel

associate with the aged patients, and (2) what stereotypes

are held concerning the aged patient. The present study is

confined to identifying the current stereotype attitudes of

nurses currently working with the aged. There is no attempt

to determine the connotations that nursing personnel asso-

ciate with the aged.


Some Personality Characteristics
in Nurse Specialization Groups

Personality characteristics which vary among speciali-

zations groups in nursing have been partially identified.

Navran and Stauffacher (1957) found, when comparing psychi-

atric nurses with college women in general, that the

psychiatric nurses differ significantly on seven variables

of the Edwards Personal Preference Schedule. The nurses

scored higher on order, deference, endurance, and aggression

and lower in autonomy, affiliation, and exhibition. It was

clear to these researchers that psychiatric nurses give







16

greater emphasis than college women in general to orderliness,

respect for authority, persistence, and forthright speech,

while playing down unconventionality, exhibitionism, and

tendencies to form strong attachments.

As a follow-up to their first study, Navran and

Stauffacher (1958) then compared personality traits between

psychiatric and nonpsychiatric nurses (general medical and

surgical nurses) and found that the medical and surgical

nurses are much more work-oriented than people-oriented;

they are more impersonal, more timid, and less able to

direct or lead others.

Lentz and Michaels (1959, 1960) also examined basic

personality factors among three categories of nursing

personnel, i.e., medical, surgical, and psychiatric nurses.

The study supported the findings of Navran and Stauffacher

(1958) with respect to the "need for dominance." Psychi-

atric nurses proved to be higher in this need than either

medical or surgical nurses. Abasement was also found to be

statistically significant. Psychiatric nurses scored

significantly lower than college women in this quality and

the medical and surgical nurses were significantly higher

than psychiatric nurses. The surgical nurses had the highest

scores. The high scores in abasement by the surgical group

were interpreted to indicate that surgical nurses prefer the

security of action which would result from working under the

orders issued by aggressive men, the physicians.







17

Very little has been researched where the intent has

been to identify the personality traits of nurses desiring to

work with the aged or are currently working with them. The

only study reviewed which has concerned itself with this

aspect of geriatrics was done by Delora and Moses (1969) and

subjects in the study were student nurses. They found that

those students indicating the highest interest in the field

of geriatrics did so on a fulfillment orientation, having

general personality traits involving a strong commitment to

a vocation like that of a missionary. They also found that

they were relatively unsocial, did not seek adventure,

did not desire to advance in their field, were older indivi-

duals, and tended to have lower aptitude scores. The

present study will not attempt to verify the personality

traits identified by Delora and Moses but add to that body

of knowledge by testing for additional personality traits.


Variables Related to Attitudes
Toward the Aged

There are several variables which relate to a person's

attitude toward the aged. Although there is not consensus

among the results of the studies included in this section,

there does appear to be some agreement that the variables

identified in the review are worthy of continued research.

There is also some indication that the variable relationship

is not the same from group to group tested.

Age has been identified as one of the variables. In a

study by Kogan and Shelton (1962), older and younger samples







18

were compared with ambivalent results. The older subjects

ranged from 40-70 years of age and came from a population

consisting of people selected at random from the general

public. The younger subjects ranged from 19-35 years of

age and were college students. Neither the older nor the

younger sample could be said to have generally more negative

or positive attitudes toward the aged. Several other studies

found that the greater the age of the subjects, the greater

the decrease found in positiveness of their attitudes to-

ward the aged (Merrill and Gunter, 1969; Tuckman and Lorge,

1953; and Gillis, 1972). However, opposite results were

found by Brown (1967), Campbell (1971), and Wolk and Wolk

(1971) when they all reported that the older subjects

demonstrated more positiveness in their attitudes toward the

aged than did the younger subjects.

The second variable identified as having some relation-

ship to a person's attitude toward the aged was level of

education. A positive relationship between the level of

education and rejection of stereotyped statements by re-

gistered nurses was found by Campbell (1971) and Brown (1967).

This relationship was not confirmed later in a study by

Gillis (1972) of nursing home administrators. Gillis found

that the more education held by administrators, the more stereo-

typed were their attitudes toward the aged. Thorson,

Whatley, and Hancock (1974) found within the population of

high school and college students studied that subjects with

more years of education had more positive attitudes than did







19

subjects with fewer years of education. The group with

fewer than 12 years of education was more negative than

the college-educated group.

A third variable, type of nursing education, has been

identified as relating to nurses' attitudes toward the aged.

A second study by Gillis (1973) concerned itself with type

of nursing education. Her study found that degree and

diploma nurses were more positive in their attitudes toward

the aged than licensed practical nurses. With one exception

there appeared to be a distinctive pattern that the higher

level of education achieved by the different nursing per-

sonnel, the more positive they became in attitudes toward

the aged. But, based on cell means, in this particular

study, the registered nurses of baccalaureate programs were

less positive than the licensed practical nurses in their

attitudes. Possible explanations for the results, according

to Gillis, were that (1) the baccalaureate curriculum did

not include geriatric nursing theory or clinical experience

with aged patients, (2) the baccalaureate nurses interpreted

their roles according to their individual personalities, and

(3) the interpretations of their roles as baccalaureate

graduates did not include care of the aged.

A fourth variable, length of time, also may relate to

a person's attitude toward the aged. Length of time has

been interpreted differently in each of three studies re-

viewed. Time was defined as (1) number of years spent

working with the aged, (2) studying gerontology which







20

included the elements of time and exposure to the subject,

and (3) amount of direct contact in working with the aged.

None of these definitions actually address the qualitative

sense of time, i.e., good, bad, or indifferent but appear

more confined to the quantitative sense of time. Gillis

(1972) found that as the length of time working with the

aged increased, positiveness in attitudes decreased. Gunter

(1971) found that time, interpreted as time spent in studying

gerontology, also decreased positiveness in attitudes.

Gunter's study is significant in that it points out the idea

that simply exposing students to time spent in studying

gerontology will not necessarily increase their positiveness

toward the aged. A study by Tuckman and Lorge (1958) is

similar to the study by Gillis and they found when length of

time was interpreted as the amount of time spent in working

with the aged, positiveness in attitudes toward the aged

increased with the increased time spent in direct contact.

Race and social status have been tested for relation-

ship to persons' attitudes toward the aged but not to the

degree that the previous four variables have been. Race,

the fifth variable, may relate to attitudes toward the aged.

Wylie (1971) indicated that the attitudes of blacks in

America are strikingly different from those of whites.

For example, Wylie identified two areas of difference

(1) blacks include the aged in the family structure more so

than whites, and (2) blacks accept old age and look forward

to the rewards of advanced years. Wylie's study is based on







21

a historical perspective and does not include statistics to

support his statements. When testing attitudes of blacks

and whites in an Atlanta, Georgia area, Thorson (1975) found

no significant difference in attitudes toward the aged.

The sixth variable, social status, has received little

attention by researchers when dealing with attitudes toward

the aged. Thorson (1975), along with finding no signifi-

cant difference attributable to race, also found no

difference which was attributable to social status. However,

it should be noted that in Thorson's study only low and

middle income groups were tested. His study does not deal

with high income groups. Therefore, the data do not span

all social classes.


Attitudes of Other Geriatrically
Pertinent Professions Toward the Aged

The studies included in this portion of the review were

selected because they represent attitudes held by pro-

fessional groups other than nursing. These groups are often

called upon to perform services for the aged. Therefore,

their attitudes may be significant, especially when one con-

siders that reinforcement of attitudes often comes from

groups encountered in one's daily activities. Nurses are

no exception to this phenomena. Because of this phenomena,

it is possible to hypothesize that the attitudes held by

nurses toward the aged do not originate with them but may

be the result of association with other professional groups.







22

Mead's theory of social behavior, as discussed in Chapter I,

lends support to this possibility.

Gunter (1971) reports that the majority of people who

are preparing for health careers are young: they are ex-

pected to be able to reverse roles dramatically, often

prematurely, and expected to provide emotional support and

care for the old. In the normal course of life, a child is

not expected to assume responsibility for his parents until

he has reared a family and reached middle age himself.

However, because of the selection of a health career, a

student may be confronted early with this responsibility in

relation to his first encounter with a patient or client.

One of the first studies was initiated by Wilensky and

Barmark (1966) where their objective was to assess the

extent of the problem faced by educators in stimulating

young doctoral students in clinical psychology in working

with the aged. The findings showed that, generally, the

subjects preferred to avoid working with the aged. When

surveying psychiatrists, Cyrus-Lutz and Gaitz (1972) found

that younger psychiatrists expressed a willingness or pre-

ference for working with older patients more frequently than

did older psychiatrists. Both of these studies reflect very

different findings. The two studies demonstrate how similar

age groups in different psychological professions vary in

their attitudes toward the aged.

A study by Farrar and Bloom (1967) revealed three im-

portant findings about social work students: (1) at the







23

time the student began his field placement, he agreed with

nearly 40 percent of the stereotypes about the aged, (2) at

the end of their field placement nearly one-third of the

students for whom data were available had higher stereotype

scores than at the beginning, and (3) when the student's

level of stereotyping was relatively high, intensive

contact with the aged did not significantly reduce the

stereotypes. Although the study by Farrar and Bloom deals

specifically with social work students, the results support

the findings of a similar study done by Gunter (1971) with

nursing students.

Spence (1968) surveyed medical students' preferences

for specialization and found that geriatric medicine ranked

below surgery, pediatrics, obstetrics, psychiatry, and

opthalmology. He also revealed that these students per-

ceived the aged as more emotionally ill, disagreeable,

inactive, independent, dull, socially withdrawn, and dis-

ruptive of family harmony than youths or adults.

In surveying the research done with geriatrically

involved other professions, it becomes clear that nurses

do not remain the only professional group generally more

negative than positive toward the aged. The groups included

in this portion of the review are all considered professional

and do encounter the aged in the performance of their duties.

If the attitudes toward the aged are generally negative

among students within a profession, it should not be too







24

surprising to find this also apparent among the practitioners

after they have completed their education.


Attitudes of Nurse Groups
Toward the Aged

Even though abundant information concerned with the

psychological, sociological, and physiological aspects of

aging is available, research studies examining the relation-

ship between the aged patient and the nurse, and the

attitudes of nursing personnel toward the aged have been

limited. In the past few years nursing homes have made im-

provements in the level of care, yet, the elderly patients

continue to receive poor quality care which is not indivi-

dualized (Campbell, 1971). Gillis (1973) has hypothesized

that the attitudes of nursing personnel toward the aged

could be used in some explanation for the inadequate and

depersonalized care being experienced by the elderly.

The few studies that have measured attitudes toward

the aged, especially attitudes of nursing personnel,

generally agree in the findings. One of the earliest

studies, a pilot study, conducted by Coe (1967) was con-

cerned with how nurses perceived the aged patient's

adjustment to the institutional routine. In several respects,

nurses expressed views similar to physical therapists.

Nurses indicated a belief that aged patients were slow, and

that it was sometimes hard to deal and to communicate with

them. They also indicated annoyances associated with

treating the aged because of their complaining, demanding,







25

incontinence, and inability to feed themselves. Thus, for

nurses, there was apparently a general negative attitude

toward providing care for the aged patient.

Campbell (1971) also found that registered nurses least

preferred working with the aged. Campbell conducted a study

in two teaching institutions in North Carolina in which she

found that no one of the categories of nursing personnel

(registered nurses, licensed practical nurses, and nursing

assistants) demonstrated a lack of stereotyped attitudes

toward the aged. In fact, on the average, registered nurses

agreed with half of the statements while the licensed

practical nurses and nursing assistants agreed with more

than 60 percent of the statements. Working with adults was

preferred over children in all three groups. The licensed

practical nurses and the nursing assistants preferred

working with old people more than registered nurses.

Nelson (1973) reports on a study conducted by Felicity

Stockwell where she screened 388 patients and 87 nurses in

12 different London hospitals to find if nursing care

differed between "most liked" and "least liked" patients.

Stockwell found that patients the nurses liked most were

those with four main qualities: (1) they knew their nurse's

name, (2) were able to communicate readily with the nurses,

(3) were able to joke and laugh with nurses, and (4) cooper-

ated in being helped to get well and expressed determination

to do so. In addition, nurses reported that bed patients

made more overt complaints than ambulatory ones. Practically







26

all the patients whom the nurses stated they did not enjoy

caring for because they grumbled and complained were con-

finded to bed. Stockwell went further to report that after

conducting this survey, it was evident that aged patients

were the most likely patients to fit the characteristics

which nurses "least liked" and were more likely to receive

negative response from nurses in the study. Negative re-

sponses of nurses were reflected by (1) the amount of time

taken to answer the lights or call buttons of patients,

(2) the number of hypodermic injections nurses were willing

to give patients for the relief of pain, and (3) the

amount of time nurses spent in verbal communication with

patients.

Only one study was reviewed that indicated the more

stereotyped the attitudes held toward the aged, the more

likely the subjects were to select work in a nursing home.

Kayser and Minnigerode (1975) used the Tuckman-Lorge Attitude

Questionnaire with 311 baccalaureate nursing students and

found such results. Kayser and Minnigerode interpreted

their findings to indicate that students' own negative

attitudes may act as an impetus to cause them to want to

work with the aged, possibly in an attempt to support what

they suspect about the aged and aging process. In addition,

the study also showed that students who have previously

worked in convalescent hospitals and nursing homes reported

that the experiences were satisfying but that they generally

preferred not to continue working in institutions for the







27

aged. This aspect of the study indicated to the researchers

that once actual experience of working with the aged had

occurred, some degree of support for the student's negative

attitudes took place and strengthened the desire not to

return to that kind of work environment.


Summary

The purpose of this review of literature was to learn

the major research findings related to attitudes toward

the aged, variables related to these attitudes, and

personality traits attributed to specific nurse specialization

groups. The following summary identifies the main points

brought out by the review which relate to the present study.

There are no conclusive data to adequately demonstrate

that stereotype attitudes of nurses and other professionals

toward the aged are a major cause in preventing individuals

from entering the field of geriatrics. Studies indicate

that attitudes of most professionals entering the field are

generally more negative than positive and yet, they continue

to work with the aged. The most that can be said regarding

attitudes toward the aged is that they may be only one of

several contributing causes for the small number of nurses

entering the field of geriatrics.

Research testing of variables related to attitudes to-

ward the aged such as age, race, education, and social

status is not conclusive when comparing various groups of

health care professionals. Nursing, for example, which has

at least three major groupings (registered nurses, licensed







28

practical nurses, and nursing assistants) reflects a

degree of variation and inconsistency in attitudes toward

the aged.

The methods by which stereotype attitudes toward the

aged are obtained and/or transmitted to professionals is not

clearly understood. There appears to be a tendency for the

negative attitudes found in student groups to remain un-

changed after becoming practitioners. The reasons for this

have not been adequately identified, other than the recog-

nition that this situation exists.

Identification of personality traits in nurses

currently working with the aged is essentially an unex-

plored field of study. There are no reports of research

reviewed which have dealt with this needed area of study.

The trend has been to use personality testing with student

nurses and generally as criteria for admission to schools

of nursing. No evidence has been found in the literature

where personality testing has been used as a screening

mechanism for entrance into the field of geriatrics.

As a result of the statement of the problem in Chapter I

and the present review of the literature, the need for

further study and research in the area of nursing and the

aged has been validated. The following chapter describes

the methodology used for the study.















CHAPTER III
METHODOLOGY

Sample

The population studied was from the metropolitan areas

of Tallahassee and Jacksonville, Florida. The sample con-

sisted of seven nursing homes which met the criteria of the

study, i.e., classified as a skilled nursing care facility.

A list of approved institutions having such classifications

was obtained from the Florida Nursing Home Association with

headquarters in Jacksonville, Florida.

Four institutions in the Tallahassee area met the

criteria and three were included in the study. They were

Extended Care of Tallahassee

Goodwood Nursing Center

Miracle Hills Convalescent and Nursing Home

Ten institutions in the Jacksonville area met the criteria

and four were included in the study. They were

Riverside Nursing Home, Inc.

Cheshire's Southside Nursing Home

Hyde Park Nursing Home

Jacksonville Convalescent Center

Four of the institutions in the Jacksonville area elected

not to participate in the study and two institutions were

involved with state accreditation reviews at the time the







30

study was conducted and refused to participate. The seven

institutions included in the study represented one half

(50%) of the total institutions in the two geographical

areas which met the criteria for the study.

The study is descriptive and not experimental. Random

sampling of the institutions used in the study and subjects

within the institutions was not done. Because of the

sensitivity of nursing homes to investigation of any kind,

at the time the study was done, it was not possible to obtain

total participation of all agencies which met the criteria.

Therefore, institutional participation was on the obtained

permission basis and subject participation within each of the

institutions was voluntary. The only institution randomly

selected was done so in order to do a pilot study which will

be described later in the chapter.

The information presented in Tables I-VII represents

data regarding the sample in the study. Table I presents

the institutions in order of participation in the study,

the number of subjects participating from each of the three

groups of nurses tested, and the percent of subject parti-

cipation from the total population available in each

institution. The total number of subjects was 110 and

represented 52.38 percent of the 210 subjects available in

the seven institutions.









TABLE I
INSTITUTIONS, NUMBER OF SUBJECTS PER
INSTITUTION IN THREE GROUPS TESTED
AND PERCENT OF SUBJECTS PARTICIPATING
PER INSTITUTION
Licensed
Registered Practical Nursing % From Each
Institution Nurse Nurse Assistants Institution

Extended Care
of Tallahassee 7 5 11 56.09%

Goodwood Nsg.
Center 5 6 8 61.29%

Miracle Hills
Convalescent 4 5 10 65.51%

Riverside Nsg.
Home, Inc. 5 4 4 50.29%

Cheshire's
Nsg. Home 3 3 4 39.50%

Hyde Park
Nsg. Home 3 4 5 44.00%

Jacksonville
Convalenscent 3 3 8 50.00%

TOTAL (N=ll0) 30 30 50 52.38%

Table II presents the number, age range, and mean age

of the three groups tested.

TABLE II
NUMBER, AGE RANGE AND MEAN AGE
OF THREE GROUPS TESTED

Personnel Number Age Range Mean Age

Registered Nurse 30 22-67 41.03 yrs.

Licensed Practical
Nurse 30 21-67 41.73 yrs.

Nursing Assistant 50 19-69 39.30 yrs.

TOTAL (N=110) 110 19-69 40.69 yrs.









Table III below presents the racial composition of

subjects in the three groups tested.

TABLE III
RACE OF SUBJECTS IN THREE GROUPS TESTED

Personnel Whites Blacks

Registered Nurse 28 2
(N=30)

Licensed Practical Nurse 18 12
(N=30)

Nursing Assistant 13 37
(N=50)

TOTAL 59 51

Table IV presents the sex of subjects in the three

groups tested.

TABLE IV
SEX OF SUBJECTS IN THREE GROUPS TESTED

Personnel Female Male

Registered Nurse 30 0
(N=30)

Licensed Practical Nurse 29 1
(N=30)

Nursing Assistant 42 8
(N=50)

TOTAL 101 9

Table V presents the religious preferences of subjects

in the three groups tested.

TABLE V
RELIGIOUS PREFERENCES OF SUBJECTS
IN THREE GROUPS TESTED

Personnel Protestant Catholic Jew

Registered Nurse 19 9 2
(N=30)
(table continued)







33

Personnel Protestant Catholic Jew

Licensed Practical Nurse 22 8 0
(N=30)

Nursing Assistant 47 3 0
(N=50)

TOTAL 88 20 2

Table VI presents the educational levels completed by

subjects in the three groups tested. Five educational levels

were used: (1) sixth grade or below, (2) junior high school,

(3) high school, (4) junior college, and (5) university. Two

subjects had a sixth grade education or less, 14 completed

junior high school, 66 completed high school, 11 completed

junior college, and 17 completed the university.

TABLE VI
TERMINAL EDUCATION LEVELS OF SUBJECTS
IN THREE GROUPS TESTED
Educational Level
Completed REG. NURSE LPN NA Total

6th Grade or Below 0 0 2 2

Junior High School 0 0 14 14

High School 14 25 27 66

Junior College 4 3 4 11

University 12 2 3 17

TOTAL 30 30 50 110

Table VII presents the number and type of nursing

educational programs of registered nurse subjects tested in

the study.







34

TABLE VII
NUMBER AND TYPE OF EDUCATIONAL PROGRAMS
COMPLETED BY REGISTERED NURSE
SUBJECTS TESTED IN THE STUDY


Type of Education Number

Diploma Program 19

Associate Degree Program 2

Baccalaureate Program 9

TOTAL 30


Instrumentation

To test the hypotheses posed in the study, three in-

struments were used: (1) the Gordon Personal Profile,

(2) the Tuckman-Lorge Attitude Questionnaire, and (3) a

Biographical Questionnaire developed by the investigator

for the study.


Gordon Personal Profile (GPP)

The Gordon Personal Profile was selected for use in the

study because it provided an obtained measure of four as-

pects of personality which are significant in the daily

functioning of normal persons, namely: ascendancy, responsi-

bility, emotional stability, and sociability. The GPP was

also selected because it utilizes a forced-choice technique

which does not allow the respondent to answer favorably to

all items, as may be done in the conventional self-report

inventories; thus, it is less susceptible to distortion by

individuals who are motivated to make a good impression

(Gordon, 1963, p. 3). The GPP also had an advantage over

other instruments considered. It can be completed in seven







35

to fifteen minutes, a distinct convenience to the study, as

the testing of subjects took place in the institution during

working hours.

The Gordon Personal Profile consists of eighteen sets

of four descriptive phrases, each such set being known as

a tetrad. Each of the four personality traits is repre-

sented by one of the descriptive phrases in each tetrad. Of

four, two phrases are of similar high average perference

values; that is, are considered by typical individuals

to be equally complimentary, and two are of similar low

average preference values, equally uncomplimentary (Gordon,

1963, p. 3). In each of the eighteen sets the respondent

is asked to mark one item as being "most" like himself and

one as being "least" like himself. The eighteen items on

which the measurement of each trait is based constitute the

scale for that trait. The four scales are separately

scored, with each item marked "MOST" contributing two

points, each unmarked item one point, and each item marked

"LEAST" no points. With this scoring system, the maximum

possible points or score on each trait is 36. If desired,

the raw score made on each of the four traits may then be

converted to appropriate percentile-rank equivalents

(Gordon, 1963, p. 4).

Norms for the GPP have been established for various

occupational groups, high school and college groups, and

specific industrial and business groups. Standardization of

the instrument was based on data from more than 5,000 subjects







36

of varied regions and populations in the United States

(Gordon, 1963, p. 13).

Reliability coefficients of the GPP, as found for four

different groups, a population of 512, ranged from .74 to

.88 using the Split-Half reliability, the Kuder-Richardson

Case III, and test-retest at one week and three month in-

tervals (Gordon, 1963, p. 21). Correlations with other

personality measures appears to be quite reasonable. For

example, the Profiles Ascendancy score is significantly

related to the Leadership value in Gordon's Survey of Inter-

personal Values (r=.39), to the need for Dominance as

measured by the Edwards' Personal Preference Schedule

(r=.55), and to the Poise, Ascendancy, and Self-Assurance

cluster of the California Psychological Inventory (r=.69)

(Gordon, 1963, p. 24). (See Appendix A for descriptive

statements contained in the Gordon Personal Profile.)


Tuckman-Lorge Attitude Questionnaire (TLAQ)

The Tuckman-Lorge Attitude Questionnaire is an objec-

tive questionnaire which measures attitudes toward the aged

in terms of stereotypes. Attitudes toward the aged have

been examined with the use of a number of instruments. The

stereotype scale developed by Tuckman-Lorge in 1953 seems

to be one of the more popular questionnaires and has been

used in a variety of studies (Campbell, 1971; Eisdorfer,

1966; Axelrod and Eisdorfer, 1961).

The TLAQ was selected because of the wide range of

stereotype attitudes it is capable of measuring. Only one







37

other instrument was seriously considered for use, the

Kogan's Attitude Toward Old People Scale (Kogan, 1961), and

it was found unacceptable by the investigator because the

major focus appeared to be social stereotyping and included

very little on physiological stereotyping. The TLAQ incor-

porates both of these components and best met the purpose of

the study.

Tuckman and Lorge obtained the material for the

questionnaire by (1) a review of the literature, (2) semi-

structured interviews with adults ranging from 21 to 65

years of age, (3) reading case records of older clients

under the care of a family agency or an institution for the

aged, and (4) discussions with social workers and directors

of institutions for the aged. The questionnaire consists

of 137 statements which were classified independently

by each author and then classified into the following:

physical characteristics (27), conservatism (14), activities

and interest (9), financial (6), family (13), personality

traits (14), attitude toward the future (5), best time of

life (5), insecurity (20), mental deterioration (14), sex

(4), interference (3), and cleanliness (3) (Tuckman and

Lorge, 1953, pp. 249-250).

All statements on the questionnaire are stereotypes

about the aged. The mean score, the number of "yes"

responses, indicates the amount of agreement with a state-

ment and thus allows for measuring the degree of

stereotyping about the aged by a given group. The statements







38

are not grouped together in the questionnaire. They are

distributed throughout the questionnaire.

Axelrod and Eisdorfer (1961) designed a study to test

the stimulus-group validity of the Tuckman-Lorge Attitude

Questionnaire and found that 96 of the 137 items were

significant at the .01 level in terms of their pertinence

to old people, age 70 or older. Consequently, in view of

their findings, they recommended that although the TLAQ

should be administered in its entirety, only the 96 items

significant at the .01 level in discriminating between age

groups should be analyzed. This study followed the

recommendation of Axelrod and Eisdorfer and administered

the entire questionnaire but analyzed only the 96 valid

items. (See Appendix B for items in Tuckman-Lorge

Attitude Questionnaire.)


Biographical Questionnaire BQ

The Biographical Questionnaire used in the study was

developed by the investigator to complement the Gordon

Personal Profile and the Tuckman-Lorge Attitude

Questionnaire. The purpose of the questionnaire was to

obtain information about the subjects which was not available

from either of the other two instruments. Additional infor-

mation obtained was as follows: (1) religious preference,

(2) educational level completed, (3) basic type of nursing

program completed, (4) preference for a field of speciali-

zation, (5) preference for working with various age groups,

(6) shift usually worked, (7) length of time in nursing and







39

current institution, (8) satisfaction or dissatisfaction

with working with the aged, (9) amount of time spent in

giving direct care to patients, (10) previous living ex-

periences with the aged and their effect on the person,

(11) current relationships with the aged, and (12) reason

for selecting the current place of employment. (See

Appendix C for items contained in the Biographical

Questionnaire.)


Pilot Administration

Prior to the study a pilot study was conducted to

determine the ability of nurses to follow the directions

and comprehend the intent of the items on the Biographical

Questionnaire. The nursing home selected for the pilot

study was located in Tallahassee, Florida. Although this

agency met the criteria for the study, it had been randomly

selected only for use in the pilot study. Fifteen nurses

representing all three groups (registered nurses, licensed

practical nurses, and nursing assistants) were administered

the instrument in one session.

Following the completion of the Biographical Question-

naire, each subject was interviewed. This gave the

investigator an opportunity to clarify and alter items that

were not clearly understood by the subjects.


Design of the Study

Six variables were controlled in the study.







40

1. Only agencies defined as skilled nursing care

facilities were utilized in the study. It was felt that

there would be more consistency among these types of

facilities because of their structure and method of

functioning. Also, there was a greater likelihood that the

facilities would have the subjects representing all three

types of nursing personnel being concerned with in the

study.

2. Only agencies where 75 percent or more of the

patient populations were 70 years of age or older were uti-

lized. It was felt that in order to obtain an accurate

profile of the attitudes of personnel toward the aged, the

agency had to have a population consisting essentially of

the aged.

3. Subjects who participated in the study had to have

been employed in the agency for a minimum of two years or

have had an equivalent amount of time in a similar agency.

It was felt that individuals who are relatively new to a

specialized agency will tend to be more positive in their

initial responses regarding that agency and the population.

Since experiences with the aged and amount of time spent in

caring for them were two of the variables being tested in

the study, a subject's time-in-the-agency was controlled.

4. Subjects who participated in the study had to be

proficient in the skills of reading and writing. The

instruments utilized in the study required the use of both

activities. The conducting of oral tests by the investigator







41

could have yielded data reflecting errors attributed to

testing effects.

5. Administering the instruments to subjects was

confined to week days rather than weekends in order to test

as many nursing personnel as possible. Staffing patterns in

nursing homes on weekends is usually decreased and there is

also a higher degree of utilization of part-time employees,

both being situations which would affect the number and

type of subjects tested.

6. Administering the instruments to subjects would

take place within the walls of the agencies. This would

tend to get a higher participation by subjects as compared

to a mail-in questionnaire approach. Also, one of the

instruments, the Gordon Personal Profile, is best admin-

istered in a controlled environment because of test security

purposes.

Collection of Data

Three instruments, the Gordon Personal Profile, the

Tuckman-Lorge Attitude Questionnaire, and a Biographical

Questionnaire developed for the study, were administered to

three types of nursing personnel in nursing homes. The

data were collected between November, 1975 and January, 1976

in Tallahassee and Jacksonville, Florida.

On the date of testing, approximately half of the

subjects entered the designated testing room, as space

for testing did not allow all subjects to be tested at one

time, and it was not possible to relieve all personnel from







42

their work responsibilities at the same time. Instructions

were given to subjects and included (1) the general purpose

of the study, (2) the guidelines for completing each of the

three instruments, (3) the assurance of anonymity by parti-

cipating in the study, and (4) obtaining assurance from

subjects that discussion of the instruments with other

personnel, not yet tested, would be respected. In addition

to the above instructions, any and all questions were

answered regarding the instruments. After administering the

instruments to the first group, the procedure was repeated

for the second group.

The number of sessions held in each agency was five:

two for the 7:00 a.m. to 3:00 p.m. shift, two for the

3:00 p.m. to 11:00 p.m. shift, and one for the 11:00 p.m.

to 7:00 a.m. shift. The 11:00 p.m. to 7:00 a.m. shift had

fewer employees and all were tested in one session.

The instruments were administered in the following

order: (1) the Biographical Questionnaire, (2) the Gordon

Personal Profile, and (3) the Tuckman-Lorge Attitude

Questionnaire. The sequence of administering the instru-

ments was based on the amount of time for completion of

each. Time needed for each instrument was (1) ten

minutes for the Biographical Questionnaire, (2) fifteen

minutes for the Gordon Personal Profile, and (3) twenty

minutes for the Tuckman-Lorge Attitude Questionnaire. In

addition, approximately ten minutes was needed for







43

instructions and questions. Each testing session took

approximately forty-five minutes.

The instruments used for the study were administered

to 110 subjects in seven institutions. The sample consisted

of subjects from each of the three groups tested and were

30 registered nurses, 30 licensed practical nurses, and 50

nursing assistants.


Hypotheses

Data from the study were subjected to both parametric

and nonparametric techniques for analysis. All data were

analyzed using the Cyber 73 computer, Controlled Data

Corporation, at Florida State University. The Statistical

Package for the Social Sciences, SPSS series, developed at

the University of Chicago was used in analyzing the data

(Nie, 1975). The study tested the following null hypotheses

through Pearson product-moment correlations, t-tests,

analysis of variance, and chi squares. All null hypotheses

were tested at the .05 level of confidence.

Hol There will be no statistically significant
difference among three types of nurses in
their mean scores on four personality traits
as measured by the Gordon Personal Profile.

Ho2 There will be no statistically significant
difference among the number of subjects in
three types of nurses scoring "above
average" and "average and below" on each of
the four personality traits of the Gordon
Personal Profile, when the 34-66 percentile
is used as the range for "average".

Ho3 There will be no statistically significant
relationship between the mean scores on
each of the four personality traits of the









Gordon Personal Profile and the number of
"yes" responses on the Tuckman-Lorge
Attitude Questionnaire.

Ho4 There will be no statistically significant
difference in the number of subjects
having lived with the aged and who prefer
geriatrics as an area of specialization
and those having lived with the aged and
who prefer any one of seven other areas of
specialization.

Ho5 There will be no statistically significant
relationship between age of nurses and
their preference for geriatrics as an area
of specialization.

Ho6 There will be no statistically significant
relationship between age in three types of
nurses and choice of age of patients to
work with.

Ho7 There will be no statistically significant
difference between the number of "yes"
responses on the Tuckman-Lorge Attitude
Questionnaire by race, sex, or religion.

Hog There will be no statistically significant
difference between the number of "yes"
responses on the Tuckman-Lorge Attitude
Questionnaire of registered nurses from
degree and nondegree educational programs

Hog There will be no statistically significant
difference between the "yes" responses
on the Tuckman-Lorge Attitude Questionnaire
by satisfaction or dissatisfaction in working
with the aged in three types of nurses.

Hol0 There will be no statistically significant
difference in the mean "yes" responses
on the Tuckman-Lorge Attitude Questionnaire
of registered nurses and licensed practical
nurses by percent of time estimated in
working with the aged.

Holl There will be no statistically significant
difference in the mean "yes" responses
on the Tuckman-Lorge Attitude Questionnaire
by older nurses (45-69 yrs.) and younger
nurses (19-44 yrs.).







45

Ho12 There will be no statistically significant
relationship between the number of "yes"
responses on the Tuckman-Lorge Attitude
Questionnaire of nurses and the number
of years worked with the aged.


Data Analysis

Hypotheses 1, 9, 10, 11

Hypotheses 1, 9, 10, 11 will be tested through analysis

of variance. The analysis of variance is a method for

dividing the variation observed in data into parts, each

part assignable to a known source, cause, or factor. In its

simplest form the analysis of variance is used to test the

significance of the difference between the means of dif-

ferent samples (Ferguson, 1971).

In hypothesis 1 the mean scores of each of four perso-

nality traits will be tested for significant difference

among three types of nurses.

In hypothesis 9 the satisfaction (positive) and dis-

satisfaction (mixed and negative) rating on the Biographical

Questionnaire will be tested for significant difference in

the number of "yes" responses on the Tuckman-Lorge Attitude

Questionnaire among three types of nurses.

In hypothesis 10 the number of "yes" responses on the

Tuckman-Lorge Attitude Questionnaire will be tested for

significant difference in the percent of time estimated in

giving care to the aged by registered nurses and licensed

practical nurses.







46

In hypothesis 11 the number of "yes" responses on

the Tuckman-Lorge Attitude Questionnaire will be tested for

significant difference between young and older nurses.


Hypotheses 2, 4, 5, 6

Hypotheses 2, 4, 5 and 6 will be tested using chi

square. Chi square is defined by Ferguson (1971) as a com-

parison of observed with theoretical frequencies. If there

are significant differences between the observed and

theoretical frequencies, this constitutes evidence for the

rejection of the null hypothesis.

A frequent application of chi square occurs when the

data are comprised of paired observations in two nominal

variables. With the use of chi square it is possible to

determine if the variables are independent of each other or

associated. Chi square provides a measure of the discre-

pancy between the observed cell frequencies and those

expected on the basis of independence. If the value of

chi square is considered significant at some accepted level

of confidence, we reject the null hypothesis that no

difference exists between the observed and expected values

We then accept the alternative hypothesis that the two

variables are associated.

In hypothesis 2 for each of the three types of nurses,

the number of scores "above average" will be related to the

number of scores "average and below".

In hypothesis 4 the number of subjects having lived

with the aged and who prefer geriatrics as an area of







47

specialization will be compared with those having lived with

the aged but who prefer any one of the seven other areas of

specialization.

In hypothesis 5 age of nurses will be related to their

preference of geriatrics as an area of specialization.

In hypothesis 6 age of nurses will be related to their

preference for working with patients of different age

groupings.


Hypotheses 3, 12

Hypotheses 3 and 12 will be tested in terms of a corre-

lation coefficient. According to Ferguson (1971) a

correlation coefficient expresses the degree of corre-

spondence or relationship between two sets of scores. The

most common procedure used to compute correlation coeffic-

ients is the Pearson product-moment correlation coefficient.

This model, designed to test linear data, takes into

account the individual's position in the group and the

amount of his deviation above and below the group mean.

In hypothesis 3 the scores on each of the four per-

sonality traits of the Gordon Personal Profile will be

correlated with the number of "yes" responses on the Tuckman-

Lorge Attitude Questionnaire.

In hypothesis 12 the number of "yes" responses on the

Tuckman-Lorge Attitude Questionnaire will be correlated with

the number of years subjects have worked with the aged.









Hypotheses 7, 8

Hypotheses 7 and 8 will be tested using the t test of

significance for a difference between two means (Edwards,

1972).

In hypothesis 7 the means of "yes" responses on the

Tuckman-Lorge Attitude Questionnaire will be tested for

difference attributable to race, sex, or religion.

In hypothesis 8 the means of "yes" responses on the

Tuckman-Lorge Attitude Questionnaire will be tested for

difference attributable to type of educational (degree

granting and nondegree granting) programs of registered

nurses.















CHAPTER IV
PRESENTATION AND ANALYSIS OF DATA


This chapter is presented in two sections. Section I,

analysis for statistical significance, presents the analysis

of the twelve null hypotheses which were tested statistically.

Section II, simple percentage comparisons, presents data re-

lated to the twelve null hypotheses but which could not be

included in the analysis because a sufficient number of

cases was not always available. Although the data in

Section II are not tested for significance, it is felt that

they reflect additional information relating to the hypotheses

and the sample of the study.


SECTION I
Analysis for Statistical Significance

Twelve null hypotheses were tested in the study. This

chapter presents the data and an analysis of each hypothesis.

Parametric and nonparametric tests were used and consisted of

analysis of variance, chi square, Pearson product-moment

correlation, and t test. All null hypotheses were tested

at the .05 level of confidence.


Hypothesis I

Hypothesis I states that there will be no statistically

significant difference among the three types of nurses in







50

their mean scores on four personality traits as measured by

the Gordon Personal Profile. Analysis of variance for each

of the four personality traits by type of nurse was used to

test the hypothesis. Table VIII presents the results of the

testing.

TABLE VIII
ANALYSIS OF VARIANCE FOR FOUR PERSONALITY
TRAITS BY TYPE OF NURSE

SOURCE SS d.f. MS F-value Sig.

ASCENDANCY

Between

Type Nurse 34.631 2 17.315 .989 .999

Total 1908.691 109 17.511

RESPONSIBILITY

Between

Type Nurse 137.000 2 68.500 3.068* .049

Total 2525.900 109 23.173

EMOTIONAL STABILITY

Between

Type Nurse 17.630 2 8.815 .388 .999

Total 2449.673 109 22.474

SOCIABILITY

Between

Type Nurse 3.810 2 1.090 .102 .999

Total 2004.591 109 18.391
*Significant at .05 level of confidence


The analysis of variance on Ascendancy by type of nurse

yielded an F value of .989. This F value is not significant.







51

Therefore, the hypothesis is not rejected. The F value

yielded on Emotional Stability is .388 and is not signifi-

cant. Therefore, the hypothesis is not rejected. The F

value yielded on Sociability is .102 and is not significant.

Therefore, the hypothesis is not rejected.

The analysis of variance on Responsibility by type of

nurse yielded an F value of 3.068. The F value is signifi-

cant at the .05 level of confidence. Therefore, the

hypothesis is rejected. A Scheffe Test for Multiple

Comparisons (Glass and Stanley, 1970) was used to determine

the specific location of the difference in total mean score

on responsibility among the three types of nurses. The total

mean score for each type of nurse was (1) 29.70 for

registered nurses, (2) 26,97 for licensed practical nurses,

and (3) 27.39 for nursing assistants. The Scheffe test

revealed that no significant total mean score difference

occurred between any one pair of nurse types.


Hypothesis II

Hypothesis II states that there will be no statistically

significant difference among the number of subjects in

three types of nurses scoring "above average" and "average

and below" on each of the four personality traits of the

Gordon Personal Profile, when the 34-66 percentile is used

as the range for "average". Chi square was used for each

of the three types of nurses to test the hypothesis. Table

IX presents the results of the testing for the registered

nurse group.







52

TABLE IX
CHI SQUARE AND FREQUENCY DISTRIBUTION OF
REGISTERED NURSES SCORING "ABOVE AVERAGE" AND
"AVERAGE AND BELOW" ON FOUR PERSONALITY TRAITS
Scored Above Average Scored Average and
an Personality Trait Below on Person-
ality Trait
Personality Trait fo fe fo fe

ASCENDANCY 12 17 18 13

RESPONSIBILITY 29 17 1 13

EMOTIONAL
STABILITY 20 17 10 13

SOCIABILITY 7 17 23 13
Chi square=37.738, 3 d.f.
p=.0000, significant


Results obtained for the registered nurse group were

tested using chi square statistic with .05 level of confi-

dence and 3 degrees of freedom. The chi square value for

the registered nurse group tested is 37.738. A chi square

this size or larger has a probability of .0000 and indicates

that the number of registered nurses in the observed cells

are significantly different from the number expected if they

had been randomly assigned. Therefore, hypothesis II was

rejected for the registered nurse group.

Using a modified test for testing multiple contrasts

among proportions, the registered nurses are significantly

higher than expectation on responsibility and only apparently

higher on emotional stability. They are significantly

lower than expectation on ascendancy and sociability.

Table X presents the results of the testing for the

licensed practical nurse group.







53

TABLE X
CHI SQUARE AND FREQUENCY DISTRIBUTION OF
LICENSED PRACTICAL NURSES SCORING "ABOVE
AVERAGE" AND "AVERAGE AND BELOW"
ON FOUR PERSONALITY TRAITS
Scored Above Average Scored Average and
on Personality Trait Below on Person-
ality Trait

Personality Trail fo fe fo fe

ASCENDANCY 8 14 22 16

RESPONSIBILITY 22 14 8 16

EMOTIONAL
STABILITY 19 14 11 16

SOCIABILITY 7 14 23 16
Chi square=23.304, 3 d.f.
p=.0000, significant


Results obtained for the licensed practical nurse group

were tested using chi square statistic with .05 level of

confidence and 3 degrees of freedom. The chi square value

for the licensed practical nurse group tested is 23.304.

A chi square this size or larger has a probability of .0000

and indicates that the number of licensed practical nurses

in the observed cells are significantly different from the

number expected if they had been randomly assigned. There-

fore, hypothesis II was rejected for the licensed practical

nurse group.

Using a modified test for testing multiple contrasts

among proportions, the licensed practical nurses are signi-

ficantly higher than expectation on responsibility. They

are significantly lower than expectation on ascendancy







54

and sociability. The contrast on emotional stability is not

significantly different from expectation.

Table XI presents the results of the testing for the

nursing assistant group.

TABLE XI
CHI SQUARE AND FREQUENCY DISTRIBUTION OF NURSING
ASSISTANTS SCORING "ABOVE AVERAGE" AND
"AVERAGE AND BELOW" ON FOUR PERSONALITY TRAITS
Scored Above Average Scored Average and
on Personality Trait Below on Person-
ality Trait

Personality Trait fo fe fo fe

ASCENDANCY 7 21 43 29

RESPONSIBILITY 39 21 11 29

EMOTIONAL
STABILITY 31 21 19 29

SOCIABILITY 6 21 44 29
Chi square=69.591, 3 d.f.
p=.0000, significant


Results obtained for the nursing assistant group were

tested using a chi square statistic with .05 level of

confidence and 3 degrees of freedom. The chi square value

for the nursing assistant group tested is 69.591. A chi

square this size or larger has a probability of .0000 and

indicates that the number of nursing assistants in the

observed cells are significantly different from the number

expected if they had been randomly assigned. Therefore,

hypothesis II was rejected for the nursing assistant group.

Using a modified test for testing multiple contrasts

among proportions, the nursing assistant group is signifi-

cantly higher than expectation on responsibility. They are







55

significantly lower than expectation on ascendancy and

sociability. The contrast on emotional stability is not

significantly different from expectation.


Hypothesis III

Hypothesis III states that there will be no statisti-

cally significant relationship between the mean scores on

each of the four personality traits of the Gordon Personal

Profile and the number of "yes" responses on the Tuckman-

Lorge Attitude Questionnaire. The Pearson product-moment

correlation coefficient was used to test the relationship.

Table XII presents the correlations for each of the perso-

nality traits with the number of "yes" responses on the

Tuckman-Lorge Attitudes Questionnaire.

TABLE XII
CORRELATION OF THE NUMBER OF "YES" RESPONSES ON
THE TUCKMAN-LORGE ATTITUDE QUESTIONNAIRE WITH MEAN
SCORES ON ASCENDANCY, RESPONSIBILITY, EMOTIONAL
STABILITY, AND SOCIABILITY

SOURCE r N Significance

Personality Trait

ASCENDANCY -.1181 110 .110

RESPONSIBILITY -.1029 110 .142

EMOTIONAL
STABILITY -.0508 110 .299

SOCIABILITY -.0788 110 .207


The intent of hypothesis III was to identify any

correlation between the stereotype attitudes toward the aged

(number of "yes" responses on the TLAQ) and personality







56

traits measured by the Gordon Personal Profile. None of the

correlation coefficients is significant at the .05 level of

confidence. Therefore, hypothesis III is not rejected.

The mean scores on the four personality traits do not

predict the scores on the Tuckman-Lorge Attitude Question-

naire in the sample of the study. The correlation

coefficients indicate that both the Tuckman-Lorge Attitude

Questionnaire and the Gordon Personal Profile test different

things and that neither can be used to predict the other.

Since no significant correlations were obtained, there is no

evidence that personality traits tested (ascendancy, re-

sponsibility, emotional stability, and sociability) will

reflect an individual's attitudes toward the aged or that an

individual's attitudes toward the aged may be the result of

having these personality traits.


Hypothesis IV

Hypothesis IV states that there will be no statistically

significant difference in the number of subjects having

lived with the aged and who prefer geriatrics as an area of

specialization and those having lived with the aged and who

prefer any one of seven other areas of specialization. A

choice of geriatrics or seven other specialization areas

was given to each subject. A pairing of geriatrics with

each of the seven other areas of specialization was done in

order to test the hypothesis. A chi square statistic was

obtained for each pairing. Table XIII presents the results

of the testing for each combination.







57

TABLE XIII
CHI SQUARE AND FREQUENCY DISTRIBUTION FOR SUBJECTS
LIVING WITH THE AGED AND PREFERRING GERIATRICS AND
SUBJECTS LIVING WITH THE AGED AND PREFERRING
OTHER AREAS OF SPECIALIZATION

SOURCE fo fe Chi square d.f. Sig.

Specialization

Geriatrics 12 7.5
4.267* 1 .05
Surgery 3 7.5

Geriatrics 12 7.5
4.267* 1 .05
Pediatrics 3 7.5

Geriatrics 12 8
3.062 1 .10
Rehabilitation 4 8

Geriatrics 12 8.5
2.118 1 .25
Psychiatry 5 8.5

Geriatrics 12 9.5
.842 1 .50
Medical 7 9.5

Geriatrics 12 10
.450 1 .50
Maternity 8 10

Geriatrics 12 10.5
.200 1 .25
Public Health 9 10.5
*Significant at the .05 level


The chi square results in Table XIII show statistically

significant difference in three of the combinations. A

chi square of 4.267 for the combination of geriatrics/surgery

is significant at the .05 level of confidence. Therefore,

the hypothesis is rejected. The chi square of 4.267 for the

combination of geriatrics /pediatrics is significant at the







58

.05 level of confidence. Therefore, the hypothesis is

rejected.

The significant difference found indicates that the

subjects who have lived with the aged will prefer working

in geriatrics more frequently that in surgery and pediatrics.

The five remaining combinations of geriatrics with psychiatry,

medical, rehabilitation, maternity, and public health nursing

are not significant. Therefore, the hypothesis is not

rejected.


Hypothesis V

Hypothesis V states that there will be no statistically

significant relationship in age of nurses and their pre-

ference for geriatrics as an area of specialization. Three

age categories were used and consisted of 19-35 years, 36-50

years, and 51-69 years. Chi square was used to test the

hypothesis. Table XIV presents the results of the testing.

TABLE XIV
CHI SQUARE AND FREQUENCY DISTRIBUTION OF
PREFERENCE FOR GERIATRICS BY AGE OF NURSES

SOURCE fo fe Chi square d.f. Sig.

Age of Nurses

19-35 yrs. 11 11 2.354 4 .6709

36-50 yrs. 6 6

51-69 yrs. 15 15


The chi square value of 2.354 is not significant at the

.05 level of confidence. Therefore, hypothesis V is not

rejected. The results reveal that there is no one specific







59

age category of nurses tested which prefer geriatrics more

than nurses in another age category. Previous research

(Brown, 1967) has indicated that younger nurses tend to

prefer not working with the aged. The findings of this

study do not support the previous findings.


Hypothesis VI

Hypothesis VI states that there will be no statistically

significant relationship between age in three types of

nurses and
age categories were used for nurses and three age categories

were used for age of patients preferred. Chi square was

used to test the hypothesis for each type of nurse.

Table XV presents the results of the testing for the

registered nurse group.

TABLE XV
CHI SQUARE AND FREQUENCY DISTRIBUTION
OF PREFERENCE FOR DIFFERENT AGE GROUPINGS OF
PATIENTS BY AGE OF REGISTERED NURSES

SOURCE fo fe Chi square d.f. Sig.

Age of Nurses 2.122 4 .7134

19-35 yrs.

Age of Patients

1-17 yrs. 1 1

18-65 yrs. 7 6

65+ yrs. 2 3
(table continued)







60

SOURCE fo fe Chi square d.f. Sig.

Age of Nurses

36-50 yrs.

Age of Patients

1-17 yrs. 1 1

18-65 yrs. 7 7

65+ yrs. 4 4

Age of Nurses

51-69 yrs.

Age of Patients

1-17 yrs. 1 1

18-65 yrs. 3 4

65+ yrs. 4 3


The chi square value of 2.122 is not significant at the

.05 level of confidence. Therefore, hypothesis VI is not

rejected for the registered nurse group. The results reveal

that there is no specific age group in registered nurses

tested which has a preference for working with a specific

age of patient.

Table XVI presents the results of the testing for the

licensed practical nurse group.

TABLE XVI
CHI SQUARE AND FREQUENCY DISTRIBUTION OF PREFERENCE FOR
DIFFERENT AGE GROUPINGS OF PATIENTS
BY AGE OF LICENSED PRACTICAL NURSES

SOURCE fo fe Chi square d.f. Sig.


(table continued)


Age of Nurses 4.839 4 .3041

19-35 yrs.











Age of Patients

1-17 yrs. 1 1

18-65 yrs. 4 5

65+ yrs. 7 6

Age of Nurses

36-50 yrs.

Age of Patients

1-17 yrs. 1 1

18-65 yrs. 5 3

65+ yrs. 1 4

Age of Nurses

51-69 yrs.

Age of Patients

1-17 yrs. 1 1

18-65 yrs. 3 4

65+ yrs. 7 5


The chi square value of 4.839 is not significant at the

.05 level of confidence. Therefore, hypothesis VI is not

rejected for the licensed practical nurse group. The

results reveal that there is no specific age group in

licensed practical nurses tested which has a preference for

working with a specific age of patient.

Table XVII presents the results of the testing for the

nursing assistant group.


Sig.


fn fe


Chi square d.f.


nnnPTTi







62

TABLE XVII
CHI SQUARE AND FREQUENCY DISTRIBUTION OF PREFERENCE
FOR DIFFERENT AGE GROUPINGS OF
PATIENTS BY AGE OF NURSING ASSISTANTS

SOURCE fo fe Chi square d.f. Sig.

Age of Nurses 7.506 4 .115

19-35 yrs.

Age of Patients

1-17 yrs. 4 3

18-65 yrs. 11 7

65+ yrs. 9 14

Age of Nurses

35-50 yrs.

Age of Patients

1-17 yrs. 2 2

18-65 yrs. 3 5

65+ yrs. 10 8

Age of Nurses

51-69 yrs.

Age of Patients

1-17 yrs. 1 2

18-65 yrs. 1 3

65+ yrs. 9 6


The chi square value of 7.506 is not significant at the

.05 level of confidence. Therefore, hypothesis VI is not

rejected for the nursing assistant group. The results reveal

that there is no specific age group in nursing assistants

which has a preference for working with a specific age of

patient.









Hypothesis VII

Hypothesis VII states that there will be no statistically

significant difference between the number of "yes" responses

on the Tuckman-Lorge Attitude Questionnaire by race, sex,

or religion. The t test of significance for a difference

between two means was used to test the hypothesis. Table

XVIII presents the results of the testing for race, sex,

and religion.

TABLE XVIII
t TEST FOR ANALYSIS OF NUMBER OF "YES" RESPONSES
ON THE TUCKMAN-LORGE ATTITUDE QUESTIONNAIRE
BY RACE, SEX, AND RELIGION
2-tail
SOURCE N MS SD t-value d.f. Prob.

Race

Black 51 62.10 18.12 2.43* 108 .017

White 59 53.80 17.64

Sex

Male 9 58.56 15.33 .16 108 .877

Female 101 57.56 18.56

Religion

Protestant 88 58.86 18.65 -1.41 108 .163

Nonprotestant 22 52.77 16.11
*Significant at the .01 level


As shown in table XVIII, the t test for race yielded a

t value of 2.43. This t value is significant at the .01

level of confidence. Therefore the hypothesis is rejected

for race. More negative attitudes were expressed by black

subjects than white subjects. This finding does not support

the findings in a previous study conducted by Thorson in







64

1975. At that time, Thorson found no significant difference

in the attitudes of white and black students toward the aged.

The t test for religion yielded a t value of -1.41 and

is not significant at the .05 level of confidence. There-

fore, the hypothesis is not rejected for religion. Although

there were three categories of religions reported in Chapter

III (Protestant, Catholic, and Jew) for purposes of analysis

these categories were collapsed into two categories

(Protestant and Nonprotestant). There were only 2 Jewish

subjects in the sample tested and in order to use the t test,

a minimum of five is desirable in each cell. The nonpro-

testant category includes both Catholic and Jewish subjects.

The results reveal that stereotype attitudes toward the aged

cannot be attributable to either of the two religion

categories tested in the study.

The t test for sex yeilded a t value of .16 and is not

significant. Therefore, the hypothesis is not rejected. It

should be noted that males constituted only 12 percent

(N=9) of the total sample tested. The results reveal that

the stereotype attitudes toward the aged cannot be attri-

butable to sex of the subjects tested in the study.


Hypothesis VIII

Hypothesis VIII states that there will be no statisti-

cally significant difference between the number of "yes"

responses on the Tuckman-Lorge Attitude Questionnaire of

registered nurses by degree and nondegree educational

programs. For the purpose of analysis, degree granting







65

programs were categorized as those which grant an Associate

Degree in nursing or a Baccalaureate Degree in nursing. The

nondegree program grants a diploma in nursing.

A t test of significance for a difference between two

means was used to test the hypothesis. Table XIX presents

the results of the testing for degree and nondegree

educational programs for registered nurses.

TABLE XIX
t TEST FOR NUMBER OF "YES" RESPONSES ON THE
TUCKMAN-LORGE ATTITUDE QUESTIONNAIRE OF REGISTERED
NURSES BY DEGREE AND NONDEGREE EDUCATIONAL PROGRAMS
2-tail
SOURCE N MS SD t-value d.f. Prob.

Type of Program

Degree 11 40.73 22.36
-.97 28 .342
Nondegree 19 48.05 18.56


The t test for type of educational programs for

registered nurses yielded a t value of -.97. This t value

is not significant. Therefore, the hypothesis is not re-

jected. In a previous study (Gillis, 1973), findings

indicated that baccalaureate graduates had more stereotype

attitudes toward the aged than did diploma graduates. The

results of this study do not support these findings.


Hypothesis IX

Hypothesis IX states that there will be no statisti-

cally significant difference between the mean "yes"

responses on the Tuckman-Lorge Attitude Questionnaire by

satisfaction or dissatisfaction in working with the aged in







66

three types of nurses. Analysis of variance was used to

test the hypothesis. Table XX presents the results of the

testing.

TABLE XX
ANALYSIS OF VARIANCE OF MEAN "YES" RESPONSES
ON THE TUCKMAN-LORGE ATTITUDE QUESTIONNAIRE BY
TYPE OF NURSE AND BY SATISFACTION OR DISSATISFACTION
OF WORKING WITH THE AGED

SOURCE SS d.f. MS F-ratio Sig.

Type of Nurse 6835.24 2 3417.62 12.08* .001

Satisfaction or
Dissatisfaction 134.22 1 134.22 .47 .999

2-way Interaction

Type of Nursing
by Satisfaction 101.09 2 50.54 .179 .999
or Dissatisfaction

Residual 29422.24 104 282.91
*Significant at the .001 level


The analysis of variance yielded on F ratio of 12.08

for type of nurse. This F ratio is significant at the .001

level of confidence. Therefore, the hypothesis is rejected

for type of nurse. A Scheffe Test for Multiple Comparisons

was used to determine the specific location of the difference

in the total mean score on the number of "yes" responses on

the Tuckman-Lorge Attitude Questionnaire among the types of

nurses. The total mean score for each type of nurse was

(1)45.37 for registered nurses, (2) 59.07 for licensed

practical nurses, and (3) 64.16 for nursing assistants. The

Scheffe test reveals that no significant total mean score

difference occurs between licensed practical nurses and







67

nursing assistants. The test reveals that there was

significant difference in the total mean score of both

licensed practical nurses and nursing assistants when

comparing with registered nurses. Registered nurses have

significantly lower number of "yes" responses on the

Tuckman-Lorge Attitude Questionnaire.

The analysis of variance yielded an F ratio of .47 for

satisfaction or dissatisfaction in working with the aged.

This F ratio is not significant at the .05 level of con-

fidence. Therefore, the hypothesis is not rejected for

satisfaction or dissatisfaction in working with the aged.

In the 2-way interaction between type of nurse by

satisfaction or dissatisfaction, the F ratio is .179. This

F ratio is not significant at the .05 level of confidence.

Therefore, the hypothesis is not rejected.


Hypothesis X

Hypothesis X states that there will be no statistically

significant difference in the mean "yes" responses on the

Tuckman-Lorge Attitude Questionnaire of registered nurses

and licensed practical nurses by percent of time estimated

in working with the aged. Analysis of variance was used to

test the hypothesis. Table XXI presents the results of the

testing.







68

TABLE XXI
ANALYSIS OF VARIANCE OF MEAN "YES" RESPONSES
ON THE TUCKMAN-LORGE ATTITUDE QUESTIONNAIRE BY TYPE OF
NURSE AND BY PERCENT OF TIME SPENT
IN WORKING WITH THE AGED

SOURCE SS d.f. MS F-ratio Sig.

Type of Nurse 2207.56 1 2207.56 6.60* .012

Percent of Time 146.12 1 146.12 .44 .999

2-way Interaction

Type of Nursing
by Percent of 115.56 1 115.56 .35 .999
Time

Residual 18751.15 56 334.84
*Significant at the .01 level


The analysis of variance yielded an F ratio of 6.60 for

type of nurse. This F ratio is significant at the .01 level

of confidence and the hypothesis is rejected. A Scheffe

Test for Multiple Comparisons was used to determine the

specific location of the difference in the total mean score

on the number of "yes" responses on the Tuckman-Lorge

Attitude Questionnaire between registered nurses and

licensed practical nurses. The total mean score for

registered nurses on the TLAQ is 45.37. The total mean

score for licensed practical nurses is 59.07. The Scheffe

Test reveals that a significant total mean score difference

occurs between the two groups of nurses. The total mean

score for licensed practical nurses is significantly higher

in number of "yes" responses on the TLAQ than registered

nurses.









The analysis of variance yielded an F ratio of .44 for

percent of time estimated in working with the aged. This F

ratio is not significant at the .05 level of confidence.

Therefore, the hypothesis is not rejected for percent of

time. When time is defined as actual time spent in working

with the aged, there is no significant difference between

registered nurses and licensed practical nurses.

In the 2-way interaction between type of nurse by

percent of time spent in working with the aged, the F ratio

is .35 which is not significant at the .05 level of con-

fidence. Therefore, the hypothesis is not rejected.


Hypothesis XI

Hypothesis XI states that there will be no statistically

significant difference in the mean "yes" responses on the

Tuckman-Lorge Attitude Questionnaire by older nurses (45-

69 yrs.) and younger nurses (19-44 yrs.). Analysis of

variance was used to test the hypothesis. Table XXII

presents the results of the testing.

TABLE XXII
ANALYSIS OF VARIANCE OF MEAN "YES"
RESPONSES ON THE TUCKMAN-LORGE ATTITUDE
QUESTIONNAIRE BY TYPE OF NURSE AND BY AGE OF NURSE

SOURCE SS d.f. MS F-ratio Sig.

Type of Nurse 6712.54 2 3356.27 11.805* .001

Age of Nurse 45.55 1 45.55 .160 .999

2-way Interaction

Type of Nurse
by Age of Nurse 71.05 2 35.52 .125 .999

Residual 29567.80 104 284.31
*Significant at the .001 level







70

The analysis of variance yielded an F ratio of 11.805

for type of nurse. This F ratio is significant at the .001

level of confidence. Therefore, the hypothesis is rejected.

Scheffe Test for Multiple Comparisons was used to determine

the specific location of the difference in total mean score

on the number of "yes" responses on the TLAQ among the three

types of nurses. The total mean scores for the three types

of nurses are 45.37 for registered nurses, 59.07 for

licensed practical nurses, and 64.16 for nursing assistants.

The Scheffe Test reveals that no significant total mean

score difference occurs between licensed practical nurses

and nursing assistants. The test reveals that a significant

total mean score difference in the number of "yes"

responses on the TLAQ occurs between licensed practical

nurses and registered nurses. There is also a significant

total mean score difference between nursing assistants and

registered nurses. The registered nurse group scores were

significantly lower in the number of "yes" responses on the

TLAQ when compared with licensed practical nurses and

nursing assistants.

The analysis of variance yielded an F ratio of .160 for

age of nurses. This F ratio is not significant at the .05

level of confidence. Therefore, the hypothesis is not

rejected. This finding indicates that older and younger

nurses do not vary significantly in the number of "yes"

responses on the TLAQ.







71

In the 2-way interaction between type of nurse and age

of nurse, the F ratio is .125 which is not significant at

the .05 level of confidence. Therefore, the hypothesis is

not rejected.


Hypothesis XII

Hypothesis XII states that there will be no statisti-

cally significant relationship between the number of "yes"

responses on the Tuckman-Lorge Attitude Questionnaire of

nurses and the number of years worked with the aged.

Pearson product-moment correlation coefficient was used to

describe the relationship between the number of "yes" re-

sponses and number of years worked with the aged.

The analysis yielded a correlation coefficient of .0229

for 110 cases and was not significant at the .05 level of

confidence. Therefore, the hypothesis was not rejected.

When time is defined as the number of years worked with

the aged, there is no significant difference in the stereo-

type attitudes toward the aged of nurses.


SECTION II
Simple Percentage Comparisons

The source for the data presented in this part of the

chapter is the Biographical Questionnaire and will be con-

fined to five items contained in the questionnaire.


Items 19, 20, 21

Item 19 asks,"Have you ever lived with your grandparents

or any other elderly person?" Item 20 asks, "How old were







72

you when you lived with these elderly persons?" Item 21

asks, "Do you consider these living experiences with the

elderly to have been positive, neutral, or negative?"

Fifty one of the subjects tested reported having lived with

an elderly person. Table XXIII presents a percent tabulation

of how old the subjects were when they lived with the aged

person and the subjects' rating of the experience as posi-

tive, neutral, or negative.

TABLE XXIII
PERCENT TABULATION OF NURSES' AGE WHEN HAVING
LIVED WITH THE AGED AND TIE RATING OF THE EXPERIENCE
Percent of Subjects Rating the
Age of Nurse When Lived Experience Positive, Neutral,
With the Aged Individual N or Negative

Positive Neutral Negative

3-10 yrs. 19 74 21 5

11-20 yrs. 22 55 18 27

21-30 yrs. 7 71 29

31-40 yrs. 1 100

41-50 yrs. 2 100---


Table XXIII indicates that subjects generally equate

their previous living experiences with the aged as being

more positive than negative. Subjects who were between 11

and 20 years of age at the time the living experience with

the aged occurred, viewed the experience as more negative.

This finding may be the result of the teen years in which

individuals are more prone to the extreme in reaction

toward authority figures and older persons.







73

TABLE XXIV
PERCENT TABULATION OF NURSES' AGE WHEN HAVING LIVED
WITH THE AGED AND THE EFFECT THE LIVING
EXPERIENCE HAD ON SELECTING WORK WITH THE AGED
Percent of Nurses' Rating the
Living Experience as Having
Age of Nurse When Lived Much or Little Effect on Job
With the Aged Individual N Selection

Much Little

3-10 yrs. 19 32 68

11-20 yrs. 22 18 82

21-30 yrs. 7 29 71

31-40 yrs. 1 100

41-50 yrs. 2 -- 100


Table XXIV indicates that subjects generally evaluate

their previous living experiences with the aged as having

little to do with selecting their current place of employ-

ment, i.e., working with the aged in nursing homes. Table

XXV reflects generally the same results but without a

categorizing by age.

TABLE XXV
PERCENT TABULATION OF NURSES' RATING OF THE
LIVING EXPERIENCE WITH THE AGED AND THE EFFECT
THE EXPERIENCE HAD ON SELECTING WORK WITH THE AGED
Percent of Nurses' Rating
Percent of Nurses' Rating the Living Experience as
the Living Experience as Having Much or Little
Positive or Negative Effect on Job Selection

Positive Negative Much Little

67% 33% 25% 75%
(N=34) (N=17) (N=13) (N=38)

Item 23

Item 23 asks the question, "Do you currently enjoy a

close relationship with any relative, friend, or acquaintance







74

who is over the age of 65?" Eighteen of the 110 subjects

responded with a "no" answer. Table XXVI presents the

percent of "no" responses by type of nurse.

TABLE XXVI
PERCENT TABULATION OF "NO" RESPONSES TO ITEM 23
OF THE BIOGRAPHICAL QUESTIONNAIRE BY TYPE OF NURSE
Percent of "no"
TYPE OF NURSE N Responses

Registered Nurse 4 22

Licensed Practical Nurse 7 39

Nursing Assistants 7 39


Item 25

Item 25 asks the question, "Does the geographical lo-

cation of this agency you are currently employed in have

anything to do with why you work here?" Sixteen subjects

said "yes." Table XXVII presents the type of responses to

the question and percent of subjects responding.

TABLE XXVII
TYPE OF RESPONSES TO ITEM 25 OF THE
BIOGRAPHICAL QUESTIONNAIRE AND PERCENT
OF SUBJECT S RESPONDING
Percent of Subjects
Responses to Item 25 N Responding

Near the University I
attend 3 19

Near the school my children
attend 1 6

Near my home 12 75

TOTAL 16 100















CHAPTER V
SUMMARY, PROCEDURE, RESULTS, CONCLUSIONS,
SIGNIFICANCE OF THE STUDY,
AND RECOMMENDATIONS FOR FUTURE RESEARCH


The initial sections of this chapter summarize the

review of literature used for the study, the procedures used

in conducting the investigation, and the results obtained.

Following this, the conclusions drawn from these results

are discussed. The significance of the study is discussed

and the chapter will close with recommendations for future

research.


Summary

This study had three primary purposes: first, to

identify the personality traits of nurses currently working

with the aged; second, to identify the social characteristics

of these nurses; and third, to identify the degree of stereo-

type attitudes toward the aged of these nurses. These

purposes were generated from the questions presented in

Chapter I and the review of literature in Chapter II.

Upon reviewing the literature pertaining to identifying

the personality traits of nurses working with the aged, it

was found that this is essentially an unexplored area in

research. The one study reviewed dealt only with student

nurses. The study reports that those students desiring to

work with the aged possess personality traits involving a

75







76

strong commitment to a vocation like that of a missionary,

are relatively unsocial, do not seek adventure, do not

desire to advance in their field, are usually older, and

tend to have lower aptitude scores.

The review of literature pertaining to identifying the

social characteristics of nurses working with the aged has

been generally confined to variables relating to stereo-

type attitudes toward the aged such as age, race, sex,

religion, and amount of education. There were no studies

reviewed which dealt with such social characteristics as

socioeconomic class or position of birth in a family, both

of which may relate to attitudes toward the aged.

Research findings related to attitudes toward the aged

revealed that attitudes are more negative than positive.

Variables such as age, race, and amount of education have

not been clearly established as having effect in promoting

the negative attitudes toward the aged and appear to vary

from group to group tested.


Procedures

One hundred and ten subjects volunteered from seven

nursing homes for participation in the study. The subjects

were practicing nurses representing three different types:

registered nurses, licensed practical nurses, and nursing

assistants.

The data were obtained by use of three instruments,

namely, the Gordon Personal Profile, a standardized







77

personality test; the Tuckman-Lorge Attitude Questionnaire

which measures the degree of stereotype attitudes toward the

aged; and the Biographical Questionnaire developed specifi-

cally for use in the study to obtain data not possible with

the administration of the first two instruments.


Results

Twelve null hypotheses concerning personality traits,

social characteristics, and stereotype attitudes toward the

aged were examined for significance at the .05 level of con-

fidence. Four statistical methods were used to test the

hypotheses. They were analysis of variance, chi square,

Pearson product-moment correlation coefficient, and t test.

In addition, hypotheses I, IX, X, and XI were further tested,

using Scheffe Test for Multiple Comparisons, in order to de-

termine the specific location of significant difference found.

Hypothesis I sought to determine the statistically

significant difference among three types of nurses on the

four personality traits of ascendancy, responsibility,

emotional stability, and sociability. The analysis of

variance revealed significant difference in the mean scores

on the personality trait of responsibility by types of

nurses. Therefore, the hypothesis was rejected. The

rejection of the hypothesis led to use of Scheffe Test for

Multiple Comparisons to determine the specific location of

the difference in total mean score among the three types of

nurses. The Scheffe test revealed no significant difference

between any one pair of nurse types.







78

Hypothesis II sought to determine the statistically

significant difference among the number of subjects in the

three types of nurses scoring "above average" and "average

and below" on each of the four personality traits. Chi

square for each of the three types of nurses revealed

significant difference for each type of nurse. Therefore,

the hypothesis was rejected.

Using a modified test for testing contrasts among pro-

portions, registered nurses were significantly higher than

expectation on responsibility and apparently but not signi-

ficantly higher on emotional stability. They were

significantly lower than expectation on ascendancy and

sociability.

Licensed practical nurses and nursing assistants were

significantly higher than expectation on responsibility

and significantly lower than expectation on ascendancy and

sociability. The contrast on emotional stability was not

significantly different from expectation.

Hypothesis III sought to determine the relationship

between the mean scores on each of the four personality

traits and the number of "yes" responses on the Tuckman-

Lorge Attitude Questionnaire. The Pearson product-moment

correlations revealed no significant relationship between

the means. Therefore, the hypothesis was not rejected.

Since no significant correlations were obtained, there is

no evidence that personality traits in the subjects tested







79

can be used to predict stereotype attitudes toward the

aged or vice versa.

Hypothesis IV sought to determine the statistically

significant difference in the number of subjects having

lived with the aged and who prefer geriatrics as an area

of specialization and those having lived with the aged but

who prefer other areas of specialization. Chi square for

seven specialization areas was obtained and significant

difference resulted in two of the seven areas of speciali-

zation. Therefore, the hypothesis was rejected for the

areas of surgery and pediatrics. The hypothesis was not

rejected for the areas of psychiatry, rehabilitation,

medical, maternity, and public health nursing. The results

revealed that subjects tested, who have lived with the aged,

more often preferred working in geriatrics than in surgery

or pediatrics.

Hypothesis V sought to determine the relationship

between age of nurses and preference for geriatrics as an

area of specialization. Chi square for three age cate-

gories was obtained. The results revealed no significant

difference by age categories. Therefore, the hypothesis

was not rejected. The results did not support previous

findings of difference attributed to age of nurses.

Hypothesis VI sought to determine the relationship

between age in each of the three types of nurses and choice

of age of patients to work with. Chi square for each type

nurse was obtained. The results revealed no significant







80

difference. Therefore, the hypothesis was not rejected.

In nursing circles, it is frequently postulated that younger

nurses will prefer working with pediatric and young adult

patients more than with the aged. The results did not

support such claims.

Hypothesis VII sought to determine the statistically

significant difference in stereotype attitudes toward the

aged which are attributable to race, sex, or religion.

A t test for each of these variables were obtained. The

results revealed no significant difference in attitudes to-

ward the aged which were attributable to sex or religion.

Therefore, the hypothesis was not rejected for sex or

religion.

The results revealed statistically significant

difference attributable to race. Therefore, the hypothesis

was rejected for race. Black subjects tested had signifi-

cantly more negative attitudes toward the aged than did

white subjects tested. The results did not support previous

findings. It should be noted that the previous findings

dealt with data collected from high school and college

students and not from individuals working with the aged. At

best, these results indicate that the stereotype attitudes

toward the aged in blacks tested, may be changing. Since

no research was reviewed which dealt with nurses currently

working with the aged, these results should not be used

comparatively to indicate that the stereotype attitudes are







81

greater in blacks than they may have been throughout the

previous years.

Hypothesis VIII sought to determine the statistically

significant difference in stereotype attitudes toward the

aged of registered nurses from degree and nondegree granting

ecuational programs. A t test of significance for a

difference between the two means was obtained. The results

revealed no significant difference in nurses from the degree

and nondegree granting programs. Therefore, the hypothesis

was not rejected. The results did not support earlier

findings which indicated that baccalaureate (degree)

graduates had more stereotype attitudes toward the aged

than did diploma (nondegree) graduates. With the focus on

education being what it is today, the results did not indi-

cate that type of nursing education made any significant

impact in helping to change the stereotype attitudes of

nurses toward the aged.

Hypothesis IX sought to determine statistically signi-

ficant difference between the mean "yes" responses on the

TLAQ by satisfaction or dissatisfaction in working with the

aged in three types of nurses. Analysis of variance was

obtained. The results revealed no significant difference

in satisfaction or dissatisfaction in working with the aged

among the three types of nurses. Therefore, the hypothesis

was not rejected.

The results revealed a statistically significant

difference in satisfaction or dissatisfaction in working







82

with the aged when related to type of nurse. Therefore, the

hypothesis was rejected. The rejection of the hypothesis

led to the use of Scheffe Test for Multiple Comparisons to

determine the specific location of the difference by type

of nurse. The results of the Scheffe Test revealed no

significant difference occurring between licensed practical

nurses and nursing assistants. The test did reveal signifi-

cant difference between both licensed practical nurses and

nursing assistants on the one hand and registered nurses

on the other. Registered nurses had significantly lower

scores on the Tuckman-Lorge Attitude Questionnaire, indi-

cating that as a group, they held less negative attitudes

toward the aged than did licensed practical nurses and

nursing assistants.

Hypothesis X sought to determine the statistically

significant difference in the mean "yes" responses on the

TLAQ of registered nurses and licensed practical nurses by

percent of time estimated in working with the aged. Analysis

of variance was obtained. The results revealed no signifi-

cant difference in percent of time estimated in working

with the aged in two types of nurses. Therefore, the

hypothesis was not rejected.

The results revealed statistically significant dif-

ference in stereotype attitudes toward the aged by type of

nurse. Therefore, the hypothesis was rejected. The

rejection of the hypothesis led to the use of Scheffe

Test for Multiple Comparisons to determine the specific

location of the difference by type of nurse. The results







83

of the Scheffe Test revealed a significant difference

occurred in licensed practical nurses, indicating that as a

group, they held more stereotype attitudes toward the aged

than did registered nurses.

Hypothesis XI sought to determine the statistically

significant difference in the stereotype attitudes towards

the aged by older nurses and younger nurses. Analysis of

variance was obtained. The results revealed no significant

difference between older and younger nurses and their stereo-

type attitudes toward the aged. Therefore, the hypothesis

was not rejected.

The results revealed statistically significant dif-

ference in stereotype attitudes toward the aged by type of

nurse. Scheffe Test for Multiple Comparisons was used to

determine the specific location of the difference by type

of nurse. The Scheffe Test results were identical to those

reported in hypotheses IX and X.

Hypothesis XII sought to determine the relationship

between stereotype attitudes of nurses and the number of

years worked with the aged. A Pearson product-moment

correlation was obtained. The results revealed no signifi-

cant relationship. Therefore, the hypothesis was not

rejected. Time, when defined as number of years worked

with the aged, was not statistically significant when re-

lated to stereotype attitudes toward the aged.







84

Conclusions

Personality Testing

Personality testing for the traits of ascendancy,

responsibility, emotional stability, and sociability re-

vealed the following profile.

1. All three types of nurses tested tended to be more

similar than different in possessing specific personality

traits. Without exception, all groups of nurses scored

significantly lower than expected on the traits of as-

cendancy and sociability and significantly higher than

expected on responsibility.

The lower scores on ascendancy may be attributable to

the effect of "history" on the profession. Nurses have not

been encouraged, particularly by physicians, to adopt active

roles in groups or to become assertive in making independent

decisions. This finding leads the investigator to further

speculate about the role of nurses in agencies such as

nursing homes. Much of the care in nursing homes could be

directed effectively by the nursing staff but it is not

likely they would do so, independent of direct orders from

a physician, especially with the low scores of nurses on

the ascendancy trait.

The lower scores on sociability were not expected by

the investigator. Nursing is an "other-oriented" profession

which calls for some expertise in being sociable and re-

flecting an interest in working with people. Speculation

regarding this finding is difficult for the investigator.







85

The size and patient capacity in nursing homes is usually

smaller than hospitals. An individual with a low sociability

trait may tend to seek employment in just such an environ-

ment, in order that he will not have to interact socially

and to the degree that other environments may require.

Emotional stability, as a personality trait was not

significantly different in the three groups of nurses

tested, although registered nurses scored somewhat higher

than licensed practical nurses and nursing assistants.

Responsibility, as a personality trait, was not signi-

ficantly different among the three groups of nurses. All

three groups scored higher than expected on the trait.

2. The personality traits tested in the subjects

had no significant correlation to stereotype attitudes

toward the aged. The degree of stereotype attitudes toward

the aged were not reflective of certain personality traits

or vice versa.


Variables Related to Selection of
Geriatrics as an Area of Specialization

The testing of the hypotheses revealed results which

were not expected by the investigator. Experience in living

with the aged was statistically significant when related to

selecting areas of specialization. The results of the study

revealed that the subjects having lived with the aged pre-

ferred working in geriatrics as a field of specialization

more frequently than they preferred working in surgery or

pediatrics.







86

Age of nurses had no statistically significant

relationship to subjects' preference for geriatrics in the

sample tested. This finding was not expected by the in-

vestigator. The finding gives some indication to the nursing

profession that recruitment of younger nurses into the field

of geriatrics is not an impossible goal. The investigator

speculates that lack of positive exposure to the aged has

possibly been a major deterrent to young nurses entering

the field of geriatrics, rather than having no desire to

work with the aged. It becomes the responsibility of leaders

in nursing education to present adequate and accurate infor-

mation regarding geriatric nursing in order to draw more

graduates into the field. It is the opinion of the investi-

gator that too many of today's nursing educators possess

stereotype attitudes toward the aged, and as a result,

do little more than convey these attitudes to students.

Age of nurses had no statistically significant relation-

ship to subjects' preference for working with different age

groups of patients.


Variables Related to Stereotype Attitudes

1. Race was found to be statistically significant in

the subjects tested when related to stereotype attitudes

toward the aged. This finding was not expected by the

investigator. The investigator speculates that stereotype

attitudes toward the aged in blacks have been essentially

ignored by researchers. Therefore, the findings of this

study may not indicate that a change is occurring in







87

attitudes of blacks toward the aged, although this is a

possibility. Further research is necessary in order to

support the findings of this study.

2. Stereotype attitudes toward the aged were not

statistically significant when related to type of nursing

education programs of registered nurses. This finding was

expected by the investigator. It is the opinion of the

investigator that "lip service only" has been given to the

study of geriatrics in the majority of nursing education

programs. In the opinion of the investigator, clinical

experiences have not been planned to adequately insure

satisfying exposure of student nurses to the aged. As a

result, the profession continues to graduate students who

are left with many of the feelings identified by previous

research which is reported in Chapter II of the study.

3. Type of nurse was statistically significant when

related to the degree of stereotype attitudes toward the

aged. Registered nurses had significantly lower scores on

the Tuckman-Lorge Attitude Questionnaire,indicating less

stereotype attitudes toward the aged. There was no signifi-

cant difference in attitudes toward the aged between

licensed practical nurses and nursing assistants.

4. No statistically significant difference resulted

in stereotype attitudes toward the aged when related to

satisfaction or dissatisfaction in working with the aged.

Neither was there statistically significant difference in

stereotype attitudes toward the aged when related to amount







88

of time estimated in working with the aged. These findings

were not expected by the investigator and, in the opinion

of the investigator, identify a definite need for planning

and implementing inservice programs which would provide

nurses with a forum for better understanding the aged.


Significance of the Study

The findings of the study have implications for the

direction the nursing profession should take in planning the

nursing education and service components of health care

related to aged patients in nursing homes.

Baccalaureate nursing education is the basic type of

education which has been recommended by the American Nurses'

Association to prepare students for assuming the leadership

role within the profession. The subjects tested in this

study indicate that ascendancy and sociability are persona-

lity traits which are not generally possessed by graduate

nurses. Additional time and exposure to exercising and

developing these traits should be given by faculty in

baccalaureate schools of nursing.

Since living with the aged was statistically signifi-

cant in this study when related to preference for geriatrics

as an area of specialization, it appears imperative that

nursing educators plan and provide additional exposure time

with aged patients for students who have no previous back-

ground (living experience) with the aged.

Registered nurses tested in the study held less stereo-

type attitudes toward the aged than licensed practical