KNOWLEDGE, ATTITUDE AND PERCEPTION OF CARE OF THE ELDERLY PATIENTS AMONG HEALTH WORKERS

CHAPTER ONE

1.1 Introduction

Care of the elderly is the fulfillment of the special needs and requirements that are unique to senior citizens. It covers such services as assisted living, adult day care, long term care, nursing homes, hospice care and home care. Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity. The care of the elderly is multidimensional and these include physical, emotional, spiritual and social care (Ayres, 2008).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Limitations of the Study, Research Questions and Hypothesis and Definition of technical terms.

1.2 Background of Study

Ageing is the accumulation of changes in a person over time (Bowen and Atwood 2004). It involves a multidimensional process of physical, psychological and social change. Some dimensions of aging grow and expand over time, while others decline. Research shows that even in late life, potentials exist for physical, mental and social growth and development (Papalia, Sterns, Feldman, and Camp, 2002). It is not a disease; but phase of life where there is retrograde biological process in growth and development which leads to decreased powers for survival and adjustment. Aging is an important part of all human societies reflecting the biological changes that occur and also reflecting cultural and societal convention.

An estimated 100,000 people worldwide die each day of age related causes (Aubrey de Grey, 2007). According to National Population Commission (NPC, 2006), persons who are old enough to receive pension who are between ages of 60-65 years are regarded as the elderly. The elderly are classified by age into young old for those aged 60-74years, middle old for those aged 75-84years, old for those aged 85-94 years and oldest old for those 95years and above. (Barman, Snyder, Kozier & Erb , 2008).

However, improvement in primary health care with focus on prevention of childhood diseases through immunization did not highlight the care of the elderly which should be one of the components of primary health care programme in most developing countries (Olise, 2011). A cursory look at the implementation of Millennium Development Goals (MDGs) by the federal government shows that there is little or no consideration of this very important segment of the population – the elderly. Also most curricula for training Health Manpower in Nigeria do not highlight the care of the elderly (Donatelle, 2011). Yet the population of this segment of the society is increasing in developing countries with their special care needs. Traditionally, in Nigeria elderly care has been the responsibility of family members and was provided within the extended family system (Ting and Woo, 2009).But with modernization, elderly care is now being provided by state or charitable institutions. This is attributable to decreasing family size, the greater life expectancy of elderly people, the geographical dispersion of families, and the tendency for women to be educated and work outside the home (Lee, 2009).

In most developing countries including Nigeria the population of the elderly is increasing rapidly but the government does not seem to be making any major commitments to elderly healthcare (Adio-Moses, 2001). The government is still assuming that families should take care of their elderly without recognizing that the extended family system is at the verge of collapse.

Currently most families find it difficult to manage their own homes and face their challenges. This is gradually leading to neglect and abuse of the elderly (Gubrium, 2002). Care of the elderly requires adequate knowledge of the ageing process, nutrition and daily needs of the elderly. In Nigeria, marginalization of the elderly especially in their care is a common episode (Abdulraheem & Parakoyi, 2005). Those involved in the provision of health care have important roles to play in programmes relating to elderly care especially in screening and detecting abuse.

Unfortunately doctors do not diagnose abuse because it is not part of their formal or professional training hence does not feature in their list of differential diagnosis (Donatelle, 2011). The health worker, according to Abdulrahem & Parakoyi (2005) plays major roles in determining and implementing desirable standards of health care, acting as a professional in developing core of professional knowledge and should have ability to impart same to others. They are often the providers of services designed to maintain health and prevent illness. Research has also shown that the quality of health care service provided to older population is strongly influenced by care givers attitude towards older people (Gallaghar, Bennet & Halford, 2006).

Therefore, in Abia State Primary Health Care (PHC) where the research was carried out, the activities that was conducted is to know the Knowledge, Attitude and Perception of Care of the Elderly Patients among Health Workers.

1.3 Statement of Problems

Investigation reveals the following problems of Knowledge, Attitude and Perception of Care of the Elderly Patients among Health Workers using Primary Health Care (PHC) Centre in Umuahia, Abia State as a case study research work;

Nurses get in contact with patients on a daily basis, so they are exposed to sharp injuries and many types of infections due to the nature of their occupation. It is important to follow standard precautions to reduce transmission of infections. In Palestine, despite of the availability of protocol for infection control in hospitals, it is applicable in varied degree from hospital to hospital. In addition, after reviewing documents from Palestinian Health Information Centre in MOH, it doesn't have any statistics regarding nurses' knowledge and practice of SP measures and those related to SI among health care workers. In addition, it doesn't have any statistics regarding health care workers who have SI or who acquired infection during work. As an expected outcome, this study will identify the importance of nurses' knowledge about SP measures and those related to SI. Also it will highlight the size of problem of stick injuries among workers during work.

1.4 Aim and Objectives of the Study

The main aim of the study is to examine the Knowledge, Attitude and Perception of Care of the Elderly Patients among Health Workers using Primary Health Care (PHC) Centre in Umuahia, Abia State as a case study. In achieving this aim, the following specific objectives were set out as follows to:

Examine the level of knowledge of the care of the elderly affects health workers in Udi and Abia Communities;
Ascertain the attitude of health workers towards care of the elderly in Udi and Abia Communities;
Determine the factor influencing health workers attitude of care towards the elderly; and
Investigate health workers practices in the provision of care of the elderly in Udi and Abia Communities

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

Does the level of knowledge of the care of the elderly affects health workers in a tertiary health facility in Umuahia, Abia State?
Is there any factor influencing health workers attitude of care towards the elderly?
What is the attitude of health workers towards care of the elderly in a tertiary health facility in Umuahia?
What are the health workers practices in the provision of care of the elderly in a tertiary health facility in Umuahia?
What are nurses’ knowledge and attitudes towards the care of elderly?
What is the perceived effect of staffing ratio on the care of the elderly?
What are the factors influencing the attitude of nurses in the care of the elderly?
What are other factors affect on the care of elderly patients?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

H0: There is no association between years of experience of health workers and their attitude towards care of the elderly in Primary Health Centre in Abia State
H1: There is an association between years of experience of health workers and their attitude towards care of the elderly in Primary Health Centre in Abia State

1.7 Significance of Study

The result will help to provide basic information for designing structures and programmes for the care of the elderly in the community. It will also provide evidence based information for health education on graceful ageing. It will serve as a reference material to other researchers in the field of community health practice.

Findings of the study will help in showing the level of knowledge and attitude of the health workers towards the care of the elderly and will help improve the decision making. The result will also help in building up knowledge base on the care of the elderly patients. Improving data base on elderly health nutrition and standard of living which will help for further research, advocacy, policy dialogue and programming.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The study focuses on the Knowledge, Attitude and Perception of Care of the Elderly Patients among Health Workers using Primary Health Care (PHC) Centre in Umuahia, Abia State as a case study.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
Research material: availability of research material is a major setback to the scope of the study.
Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

…

CHAPTER TWO

2.0 Literature Review

2.1 Introduction

The review of relevant literature is the main topic of this chapter. A literature review covers theoretical and methodological contributions to a certain issue in addition to the state of knowledge at the time of writing. It provides information about the state of the art in relation to the subject you are writing about. It examines the body of work on the chosen subject. The literature evaluation in this study comprises the …

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TABLE OF CONTENTS
PRELIMINARY PAGES

Title page
Approval page
Dedication
Acknowledgement
Table of Contents
Abstract
CHAPTER ONE
INTRODUCTION
1.1 Introduction
1.2 Background …
⋮
CHAPTER TWO
LITERATURE REVIEW
2.1 Introduction
2.2 Conceptual Review
2.3 Theoretical Framework
⋮
2.4 Empirical Studies
2.5 Research Gaps
2.6 Summary of Literature Review
CHAPTER THREE

RESEARCH METHODOLOGY

3.1 Introduction

3.2 Research Design

3.3 Population of Study

3.4 Sampling and Sampling Technique

3.5 Validation of Research Instrument

3.6 Method of Data Collection

3.7 Method of Data Analysis

3.8 Questionnaire Administration

3.9 Ethical Consideration

3.10 Statistical Analysis

CHAPTER FOUR

DATA ANALYSIS, RESULT AND DISCUSSION

4.1 Introduction

4.2 Presentation and Analysis of Data

4.3 Re-statement of Research Questions

4.4 Test of Hypotheses

4.5 Discussion of Findings

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

5.1 Introduction

5.2 Summary of Findings

5.3 Conclusion

5.4 Recommendation

5.5 Suggestion for Further Study

REFERENCES

APPENDIX A - “QUESTIONNAIRE”

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