| Objective:Based on Bandura’s reciprocal determinism, the current longitudinal study aimed to investigate motivation towards gerontological caring and its associated personal and contextual factors among undergraduate nursing students.Methods:Self-designed general information questionnaire, Gerontological Nursing Career Motivation questionnaire, Geriatrics Attitudes Scale (GAS), Anxiety about Aging Scale (AAS), Interpersonal Reactivity Index (IRI), Psychological Strain Scales (PSS) and Gerontological Nursing Clinical Practice Environment questionnaire were used to investigate 351 undergraduate nursing students from six first-class hospitals during July 2014 to January 2015 in a longitudinal study. The sample was surveyed three times. Data were analyzed by SPSS 19.0.Results:1. The changes of score of gerontological caring motivation-expectancy and value among undergraduate nursing studentsAt Time 1, the total average score of gerontological caring motivation-expectancy was (3.37±0.55), the total average score of gerontological caring motivation-value was (3.28±0.47). The scores of each dimension of value were interest (3.74±0.64). utility (3.17±0.60), importance (3.05±0.66) and cost (3.31±0.72). At Time 2. the total average score of gerontological caring motivation-expectancy was (3.50±0.56), the total average score of gerontological caring motivation-value was (3.32±0.44). The scores of each dimension of value were interest (3.75±0.61), utility (3.26±0.62), importance (3.15±0.65) and cost (3.25±0.72). At Time 3, the total average score of gerontological caring motivation-expectancy was (3.47±0.54), the total average score of gerontological caring motivation-value was (3.28±0.50). The scores of each dimension of value were interest (3.67±0.72), utility (3.22±0.68), importance (3.15±0.67) and cost (3.18±0.72).The proportion of undergraduate nursing students, who rated the total average score of gerontological caring motivation-expectancy below the median, is 15.7%, 10.5%,10.2%, respectively. The proportion of undergraduate nursing students, who rated the total average score of gerontological caring motivation-value below the median, is 21.3%,18.0%,22.6%, respectively.The results of repeated measures analysis showed that there were significant differences of total average score of gerontological caring motivation-expectancy at various points in time, while not the total average score of gerontological caring motivation-value. The differences of score of importance and cost were significant at points in time, respectively.2. The statistical differences of gerontological caring motivation in different characteristics of general information of undergraduate nursing students①ndergraduate nursing students who made the major of nursing science as their top choice of college admission rated higher score of gerontological caring motivation-value (P<0.01). ②ndergraduate nursing students who lived together with older adults at home had higher score of gerontological caring motivation-value (P<0.01).③ndergraduate nursing students who had good relationship with older adults responded higher scores of gerontological caring motivation-expectancy and value (P<0.01).④ndergraduate nursing students who had experience of caring older adults responded higher scores of gerontological caring motivation-expectancy and value.3. The correlations between personal/contextual factors and gerontological caring motivation(1) Relationship between personal factors and gerontological caring motivation:1) The scores of geriatric attitude at three points in time were 3.56±0.39,3.54± 0.38,3.50±0.40, respectively. And there was no significant difference among the three points in time. The score of geriatric attitude was positively correlated with gerontological caring motivation-expectancy and value (all P<0.01).2) The scores of aging anxiety at three points in time were 48.23+5.25,47.70+ 4.50,47.00±4.50, respectively. And the score was the lowest at Time 3 (P<0.01). The score of aging anxiety was negatively correlated with gerontological caring motivation-expectancy and value (all P<0.01).3) The scores of empathy at three points in time were 52.17±9.31,50.60±9.84, 49.58±9.58, respectively. And the score was highest at Time 1 (P<0.01). The score of empathy was positively correlated with gerontological caring motivation-expectancy and value (all P<0.01).4) The total scores of strain at three points in time were 99.33±21.44,99.15± 24.23,98.74±24.56, respectively; scores of value strain were 28.70±6.14,28.52± 6.38,27.87±6.52, respectively; scores of aspiration strain were 25.94±6.86,25.83± 7.79,25.38±7.25, respectively; scores of deprivation strain were 21.72±6.55,21.95 ±7.38,22.24±7.24, respectively, scores of coping strain were 22.97±6.26,22.84± 6.82,23.26±7.20, respectively. There was no significant difference among three points in time. At Time 1, score of coping strain was negatively correlated with gerontological caring motivation-expectancy (P<0.05); at Time 2, score of coping strain was also negatively correlated with gerontological caring motivation-expectancy (P<0.05); at Time 3, total score of strain, score of aspiration strain, deprivation strain and coping strain were negatively correlated with gerontological caring motivation-expectancy (P<0.01). And score of coping strain was negatively correlated with gerontological caring motivation-value (P<0.05) at Time 3.(2) Relationship between contextual factor and gerontological caring motivation:Undergraduate nursing students self-rated scores of clinical practice environment at three points in time were 3.40±0.54,3.33±0.56,3.27±0.56, respectively. And the score was the highest at Time 1 (P<0.05, P<0.01). Undergraduate nursing students self-rated score of gerontological nursing clinical practice environment was positively correlated with gerontological caring motivation-expectancy and value (P<0.01).4. Factors influencing gerontological caring motivation-expectancy and value analyzed by multiple regressions at three different points in timeT1:Factors associated with the score of gerontological caring motivation-expectancy included gerontological nursing clinical practice environment, aging anxiety, empathy and the relationship with older adults. These four variables accounted for 32.9% of the variance in the score of gerontological caring motivation-expectancy.Factors associated with the score of gerontological caring motivation-value included gerontological nursing clinical practice environment, geriatric attitude, aging anxiety, the top choice of the major of nursing, the relationship with older adults and living together with older adults at home. These six variables accounted for 38.2% of the variance in the score of gerontological caring motivation-value.T2:Factors associated with the score of gerontological caring motivation-expectancy included gerontological nursing clinical practice environment, aging anxiety, empathy and the relationship with older adults. These four variables accounted for 32.8% of the variance in the score of gerontological caring motivation-expectancy.Factors associated with the score of gerontological caring motivation-value included gerontological nursing clinical practice environment, geriatric attitude, empathy, aging anxiety, and the relationship with older adults. These five variables accounted for 29.5% of the variance in the score of gerontological caring motivation-value.T3:Factors associated with the score of gerontological caring motivation-expectancy included gerontological nursing clinical practice environment, aging anxiety, geriatric attitude and empathy. These four variables accounted for 37.2%of the variance in the score of gerontological caring motivation-expectancy.Factors associated with the score of gerontological caring motivation-value included gerontological nursing clinical practice environment, geriatric attitude, empathy, aging anxiety, and the top choice of the major of nursing. These five variables accounted for 30.9% of the variance in the score of gerontological caring motivation-value.5. Factors influencing gerontological caring motivation-expectancy and value over time analyzed by generalized estimating equationsInternship time (B=-0.154), relationship with older adults (B=0.285), aging anxiety (B=-0.023), empathy (B=0.008), and gerontological nursing clinical practice environment (B=0.368) were the significant predictors of gerontological caring motivation-expectancy (all P<0.01).The top choice of the major of nursing (B=0.097), relationship with older adults (B=0.316), geriatric attitude (B=0.250), aging anxiety (B=-0.014), empathy (B=0.006) and gerontological nursing clinical practice environment (B=0.281) were the significant predictors of gerontological caring motivation-value (all P<0.01).Conclusions:1. The degree of motivation towards gerontological caring among undergraduate nursing students was moderate. The gerontological caring motivation-expectancy initially increased and then trended to relatively stable, while the gerontological caring motivation-value had no obvious changes over time. This finding may remind nursing educators to pay more attention on the changes of value and aspiration of gerontological caring among undergraduate nursing students during their internship.2. The top choice of the major of nursing, relationship with older adults, geriatric attitude, aging anxiety, empathy. and gerontological nursing clinical practice environment were important factors associated with gerontological caring motivation-expectancy and value over time.3. In the process of teaching and instructing, nursing educators should fully understand the potential personal and contextual factors such as attitudes, aging anxiety, empathy, clinical practice environment and relationship with older adults, which are associated with gerontological caring motivation among undergraduate nursing students. Effective interventions should be taken to inspire nursing students with confidence of gerontological caring, and to improve their views on older adults and values of gerontological caring. |
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