Perceptions of Geriatric Medicine and Care of the Elderly: An Exploratory Survey of Physicians from the Middle East and Africa

Abstract

Background The number of older people is growing in the Middle East and Africa (MEA). We aimed to explore the attitudes of MEA's physicians toward the care of the elderly and nursing homes.

Methods We surveyed 137 doctors practicing in the MEA region in 2017 using an online questionnaire that included attitude scales of geriatrics and nursing homes.

Results Most respondents were senior (47.1%) or in middle grades (35.3%), in public facilities (77.4%), and practiced internal medicine and subspecialties. More respondents (86%) agreed with what was perceived as the most exciting and entertaining qualities of most older people in their accounts of their past experiences. Also, 69.0% of respondents disagreed that older people need/demand no more attention or love than younger people. At the same time, 43.6% of respondents were neutral on the question relating to older people's power in business and politics. Positive attitudes, that is, older people's willingness to continue working for as long as possible, and that wisdom with age scored 61.5% was supported by 85.1 and 61.5% of the respondents, respectively.

On the other hand, 53.7% of respondents agreed that older people could not adjust and change with changing circumstances, 70.9% disagreed that older people make neighborhoods less favorable. However, only 15.5% disagreed with the statement that older people cannot adjust and change with changing circumstances. Nearly two-thirds thought nursing homes were not well developed (63.0%) in the MEA region. Also, 59.8% said that the expected reimbursement is low, 57.7% were concerned about complicated medical problems, and 57.3% highlighted the deficits in training. There was low satisfaction with providing nursing home care despite agreeing that they may feel professionally satisfied providing nursing home care (49.5%). The respondents were neutral (47.3%) or somewhat agreed (42.9%) about enjoying nursing home care.

Conclusion There is a suboptimal attitude of practicing physicians to geriatrics that needs improvements.

Keywords

elderly care - geriatrics attitude scale - doctors - attitudes toward older people - geriatrics education - nursing home care - Middle East - Africa

Authors' Contributions

S.A.B. and S.H. proposed the study; S.A.B. adopted the questionnaires and managed the survey process. All authors examined the data, revised the manuscript for intellectual content and presentation, and approved its final version.

Compliance with Ethical Standards

The study was approved by the Institutional Review Board of Sheikh Khalifa Medical City, Abu Dhabi, UAE. Participants provided informed consent to participate before they could access the survey questions. All data were analyzed anonymously.

Publication History

Article published online:
11 July 2022

• References

• 1 World Health Organization. Ageing and Health. Accessed March 6, 2021 at: www.who.int/news-room/fact-sheets/detail/ageing-and-health
• 2 Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet 2009; 374 (9696): 1196-1208
• 3 Chatterji S, Byles J, Cutler D, Seeman T, Verdes E. Health, functioning, and disability in older adults–present status and future implications. Lancet 2015; 385 (9967): 563-575
• 4 Caliskan T, Kendir C, Tekin N, Kartal M. Attitudes toward the elderly among young family physicians in Turkey. J Family Med Prim Care 2018; 7 (05) 998-1001
• 5 Hussein S, Ismail M. Ageing and elderly care in the Arab region: policy challenges and opportunities. Ageing Int 2017; 42 (03) 274-289
• 6 Chemali Z, Chahine LM, Sibai AM. Older adult care in Lebanon: towards stronger and sustainable reforms. East Mediterr Health J 2008; 14 (06) 1466-1476
• 7 Abyad A, Hammami SO. Geriatric Medicine in the Arab World. In: Laher I. ed. Handbook of Healthcare in the Arab World. Cham: Springer; 2019
• 8 Kogan N. Attitudes toward old people: the development of a scale and an examination of correlates. J Abnorm Soc Psychol 1961; 62 (01) 44-54
• 9 Helton MR, Pathman DE. Caring for older patients: current attitudes and future plans of family medicine residents. Fam Med 2008; 40 (10) 707-714
• 10 Beshyah SA, Ali KF, Mustafa HEI, Hajjaj IM, Hafidh K, Abdelmannan DK. Doctors' attitude and engagement in research: a survey from two emerging regions. Ibnosina J Med Biomed Sci 2020; 12 (04) 307-314
• 11 Beshyah SA, Ali KF, Hafidh K. Attitudes of physicians and scientists to peer reviewing for biomedical journals: a survey from the Middle East and Africa. Ibnosina J Med Biomed Sci 2021; 13 (01) 32-40
• 12 Ekhzaimy A, Beshyah SA, Al Dahmani KM, AlMalki MH. Physician' attitudes to growth hormone replacement therapy in adults following pituitary surgery: results of an online survey. Avicenna J Med 2020; 10 (04) 215-222
• 13 Beshyah SA, Sherif IH, Mustafa HE, Saadi HF. Patterns of clinical management of hypothyroidism in adults: an electronic survey of physicians from the Middle East & Africa. J Diab Endo Prac 2021; 4 (02) 75-82
• 14 Lee M, Reuben DB, Ferrell BA. Multidimensional attitudes of medical residents and geriatrics fellows toward older people. J Am Geriatr Soc 2005; 53 (03) 489-494
• 15 Leung S, Logiudice D, Schwarz J, Brand C. Hospital doctors' attitudes towards older people. Intern Med J 2011; 41 (04) 308-314
• 16 Krain LP, Fitzgerald JT, Halter JB, Williams BC. Geriatrics attitudes and knowledge among surgical and medical subspecialty house officers. J Am Geriatr Soc 2007; 55 (12) 2056-2060
• 17 Seferoğlu M, Yıldız D, Pekel NB, Güneş A, Yıldız A, Tufan F. Attitudes of neurology specialists toward older adults. Aging Clin Exp Res 2017; 29 (04) 787-792
• 18 Hogan TM, Chan SB, Hansoti B. Multidimensional attitudes of emergency medicine residents toward older adults. West J Emerg Med 2014; 15 (04) 511-517
• 19 Yang Y, Xiao LD, Ullah S, Deng L. General practitioners' knowledge of ageing and attitudes towards older people in China. Australas J Ageing 2015; 34 (02) 82-87
• 20 Hughes NJ, Soiza RL, Chua M. et al. Medical student attitudes toward older people and willingness to consider a career in geriatric medicine. J Am Geriatr Soc 2008; 56 (02) 334-338
• 21 Chua MP, Tan CH, Merchant R, Soiza RL. Attitudes of first-year medical students in Singapore towards older people and willingness to consider a career in geriatric medicine. Ann Acad Med Singap 2008; 37 (11) 947-951
• 22 De Biasio JC, Parkas V, Soriano RP. Longitudinal assessment of medical student attitudes toward older people. Med Teach 2016; 38 (08) 823-828
• 23 Kishimoto M, Nagoshi M, Williams S, Masaki KH, Blanchette PL. Knowledge and attitudes about geriatrics of medical students, internal medicine residents, and geriatric medicine fellows. J Am Geriatr Soc 2005; 53 (01) 99-102
• 24 AlZamil A, AlHoqail R, Alodhayani A. Barriers and attitudes of family and internal medicine residents toward geriatric patients: a cross-sectional analytical study. Adv Med Educ Pract 2019; 10: 585-590
• 25 Abd-Al-Atty MF, Abd Elaziz KM. The attitude of Egyptian physicians toward geriatric medicine. J Am Geriatr Soc 2009; 57 (09) 1727-1728
• 26 Abd El-Fatah S. Unmet healthcare needs for older people attending the outpatients' clinics of a university hospital in Cairo, Egypt: a qualitative study. J Egypt Public Health Assoc 2017; 92 (04) 220-227
• 27 Hammami SO, Hammami AS, Abyad A. Older Population and the Health System. In: Laher I. ed. Handbook of Healthcare in the Arab World. Cham: Springer; 2019
• 28 Tufan F, Yuruyen M, Kizilarslanoglu MC. et al. Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study. Arch Gerontol Geriatr 2015; 60 (02) 307-310
• 29 Faulk CE, Lee TJ, Musick D. Implementing a multidimensional geriatric curriculum in a physical medicine and rehabilitation residency program. Am J Phys Med Rehabil 2012; 91 (10) 883-889
• 30 Wlodarczyk D, Chylińska J, Lazarewicz M. et al. Enhancing doctors' competencies in communication with and activation of older patients: the Promoting Active Aging (PRACTA) Computer-Based Intervention Study. J Med Internet Res 2017; 19 (02) e45
• 31 You P, Leung M, Xu VY. et al. Pre-clerkship observerships to increase early exposure to geriatric medicine. Can Geriatr J 2015; 18 (04) 225-230
• 32 Haque AF, Soong DG, Wong CL. Assessing the impact of a geriatric clinical skills day on medical students' attitudes toward geriatrics. Can Geriatr J 2013; 17 (01) 12-15
• 33 Mathew E, Shaikh R, Al Sharbatti S, Sreedharan J. Introducing geriatric health in medical training in Ajman, United Arab Emirates: aco-curricular approach. Australas Med J 2011; 4 (06) 346-353