Brown Jayne, Nolan Mike, Davies Sue, Nolan Janet, Keady John
Glasgow Caledonian University, UK.
Int J Nurs Stud. 2008 Aug;45(8):1214-32. doi: 10.1016/j.ijnurstu.2007.07.002. Epub 2007 Aug 13.
Gerontological nursing is often viewed as unchallenging and is rarely a positive career choice for student nurses. Issues of recruitment and retention in gerontological nursing are a global phenomenon and strategies are needed to encourage more students to opt for this area of work.
To identify the role and influence of students' learning experiences on shaping their predispositions to work with older people and to identify the characteristics of a positive learning environment that might promote a more favourable view of gerontological nursing.
The study was a 312-year longitudinal investigation using multiple methods of data collection and analysis, including an extensive review of the literature, large-scale postal surveys, focus groups and case studies of clinical placements. The design of the study was emergent and essentially constructivist, and participants, especially student nurses, were actively engaged in the on-going process of data analysis.
The results suggest that students do not necessarily enter nurse training with negative predispositions towards work with older adults, but that such negative views develop during their training largely as a result of clinical placements and extra-curricula paid work. Student nurses are often exposed to 'impoverished' environments of care in which they witness poor standards of care and negative attitudes towards older people. However, if they experienced 'enriched' environments they are far more likely to view gerontological nursing in a favourable light. The characteristics of an enriched environment can be understood using the Senses Framework as an analytic lens to interpret students' learning experiences.
The study reinforces the vital role that the placement experience plays in helping students to identify with a particular area of practice. The promotion of an 'enriched' environment of learning and care can be used to help ensure that students have a positive experience of learning to care for older people.
老年护理常常被视为缺乏挑战性，很少成为学生护士积极的职业选择。老年护理领域的招聘和留用问题是一个全球现象，需要采取策略鼓励更多学生选择这一工作领域。
确定学生学习经历在塑造其从事老年护理工作倾向方面的作用和影响，并确定可能促进对老年护理形成更积极看法的积极学习环境的特征。
该研究是一项为期312年的纵向调查，采用多种数据收集和分析方法，包括广泛的文献综述、大规模邮寄调查、焦点小组以及临床实习案例研究。研究设计具有灵活性且本质上是建构主义的，参与者，尤其是学生护士，积极参与数据分析的持续过程。
结果表明，学生进入护士培训时不一定对从事老年护理工作有负面倾向，但这种负面看法在培训期间很大程度上是由于临床实习和课外有偿工作形成的。学生护士经常接触到“匮乏”的护理环境，在其中他们目睹了糟糕的护理标准和对老年人的负面态度。然而，如果他们经历“丰富”的环境，他们更有可能对老年护理持积极看法。可以使用感官框架作为分析视角来理解丰富环境的特征，以解读学生的学习经历。
该研究强化了实习经历在帮助学生认同特定实践领域方面所起的关键作用。促进“丰富”的学习和护理环境可用于帮助确保学生在学习照顾老年人方面有积极的体验。
