Empathy and Attitude upon An Aged Body: Aged Simulation Suit Among Undergraduate Physiotherapy Students

Abstract

Background and Purpose: When empathy and attitude levels of health professionals are high, patient compliance and satisfaction are increased. The purpose of this study was to assess the empathy and attitude levels of undergraduate physiotherapy students towards older people before and after wearing the aged simulation suit by performing pre-defined related scenarios. Methods: The aged simulation suit was put on 63 students to complete the pre-defined scenarios, which included reading, eating, walking, and sitting to determine the experiences and emotions of students via semi-structured questions and interviews. The empathy and attitude levels were evaluated using the Jefferson Scale of Empathy-Health Professions Students (JSE-HPS) version and Kogan's Attitudes Towards Old People (KAOP) scales at baseline and immediately after performed scenarios. Results: The scores of the JSE-HPS and its sub-scales, including "perspective-taking" (p=0.000) and "compassionate care" (p=0.008), were significantly improved, while "standing in patient's shoes" was significantly decreased after the intervention (p=0.005). KAOP positive items were found to be higher compared to the baseline results (p=0.040). Besides, 87.1% of the students stated that their behavior towards older people would change positively. Conclusion: Using aged simulation suits may be an effective educational technique that positively contributes to undergraduate physiotherapy students' attitudes and empathy.

Keywords

• Empathy
• attitude
• physiotherapy students
• aged simulation suit
• older people

References

1. World Population Ageing. United Nations Department of Economic Social Affairs 2019; Available from: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf.
2. Boz C and Ozsarı SH. The causes of aging and relationship between aging and health expenditure: An econometric causality analysis for Turkey. Int J Health Plann Manage 2019; 35:162-170.
3. Günsoy G and Tekeli S. Nüfusun Yaşlanması ve Ekonomik Büyüme İlişkisi: Türkiye Üzerine Bir Analiz. Amme İdaresi Dergisi 2015; 48:35-87.
4. TUIK İstatistiklerle Yaşlılar. 2019; Available from: https://data.tuik.gov.tr/Bulten?p=%C4%B0statistiklerle-Ya%C5%9Fl%C4%B1lar-2019-33712.
5. Cesari M, Kritchevsky SB, Newman AB, et al. Added value of physical performance measures in predicting adverse health‐related events: results from the Health, Aging and Body Composition Study. J Am Geriatr Soc 2009; 57:251-259.
6. Janssen I, Heymsfield SB, and Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002; 50:889-896.
7. Newman AB, Haggerty CL, Goodpaster B, et al. Strength and muscle quality in a well‐functioning cohort of older adults: the Health, Aging and Body Composition Study. J Am Geriatr Soc 2003; 51:323-330.
8. Shimada H, Makizako H, Doi T, Tsutsumimoto K, and Suzuki T. Incidence of disability in frail older persons with or without slow walking speed. J Am Med Dir Assoc 2015; 16:690-696.

9. Davis MH, Empathy: A social psychological approach. 2018: Routledge.
10. Aring CD. Sympathy and empathy. J Am Med Assoc 1958; 167:448-452.
11. Nunes P, Williams S, Sa B, and Stevenson K. A study of empathy decline in students from five health disciplines during their first year of training. Int J Med Educ 2011; 2:12-17.
12. Turan E, Yanardag M, and Metintas S. Attitudes of students of health sciences towards the older persons. Nurse Educ Today 2016; 36:53-7.
13. Ferri P, Rovesti S, Panzera N, Marcheselli L, Bari A, and Di Lorenzo R. Empathic attitudes among nursing students: a preliminary study. Acta Biomed 2017; 88:22-30.
14. Ward J, Cody J, Schaal M, and Hojat M. The empathy enigma: an empirical study of decline in empathy among undergraduate nursing students. J Prof Nurs 2012; 28:34-40.
15. Kim SS, Kaplowitz S, and Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof 2004; 27:237-251.
16. Zachariae R, Pedersen CG, Jensen AB, Ehrnrooth E, Rossen PB, and von der Maase H. Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. Br J Cancer 2003; 88:658-665.
17. Hojat M, Louis DZ, Markham FW, Wender R, Rabinowitz C, and Gonnella JS. Physicians' empathy and clinical outcomes for diabetic patients. Acad Med 2011; 86:359-364.
18. Chen AM, Kiersma ME, Yehle KS, and Plake KS. Impact of the Geriatric Medication Game® on nursing students' empathy and attitudes toward older adults. Nurse Educ Today 2015a; 35:38-43.
19. Chen AM, Plake KS, Yehle KS, and Kiersma ME. Impact of the geriatric medication game on pharmacy students' attitudes toward older adults. Am J Pharm Educ 2011; 75:158.
20. Chen AM, Kiersma ME, Yehle KS, and Plake KS. Impact of an aging simulation game on pharmacy students’ empathy for older adults. Am J Pharm Educ 2015b; 79.
21. Henry BW, Ozier AD, and Johnson A. Empathetic responses and attitudes about older adults: How experience with the aging game measures up. Educ Gerontol 2011; 37:924-941.
22. Schmall V, Grabinski CJ, and Bowman S. Use of games as a learner-centered strategy in gerontology, geriatrics, and aging-related courses. Gerontol Geriatr Educ 2008; 29:225-233.
23. Faul F, Erdfelder E, Lang AG, and Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39:175-91.
24. Hojat M, Empathy in health professions education and patient care. 2016, New York: Springer International.
25. Fields SK, Mahan P, Tillman P, Harris J, Maxwell K, and Hojat M. Measuring empathy in healthcare profession students using the Jefferson Scale of Physician Empathy: health provider--student version. J Interprof Care 2011; 25:287-93.
26. Ogiwara S, Inoue K, and Koshimizu S. Reliability and Validity of a Japanese Version ofAttitudes Towards the Elderly'Scale. J Phys Ther Sci 2007; 19:27-32.
27. Küçükgüçlü Ö, Mert H, and Akpınar B. Reliability and validity of Turkish version of attitudes toward old people scale. J Clin Nurs 2011; 20:3196-203.
28. Sari D, Taskiran N, Baysal E, Acar E, and Cevik Akyil R. Effect of an aged simulation suit on nursing students' attitudes and empathy. Eur Geriatr Med 2020; 4:667-675.
29. Kullman K. Prototyping bodies: a post-phenomenology of wearable simulations. Des Stud. 2016; 47:73-90.
30. Weber RP, Basic content analysis. 2nd edn. ed. 1990, Newbury Park: Sage.
31. Richardson C, Percy M, and Hughes J. Nursing therapeutics: Teaching student nurses care, compassion and empathy. Nurse Educ Today 2015; 35:e1-e5.
32. Tremayne P, Burdett J, and Utecht C. Simulation suit aids tailored care. Nurs Older People 2011; 23:19-22.
33. Karaca A, Açıkgöz F, and Akkuş D. Eğitim ile empatik beceri ve empatik eğilim geliştirilebir mi?: Bir sağlık yüksekokulu örneği. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2013.
34. Varkey P, Chutka DS, and Lesnick TG. The aging game: improving medical students’ attitudes toward caring for the elderly. J Am Med Dir Assoc 2006; 7:224-229.
35. Adelman RD and Albert RC. Medical student attitudes toward the elderly: a critical review of literature. Gerontol Geriatr Educ 1988; 7:141-156.
36. Green SK, Keith KJ, and Pawlson LG. Medical students' attitudes toward the elderly. J Am Geriatr Soc 1983; 31:305-309.
37. Herdman E. Challenging the discourses of nursing ageism. Int J Nurs Stud 2002; 39:105-14.
38. Wilson SE, Prescott J, and Becket G. Empathy levels in first-and third-year students in health and non-health disciplines. Am J Pharm Educ 2012; 76.
39. Amanda S. Eymard BDC, Todd M. Keller. "Take a Walk in My Shoe“ : Nursing Students Take a Walk in Older Adults' Shoes to Increase Knowledge and Empathy. Geriatr Nurs 2010; 31:137-141.
40. Bauchat JR, Seropian M, and Jeffries PR. Communication and empathy in the patient-centered care model—why simulation-based training is not optional. Clin Simul Nurs 2016; 12:356-359.
41. Hafskjold L, Sundler AJ, Holmström IK, Sundling V, van Dulmen S, and Eide H. A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol. BMJ open 2015; 5.
42. Kristensen DV, Sundler AJ, Eide H, Hafskjold L, Ruud I, and Holmström IK. Characteristics of communication with older people in home care: a qualitative analysis of audio recordings of home care visits. J Clin Nurs 2017; 26:4613-4621.
43. Hojat M, Vergare MJ, Maxwell K, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med 2009; 84:1182-1191.
44. Doherty M, Mitchell EA, and O'Neill S. Attitudes of Healthcare Workers towards Older People in a Rural Population: A Survey Using the Kogan Scale. Nurs Res Pract 2011; 2011:352627.
45. Zehirlioglu L, Yönt GH, Bayat E, and Günay B. Hemşirelerin Yaşlılara Yönelik Tutumları ve Etkileyen Faktörlerin Belirlenmesi. Yıldırım Beyazıt Üniversitesi Hemşirelik E-Dergisi 2016; 3:10-18.
46. Pehlivan S and Vatansever N. Hemşirelerin Yaşlıya Tutumları ve Etkileyen Faktörler. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2019; 45:47-53.