Rol Oynama ve Yaşlı Simülasyon Kıyafetinin Yaşlılara Karşı Empati ve Olumlu Tutum Üzerindeki Etkisi

Abstract

Amaç: Bu çalışmanın amacı, hemşirelik ve tıp öğrencilerinde tek başına rol oynama ve rol oynama ile yaşlı simülasyon kıyafeti ile birlikte kullanılmasının yaşlılarla empati kurma ve onlara karşı olumlu tutum geliştirme üzerindeki etkisini belirlemektir.
Yöntem: Araştırma, 64 hemşirelik ve tıp öğrencisinin katılımıyla ön test son test deneysel desende gerçekleştirilmiştir. Tüm öğrencilere yaşlılarla empati kurma eğitimi verildi, öğrencilerden Jefferson Empati Ölçeği ve Kogan'ın Yaşlılara Yönelik Tutum Ölçeği'ni doldurmaları istendi. Daha sonra deney grubuna yaşlı simülasyon kıyafeti giydirilmiştir (n: 34). Deney grubundaki öğrenciler yaşlı simülasyon giysisini giydikten sonra günlük yaşamdan aktivitelerle (beslenme, fiziksel aktivite, tuvalete gitme vb.) ilgili üç senaryoya odaklanan bir dizi görevi yerine getirmişlerdir. Görevleri tamamladıktan sonra öğrencilerle yarı yapılandırılmış görüşme formu aracılığıyla derinlemesine görüşmeler yapılmıştır. Çalışmanın son bölümünde hem deney hem de kontrol grubundaki öğrenciler tekrar Jefferson Empati Ölçeği ve Kogan'ın Yaşlı İnsanlara Karşı Tutum Ölçeği'ni doldurmuşlardır. Nicel veriler, IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Sürüm 25.0. Armonk, NY: IBM Corp.) ve SAS yazılımı (Sürüm 9.3; PROC MIXED SAS Institute, Cary, NC, ABD) ile analiz edildi. Nitel veri analizi MAXQDA yazılımı (Versiyon 12) ile yapıldı. İçerik analizi için temalar ve kodlar belirlendi. Değişkenlerin normal dağılımını incelemek için Shapiro-Wilks testi, verilerin analizinde betimsel istatistikler, bağımsız örneklem t testi veya Mann-Whitney U Testi kullanılmıştır. İstatistiksel anlamlılık p<0.05'te kabul edilmiştir.
Bulgular: Hemşirelik ve tıp öğrencilerinin empati puan ortalamalarına bakıldığında her iki fakültede deney ve kontrol grupları arasında fark olduğu görülmektedir. Uygulama öncesi ve sonrası puanlar arasındaki değişim artış yönünde olup deney ve kontrol gruplarında anlamlıdır. Öğrencilerin yaşlılara yönelik tutum puan ortalamalarındaki değişimler fakültelere ve gruplara göre farklılık göstermektedir. Öğrenciler mülakatlarında yaşlı simülasyon giysisi ile yaşlıların fiziksel yetersizliklerini hissedebildiklerini ifade ederken, rol oynamada empatinin daha çok duygusal yönünü deneyimlediklerini belirtmişlerdir. Öğrenciler kursun sonunda yaşlılara karşı davranışlarında olumlu değişiklikler olabileceğini açıkladılar.
Sonuç: Tek başına rol oynama ve rol oynama ile yaşlı simülasyonunun birlikte uyumunun yaşlılara karşı olumlu tutum ve empatik yaklaşım gösterme açısından birbirini desteklediği düşünülebilir. 

Keywords

• Yaşlı Bireyler
• Empati
• Tutum
• Simülasyon
• Rol Oynama

The Effect of Role-Playing and Aged Simulation Suit on Empathy and Positive Attitude towards the Older-People

Abstract

Aim: The aim of this study was to determine the effect of role playing alone and role playing and simulation with aged simulation suit together on empathizing with the older people, and positive attitudes towards them among nursing and medical students.
Methods: The study was carried out in the pre-test post-test experimental design, with e participation of 64 nursing and medical students. All students were given a course on empathizing with the older people; and students were asked to fill out the Jefferson Scale of Empathy and Kogan's Attitude Towards Older People Scale. Then the experimental group used an aged simulation suit (n: 34). After putting on the aged simulation suit the students fulfilled a set of tasks that were focused on three scenarios related to activities of daily life (nutrition, physical activity, going to the bathroom, etc.). After completing the tasks, the students were asked to fill out the Jefferson Scale of Empathy and Kogan's Attitude Towards Older People Scale again. Later, in-depth interviews were held with students through a semi-structured interview form. The quantitative data were analyzed with IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) and SAS software (Version 9.3; PROC MIXED SAS Institute, Cary, NC, USA). Qualitative data analysis was performed with MAXQDA software (version 12). Themes and codes were specified for content analysis. The Shapiro-Wilks test was conducted to examine the normal distribution of variables, and descriptive statistics, independent sample t test or Mann-Whitney U Test were utilized for data analyses. Statistical significance was accepted at p<0.05.
Results: The mean empathy scores of both of the nursing and medical students differed between the experimental and control groups. The post-intervention scores significantly increased in both of the experimental and control groups compared to pre-intervention scores. The changes in the mean older people attitude scores of the students varied regarding the school and the study groups. a In the interviews the students expressed that they could feel the physical incapability of the older people with the aged simulation suit and they experienced the emotional aspect of empathy further in role playing. Students stated that positive changes might occur in their behavior towards the older people by the end of the course.
Conclusions: The findings of the study suggest that role playing alone and role playing, and aged simulation suit together support each other in terms of showing positive attitudes and empathic approach to the older people. 

Keywords

• Older People
• Empathy
• Attitudes
• Simulation
• Role Playing

References

1. Referans1 Chen, A. M., Kiersma, M. E., Yehle, K. S., & Plake, K. S. (2015). Impact of the geriatric medication game® on nursing students' empathy and attitudes toward older adults. Nurse Education Today, 35(1), 38–43.
2. Referans2 Kose, G., Ayhan, H., Tastan, S., Iyigun, E., Hatipoglu, S., & Acıkel, C. H. (2015). Sağlık alanında farklı bölümlerde öğrenim gören öğrencilerin yaşlı ayrımcılığına ilişkin tutumlarının belirlenmesi. Gulhane Medical Journal, 57(2), 145-152.
3. Referans3 Zhang, S., Liu, Y., Zhang, H., Meng, L., Liu, P., 2016. Determinants of undergraduate nursing students care willingness towards the elderly in China: attitudes, gratitude and knowledge. Nurse Educ. Today 43, 28–33.
4. Referans4 Gallo, V. (2019). Ageism in nursing education: A review of the literature. Teaching and Learning in Nursing, 4, 208–215.
5. Referans5 Demirtas, A., & Basak, T. (2020). Daily life activities simulation: Improving nursing students' attitudes toward older patients. Japan Journal of Nursing Science, e12375.
6. Referans6 Abdool PS, Nirula L, Bonato S, Rajji TK, Silver IL. Simulation in undergraduate psychiatry: exploring the depth of learner engagement. Acad Psychiatry. 2017;41(2):251–61.
7. Referans7 Lavalliere, M., D'Ambrosio, L., Gennis, A., Burstein, A., Godfrey, K. M., Waerstad, H., … Coughlin, J. F. (2017). Walking a mile in another's shoes: The impact of wearing an age suit. Gerontology & Geriatrics Education, 38, 171–187.
8. Referans8 Sari, D., Taskiran, N., Baysal, E., Acar, E., & Akyil, R. C. (2020). Effect of an aged simulation suit on nursing students’ attitudes and empathy. European geriatric medicine, 11(4), 667-675.

9. Referans9 Craft, J., & Ainscough, L. (2015). Development of an electronic role-play assessment initiative in bioscience for nursing students. Innovation in Education and Teaching International, 52(2), 172–184.
10. Referans10 Robinson, S. B., & Rosher, R. B. (2001). Effect of the “half-full aging simulation experience” on medical students' attitudes. Gerontology & Geriatrics Education, 21(3): 3-12.
11. Referans11 Bas-Sarmiento, P., Fernández-Gutiérrez, M., Baena-Baños, M., Correro-Bermejo, A., Soler-Martins, P. S., & de la Torre-Moyano, S. (2020). Empathy training in health sciences: A systematic review. Nurse education in practice, 44, 102739.
12. Referans12 Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Veloksi, J. J., & Magee, M. (2002). The jefferson scale of physician empathy: further psychometric data and differences by gender and specialty at item level. Academic Medicine, 77(10), S58-S60.
13. Referans13 Ward, J., Schaal, M., Sullivan, J., Bowen, M. E., Erdmann, J. B., & Hojat, M. (2009). Reliability and validity of the jefferson scale of empathy in undergraduate nursing students. Journal of Nursing Measurement, 17(1), 73-88. doi: 10.1891/1061-3749.17.1.73
14. Referans14 Gonullu, I. & Oztuna, D. (2012). A Turkish adaptation of the student version of the jefferson scale of physician empathy. Marmara Medical Journal, 25(2), 87-92.
15. Referans15 Yanik, A., & Saygili, S. (2014). Validity and Reliability of the Turkish Version of Jefferson Scale of Empathy for nursing students. Turkiye Klinikleri Journal of Medical Sciences. 34(1), 111-119. doi: 10.5336/medsci.2013-37793
16. Referans16 Kucukguclu, O., Mert, H. & Akpinar, B. (2011). Reliability and validity of Turkish version of attitudes toward old people scale. Journal of Clinical Nursing, 20(21-22), 3196-3203. doi: 10.1111/j.1365-2702.2011.03764.x
17. Referans17 Türgay AS, Şahin S, Aykar FŞ, Sarı D, Badır A, Özer ZC. Attitudes of Turkish nursing students toward elderly people. European Geriatric Medicine 2015; 6(3): 267-70.
18. Referans18 Jeong, H., Lee, Y., & Kwon, H. (2017). Effects of senior simulation program for nursing students: An integrated Study in South Korea. EURASIA Journal of Mathematics, Science and Technology Education, 13(8), 4437-4447.
19. Referans19 Hajibabaee, F., Farahani, M. A., Ameri, Z., Salehi, T., & Hosseini, F. (2018). The relationship between empathy and emotional intelligence among Iranian nursing students. International journal of medical education, 9, 239.
20. Referans20 Mirani, S. H., Shaikh, N. A., & Tahir, A. (2019). Assessment of clinical empathy among medical students using the Jefferson Scale of Empathy-Student Version. Cureus, 11(2).
21. Referans21 Shaheen, A., Mahmood, M. A., Zia-ul-Miraj, M., & Ahmad, M. (2020). Empathy levels among undergraduate medical students in Pakistan, a cross sectional study using Jefferson scale of physician empathy. JPMA. The Journal of the Pakistan Medical Association, 70(7), 1149-1153.
22. Referans22 Van Winkle LJ, Fjortoft N, Hojat M. Impact of a workshop about aging on the empathy scores of pharmacy and medical students. Am J Pharm Educ. 2012;76:9
23. Referans23 Kelm, Z., Womer, J., Walter, J.K., Feudtner, C., 2014. Interventions to cultivate physician empathy: a systematic review. BMC Med. Educ. 14, 219
24. Referans24 De Abreu, I. D., Hinojosa-Lindsey, M., & Asghar-Ali, A. A. (2017). A simulation exercise to raise learners’ awareness of the physical and cognitive changes in older adults. Academic Psychiatry, 41(5), 684-687.
25. Referans25 Saleh, N., Elsayed, E., Mohamed, H., El-Gilany, A.H., 2017. Simulated aging game/traditional lecture and students’ knowledge and attitude. Alexandria Sci. Nurs. J. 19 (1), 163–176.
26. Referans26 da Nova Fernandes, C. S. N., Couto, G., & Afonso, A. (2019). An aging simulation game’s impact on the attitudes of nursing students. Nursing Practice Today.
27. Referans27 Cheng, W. L. S., Ma, P. K., Lam, Y. Y., Ng, K. C., Ling, T. K., Yau, W. H., ... & Li, P. P. (2020). Effects of Senior Simulation Suit Programme on nursing students' attitudes towards older adults: A randomized controlled trial. Nurse education today, 88, 104330.
28. Referans28 Eymard, A. S., Crawford, B. D., & Keller, T. M. (2010). “Take a walk in my shoes”: nursing students take a walk in older adults' shoes to increase knowledge and empathy. National Gerontological Nursing Association, 31(2), 137-141.
29. Referans29 Alshehry, A. S., Almazan, J. U., & Alquwez, N. (2019). Influence of religiosity on the Saudi nursing students’ attitudes toward older people and perceptions on elderly care. Journal of religion and health, 1-14.
30. Referans30 Hsu, M. H. K., Ling, M. H., & Lui, T. L. (2019). Relationship between gerontological nursing education and attitude toward older people. Nurse education today, 74, 85-90.
31. Referans31 De Biasio, J. C., Parkas, V., & Soriano, R. P. (2016). Longitudinal assessment of medical student attitudes toward older people. Medical teacher, 38(8), 823-828.
32. Referans32 Elbi, H., Altan, S., De Biasio, J. C., Parkas, V., & Soriano, R. P. (2016). Longitudinal assessment of medical student attitudes toward older people. Medical teacher, 38(8), 823-828.
33. Referans33 Gholamzadeh, S., Khastavaneh, M., Khademian, Z., & Ghadakpour, S. (2018). The effects of empathy skills training on nursing students’ empathy and attitudes toward elderly people. BMC Medical Education, 18(1), 1-7.
34. Referans34 Lucchetti, A. L. G., Lucchetti, G., de Oliveira, I. N., Moreira-Almeida, A., & da Silva Ezequiel, O. (2017). Experiencing aging or demystifying myths?–impact of different “geriatrics and gerontology” teaching strategies in first year medical students. BMC medical education, 17(1), 1-9.