The effect of interventions for healthcare students to develop positive attitude towards the elderly: A meta-analysis study

The rise in the elderly population all over the world has led to an increase in the healthcare needs of elderly individuals. For the elderly population with a high probability of encountering healthcare providers, access to quality healthcare is associated with positive attitudes of health professionals towards the elderly. Thus, healthcare professionals need programs to help them develop positive attitudes towards the elderly during their education process. This study aims to explore the effect of interventions that encourage healthcare students to develop positive attitudes towards the elderly. The inclusion criteria for the studies searched for this research, which was conducted by meta-analysis method, were randomized controlled and non-randomized controlled trials with low risk of bias, conducted with students in bachelor's or associate programs in the field of health, aimed to develop positive attitudes towards the elderly, assessing attitudes towards the elderly with valid and reliable tools, as well as the articles, research reports and theses/dissertations published in Turkish and English languages between January 2002 and July 2022. Literature search was performed in 8 databases (APA PsycInfo, CINAHL Complete, "Cochrane Central Register of Controlled Trials" (CENTRAL), Medline Complete, ProQuest Dissertations and Theses Global, Scopus, TR Index, WOS Core Collection and National Thesis Center) between June 15, 2022 and July 31, 2022. The evaluation of titles and abstracts of the studies retrieved through literature search by relevance to the topic, the full text review according to inclusion-exclusion criteria, and the evaluation for bias were all completed in three stages by two independent reviewers. The bias assessment of the studies was performed with Cochrane bias assessment tools. As a result of the search, 14101 studies were retrieved. Following the literature search, 3882 studies were excluded due to duplication. 10219 studies were evaluated according to title and abstract and 125 studies were included in the full text evaluation. Following the database search, a reference search was carried out; 3 studies found were included for bias assessment. Finally, 26 articles were included in the bias assessment and 13 studies were included in the meta-analysis. Comprehensive Meta Analysis (CMA) package program was used to evaluate the data. Hedges g was analyzed for effect size, while Q statistic and I2 values were analyzed for heterogeneity test. Orwin's fail-safe N value, Kendall's τ coefficient and Egger's regression analysis methods were used for publication bias. The significance value for publication bias was set at p<0.05. Publication bias is presented with a funnel plot, and effect size with a forest plot. Following the meta-analysis, the effect size of positive attitude development interventions for the elderly was found to be statistically significant at 0.422 (95% CI: 0.013: 0.830) (p=0.043). 13 studies in which the effect of positive attitude development interventions for the elderly was examined revealed that the effect was moderately in favor of the experimental group. Although there are a large number of studies in the literature that aim to develop positive attitudes towards the elderly, well-designed studies with high methodological quality are needed to obtain high level evidence.