The influence of ageism on stereotypical attitudes among allied health students in Japan: a group comparison design

Fukase et al. BMC Medical Education (2021) 21:27 https://doi.org/10.1186/s12909-020-02439-0 RESEARCH ARTICLE Open Access The influence of ageism on stereotypical attitudes among allied health students in Japan: a group comparison design Yuko Fukase1* , Naoto Kamide1, Norio Murayama2, Akie Kawamura1, Kanako Ichikura1, Yoshitaka Shiba1 and Hirokuni Tagaya1 Abstract Background: Ageism is a serious problem in medical care. The importance of ageism-related education for students has been emphasized. To determine the most effective approach to ageism-related education for allied health students, this study examined ageism among this group of students, with the hypothesis that ageism was expressed not only toward elderly adults but also toward individuals other than elderly adults. Methods: A questionnaire survey was conducted among 154 allied health students in Japan. The questionnaire involved tree drawings to evaluate the drawer’s personality and a measurement of the participants’ ageism. There were two display conditions for tree drawing. In the elderly display condition, participants were informed that the drawer was an elderly person, and in a control condition, participants were not informed of the drawer’s age. Participants were randomly assigned to each condition and were required to evaluate the drawer’s personality based on 5 personality traits. After the evaluation, all participants were required to complete the Japanese short version of the Fraboni Scale of Ageism (FSA-J). Results: The participants were 123 allied health students, 61 of whom were in the elderly display condition and 62 of whom were in the control condition. Based on the mean score on the FSA-J (M = 29.80), we divided the participants into a low-FSA-J group (N = 64) and a high-FSA-J group (N = 59). There was no significant difference between the display conditions on the FSA-J score. In the high-FSA-J groups, the control condition evaluated the drawer’s personality as more timid than did the elderly display condition (F = 4.26, df = 1, 119). For negligence, the high-FSA-J group evaluated the drawer’s personality as more negligent than did the low-FSA-J group (F = 4.08). For broad interests, the main effects of condition and groups were significant (F = 4.23). Conclusions: The results suggested that ageism indicated a negative evaluation not only of elderly adults but also of individuals other than elderly adults, and students with negative ageism might evaluate the elderly drawer more positively. We have discussed the possibility that negative ageism among allied health students in Japan might underlie these positive stereotypes. Keywords: Ageism in health care, Allied health students, Stereotype, Education about ageism, Random allocation * Correspondence: 1 Kitasato University School of Allied Health Sciences, 1-15-1, Kitazato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan Full list of author information is available at the end of the article © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Fukase et al. BMC Medical Education (2021) 21:27 Background Ageism, or a negative prejudice toward elderly adults, is a serious problem in medical care. It has been reported that a negative attitude among healthcare professionals toward elderly patients leads to low-quality care and therapy [1, 2] and elder abuse and neglect [3, 4]. In Japan, 50.2% of all patients are older [5], and ageism in health care is an urgent issue [6]. To reduce ageism, the importance of education for allied health students has been emphasized [7–12]. Ageism among young people is thought to be caused by a lack of knowledge, a lack of communication with elderly adults, aging anxiety and a fear of death [13–16]. North et al. [17] suggested that ageism among the young toward elderly adults is based on their envy of the resources, societal position, unequal sharing of government money and public space afforded to elderly adults, as well as the limited participation of elderly adults in activities usually reserved for younger people. It was reported that education based on information about elderly adults and descriptions of an intergeneration between elderly and young individuals were effective ways to reduce ageism among undergraduate students [18]. These studies argued that an effective educational program can contribute to a negative attitude toward elderly adults among allied health students. For effective education on ageism for allied health students, it might be necessary to consider negative attitudes toward not only elderly adults but also those other than elderly adults because ageism might be associated with personality traits; for example, ageism is negatively associated with agreeableness and conscientiousness and positively associated with neuroticism [19]. Whether ageism is caused by a lack of knowledge, a lack of communication, or an unconscious fear of aging and death, ageism is nonetheless prejudice toward others. When ageism influences behavior not only toward elderly adults but also toward those other than elderly adults, education on only attitudes toward elderly adults is insufficient to reduce ageism. Therefore, this study examined ageism among allied health students, including negative attitudes toward elderly adults and toward those other than elderly adults. If a negative attitude based on ageism influences only elderly adults, then allied health students with high levels of ageism evaluated only elderly adults negatively. Page 2 of 7 drawer’s personality using the tree drawing and answer the measure of participant levels of ageism. A tree drawing is a projective test [21]. Usually, it is used to assess the drawer’s personality; however, this study used it to assess the assessor’s attitude toward elderly adults according to the suggestion that the evaluation somewhat reflected the assessor’s values [22]. There were two display conditions of the tree drawing, however, the same tree dr (...truncated)