Sadra Medical Journal

The Effect of an Educational Program Based on Classical Persian Literature on the Quality of Elderly Care and Attitude toward Aging among Undergraduate Nursing Students: A Randomized Controlled Trial

Document Type : Original Article

Authors

Seyedeh Najmeh Hosseini 1
Abdolrahim Asadollahi 1
Fateme Moradi 2
Leila Ghahremani 3
Sorur Javanmardifard 4

1 Department of Gerontology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of General, School of Paramedical Sciences Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

4 Community Based Psychiatric Care Research Center, Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.30476/smsj.2025.103112.1549
Abstract
Introduction: Key challenges in elderly care include poor relational quality and a negative attitude towards older adults. Addressing this issue requires first changing the attitude of younger individuals. This study investigated the effect of an educational program utilizing teachings from classical Persian literature on the quality of elderly care and attitudes toward aging among undergraduate nursing students.
Methods: This experimental study was a randomized controlled trial conducted in 2023 with 86 undergraduate nursing students. Participants were selected via a simple random allocation method with equal blocks using student ID numbers and were divided equally into an intervention group and a control group. The intervention group participated in six 45-minute, in-person training sessions. Assessments were conducted at four time points for both groups. The attitude variable was measured using Kogan’s Attitudes toward Old People (KAOP) scale, and the quality of care was measured using a nursing care quality questionnaire across four phases. Data were analyzed using repeated-measures ANOVA (r-ANOVA) in JAMOVI software (version 2.3).
Results: The mean age of the participants was 23.70±3.38 years (range: 19-41 years), with 52.3% male and 47.7% female. No significant differences were observed in demographic variables between the groups before the intervention. Repeated-measures ANOVA revealed a significant difference in the mean attitude scores across the four measurement stages between and within the groups, specifically on the appreciation and prejudice subscales, indicating that the training positively improved students’ attitudes towards older adults (P<0.001). However, the mean overall score for nursing care quality, across the physical, communicative, and psychosocial dimensions, indicated no significant difference between the groups across the four measurement periods (P>0.05), suggesting that the training led to only minimal changes in this area.
Conclusion: An educational approach based on classical Persian literature could positively influence nursing students’ attitudes toward the social status of the elderly. While the training demonstrated some effectiveness, its impact on improving the overall quality of nursing care was limited. 

Keywords

Attitude
Geriatric Nursing
Quality of Health Care
Elderly
Caregiver
  1. Soegiarto G, Purnomosari D. Challenges in the Vaccination of the Elderly and Strategies for Improvement. Pathophysiology. 2023;30(2):155-73.
  2. Organization WH [Internet]. Definition of an older or elderly person. c2013. [Accessed 30 June 2015]. Available from: www.who.int/healthinfo/survey/ageingdefnolder/en/
  3. El Hayek S, Cheaito MA, Nofal M, Abdelrahman D, Adra A, Al Shamli S, et al. Geriatric Mental Health and COVID-19: An Eye-Opener to the Situation of the Arab Countries in the Middle East and North Africa Region. Am J Geriatr Psychiatry. 2020;28(10):1058-69.
  4. Jazayeri E, Kazemipour S, Hosseini SR, Radfar M. Quality of life in the elderly: A community study. Caspian journal of internal medicine. 2023;14(3):534.
  5. Pandey NM, Tripathi RK, Kar SK, Vidya KL, Singh N. Mental health promotion for elderly populations in World Health Organization South-East Asia Region: Needs and resource gaps. World J Psychiatry. 2022;12(1):117-27.
  6. Borges MM, Custódio LA, Cavalcante DdFB, Pereira AC, Carregaro RL. Direct healthcare cost of hospital admissions for chronic non-communicable diseases sensitive to primary care in the elderly. Ciência & Saúde Coletiva. 2023;28:231-42.
  7. Santana E, Mendes F, Bernardo J, Silva R, Melo P, Lima P, et al. Difficulties in Caring for the Older Adults: Perspective of Brazilian and Portuguese Caregivers. Nurs Rep. 2023;13(1):284-96.
  8. Supaporn K, Thaniwattananon P, Isaramalai S-a, Khaw T. Home-based end-of-life care for Thai elders: Family caregivers’ perspectives. Kasetsart Journal of Social Sciences. 2022;43(4):1085–94-–94.
  9. Lu M, Peng X, Chen M. Changes in the death probability of China’s elderly population and rethinking the definition of old age. China Population and Development Studies. 2019;2(3):284-300.
  10. Mehri N, Messkoub M, Kunkel S. Trends, determinants and the implications of population aging in Iran. Ageing International. 2020;45(4):327-43.
  11. Dahlke S, Kalogirou MR, Swoboda NL. Registered nurses’ reflections on their educational preparation to work with older people. Int J Older People Nurs. 2021;16(2):e12363.
  12. Zhang H, Sun H. Knowledge, attitude and self-efficacy of elderly caregivers in Chinese nursing homes: a cross-sectional study in Liaoning Province. BMJ Open. 2019;9(11):e029869.
  13. Donizzetti AR. Ageism in an Aging Society: The Role of Knowledge, Anxiety about Aging, and Stereotypes in Young People and Adults. Int J Environ Res Public Health. 2019;16(8);1329.
  14. Purfarzad Z, Bahrami M, Keshvari M, Rafiei M, Sivertsen N, Cert G. Effective Factors for Development of Gerontological Nursing Competence: A Qualitative Study. J Contin Educ Nurs. 2019;50(3):127-33.
  15. Yu X, Wang Q. A study on the factors influencing old age identity among the Chinese elderly. Front Public Health. 2022;10:1027678.
  16. Mahjoub F. A comparative Analysis of the Story of. Literary Arts. 2021;13(2):127-50.
  17. Ahbabi M. A Comparative Study of Zahhak’s Dual Character in Mythology, History, and Archeological Findings in Iran and Tajikistan. Anthropology & Archeology of Eurasia. 2016;55(3-4):301-15.
  18. Saghafi A, Bahramnezhad F, Poormollamirza A, Dadgari A, Navab E. Examining the ethical challenges in managing elder abuse: a systematic review. J Med Ethics Hist Med. 2019;12:7.
  19. Kogan N. Attitudes toward old people: the development of a scale and an examination of correlates. J Abnorm Soc Psychol. 1961;62:44-54.
  20. Rejeh N, Heravi-Karimooi M, Montazeri A, Foroughan M, Vaismoradi M. Psychometric properties of the Iranian version of the Kogan’s Attitudes Toward Older People Scale. Jpn J Nurs Sci. 2012;9(2):216-22.
  21. Dyer ED, Monson MA, Cope MJ. Increasing the quality of patient care through performance counseling and written goal setting. Nursing Research. 1975;24(2):138-43.
  22. Sabzianpur Z, Nuri S. Effect of spiritual intelligence on quality of nursing care of educational and treatment hospitals in Hamadan. Avicenna Journal of Nursing and Midwifery Care. 2019;27(1):18-24.
  23. Jamovi P. Jamovi (Version 2.3)[Computer Software]. 2022.
  24. Min SH, Zhou J. smplot: An R Package for Easy and Elegant Data Visualization. Front Genet. 2021;12:802894.
  25. Soleimaninejad A, Abolfathi Momtaz Y, Taheri Tanjani P. The relationship between gender and attitudes toward older adults among medical science students of Tehran city university. Journal of North Khorasan University of Medical Sciences. 2018;10(3):21-8.
  26. Berger R. Aging in America: Ageism and general attitudes toward growing old and the elderly. Open Journal of Social Sciences. 2017;5(08):183.
  27. Yu SJ, Kim SM, Lee YJ. [The effect of senior simulation on nurses’ attitude toward the elderly]. Taehan Kanho Hakhoe Chi. 2004;34(6):974-82.
  28. Afolabi AO, Eboiyehi FA, Afolabi KA. Gender analysis of nurses’ attitude towards care of the elderly with dementia in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria. J Women Aging. 2020;32(2):203-19.
  29. Lopez-Hernandez L, Martinez-Arnau FM, Castellano-Rioja E, Botella-Navas M, Perez-Ros P. Factors Affecting Attitudes towards Older People in Undergraduate Nursing Students. Healthcare (Basel). 2021;9(9).
  30. Papi S, Najafi H, Noori SR, Fadayevatan R. Analysis of the Attitudes of Iran’s Council Representatives towards the Aging Phenomenon. Journal of health research in community. 2023;9(2):17-27.
  31. Shaban Ghoochan K, Tavoossi M, Mahoozi M. An Analysis of Irony’s Artworks in Saadi Shirazi’s Poetry. Interpretation and Analysis of Persian Language and Literature Texts (Dehkhoda). 2020;12(44):191-218.
  32. Topp SM, Sheikh K. Are We Asking All the Right Questions About Quality of Care in Low- and Middle-Income Countries? Int J Health Policy Manag. 2018;7(10):971-2.
  33. de Almeida Tavares JP, da Silva AL, Sa-Couto P, Boltz M, Capezuti E. Portuguese nurses’ knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51-61.
  34. Liu YE, Norman IJ, While AE. Nurses’ attitudes towards older people and working with older patients: an explanatory model. J Nurs Manag. 2015;23(8):965-73.
  35. Nazari S, Poortaghi S, Sharifi F, Gorzin S, Afshar PF. Relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. BMC Health Serv Res. 2022;22(1):840.
  36. Farokhzadian J, Miri S, Doostkami M, Rezahosseini Z, Shahrbabaki PM. Promoting the psychosocial and communication aspects of nursing care quality using time management skills training. J Educ Health Promot. 2020;9:361.
Sadra Medical Journal
Volume 13, Issue 3
Summer 2025
Pages 478-493

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