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<h4>ABSTRACT</h4> <P>The purpose of this study was to investigate nursing students’ knowledge of and attitudes toward older adults in the first and fourth years of a baccalaureate program, following the introduction of a context-based learning (CBL) curriculum, and to compare the fourth-year CBL student findings to those of fourth-year students in the final year of the traditional, lecture-based baccalaureate program. The Facts on Aging Questionnaire was used to assess knowledge, and the Aging Semantic Differential was used to assess attitudes toward aging related to societal influences. Although there were differences in knowledge and attitudes between fourth-year CBL and fourth-year traditional students, the differences were not significant. These findings support earlier work that an integrated curriculum may not significantly improve knowledge of age-related changes nor positively influence attitudes that are already positive. The Reactions to Ageing Questionnaire was used to examine students’ attitudes toward personal aging. There was a significant positive increase in CBL students’ attitudes toward personal aging from the first to fourth years of the program. This suggests that CBL learning fosters an inner maturity toward personal aging. </P> <h4>AUTHORS</h4> <P>Received: August 25, 2003</P> <P>Accepted: July 15, 2005</P> <P>Dr. Williams is Associate Professor, Dr. Anderson was Associate Professor (retired), and Dr. Day is Professor and Associate Dean of Academic Planning and Undergraduate Programs, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.</P> <P>The authors thank Dr. Mahvash Salsali for the initial data entry and analyses and Wayne Day for completion of the data entry and analyses. Consultation with Dr. L. Gething facilitated interpretation of the findings on the Reactions to Ageing Questionnaire. </P> <P>Address correspondence to Beverly Williams, PhD, RN, Associate Professor, Faculty of Nursing, 3rd Floor Clinical Sciences Building, University of Alberta, Edmonton, Alberta, Canada T6G 2G3; e-mail: <a href="mailto:beverly.williams@ualberta.ca">beverly.williams@ualberta.ca</a>.</P>

Goals of gerontological nursing include maximizing health and confronting functional impairments. The health of older adults is often fragile because of age-related change, complicated by chronic illnesses. Identification of changes in health status permits responsive care and consultation but requires proficiency in physical assessment. In 1995, research was conducted in Alberta, Canada, on registered nurse case managers' reported use of assessment skills. Nineteen continuing-care facilities in 1 of 17 provincial health regions participated (N = 189). After expert review and pilot testing, questionnaires were distributed to two independent groups: nurse administrators/staff development coordinators and case managers (response rate = 73%). Qualitative data were subjected to descriptive, interpretive, and pattern coding. Reported are factors constraining or facilitating physical assessment in continuing care. Neuman's concept of the created environment provided a factor-organizing framework. A holistic view of environment and data source triangulation increased confidence in the comprehensiveness and credibility of results.

This report compares 20th-century Canadian hospital and nonhospital location-of-death trends and corresponding population mortality trends. One of the chief findings is a hospitalization-of-death trend, with deaths in hospital peaking in 1994 at 80.5% of all deaths. The rise in hospitalization was more pronounced in the years prior to the development of a national health care program (1966). Another key finding is a gradual reduction since 1994 in hospital deaths, with this reduction occurring across all sociodemographic variables. This suggests nonhospital care options are needed to support what may be an ongoing shift away from hospitalized death and dying.

Research programs on teaching and learning environments and practice in nursing education need to be developed. Lobbying is needed to increase funding for this type of research at national and international levels.