s u m m a r y a r t i c l e i n f o Background: With the increased number of older people globally, caring for older people has become a challenge for many countries. Nurses have a pivotal role in providing quality care for older people and care is affected by their attitudes. The preparation of nurses to deliver quality care needs to be instilled during their studying in the Schools of Nursing. Objective: To examine the attitudes of nursing students toward and their willingness to work with older people in Sri Lanka. Methodology: A purposive sample of 98 first to fourth year undergraduate nursing students in the Department of Nursing, University of Peradeniya completed a self-administered questionnaire consisting of socio-demographic variables, Kogan's Attitudes toward Older People Scale, and questions related to willingness to work with older people. Results: Fifty percent of the respondents (n = 49) held slightly positive attitudes toward older people while 45% (n = 44) held slightly negative attitudes. About one-third of the respondents (29.9%, n = 29) selected the elderly group as the least preferred group for their future career from the categorized seven age groups. Only 5.1% (n = 5) of the respondents ranked the elderly group as the first preferred group. There was a significant difference in attitudes between students who lived with older people and students who did not live with older people (t = 2.565, p = .012). There was a positive relationship between attitudes and preference for working with older people (r = .342, p = .001). Conclusion: Nursing students have moderately positive attitudes toward older people; however, they show little interest in working with older people. Living with older people develops positive attitudes of young people toward older people. Attitudes are related to the selection in area of specialty in nursing. Nursing curricula need to include Gerontological Nursing as a major area.

Background The rate of cardiac rehabilitation attendance at the Sarawak Heart Centre was identified as very low, and the reason has not been investigated. A scale is needed to identify barriers to participation in cardiac rehabilitation among patients with heart disease in Sarawak, Malaysia. Purpose The purposes of this study were to translate, adapt, and evaluate the Malay-language version of the Cardiac Rehabilitation Barriers Scale (CRBS) and to measure the psychometric properties of the Malay-version CRBS to justify its use in Sarawak. Methods A forward and back-translation method was used. Content validity was assessed by three experts. Psychometric testing was conducted on a sample of 283 patients who were eligible to participate in cardiac rehabilitation. A construct validity test was performed using factor analysis. Cronbach's alpha was used to examine the internal consistency. The test–retest reliability was calculated using the intraclass correlation coefficient on 22 participants. Independent-samples t test and analysis of variance were conducted to assess the criterion validity. Mean scores for total barriers of the scale and each individual factor were compared among the different patient characteristics. Results The Malay-version CRBS showed an item level of content validity index of 1.00 for all of the items after improvements were made based on the experts' suggestions. The factor analysis, using principal component analysis with direct oblimin rotation, extracted four factors that differed from the original study. These four factors explained 52.50% of the cumulative percentage of variance. The Cronbach's alphas ranged from .74 to .81 for the obtained factors. Test–retest reliability was established using the intraclass correlation coefficient value of .78. Criterion validity was supported using the significant differences in the mean score for total barriers among educational level, driving distance, travel time to the hospital, and cardiac rehabilitation attendance. Conclusions/Implications for Practice This study found the Malay-version CRBS to be a valid and reliable instrument. It may be used with inpatients to identify barriers to participation in cardiac rehabilitation to promote rehabilitation attendance and improve patient care.

BackgroundPersisting delay in seeking treatment among Acute Myocardial Infarction (AMI) patients was reported in Malaysia despite intensified efforts in educating the public on symptoms of AMI and the importance of seeking prompt treatment. Studies outside Malaysia have shown that patients’ personal thoughts during symptom onset could contribute to the delay. The purpose of this study is to explore the barriers of AMI patients prior to the decision of seeking treatment in Malaysia.MethodsA qualitative descriptive research approach was chosen. Individual in-depth interviews were conducted among 18 patients with AMI. Data were analysed using thematic analysis. Recordings were transcribed and coded, codes were subsequently organized into categories. The stages of coding and identifying categories were repeated before themes were identified.ResultsThree meaningful themes with nine sub-themes that may have influenced the delayed decision to seek treatment were identified. Some themes identified were culturally bound.ConclusionsThe findings of this study give insights on barriers prior to the decision of seeking treatment when patients were experiencing AMI. Findings indicates that interventions targeted at increasing knowledge about AMI symptoms and correct actions using an informative approach at the current practice may not be adequate to reduce patient delay. The findings of this study could provide basis for the development of interventions that are culturally relevant to the Malaysians setting to promote behavioural change in the population and reduce pre-hospital delay.

Physical inactivity is a vital risk factor for the development and maintenance of chronic ill-health conditions among older adults. This study examined personal factors associated with physical activity (PA) behavior of urban-dwelling older adults in Sri Lanka, a middle-income country in South Asia. A total of 880 older adults (aged ≥60 years) participated in this cross-sectional study. They responded to anthropometrical, health, and socio-demographic data pertaining to their current physical and behavioral status. The mean age of the participants was 70.1 years ( SD ±6.0), and the majority (75%) were women. Increasing age, male gender, middle income, having cardiovascular diseases or arthritis, deficiencies in muscle strength and balance, pain, and lower self-rated health were associated with insufficient PA behavior among the participants. Old-age physical activity promotion programs should target older adults in advanced ages and men in particularly, as they are highly vulnerable to sedentary lifestyles. Muscle strength and balance, a neglected area in PA promotion in older adults, seem to play an important role in older adults’ participation in physical activities. Incorporation of pain management, and muscle strength and balance techniques into older adults’ PA promotion programs would probably increase adherence rates of the participants in such programs.

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