Physiotherapists' attitudes towards old and young patients in persistent vegetative state (PVS)

Abstract

PurposeThe purpose of this paper is to uncover attitudes of physical therapists (PTs) who treat vegetative state (VS) patients, and to raise awareness to ethical and professional dilemmas: Are PTs influenced by ageist perceptions? Do they consider physiotherapy to be effective or futile?Design/methodology/approachEthical questions and complex dilemmas are by and large subconscious and rarely explicitly voiced, but can be identified by revealing implicit therapists' personal and professional approach to patients. A quantitative six‐point Likert scale questionnaire was developed, which presented two VS cases – young and old, followed by practical‐ethical questions concerning key issues including: treatment choices, quality of life, prolongation of life, futile treatment (n=101, 68 percent return rate).FindingsThe results reveal a complex reality: on the one hand PTs expressed a positive perception of their profession, and consider all treatment components important for VS patients and their families regardless of age; on the other hand, significant preference for treating the younger VS patient was found.Practical implicationsThere is a need for raising awareness of physiotherapists to the social phenomenon of ageism and its implications on daily professional and ethical conduct.Originality/valueWhile other studies revealed ageism in various health care settings, this study was original both in its methodology (examining implicit ageism via contrasting vignettes), and its unique context (VS patients) which in theory could be viewed as “ageless” in light of the patients' permanent condition.

Öğrencilerin yaşlı ayrımcılığına ilişkin tutumları: bir üniversite örneği

“…Üniversitelerin tıp fakülteleri dışında hemşirelik, diş hekimliği, eczacılık, fizyoterapi ve rehabilitasyon, ev ekonomisi, beslenme ve diyetetik, sosyal hizmetler, psikoloji, mimarlık ve çevre tasarımı gibi bölümlerinde de yaşlı sağlığı ile ilgili-bağlantılı çalışmalar yürütülmektedir. [8][9][10][11] Literatürde yaşlıya yönelik tutumların olumsuz olmasının meslek yaşamında yaşlıyı ihmal etme ya da olumsuz yönde yaşlı ayrımcılığına yol açabileceği vurgulanmaktadır. 12,13 Özellikle uğraş alanı insan olan sağlıkla ilgili mesleklerde yaşlıya yönelik tutum mesleki pratiğe yansımaktadır.…”

Scoping Review on Ageism against Younger Populations

“…For example, in access to HIV antiretroviral treatment and heart transplant [ 127 ], and in terms of waiting lists [ 126 ]. There is also a significant preference for treating younger versus older patients in the vegetative state [ 43 ], and a perception that younger people deserve more psychosocial support [ 161 ]. The perceptions of social workers towards homeless people are also less harsh if the target is younger [ 162 ].…”

“…Some studies looked at the influence or rater’s age on the preference for or stereotyping of targets of various ages [ 48 , 64 , 66 , 67 , 69 ], showing inconsistent results. Other studies explored the influence of this determinant in performance evaluations of targets of different ages by either employers [ 30 ] or clients [ 53 , 65 ] or in treatment decisions for younger and older patients [ 43 ]. These studies generally found no or minimal effect of rater age.…”

Introduction: between law, ageing and ageism

“…Finally, while the challenges of both defining and explaining ageism continue, yet another growing body of research has been conducted into the ways in which ageism manifests itself in everyday life. Indeed numerous studies in the field of healthcare have shown how physicians, nurses, physiotherapists and more, not only hold ageist attitudes towards older patients, but also operate in discriminatory ways, providing older patients with inappropriate care (Inbar et al, 2012;Topaz and Doron, 2013).…”