Emergency nurses' and physicians' perceptions and self-assessed competence in providing care to older patients.

AIM: This study examined emergency nurses' and physicians' perceptions and self-assessed competence in caring for older patients. METHODS: Data were analyzed using a mixed methods approach and quantitative data were supplemented with qualitative responses. There were 451 nurses and physicians working at the two examined emergency departments, with 125 of them responding to the survey; the response rate was 27.7 %. RESULTS: Physicians and nurses felt that acutely ill older patients are a responsibility of emergency services. Nurses were more critical than physicians (p = 0.000) of the failure to recognize older patients as a special group at the emergency department. Over half (51.8 %) of the physicians and 29.0 % of the nurses (p = 0.027) felt that older patients' special needs had been considered during facility planning. Nurses and physicians described the problems related to multimorbidity and aging relatively similarly. Both expressed a need for more knowledge in geriatrics and gerontology. CONCLUSION: Future facility planning and care processes at the emergency department should better consider the specific needs of older patients. The results also emphasize a need to more effectively prioritize competence and educational needs of emergency staff and recognize caring for older patients as a specific competence area in the emergency department.

Age Diversity in Neighborhoods-A Mixed-Methods Approach Examining Older Residents and Community Wellbeing.

This paper focuses on age diversity in neighbourhoods and its possible impacts on community wellbeing. The aims of this paper are (a) to investigate whether age diversity in neighbourhoods contribute to older residents' wellbeing and (b) to explore older residents' experiences and views on age diversity in their neighbourhood. These questions are addressed using a mixed-method approach combining survey and interview data and analysis. The data is derived from a survey (n = 420) and 19 semistructured interviews addressed to the older residents of a rental house company located in Eastern Finland. The interview data is analysed using qualitative content analysis. The results of qualitative data indicate that older adults see various benefits in an age-diverse living environment. In the quantitative analysis, we apply multilevel models in our statistical analyses to take both community- and individual-level variation into account. The quantitative results show that older adults living in age-diverse neighbourhoods reported higher community wellbeing. Such association was not found among the younger residents. Overall, our study adds to the understanding of the importance of neighbouring relations on community wellbeing in later life. The results can be utilized when developing age-friendly environments and housing policies at local and national levels.

Two dimensions of trust in physicians in OECD-countries.

PURPOSE: The purpose of this paper is to analyse citizens' trust in physicians in 22 OECD countries. DESIGN/METHODOLOGY/APPROACH: The authors measure trust in physicians using items on generalised and particularised trust. Individual-level data are received from the ISSP Research Group (2011). The authors also utilise macro variables drawn from different data banks. Data were analysed using descriptive statistics and xtlogit regression models. The main micro-level hypothesis is that low self-reported health is strongly associated with lower trust in physicians. The second micro-level hypothesis is that frequent meetings with physicians result in higher trust. The third micro-level hypothesis assumes that males, and older and better educated respondents, express higher trust compared to others. The first macro-level hypothesis is that lower income inequality leads to higher trust in physicians. The second macro-level hypothesis is that greater physician density leads to higher trust in physicians. FINDINGS: The authors found that the influence of individual and macro-level characteristics varies between trust types. Results indicate that both trust types are clearly associated with individual-level determinants. However, only general trust in physicians has weak associations with macro-level indicators (mainly physician density) and therefore on institutional cross-country differences. It seems that particularised trust in a physician's skills is more restricted to the individuals' health and their own experiences meeting doctors, whereas general trust likely reflects attitudes towards the prevalent profession in the country. ORIGINALITY/VALUE: The findings hold significance for healthcare systems research and for research concerning social trust generally.