A multifactorial study of age bias among rehabilitation professionals.

ABSTRACT

OBJECTIVES: To assess different dimensions of age bias among rehabilitation professionals and to determine the effect of patient gender and behavior on these biases. DESIGN: Between-subjects questionnaire study. SETTING: Randomly selected institutions accredited with the Commission on the Accreditation of Rehabilitation Facilities (CARF). PARTICIPANTS: Nine hundred seventy-four rehabilitation professionals from 9 disciplines at 23 CARF-accredited facilities. INTERVENTIONS: Each professional received a vignette case history of an amputation patient who varied in age (36yr, 76yr), gender (male, female), and patient behavior (ideal, depressed, noncompliant). The vignette was followed by the Professional Bias Questionnaire (PBQ), which included 25 questions assessing the professionals' responses to the patient. MAIN OUTCOME MEASURES: Main effects and interaction effects for age, gender, and behavior for the PBQ. RESULTS: Factor analysis of the PBQ questionnaire yielded 4 reliable scales the professional's judgment of the patient's psychologic neediness, postdischarge potential, worthiness for rehabilitation, and their personal reaction to working with the patient. Analyses of variance resulted in significant age by behavior interaction effects for 3 of the 4 scales. Older patients were viewed more negatively than equivalent younger patients when they were noncompliant. Professionals also had a more negative personal reaction to depressed older patients compared with equivalent younger patients. In contrast, gender bias was only found in 1 specific situation and did not interact with age bias. CONCLUSION: Several forms of bias toward older adult patients were found among rehabilitation professionals, but they were present only when patient behavior was less than ideal. Age bias continues to be a critical issue in the equity of rehabilitation services and should be addressed with training and policy changes.