JCPSLP Vol 17 No 2 2015_web

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JCPSLP Volume 17, Number 2 2015 77
Interest in working with older people
Pre-placement, a preference for working with younger people
emerged from weighted ranked employment preferences
based on setting and caseload age (refer to Figure 3). A
trend of declining interest with increasing age of the client
population was evident within the acute hospital setting,
where working with adults younger than 65 was rated most
favourably (group weighted preference score: 9), than with
those between 65 and 85 years (preference score: 8.4),
followed by those older than 85 (group weighted preference
score: 6.9). The same trend was evident within a hospital-
was partly or exclusively in residential care settings (n = 19).
Eight participants completed a placement in an out-patient
rehabilitation setting and were excluded from this analysis
as group numbers were low. Levine’s test equality of error
variances was used to examine whether assumptions of
homogeneity were violated, which revealed no violation
occurred on any variable.
Results
Knowledge about communication and
swallowing in older people
In rating their pre-placement knowledge of communication
and swallowing changes and disorders found in older
people and people with dementia in particular (Figure 1),
participants reported greater knowledge regarding
age-related and acquired communication disorders than
about swallowing changes and disorders. Knowledge about
changes in swallowing due to dementia was rated the
lowest, with 13 participants (17.5%) reporting no
knowledge prior to commencing their placement.
100
90
80
70
60
50
40
30
20
10
0
% of participants
K1 K2 K3 K4
Pre-placement knowledge (n=74)
I know a lot
I know quite a lot
I only know a little
I know nothing
Figure 1. Students’ reported knowledge pre-placement
Note. K1 Age related and acquired communication changes and
disorders in older people. K2 Communication changes associated
with dementia. K3 Age related and acquired swallowing disorders in
older people. K4 Swallowing changes associated with dementia.
Confidence in working with older people
Ratings of pre-placement confidence in management of
age related and acquired communication disorders (Figure
2) revealed that participants reported the greatest degree of
confidence in their ability to assess and manage adult-
acquired language disorders and swallowing disorders in
medically well older people (54% felt confident to do either
of these tasks independently or with some support [i.e.,
from a clinical educator]). The lowest confidence levels (not
confident but with a good idea of what is required, or, not
confident and unsure of what is required) were reported for
cognitive-communication disorders (62.2%) and swallowing
disorders secondary to dementia (75.7%).
Attitudes about older people
The pre-placement UCLA-GAS mean score for all
participants (3.83±0.4) indicated that participants generally
had a positive attitude about older people. Participants who
reported prior contact with medically unwell older family
members (n = 14) had a slightly more positive UCLA-GAS
attitude score (3.98±0.3) than that of the total cohort. As
presented in Table 1, most participants expressed positive
attitudes about spending time with older people (79.7%)
and about listening to information about their lives (91.8%).
100
90
80
70
60
50
40
30
20
10
0
% of participants
C1 C2 C3 C4 C5 C6 C7
Confidence in clinical skills prior to a clinical placement in
an adult service.
Confident, can do it
independently
Confident, but will
need support
Not confident, but have a
good idea of what is required
Not confident, unsure of
what is required
Figure 2. Students’ reported confidence pre-placement (n = 74)
Note. Assessment and management of: C1 communication changes
arising as a normal part of ageing, C2 acquired motor speech
disorders in older people, C3 language disorders in older people,
C4 cognitive-communication disorders, C5 swallowing disorders in
medically well older people, C6 swallowing disorders in medically
complex older people, and C7 swallowing in people with dementia.
Paediatric caseload
Acute: Adults>65 years old
Acute: 65–85 years old
Acute: <85 years old
In-patient rehabilitation:
>65
In-patient rehabilitation:
<65
Out-patient rehabilitation:
Adults
Residential care: medically
well older people
Residential care: medically
complex older people
Dementia: acute care
setting
Dementia: residential care
setting
Palliative care
8
9
8.4
6.9
8.7
7.9
6.3
5.3
5.1
3.2
4.5
4.5
6.8
7.7
8.8
6.2
9.1
8.6
5.9
5.9
5.8
4.3
4.9
4.7
Weighted preference scores
Less preferred More preferred
Pre
Post
Preferred future employment by age and setting
Figure 3. Students’ preferred future employment: pre- and post-
placement