JCPSLP Vol 17 No 2 2015_web

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

100 90 80 70 60 50 40 30 20 10 0 % of participants

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

C1 C2 C3 C4 C5 C6 C7 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.

lowest, with 13 participants (17.5%) reporting no knowledge prior to commencing their placement.

Figure 2. Students’ reported confidence pre-placement (n = 74)

100 90 80 70 60 50 40 30 20 10 0 % of participants K1

Preferred future employment by age and setting

Pre-placement knowledge (n=74)

8

Paediatric caseload

I know a lot I know quite a lot

I only know a little I know nothing

6.8

9

Acute: Adults>65 years old

7.7

8.4

Acute: 65–85 years old

8.8

6.9

Acute: <85 years old

6.2

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

8.7

9.1

7.9

K2

K3

K4

8.6

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.

6.3

5.9

5.3

5.9

Figure 1. Students’ reported knowledge pre-placement

5.1

5.8

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 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%). disorders secondary to dementia (75.7%). Attitudes about older people The pre-placement UCLA-GAS mean score for all

3.2

Pre Post

4.3

4.5

4.9

4.5

Palliative care

4.7 Weighted preference scores Less preferred

More preferred

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- Figure 3. Students’ preferred future employment: pre- and post- placement

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JCPSLP Volume 17, Number 2 2015

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