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Nursing students show moderately positive attitudes toward older adult care across 11 countries

Nursing students show moderately positive attitudes toward older adult care across 11 countries
Photo by National Cancer Institute / Unsplash
Key Takeaway
Interpret pooled KAOP scores cautiously due to high heterogeneity and low-quality studies.

This systematic review and meta-analysis synthesized data from 19,933 and 4,399 nursing students across 11 countries to assess attitudes toward older adult care. The primary outcome was the Kogan's Attitudes Toward Older People (KAOP) scale, using two versions: KAOP 34–238 and KAOP 34–204. The pooled mean KAOP 34–238 score was 146.41 (95% CI: 141.16–151.66, I2 = 99.8%), and the pooled mean KAOP 34–204 score was 130.95 (95% CI: 125.53–136.39, I2 = 99.5%). These scores indicate moderately positive attitudes overall.

However, the evidence is limited by very high heterogeneity (I2 = 99.8% and 99.5%), suggesting substantial variability across studies. Additionally, eight studies were classified as low quality, which may affect the reliability of the pooled estimates. Subgroup analyses revealed statistically significant differences in predictor variables, but details were incomplete.

The findings suggest that nursing students generally hold moderately positive attitudes toward caring for older adults, but the high heterogeneity and study quality issues warrant cautious interpretation. These results may inform efforts to optimize geriatric nursing education, though further high-quality research is needed.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
BackgroundGlobal population aging has precipitated an increased demand for professional geriatric care while facing a shortage of nursing personnel and inconsistent attitudes toward older adults care among nursing students. A systematic review and meta-analysis were conducted to examine nursing student’s attitudes toward older adults care and the factors that influence these attitudes in order to optimize the education of geriatric nurses.MethodsThis meta-analysis was reported following the PRISMA 2020 Checklist. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang data, VIP, and Chinese Biomedical Literature Service System were systematically searched from inception to July 4, 2024, to identify cross-sectional surveys reporting nursing student’s attitudes toward older adults. Meta-analysis was performed using Stata 17.0 software after two researchers independently screened the literature, extracted information, and evaluated the risk of bias in the included studies. Subgroup and sensitivity analyses were performed to address heterogeneity. Funnel plots and Egger’s test were used to assess the publication bias.ResultsSixty-four studies of nursing student’s attitudes toward geriatric care from 11 countries, 47 using KAOP 34–238 and 17 using KAOP 34–204, involved 19,933 and 4,399 nursing students, respectively. Fifty-six studies were assessed as being of high or moderate quality, while eight studies were classified as low quality. Regarding nursing students’ attitudes toward older adults, the results of the meta-analysis showed that the KAOP 34–238 score was 146.41 (95% CI: 141.16–151.66, I2 = 99.8%), and the KAOP 34–204 score was 130.95 (95% CI: 125.53–136.39, I2 = 99.5%). Subgroup analyses of these predictor variables revealed that nursing students showed statistically significant differences in the following factors (p 
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