Medical Student Attitudes Toward Older Patients: Predictors and Consequences.

摘要

The attitudes of medical students toward older patients were examined using an experimental, between-subjects design. The effects of patient age, gender, and symptoms of depression on medical student beliefs, attitudes, behavioral intentions, and behavior toward patients were studied. Subjects were 88 advanced medical students who were unaware of the purpose of the study. Each student listened to one of eight audiotaped portrayals of a patient presenting his or her symptoms. The patient was either 32 or 67 years old, male or female, and depressed or not depressed. Each portrayal followed the same basic script, except that depressed patients complained of additional symptoms of weight loss and early morning awakening. Subjects completed questionnaires assessing their attitudes toward the patient, their beliefs concerning the patient's emotional and physical health, their intentions for evaluating and treating the patient, and their recall of information presented by the patient. While the patient characteristics did not influence attitudes toward the patient, they did influence beliefs, intentions, and behavior. Referral to a nonpsychiatric physician was rated more likely for older than for younger patients. Medical students rated males as more seriously ill than females and were more likely to recommend laboratory tests for males than for females. In contrast, medical students rated medication as more likely for female than for male patients. They rated depressed patients as more seriously ill than nondepressed patients. Recall of symptoms presented was better for depressed than nondepressed patients, suggesting that medical students listened more attentively to the depressed patients. Counseling and reassurance were considered more likely for depressed females than for depressed males. A consultation with a nonpsychiatric physician was considered more likely for depressed males than for other patients.