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Educational Gerontology

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ATTITUDES TOWARD AGING AMONG PACIFIC ISLANDER HEALTH STUDENTS IN FIJI

Suzy Gattuso; Anna Shadbolt

Online publication date: 10 November 2010

To cite this Article Gattuso, Suzy and Shadbolt, Anna(2002) 'ATTITUDES TOWARD AGING AMONG PACIFIC

ISLANDER HEALTH STUDENTS IN FIJI', Educational Gerontology, 28: 2, 99 106 To link to this Article: DOI: 10.1080/03601270252801364 URL: http://dx.doi.org/10.1080/03601270252801364

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ATTITUDES TOWARD AGING AMONG PACIFIC ISLANDER HEALTH STUDENTS IN FIJI

S u z y Ga t t u s o
Sch ool of Com m u n ity H ealth , Ch ar les St u rt U n iver sity, Albu r y, Au st ra lia

An n a S h a d b olt
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Cen t r e for Gr ief E duca t ion , Melbou r ne, Au st ra lia

The relation between attitudes to aging and cultural values is a complex one. This study contrasts attitudes to aging among Paci c Islander students with attitudes in a comparable Australian sample. Australian society is represented as ageist, whereas Paci c Islander cultures are reported to be age-inclusive. Attitudes were assessed using the Reactions to Ageing Questionnaire, and data also were collected on levels of intimate contact with older people, said to be related to attitude. A comparison of Australian with Paci c Islander data showed no difference in attitude or degree of intimate contact. Within the Paci c Islander sample indigenous Fijians had signi cantly more positive attitudes than did Indo-Fijians and signi cantly more intimate contact. Indo-Fijians, but not indigenous Fijians, also were signi cantly more negative in attitude than Australian students. Educators aiming to incorporate gerontological knowledge and to challenge ageism in the curriculum should not assume student attitudes are congruent with traditional cultural beliefs. They need to be knowledgeable about and sensitive to differences among various cultural groups within the student population, especially where those students will have the health care of the old in their hands in the future.

Address cor r espon den ce t o Su zy Ga t t u so, Sch ool of Com m u n it y H ea lt h , Ch a r les Stu r t Un iver sit y, P.O. Box 789, Albu r y, New Sou t h Wa les 2640, Au st ra lia . E -m a il: sga t t u so@csu .edu .au

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Th er e is va lu e in exa m inin g differ en t cu ltu r es a n d t h eir expect a t ion s a bou t a gin g in or der t o u n r a vel u n iver sal pr ocesses of a gin g a n d t h ose fea t u r es t h a t a r e r ela t ed t o cu ltu r e (Ca t t ell, 1989). H ist or ica lly, a t t it u des t o older people h a ve va r ied widely a cr oss cu ltu r es a n d a cr oss t im e (Bla ikie, 1999). H ealt h cu r r icu lum t h a t incor por a t es ger on t ologica l kn owledge a im ed a t ch a llen gin g st er eot ypes a bou t a gin g n eeds t o t a ke int o a ccou n t speci c cu ltu r a l va lu es a n d h ist or ica l t r a dition s in or der t o be effect ive. F ea t u r es of P a ci c Isla n der cu ltu r es r eleva n t t o a t t itu des t o a gin g a n d t h e h ea lth car e of older peop le in clu de t h e t r a dit ion a l position of older people a s a u t h or it y gu r es (H olm es, 1987; Lu m , 1995) a n d a s fa m ily decision m a k er s a n d t h e k eeper s of fa m ily a n d cu ltu r a l wisdom (Br own e & Br oder ick, 1994, p. 254). Th e t er m for t h is cu ltu r a l wisdom in F ijia n cu ltu r e is Yalomatua, wh ich is pa ssed on fr om gen er a t ion t o gen er a tion t h r ou gh a n or a l t r adition . E xt en d ed fa m ily pa t t er n s a r e com m on in P aci c Isla n d cu ltu r es; 7080% of elder s live wit h t h eir ch ildr en (Ca t t ell, 1989). Ca r e pa t t er n s for elder s wh o a r e sick or disa bled a r e sim ila r t o t h e dom ina n t pa t t er n of fa m ily ca r e in Au st r a lia , t h ou gh beca u se of m a r r iage a n d k insh ip cu st om s, da u gh t er s-in -la w a r e m or e likely t h a n da u gh t er s t o pr ovide ca r e (Ru bin st ein , 1994). In st itu t ion a l ca r e is a la st r esor t a n d older peop le wit h disablin g illn esses a r e sh elt er ed with in t h e fa m ily, given t a sk s t h a t a r e wit h in t h eir level of com p et en ce an d t r eat ed wit h love a n d com pa ssion (Ba r ker, 1991, p. 183). In F iji, bot h m a jor r a cia l gr ou ps in digen ou s F ijia n s a n d In doF ijia n s h a ve a st r on g t r a dition of ext en ded fa m ily ca r e for t h e elder ly. F or t h e for m er, t h e size of t h e ext en ded fa m ily, villa ge t r a dition , a n d t h e com m u n a l own er sh ip of la n d diffu ses car e for th e elder ly a m on g kin sfolk ou t side t h e imm edia t e fa m ily wit h in villa ges an d in ot h er villages (P la n ge, 1988). In h er ited r espon sibilit y a n d t h e obligat ion of ca r in g for on es im m edia t e blood r ela t ives is ext en ded t o in clu de a ll ot h er blood k in ir r espect ive of gen er a t ion a n d gr ou p a f lia t ion . Th r ou gh m a r r ia ge, t h is obliga t ion ext en ds t o on es in -la ws a n d t h eir kin . Th is m ea n s t h a t t h e wider t h e socia l n et wor k of r ela t ion sh ips, t h e m or e on e feels secu r e a n d a ssu r ed of bein g ca r ed for (Ra vu vu , 1983). Th e In do-F ijia n s ar r ived in F iji as individu a l inden t u r ed la bou r er s, wit h ou t fa m ily. H owever, for m s of ext en ded fa m ilies wer e est a blish ed a s t h e r st gen er a t ion of la bou r er s su r vived a n d beca m e h ea ds of h ou seh olds (N a idu , 1980), a n d, despit e h a r dsh ips a n d isola t ion , t h e t r a dit ion a l et h ic of a ca r ing ext en ded fa m ily was r ecr ea t ed (J a wa den a ya , 1975). Th u s, on e m igh t dedu ce t h a t t h er e wou ld be a h igh level of r esp ect for t h e a ged in isla n der cu ltu r es a n d h en ce a positive a t t itu d e t o

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a gin g. H owever, beliefs abou t h ow a differ en t cu ltu r e r ega r ds a gin g, ba sed on st er eot ypica l idea s a bou t t h e cu ltu r e, m a y be ser iou sly in er r or. Th e st u dy by H a r wood, Giles, Ot a , a n d P ier son (1996) of st u den t a t t itu des in P aci c Rim cu ltu r es fou n d t h a t Asia n cu lt u r es, gen er a lly viewed a s m or e fa vou r a ble in t h eir r ega r d for t h e old t h a n west er n cu ltu r es, wer e n ot con sist en t in a t titu des t o agin g. Th ey con clu d ed t h a t simila r pr oblem s m a y be fa ced by older a du lts in ver y differ en t cu ltu r a l con t ext s in t h eir dea lin gs with t h e you n g (p. 314). Sh a r ps, P r icesh a r ps, a n d H a n son (1998) fou n d t h e a t t itu des of you n g Th a i a du lts, in a cu ltu r e wh er e lia l piet y is t r a dition a l, wer e m or e n ega t ive t h a n t h ose of st u den t s in t h e U .S., seen a s a m or e a geist cu ltu r e. Th ey con clu ded t h a t a t r adition of gr ea t er cu lt u r a l r espect for elder s does n ot n ecessa r ily pr ot ect t h em fr om n ega t ive st er eot ypin g. In m ixed cu ltu r es, t h e t r a dition a l views of a m in or ity gr ou p m a y sh ift t owa r ds t h e va lu es of t h e dom in a n t gr ou p. Su ch a sh ift wa s n ot ed in on e st u dy in H a wa ii, wh er e P a ci c Isla n der com m u n ities sh ift ed fr om fa m ily or ien t a t ion s t o m or e in dividu alist ic beliefs (Br a u n & Br own e, 1998). H ealt h pr ofession a ls in cou n t r ies of a dopt ion a lso m a y con t r ibu t e t o a sh ift in at t itu des wh ich will h a ve a n im pa ct on views a bou t a gin g. In Au st r a lia , m igr a n t s fr om t h e Sou t h P a ci c (pr in cipa lly fr om F iji, Ton ga , a n d West er n Sa m oa ) con st itu t e a m in or ity gr ou p wh os e cu ltu r a l va lues a r e disr ega r ded (U r i, 1993). H ea lth ca r e st a ff m a y ign or e pr efer en ces a m on g isla n der s for pa r t icu la r st r a t egies, su ch a s t r a dit ion a l h ea lin g pr a ct ices (Ba r k er, 1991) a n d n ot differ en tia t e bet ween differ en t isla n der cu ltu r es eith er beca u se of ign or a n ce or disr ega r d for im por t a n t et h n ic differ en ces (Bar k er, 1993). Th is r esea r ch exa m ines a t t itu des t o a gin g a m on g st u den t s fr om P aci c Isla n d n a t ion s en r olled in pr ofession a l h ealth edu ca t ion a t t h e U n iver sity of t h e Sou t h P a ci c, t h e F iji Sch ool of Medicin e, a n d t h e F iji Sch ool of N u r sin g; r ela t es a t t itu des t o cu ltu r a l fea t u r es of isla n der com m u n ities; a n d com pa r es a t t itu d es t o t h ose of a n Au st r a lia n sa m ple of st u den t s. Au st r alia is r egar ded a s a n a geist cu ltu r e, wit h a t t itu des or igin at in g in t h e pa t t er n s of wh ite set t lem en t a n d t h e ea r ly est a blish m en t of t h e n u clea r fa m ily pa t t er n in Au st r a lia n societ y (Da vison , 1995). Given t h e cu ltu r a l views of isla n der com m u n ities, st u den t s fr om t h ose com m u n ities sh ou ld h old m or e fa vou r a ble a t t itu d es t o a gin g t h a n st u den t s in Au st r a lia . H owever, given t h e cou n t er -in t u itive n d ings discu ssed a bove, wh et h er isla n der st u den t s a r e less a geist t h an Au st r a lia n st u den t s is a n open qu est ion .

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1

THE PACIFIC ISLANDER SAMPLE

Mor e t h a n h a lf of t h e 172 st u den t s wh o pa r t icipa t ed wer e en r olled in n u r sing (53%); 17% wer e en r olled in m edicin e a n d 12% in den t ist r y. Th e r em a in in g 18% wer e en r olled in a diver se r a n ge of cou r ses inclu ding cou n sellin g, psych ology, ph a r m a cy, a n d r a diogr a p h y. Most wer e in t h eir secon d or t h ird yea r of st u dy (83%). Mean a ge was 22 yea r s (SD 4.3, r a n ge 1850). Th e sa m ple wa s pr edom in a n t ly fem a le (78%) a n d F ijia n bor n (83%). Ot h er cou n t r ies of or igin inclu ded t h e Solom on Isla n ds, Cook Isla n ds, Ton ga , a n d Sa m oa . Wit h in F ijia n s t h er e wer e t wo m a in cu ltu r al gr ou ps iden t ifyin g t h em selves as indigen ou s F ijia n (66%) or In do-F ijia n (34%). THE AUSTRALIAN SAMPLE A t ot a l of 136 st u den t s en r olled in r st a n d secon d yea r u n iver sity edu ca t ion in h ea lth (40% in n u r sing) pa r t icipa t ed. As in t h e isla n der sa m ple t h ey wer e pr edom ina n t ly fem a le (92%). Mea n a ge wa s 22 yea r s (SD 5.9, r a n ge 1846). Mos t wer e Au st r a lia n bor n (95%) with t h e r em a inder bein g m igr a n t s fr om Eu r ope in ch ildh ood. Th is sa m ple is m or e fu lly descr ibed in Ga t t u so a n d Sa w (1998). SURVEY INSTRUMENTS Th e Rea ct ion s t o Agin g Qu est ion n a ire (RAQ), a 27-it em qu est ion n a ir e developed by Get h in g (1994), was u sed in t h is r esea r ch . Respon den t s a r e a sk ed t o a gr ee or disa gr ee (on a six-poin t sca le) with ea ch st a t em en t as it r efer s t o t h eir own beliefs a bou t wh a t it wou ld be lik e t o be over 65 year s of a ge. It em s explor e expect a t ion s of, for exa m ple, lon elin ess a n d sen ilit y, t h r ou gh ba lan ced positively a n d n ega t ively wor ded st a t em en t s. H igh er scor es on t h e qu est ion n a ir e a r e a ssocia t ed wit h m or e positive a t t itu des t o a gein g. Scor es below 100 a r e r ega r ded a s n ega t ive in a t t itu de t owa r ds a ge. It is ar gu ed t h a t st u den t s ar e lik ely t o ba se t h eir a t t itu d es t owa r d older people wit h wh om t h ey com e in con t a ct in t h e fu t u r e a s h ea lth pr a ct ition er s on t h eir per son a l views a bou t a gein g. Wh er e t h ose views a r e u n in for m ed or dem ean in g t o older people edu ca t ion a l st r at egies a r e n eeded t o cou n t er in a ccu r a cies a n d st er eot ypes. St u den t s a lso wer e a sk ed t o est im a t e t h e n u m ber s of people a ged 65 an d over t h ey iden t i ed a s fa m ily or fr ien ds (in t im a t e con t a ct ).
The secon d a u t h or con du ct ed t h e st u dy in F iji, wh er e sh e wa s em ploye d a s a lect u r er a t t h e Un iver sity of th e Sou t h P a ci c.
1

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N on in t ima t e con t a ct wa s oper a t ion a lised a s t h e n u m ber of people over t h e a ge of 65 iden t i ed by st u den t s a s kn own in ot h er wa ys (e.g., t h r ou gh wor k). N on st er eot ypica l a t t itu des t o older people a r e sa id t o be a ssocia t ed wit h gr ea t er kn owledge a n d fr equ en cy of con t a ct (An gu illo, Wh itbou r n e, & P ower s, 1996), alt h ou gh t h e n a t u r e of con t a ct m a y be cr u cia l. In t im a t e con t a ct , for exa m ple wit h a gr a n dpa r en t , m a y lea d t o less n ega t ive a t t itu des (St r ick er & H illm an , 1996).

RESULTS Age, gen der, a n d con t a ct wer e u n r ela t ed t o a t t itu de scor e in t h e Au st r a lia n sa m ple. RAQ scor e for P a ci c Isla n der st u den t s wa s m or e n ega t ive t h a n t h a t of Au st r a lia n st u den t s, a s Table 1 sh ows. Th is wa s in spite of t h e for m er h a vin g gr ea t er int im a t e con t a ct . H owever, differ en ces in scor e a n d int im a t e con t a ct wer e n ot st a t ist ica lly sign i ca n t . Isla n der st u den t s h a d sign i ca n t ly less con t a ct wit h older a du lts ou t side kin sh ip a n d fr ien dsh ip n et wor k s th a n did Au st r a lia n st u den t s (t 4.42, df 1, 290, p < :001), r e ect ing t h e gr ea t er focu s on kin sh ip r ela t ion sh ips a m on g isla n der st u den t s, con sist en t wit h cu ltu r a l n or m s. Beca u se n o cu ltu r e wor k s in m on olit h ic wa ys a n d t h er e ca n be sign i ca n t differ en ces in va lu es a m on g differ en t su bcu ltu r es, a com pa r ison was m a de bet ween t h e t wo la r gest et h n ic gr ou ps in t h e isla n der sa m ple. Wit h in t h e m a jor ity cu ltu r a l gr ou p in t h e P a ci c Isla n der sa m ple (t h ose bor n a n d gr owin g u p in F iji), m ea n a t t itu de scor e for in digen ou s F ijia n s wa s 100.6 (SD l9.5, n 84) a n d for In doF ijian s it wa s 91.0 (SD 19.2, n 41). Th e for m er wer e sign i ca n t ly m or e posit ive in a t t itu des t o a geing t h a n t h e la t t er (t 2.57, df 1,123,
TABLE 1 RAQ Scor e a n d Con t act Da t a: Au st ra lia n an d Isla n der Sa m ples
Mean Scor e Isla n der Au str a lian In t ima te con t a ct Isla n der Au str a lian Non in tima t e con t a ct Isla n der Au str a lian 98.9 102.3 14.3 13.4 11.6 25.5 SD 20.9 17.4 12.6 13.5 12.5 37.9 N 172 136 164 130 165 127

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p .01). Th ey a lso wer e m u ch m or e likely t o h a ve int im a t e con t a ct wit h elder s (m ean 15.7, SD 13.8 vs. m ea n 11.1, SD 9.4, t 2.06, df 1,115, p < .05). Th er e was n o differ en ce in n on int im a t e con t a ct bet ween t h ese t wo gr ou ps. A fu r t h er com pa r ison wa s m a de bet ween ea ch of t h e F ijia n gr ou ps a n d t h e Au st r a lia n sa m ple. Wh ile t h er e wa s n o differ en ce bet ween Au st r a lian a n d in digen ou s F ijia n st u den ts t h e In do-F ijia n st u den t s wer e sign i ca n t ly m or e n ega t ive in at t itu de t h a n Au st r a lia n st u den t s (t 3.54, df 1,175, p .001). DISCUSSION In t h is st u dy, t h er e wa s over a ll n o differ en ce bet ween st u den t s fr om a r epu t edly a geist cu ltu r e a n d t h ose fr om cu ltu r es wh ich a r e r espect fu l a n d h on ou r ing of old a ge. P er h a ps t h is is a n effect of globa lisa t ion , wit h its im pa ct on t r a dit ion a l cu ltu r es, wh ich , m or e a n d m or e, r e ect s west er n t ech n ocr a t ic va lues. P er h a ps t h e edu ca t ion of h ea lth pr ofession a ls with its em ph a sis on th e pr oblem s of old a ge pr odu ces sim ila r ly n ega t ive views in spit e of cu ltu r a l differ en ces. H owever, t h ese int er pr et a t ion s wou ld n ot expla in t h e differ en ce in a t t itu des bet ween indigen ou s F ijia n s a n d lndo-F ijia n s, a differ en ce t h a t m a y r e ect t h e wa y t h ese t wo gr ou ps wer e for m ed h ist or ica lly. Da vison (1995, p. 40) h a s su ggest ed t h a t , in Au st r a lia , t h e h ist or ica l wh ite set t lem en t of you n g peop le sepa r a t ed fr om ot h er k in crea t ed a societ y wit h ou t gr a n dpa r en t s wh ich led to a per sist ing focu s on a you t h cu ltu r e, a n d con t em pt for or a t lea st a m biva len ce a bou t t h e a ged. Th e or igin a l m igr a t ion pa t t er n s of you n g In dia n s, wit h ou t ext en ded fa m ily, t o F iji a lso m a y h a ve pla yed a pa r t in fost er ing n ega t ive views of a gein g. Wit h in In dia n cu ltu r e t h er e also is t h e pot en t ia l for gr ea t er con ict bet ween gen er a t ion s beca u se of t h e t r a dition of you n g wom en on ce t h ey a r e m a r r ied coh a bit ing with t h e h u sba n ds fa m ily wh ich involves ca r e of t h e h u sba n ds pa r en t s. In digen ou s F ijia n s st ill pr eser ve st r on g h ier a r ch ica l t r a dit ion s of r espect for elder s (e.g., t h r ou gh th eir ch ie y syst em ). An u n pu blish ed st u dy by t h e secon d a u t h or, ba sed on t h e con cept of in dividu a list ic an d collect ivist cu ltu r es (Boch n er, 1994; H ofst ede, 1994), indica t ed t h at In do-F ijia n st u d en t s in t h e st u dy focu ssed m or e on self wh er ea s indigen ou s F ijia n s focu ssed on com m u n ity a n d cla n . In t h e ligh t of t h is, t h e n ding in t h is st u dy t h a t In do-F ijia n s h a d sign i can t ly less in t ima t e con t a ct wit h elder s, in spite of sh a r in g a com m on t r a dition with indigen ou s F ijian s of a ca r in g ext en ded fa m ily, con r m s wh a t m a y be a gen er a t ion a l sh ift in cu ltu r a l va lu es in t h is gr ou p.

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F r om t h is st u dy, a n d pr eviou s r esea r ch , on e m u st con clu de t h a t t h e r ela t ion bet ween cu ltu r e a n d a t t itu de is qu ite com p lex. Edu ca t or s sh ou ld n ot a ssu m e t h a t st u den t s pr epa r in g t o be h ea lth pr ofession a ls h a ve a t t itu des con gr u en t wit h cu ltu r a l beliefs. P r ogr a m m ing, ba sed on ger on t ologica l kn owledge, a n d a im ing t o ch a llen ge ina ccu r a t e a n d dem ea n ing views on old a ge, n eeds t o be in cor por a t ed in t h e h ea lth cu r r icu lu m , wh er ever st u den t s will h a ve t h e ca r e of th e old in t h eir h a n ds.

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