Attitude of Health Personnel ; Career Choice ; Geriatrics ; Humans ; Singapore ; Students, Medical ; psychology

INTRODUCTIONTraining of future physicians in the care of elderly patients will need to evolve in accordance with the exponential increase of elderly patients, but some may have preconceived attitudes affecting their management. This study determined medical students' attitudes towards older people and their willingness to consider a career in Geriatric Medicine.

MATERIALS AND METHODSAll 250 first-year medical students, prior to any formal clinical exposure at the National University of Singapore School of Medicine, were asked to participate voluntarily in the study based on the UCLA Geriatrics Attitudes Scale. The 14-item questionnaire consisted of a mixture of positively and negatively worded questions answered on a 5-point Likert scale. A fifteenth question enquired about their willingness to consider Geriatric Medicine as a potential career choice.

RESULTSThe mean UCLA attitudes score was 3.58 [+/-standard deviation (SD), 0.41] suggesting a generally positive attitude. There was a strong association between attitude scores and willingness to consider Geriatric Medicine as a career (R = 0.48, P <001). However, only one third of the cohort was willing to consider a career in Geriatric Medicine. There was no difference in attitude scores between male and female students, but females were significantly more likely to consider Geriatric Medicine as a potential career choice.

CONCLUSIONFirst-year medical students in Singapore have a generally positive attitude towards older people, although only 1 in 3 persons was willing to consider a career in Geriatric Medicine. Higher attitude scores and female gender were the main predictors of willingness to consider a career in Geriatric Medicine.

Adult ; Aged ; Attitude of Health Personnel ; Career Choice ; Education, Medical ; ethics ; Female ; Geriatrics ; education ; Humans ; Male ; Physician-Patient Relations ; ethics ; Professional-Patient Relations ; Prospective Studies ; Schools, Medical ; Sex Factors ; Singapore ; Students, Medical ; psychology ; Surveys and Questionnaires ; Young Adult

Introduction: Hyponatraemia is the commonest electrolyte abnormality and has major clinical implications. However, few studies of hyponatraemia in the primary care setting has been published to date. OBJECTIVES: To determine the prevalence, potential causes and management of hyponatraemia and to identify factors associated with severity of hyponatraemia among older persons in a primary care setting. Methods: Electronic records were searched to identify all cases aged ≥60 years with a serum sodium <135mmol/l, attending outpatient clinic in 2014. Patients’ medical records with the available blood test results of glucose, potassium, urea and creatinine were reviewed. Results: Of the 21,544 elderly, 5873 patients (27.3%) had electrolyte profile tests. 403 (6.9%) had hyponatraemia in at least one blood test. Medical records were available for 253, mean age 72.9±7.3 years, 178 (70.4%) had mild hyponatraemia, 75 (29.6%) had moderate to severe hyponatraemia. Potential causes were documented in 101 (40%). Patients with moderate to severe hyponatraemia were five times more likely to have a cause of hyponatraemia documented (p<0.01). Medications were the commonest documented cause of hyponatraemia (31.7%). Hydrochlorothiazide use was attributed in 25 (78.1%) of 32 with medication-associated hyponatraemia. Repeat renal profile (89%) was the commonest management of hypotonic hyponatraemia.