Origins and Development of the UCLA-GAS
The UCLA Geriatric Attitudes Scale (UCLA-GAS) was developed and validated in 1998 by David B. Reuben and colleagues at the University of California, Los Angeles. It was created to provide a consistent way to measure healthcare professionals' attitudes toward older patients, addressing limitations in existing scales. The development process involved selecting 14 items from a larger pool, based on their ability to differentiate attitudes across different levels of medical training. The goal was a brief, reliable, and valid tool for educational and clinical use.
The Structure and Format of the Scale
The UCLA-GAS uses 14 statements rated on a 5-point Likert scale (1=strongly disagree to 5=strongly agree). It includes a mix of positively and negatively worded statements to avoid bias. Negative items are reverse-scored during analysis. The total score, ranging from 14 to 70, is the sum of all item scores, with higher scores indicating more positive attitudes. A score of 42 represents a neutral attitude.
The Four Sub-dimensions of Attitude
Initial analysis suggested the UCLA-GAS measures four dimensions of attitude: Social Value, Medical Care, Compassion, and Resource Distribution. However, the consistency of this four-factor structure has been questioned in subsequent research.
Application of the UCLA-GAS in Geriatric Care
The UCLA-GAS is primarily used in educational research to evaluate interventions designed to improve attitudes toward older adults among health professionals and students. It has also been used to compare attitudes across different healthcare disciplines and training levels. The scale has been translated for international use, enabling cross-cultural comparisons. However, studies often show only modest improvements in attitudes, leading to questions about the scale's sensitivity.
Strengths and Limitations
The UCLA-GAS is brief and easy to administer, specifically targeting healthcare providers. However, it has limitations, including validity concerns, an inconsistent factor structure, and potentially suboptimal reliability in some contexts. Critics also suggest the scale may inadvertently support ageist views.
Comparing the UCLA-GAS with Other Attitude Scales
Comparing the UCLA-GAS to other scales like the Dementia Attitude Scale (DAS) and the Aging Semantic Differential (ASD) highlights its focus on general geriatric attitudes among healthcare providers. The DAS specifically addresses attitudes toward individuals with dementia, while the ASD uses bipolar adjectives to assess attitudes. The choice of scale depends on the specific research or educational goal.
| Feature | UCLA Geriatrics Attitudes Scale (UCLA-GAS) | Dementia Attitude Scale (DAS) | Aging Semantic Differential (ASD) |
|---|---|---|---|
| Focus | General attitudes toward older people and geriatric care. | Attitudes specifically towards people with dementia, including comfort and knowledge. | Attitudes toward older people using polar adjectives (e.g., pleasant-unpleasant). |
| Format | 14-item, 5-point Likert scale statements. | 20-item, 7-point Likert scale statements. | 32-item, 7-step scale using bipolar adjectives. |
| Target Population | Primarily healthcare providers and students. | Healthcare professionals, students, and the general public. | Originally non-medical undergraduates, but used for various groups. |
| Dimensions | Originally four factors (Social Value, Medical Care, Compassion, Resources), but inconsistent. | Two or three factors, typically Comfort and Knowledge (or Discomfort). | Factors like instrumental-ineffective, autonomous-dependent, and personal acceptability. |
| Strengths | Brief, easy to administer, and specifically designed for clinical training contexts. | Specifically targets dementia attitudes, with evidence of validity and reliability. | Captures complex concepts relatively quickly, and may be less susceptible to social desirability bias. |
| Weaknesses | Validity concerns, inconsistent factor structure, potential for ageism. | Factor structure has been debated across different populations and studies. | Outdated adjectives, ambiguous selection criteria, validity concerns. |
The Future of Attitude Measurement in Geriatrics
Effective tools for measuring attitudes in geriatrics remain important. The development of scales like the UCLA-GAS reflects growing awareness of ageism and the need for compassionate care. Future research should aim to refine existing scales or develop new instruments with better validity and sensitivity to attitude changes. Educational strategies combining knowledge with positive clinical experiences with older adults, measured by robust scales, are essential for preparing future healthcare providers. For a critical synthesis, visit MedEdPORTAL: Critical Synthesis Package: UCLA Geriatrics Attitudes Scale.
