Holistic Gerontology for Direct Care Workers: Differences Among Anxiety, Knowledge, and Locus of Control of Direct Care Workers and Senior Adults

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Educational Studies and Research

First Advisor

W. Lee Pierce

Advisor Department

Educational Studies and Research


One challenge facing America in the new millennium is an increasing senior adult population and its needs which will require health care workers to have an enhanced understanding of senior adults. The purpose of this study was to examine learning needs of direct care workers, who work with senior adults, based on their understanding of senior adults as compared with the understanding level of senior adults. The information obtained was used to develop a preliminary curriculum structure to provide a tool for meeting the needs of Nurse Aides/Certified Nursing Assistants. During the spring and summer of 1998, a survey was made of 78 senior adults in five levels of independence and 84 direct care workers including Nurse Aides/Certified Nursing Assistants, Licensed Practical Nurses, and Registered Nurses from medical and long-term-care environments. The perceptions of direct care workers and senior adults about aging and senior adults were compared using three instruments: (a) Facts on Aging Quiz, (b) Anxiety about Aging Scale, and (c) Locus of Control Questionnaire. The initial MANOVA examined the three instruments together between the direct care workers and senior adults, revealing a statistically significant difference between the mean vectors of the two groups. One-way ANOVAs performed on the individual instruments revealed the senior adult to be less aware of the facts on aging and to have a lower Locus of Control index than the direct care workers. The direct care workers showed greater Anxiety about aging than did the senior adults. The only statistically significant difference in the mean scores within the major groups occurred among the direct care workers on the Facts on Aging Quiz supporting the benefit of learning for understanding aging and senior adults. Additional examinations of the data revealed that education level was a statistically significant factor among the direct care workers on the criterion of Facts on Aging and Anxiety about Aging. The results supported an informal hypothesis that the direct care workers who spend the most personal time with senior adults had the least understanding of aging and senior adults and confirmed a need to provide additional learning opportunities for Nurse Aides/CNAs in a holistic approach to gerontology.