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Ageism and suicide: A structural equation modeling analysis and evaluation of a high-fidelity simulation-based
Eva Gil Pons1, Carolina Pinazo-Clapés2, Alicia Sales Galan3
1Universidad Europea de Valencia (UEV), Universidad Europea de Valencia: Pg. de l'Albereda, 7, El Pla del Real, 46010, València, Spain.
Background:
Ageism is recognized by the World Health Organization as the third most common form of discrimination globally. In middle-aged and older adults, this type of discrimination has been linked to poorer mental health outcomes and an increased risk of suicide. However, this connection remains insufficiently studied. Gaining deeper insight into how ageism contributes to suicide risk is essential to inform prevention strategies and improve care for older populations. In this context, high-fidelity clinical simulation emerges as a promising educational approach to train professionals, foster empathy, and reduce age-related biases in mental health care.
Aims:
To analyse the relationship between mistaken beliefs about suicide and ageism and to evaluate the effectiveness of clinical simulation in reducing ageism in students.
Methods:
Quantitative cross-sectional design. A total of 370 nursing and psychology students participated. Structural equation modelling (SEM) was used to relate mistaken beliefs about suicide and the subdimensions of the CENVE questionnaire on stereotypes towards old age.
Results:
Students underestimated the risk of suicide in older adults. Misconceptions about suicide predicted ageist attitudes. High-fidelity simulation significantly reduced stereotypes on motivation and personality dimensions. A well-fitting model (χ² = 218.612; df = 111; CFI = 0.942; RMSEA = 0.045; CI [.036-.054]; SRMR = 0.039) showed that the "attention-seeking" suicide myth significantly predicted ageist attitudes in health, motivation, and personality. The "normal-for-age" myth significantly predicted ageist health and personality stereotypes.
Conclusions:
Clinical simulation is effective in reducing ageism and encourages a more empathetic and respectful approach to suicidal ideation and behavior in older adults.
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