Purpose: This qualitative study investigated the willingness and attitudes of undergraduate nursing undergraduates enrolled in a geriatric nursing minor to pursue careers in long-term care facilities.
Methods: A phenomenological approach was used. Semi-structured, in-depth individual interviews were conducted with 14 students who had voluntarily chosen the geriatric nursing minor and completed required theoretical and clinical coursework. Interviews took place between September 2024 and June 2025. Transcripts were analyzed using thematic analysis.
Results: Three primary themes were identified: (1) Nascent interest in geriatric care; (2) Perceived deficiencies in professional competence for geriatric care roles; and (3) An underdeveloped “government–society–family” collaborative geriatric care ecosystem.
Conclusion: Although participants acknowledged strong market demand for geriatric care professionals, most preferred hospital careers. Influencing factors included perceived social status of long-term care settings, misalignment between existing skills and role demands, limited career development pathways, and high labor intensity in long-term care.
Global and national demographic changes have increased demand for elder care. The study frames these trends with statistics indicating substantial growth in older populations and a rising prevalence of multimorbidity, disability, and dementia among older adults. In China, aging and smaller household sizes have increased reliance on institutional long-term care; by the end of 2023, there were 404,000 long-term care facilities providing 8.23 million beds.
Concurrently, many countries face shortages of trained geriatric care personnel. The literature cited in the study links low social recognition, weak professional identity, high workloads, and ageism to staffing challenges, high turnover, and compromised care quality in long-term care settings. Evidence associating staffing levels and skill mix with care outcomes is summarized to justify the importance of developing a qualified elder-care workforce.
The study positions university-based geriatric training and school–enterprise cooperative models as potential strategies to cultivate professionals for the growing long-term care sector.
Participants were recruited using purposive sampling from students who voluntarily enrolled in a geriatric nursing minor delivered through a university–facility cooperative “order-based” training partnership. The minor was offered in the fall semester of participants’ junior year. Recruitment and data collection occurred from September 2024 to June 2025.
Inclusion criteria required voluntary minor enrollment, participation in the cooperative training initiative, completion of all required theoretical and clinical coursework in geriatric nursing, and informed consent for participation and audio recording. Exclusion criteria were attendance below 90% for theoretical courses or below 100% for practicum courses.
Forty-three students met eligibility criteria; interviews proceeded until thematic saturation. After 12 interviews revealed no new themes and two additional interviews confirmed saturation, the final sample comprised 14 students. Participants received a small token of appreciation entered as a post-study lottery; incentives were practical items funded by the research team budget.
Data collection consisted of semi-structured, in-depth individual interviews. Interview transcripts were analyzed through thematic analysis to identify recurrent patterns and themes related to career willingness and attitudes toward work in long-term care facilities.
The Social Cognitive Career Theory (SCCT) guided interpretation. SCCT emphasizes the roles of self-efficacy, outcome expectations, and personal goals in shaping career interests and choices, while contextual factors—such as family support, policy environment, and social norms—moderate those cognitive processes.
The research team included four members. The first author was a university faculty member with a master’s degree who taught laboratory and practical courses for third- and fourth-year students and had direct familiarity with students’ academic and clinical experiences. The geriatric nursing minor operates within a school–enterprise cooperative model in partnership with municipal long-term care facilities, reflecting institutional efforts to train geriatric care professionals.
Participants expressed an emergent or limited interest in geriatric care. While students recognized the societal need for elder-care professionals, many did not view long-term care as their preferred career path. Preference for hospital environments was common, reflecting expectations regarding professional status, clinical complexity, and perceived prestige.
Students reported perceived gaps between their current skills and those required for effective long-term care practice. Concerns included insufficient preparation for the unique demands of caring for older adults with complex chronic conditions, disability, or dementia. Limited confidence in geriatric-specific competencies influenced outcome expectations and diminished intentions to choose long-term care employment.
Participants noted systemic barriers beyond individual capability. The study highlights an underdeveloped “government–society–family” collaborative ecosystem for geriatric care, where policy, social recognition, family expectations, and institutional support are not yet aligned to promote careers in long-term care. Factors cited included low social status of long-term care facilities, constrained career development opportunities, and high labor intensity.
Interpreting findings through SCCT, the study suggests that low self-efficacy in geriatric competencies, unfavorable outcome expectations related to social status and career progression, and contextual barriers reduce students’ interest in long-term care careers. The authors underscore the role of targeted education, improved practicum experiences, policy support, and stronger collaboration between universities and long-term care facilities to enhance vocational interest and readiness.
The cooperative minor and school–enterprise training model are presented as promising interventions but require reinforcement by systemic changes—such as improved professional recognition, clearer career pathways, and resource investments—to shift students’ preferences.
Among nursing undergraduates who completed a geriatric nursing minor, awareness of labor market demand for elder-care professionals coexisted with a preference for hospital work. Career choices were influenced by perceived low status of long-term care, competence gaps, limited advancement opportunities, and high work intensity. The study recommends that educators and policymakers address both individual competence development and broader contextual barriers to strengthen the geriatric care workforce.
Funding: The study was supported by the Humanities and Social Sciences Research Project of the Education Department of Anhui Province (2023AH051723) and the National Student Innovation and Entrepreneurship Program (202310368038). Funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation.
Data availability: Interview data are restricted to protect participants’ privacy. Requests for access must be directed to the Ethics Committee of the School of Nursing of Wannan Medical University at the provided institutional email.
Competing interests: The authors declared no competing interests.