Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. / Name of the candidate and address(in block letters) / ROSHAL SAVINA LOBO
I YEAR M. Sc. NURSING
ATHENA COLLEGE OF NURSING
FALNIR ROAD
MANGALORE – 575 001.
2. / Name of the Institution / ATHENA COLLEGE OF NURSING
FALNIR ROAD
MANGALORE – 575 001.
3. / Course of Study,
Subject / M. Sc. NURSING
PSYCHIATRIC NURSING
4. / Date of Admission to the course / 25-07-2011
5. / Title of the Topic
A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE OF PRE-DEGREE STUDENTS TOWARDS NURSING AS A PROFESSION IN SELECTED PRE-UNIVERSITY COLLEGES AT MANGALORE.
6. / Brief Resume of the Intended Work
Introduction
Nursing is as old as human life itself; however, the shortage of nurses is not a recent phenomenon, nor one restricted to a specific geographical location. The profession is said to have long suffered from public stereotyping and from being closely associated with feminity and powerlessness. The time has never been better for nurses to reach out to the public to change certain perceptions about nursing. Various people have different understandings of the nursing profession based on prior events in their lives since perceptions are subjective.1
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death. Nurses work in a large variety of specialties where they work independently and as part of a team to assess, plan, implement, and evaluate care.
Nurses care for individuals of all ages and cultural backgrounds who are healthy and ill in a holistic manner based on the individual’s physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology in caring for those individuals. A professional nurse therefore, is a person who has completed a basic nursing education programme and is licensed in his/her country to practice professional nursing.
In the largest workforce within the healthcare system, nurses represent a major role in the provision of frontline care. Whilst this may be the case, the question is whether or not the general public has any clear understanding as to what a nurse’s role is and the process involved in becoming a nurse.2
6.1 Need for the Study
The literature from North America suggests that the public’s attitude towards the nursing profession is a negative one. Such negative attitudes were also found from cross-cultural studies including studies from Saudi Arabia and Kuwait.3
Although negative as a whole, some positive aspects have also been found amongst university students and high school students. Nursing was considered a caring profession which was associated with knowledge, technical skills, and safety.4 Public attitude towards nursing is a controversial issue; public perception of nursing is still as traditional role emphasising on auxiliary role to support physician and alliance with hospital.
In a study with 25 nurses/mothers from a hospital in the city of Rio de Janeiro, the practitioners described nursing as multi-valued, low-paid, and with reduced acknowledgement for the work performed. The lack of incentives, among other aspects, can cause work dissatisfaction in practitioners.5
In India about 90% of people have minimum knowledge regarding nursing. They consider nursing to be a simple task and that anyone can be a nurse. They consider nurses to be physician’s assistants and perform menial work like cleaning, bathing, and grooming of patients.6
Historically, nursing has been perceived negatively by the public. Nursing has been considered a female occupation focused on caring and simple curative practices. Nurses were taught to be subservient handmaidens of physicians, and to adhere to hospital policy rather than to foster scientific knowledge and problem-solving skills during their training. Because of the influence of gender discrimination and its historical training context, nursing professionals have had limited autonomy and minimal power in managing health services.7
A study in Hong Kong among 19 students (10 women and 9 men) from three schools analysed the perception of secondary-level students about nursing. The participants reported that the activities attributed to nurses included helping patients with hygiene and medication; helping the doctor; obeying orders; cleaning and teaching new nurses. The profession was also identified as being stressful and dangerous (physical contamination) 2.
The poor knowledge and attitude towards nursing as a profession has made nursing a low profile course, and hinders its advancement even more. The public’s attitudes towards nursing appear to depend upon the degree of knowledge and economic power nurses receive. Perceptions of advanced secondary school students of nursing are important
because they offer strategic clues towards successful recruitment of the next generation of nurses. To attract more individuals to the profession, a positive image of nursing needs to be engendered by nurse education and the general community. Attitudes, beliefs, and values are highly subjective areas, usually based upon perception and not fact. Perceptions held by the public about the nursing profession greatly influence the personal and public image of nursing. To improve nurse’s social image is to intervene in the social image of nursing that exists in the general public and among professionals.
The investigator during casual talk with high school students and other peer group realized that they consider nursing as a low profession. They believe that people choose nursing because they were not able to get admission for any other degree courses. Therefore, the investigator is interested in finding out the knowledge and attitude of pre-university students regarding nursing as a profession. From the experience of the investigator and discussion with colleagues and experts, the investigator realised that it is important to know the knowledge and attitude of pre-university students regarding nursing as a profession since this is the period students think of their future plans for higher education. Instilling right knowledge and attitude is very important.
6.2 Review of Literature
Review of literature is an important step in the development of a research project. A research literature review is a written summary of the state of existing knowledge on a research problem.
Review of literature means a critical summary of research on a topic of interest, often prepared to put a research problem content as the basis for an implementation project.8
A study was conducted in Hong Kong to determine high school students’ attitude towards nursing profession. The sample consisted of 306 high school students. Majority of the students in this study reported that they considered nursing education to be costly and difficult; they viewed nurses as performing unpleasant tasks and not being well paid. Twenty percent of the sample believed that nurses spent majority of their time socialising
with doctors rather than fulfilling more responsible tasks. Only 8.6% of the sample indicated that they were going to choose nursing as a profession.9
Another study was conducted in Boston, United States, to investigate young adults’ perceptions of nursing. Using convenience sampling technique, 99 undergraduate students enrolled in a general education course at a large North Eastern University were selected. Data was collected by administering a questionnaire. Majority of the students (72.7%) were over 21 years of age; the remaining students (25.3%) were under 21 years. Most of them 75% were female and 25% were male. Among the sample 46.5% had a relative who was a nurse and 52.6% had no nurse relative. A MANOVA programme was chosen as the statistical method because a number of independent variables were included in the study. The study findings revealed that female students perception of nursing was that nursing was more difficult (a mean score of 5.253 compared to a mean score of 4.458, p<0.05), more challenging (a mean score of 5.426 compared to a mean score of 4.625, p<0.01), and more responsible (a mean score of 6.066 compared to a mean score of 5.500, p<0.05) than did their male counterparts. Those students who had a nurse in the family viewed nursing as significantly more challenging (a mean score of 5.630 compared to a mean score of 4.942, p<0.01), a source of higher pay (a mean score of 4.130 compared to a mean score of 3.288, p<0.01), and a greater benefit to society (a mean score of 6.392 compared to a mean score of 5.865, p<0.05), than their counterparts who did not have a relative who was a nurse.10
A study was conducted in Ilala district, Dar Es Salaam, to assess the knowledge and attitude of secondary high school students towards nursing profession, explore factors that promote aspiration to enrol in nursing schools and to explore factors that deter aspiration to enrol in nursing schools. The study was an exploratory cross-sectional, using both qualitative and quantitative methods and was conducted in Azania and Jangwani secondary schools in Ilala district. Using convenience sampling and multistage sampling, 50 male and 50 female students who opted for physics, chemistry and biology were selected. The findings revealed that girls were more aware (79.2%) about nursing as a profession compared to boys (76.9%). Non-awareness was mostly about nurses being capable of independent practice, making decisions for themselves, working with high technology, following physician’s orders without questioning and feeling good about what they do.
Although students were aware of nursing they did not want to opt to join the profession, due to the image they have of it from the public.1
A study was undertaken with 19 high school students in Hong Kong to elicit their perceptions of nursing as a profession. The study also sought to gauge the extent of the students’ intentions on pursuing a career in nursing. The sample consisted of 10 female and 9 male participants who volunteered to be included in the study. Study findings showed that the image of nursing was poor and that nursing as a career was far from desirable amongst the sample. The reasons appeared to be related to the notion of monetary rewards and status within the Hong Kong community. There was also lack of knowledge as to what nurses do. The study suggested the need for the profession to find ways of publicizing and marketing the positive aspects with elements of realism in the general population.2
A descriptive study was conducted in Brazil to assess the perception of third year secondary level students towards nursing. The sample consisted of 46 girls. Among the sample only 7.7% opted for nursing. Among other professional courses nursing occupied the eighth place in the ranking among 14 professions. Regarding salary perception nursing dropped to the 9th place. Findings of the study revealed that students were having a low image towards nursing 11.
A study was conducted in Saudi among high school students to find out their knowledge, attitude and intention towards nursing profession and to identify the perception of causes preventing them from becoming a nurse. Using stratified random sampling technique 479 high school students were selected. Data was collected using a questionnaire. The results showed that students scored a reasonable level on the knowledge dimension; however they achieved very low scores on attitude and intention of being a nurse in the future. Only 5.2% preferred nursing as their future job. Long working hours, high work load compared to other jobs were the reasons for preventing them from becoming a nurse.12
A descriptive study was conducted to know the non-English speaking background (NESB) high school students’ attitudes towards the nursing profession in Australia. Using convenience sampling technique, 162 NESB high school students with parents from Korea, Lebanon, Vietnam, and China were recruited from Sydney, New South Wales, Australia.
The data were collected by using a questionnaire technique to measure student’s knowledge about, attitude towards and intention to study nursing. Descriptive and inferential statistics were used to describe students’ knowledge, attitude and intention scales among the NESB groups. According to the results, NESB groups were compared on knowledge, attitude and intention scales. The Post Hoc Tukey HSD tests found no significant differences between the groups on adjusted means for knowledge (p≥0.213641), while Korean students differed from the other groups on attitude (p≤0.022481) and intention (p≤00.018929). No other pair-wise comparisons were significant. Therefore, on scale scores adjusted for Australian as a percentage of age, Korean students scored lower than the other NESB groups on attitude and intention towards nursing, but not on knowledge. Lebanese, Vietnamese and Chinese groups were homogenous on attitude and intention. Also less than 10% of students included nursing among their preferred career options. Korean students scored lower than the other NESB groups on attitude and intention towards nursing.13
A descriptive study was conducted to assess the knowledge and attitude of public towards nursing profession in a selected hospital at Mangalore. The sample for the study comprised of 300 publics selected from a hospital. Among the samples selected, 75% were male and 25% were female. Data was collected using a questionnaire and attitude scale. The findings revealed that a significant association was found between attitude, knowledge and the presence of nurse in the family and source of information 6.
6.3 Problem Statement
A study to assess the knowledge and attitude of pre-degree students towards nursing as a profession in selected pre-university colleges at Mangalore.
6.4 Objectives of the Study
1. To assess the knowledge level of pre-degree students towards nursing profession as measured by a structured knowledge questionnaire.
2. To assess the attitude of pre-degree students towards nursing as a profession as measured by an attitude scale.
3. To find out the relationship between the mean knowledge score and mean attitude score.
4. To find out the association between the mean knowledge score and mean attitude score with selected demographic variables (stream of study, education of parents, occupation of parents, family income).
6.5 Operational Definitions
Nursing profession: In this study, nursing profession refers to a job-oriented course which will prepare an individual to care for the sick in the hospital, community or home.
Knowledge: In this study, it refers to the accurate information received through written responses from the participants to the questionnaire regarding nursing profession.