6. / Brief resume of the intended work
6.1Need for the study
The community has been described as one of the most fruitful area for improving the health of the people. Nurses and all other health professionals must actively consider the influence of the community on the health status of the patient. A focus on preserving and promoting health and preventing illness for all people in the community will not only have an impact on the health of the identified client, but will reach the lives of numerous people who are not in the health care system.
Nursing has broadened its scope from hospitals to the community. Care at home can effectively prevent illness and promote the health and welfare of the family. Hanks and smith (1999) in their study, “implementing nurse home visitation programme, quoted that , recent evaluation of two large clinical trials of nurse home visitation provide evidence that there are positive health and socio economic benefits from nursing interventions.”
Home visits refer to meeting the health needs of the people at their door steps. The goals of these early home health care visits were to care for the sick, to teach the family how to care for the person, and above all to protect the public from the spread of disease.
A descriptive study was conducted by on assess the attitude of Basic B. Sc. Nursing students towards clinical experience in selected colleges of Mangalore. A Likert-type questionnaire was used on 150 Basic B. Sc. Nursing students using stratified random sampling technique. The findings of the study revealed that the mean attitude percentage score towards clinical experience was 66.64% showing positive attitude towards clinical experience. It was also found that the demographic variables of age, sex and educational status influenced students’ attitude while no relationship was found between year of study of the students and their attitude towards clinical experience.
A study was conducted on health workers attitude .Which can create communication barriers, the study shows that health workers did not have a good understanding of mothers beliefs and practices related to diarrhoeal diseases management and used to criticize mothers for what they have not done, these negative attitude discouraged mothers and following their advice.
Home care visits at one time-centred around visits to mothers and children, care of the chronically ill person, and an emphasis on health promotion. Today this speciality area of nursing is synonymous not only with acute but also with intensive home care.
The practice setting of home health care regardless of the community in which the services are delivered is a place called “HOME”. Home is a place where nurses have delivered and coordinated care over a century It has been found that nurses during home health care finds health problems which she feels vitally affects the family and discusses these problems and recommendations with the family.
Home visiting has all the time, been a challenge, going at the people’s doors and convincing them to accept and value their health, and also to provide them with knowledge related to health Thus Home health care is one of the most important needs in nursing . So the effects of the extension of health care facilities to home are a boost to the nation’s progress.
6.2Review of literature
Nursing practice in community settings differs considerably from hospital practice. Although performing traditional nursing skills e. g., injections, vital signs, dressings in the role of care provider is still an integral part of nursing practice, the importance of other roles is increasing e. g., educator, counsellor, manager, leader, advocate, researcher etc. Recognition of the unique health care needs of the older clients, emphasis on health promotion and shortened hospital stays, have decreased the costs and changed the health care system and practice of nursing.
According to Meg Doherty (1994),” essential to the success of service delivery in the home is the basic element of trust. In this setting, home health providers become entrusted with the privilege of an intimate view of family living ordinarily reserved for family members only.”
A study was conducted on nursing students’ knowledge and community clinical practicum on the family nursing of 63 students. A pre-test, post-test design was used to assess the impact of the 13-week family nursing clinical practice on the perceived self-efficiency of two groups of nursing students. Students completed the Family Nursing Self-Efficacy Questionnaire (FNSE) at the beginning of the academic year and 4 and 8 months later to coincide with the timing of the practicum for each group. A two-factor repeated measures analysis of variance (ANOVA) revealed a significant group time effect ( = 80, p < 0.001). Students’ self-efficacy differed significantly (t = 4.3, p < 0.001), supporting the positive effects of the clinical practicum on students’ self-efficacy. The study highlighted the need for planning learning experiences for students in a community setting which provides better opportunities for actual performance.
Conducted a study to “analyze the factors that influence the desire to use public health nursing visit and visiting nursing agencies service. A total of 5,775 aged 65 and over and 4,774 age of 64 and below responded to the questionnaire The important finding of the study were 2,474 (42.8%) aged 65 and over and 34.4% aged 64 and below knew about public health nursing visit and service provided .28.3% aged 65 and above and 22.5% aged 64 and below were aware of visiting nursing agencies service.
A study was conducted on, Factors predicting completion of a Home visitation program by high risk pregnant women The study examined association between women’s socio- demographic characteristics, perceived needs, psychological functioning, informal social support networks and their duration of participation in material home visitation program. The important finding of the study was, women with greater social support needs and healthier behaviors were more receptive to long term home visitation than other women.
A study conducted on “Do clinical experiences affect nursing students’ attitude towards the elderly?” One hundred and forty subjects were selected ranging in age from 18 to 51 years, among whom 126 were females and 14 males. Kogan’s attitude scale towards old people (1961) was used to ascertain subjects’ attitudes. Palmore’s facts on aging quiz (1977) were used to assess subjects’ knowledge on mental, physical and social facts about the aging process. Data regarding prior experience with the elderly were obtained. These tools were administered prior to their clinical experience as well as at the completion of clinical experience of three months. Results indicated difference in attitudes following a clinical experience than in attitudes measured prior to the experience (t(85) = -2.40, p < 0.05). The scores obtained after the clinical experiences (m = 155.64) were higher than those obtained before the experience (m = 150.83) the study also revealed that there was a positive relationship between subjects’ attitude towards the elderly and their knowledge about elderly (t(85)=0.31, p < 0.05). The findings stated that students’ attitudes were improved after their clinical experience (t(53) = 2.52, p < 0.01).
A Research Study was conducted on the attitudes of nursing and medical students towards aspects of patient care and nurses’ role organizing that care. The sample consisted of 12 medical students and 19 under-graduate-nursing students in the final year of study at University A and B at Ireland using non-probability sampling. A Likert-type questionnaire was developed having 31 items. Medical students were rather cure oriented
(N = 6, 54.6%) than nursing students who showed care orientation (N = 16, 84.3%). The nursing students had a more positive attitude (N = 15, 99%) towards the need for a nursing assessment than their medical colleagues
(N = 4, 36.4%). Although statistically significant differences were found in the care-cure orientation of both groups, the nursing students were more care oriented than their medical colleagues. All students clearly recognized the importance of care.
A study conducted by Gilboe, Laschinger, Fliesser, Griffen and Foran (1997) evaluated the nursing students’ knowledge and community clinical practicum on the family nursing of 63 students. A pre-test, post-test design was
used to assess the impact of the 13-week family nursing clinical practice on the perceived self-efficiency of two groups of nursing students. Students completed the Family Nursing Self-Efficacy Questionnaire (FNSE) at the beginning of the academic year and 4 and 8 months later to coincide with the timing of the practicum for each group. A two-factor repeated measures analysis of variance (ANOVA) revealed a significant group time effect ( = 80, p < 0.001). Students’ self-efficacy differed significantly (t = 4.3, p < 0.001), supporting the positive effects of the clinical practicum on students’ self-efficacy. The study highlighted the need for planning learning experiences for students in a community setting which provides better opportunities for actual performance.
6.3Statement of the problem
An exploratory study to determine attitude and the factors influencing attitude of the nursing students of a selected college of nursing towards home visiting.
6.4Objectives of the study
  1. To determine the attitude of nursing students towards home visiting.
  2. To determine the factors influencing the attitudes of nursing students towards home visiting.
  3. To find the association between attitude and selected demographic variable.
  4. Operational definitions
  1. Home visiting: Home visiting means the visit of a nurse to a family and the health services provided by nursing students to the community.
It includes the nurses’ approach towards the family, Building up the interpersonal relationship, Care given or activity carried out by the student, Time spent by the nurse, frequency of visits paid and closing of the visit.
  1. Nursing students: In this study, nursing students are those who have been already exposed to the field and completed 450 hours of field experience.
Fourth year nursing students are those who will complete their field experience during their posting.
  1. Attitude: In this study attitude refers to the verbal expression of feeling of nursing students regarding home visiting. This is measured by an attitude scale and expressed in terms of attitude scores.

6.6Assumptions
The study assumes that
  1. Nursing students exposed to community setting will have some attitude towards home visiting.
  2. Those who are willing to participate in the study.
  3. Those who give response freely and frankly.
  4. Delimitations
The study is delimited to:
  1. Nursing students who are exposed to community field experience.
  2. To one selected one college only.
6.8 Projected outcome/Hypotheses
All hypotheses will be tested at 0.05 level of significance.
H1:There will be a significant association between attitude scores and selected variables.
7. / Materials and methods
7.1Source of data
Nursing students of a selected college of nursing in Mangalore.
7.1.1Research design
The present study adopts descriptive survey design.
7.1.2Setting
The study will be conducted in a reputed college of nursing situated in the heart of Mangalore city. The college has been imparting nursing education since years and offers courses like B. Sc., P. C. B. Sc. and M. Sc. nursing. The college is well-equipped and has modern facilities for providing state of art education to young aspirants who come from far and near to enrich their knowledge in caring for the sick and dying.
7.1.3Population
The population selected for the study comprised of nursing students who has been exposed to the community field experience and able to build rapport with the family, identified the problems and give care according to the needs of the family and available at the time of data collection.
7.2Method of data collection
7.2.1Sampling procedure
Non-probability connivance sampling technique will be used.
7.2.2Sample size
The sample size for the study would comprise 100 nursing students.
7.2.3Inclusion criteria for sampling
Nursing students:
are willing to participate.
who are studying B. Sc. nursing.
who had exposure to community posting during their course.
7.2.4Exclusion criteria for sampling
Nursing students:
who are not willing to participate.
who have not had community clinical posting.
7.2.5Instruments intended to be used
Selected attitude scale will be used to assess the attitude of nursing students.
Structured questionnaire will be used to assess the factors influencing attitude towards home visit.
7.2.6Data collection method
Permission will be obtained from the concerned authority and informed consent will be obtained from the subjects. Attitude scale questionnaire will be administered to the subjects and then it will be collected and analyzed the data.
7.2.7Data analysis plan
Descriptive and inferential statistics will be used to analyze the data i.e. we can use the descriptive statistics like frequency table and percentage are used to describe attitude of nursing students, and inferential statistics such as chi-square would be used to see the correlation between selected variables and attitude, and between factors and attitude. Finding will be presented in the form of tables and figures.
7.3Does the study require any investigation or interventions to be conducted on patients or other human or animals? If so, please describe briefly.
Yes, administration of attitude scale needs to be administered to the subjects.
7.4Has ethical clearance been obtained from your institution in case of 7.3?
Yes, ethical clearance has been obtained.
8. / List of references
  1. Pereira LJ. A study to assess the attitude of Basic B. Sc. Nursing graduates towards clinical experience in selected college of Mangalore.
  2. Aubel J. Health workers’ attitudes can create community barriers. Health Forum 1991;12(4):466-71.
  3. MegDoherty. Community health nursing and home health nursing. Philadelphia: W. B. Saunders Company; 1994.
  4. Gilboe MF, Laschinger SH, Fliesser LY, Griffin CW. The effect of a clinical practicum on undergraduate nursing students’ self-efficacy for community-based family nursing practice. Journal of Advanced Nursing 1997;19:527-36.
  5. Nakayama A. Analysis of factors that influence the desire to use public health nursing visit and visiting agencies service. International Journal of Nursing Studies 2003;32(2):299-309.
  6. Waliser MN. Factors predicting completion of a home visitation program by high risk pregnant women 2002;90(3):121-4.
  7. Sheffler, S 1998” Do clinical experiences affect nursing students” Journal of Nursing Education,34 ; 312-315
  8. Rayan, A.A. and McKenna ,P.H.,1994.”A comparative Study of the attitudes of nursing and medical students to aspects of patient care and the nurses ‘ role in organizing that care” Journal of Advance Nursing 19;114-123
  9. Heidgerken, L.E.,Teaching and learning in school of Nursing, New Delhi; Koak Publishers Pvt. Ltd., 1998
  10. Park , J.E., Text Book of Preventive and Social Medicine, 16th edition, Jabalpur; M/s Banarsidas Bhanot.2000
  11. Murray, M. and Chambers, M., 1990 “ characteristics of students entering different forms of nurse training “ Journal of Advanced Nursing 15;1099-1105
  12. Rosen L.M., 2000, Associate and baccalaureate degree final semester students perceptions of self efficacy concerning community health nursing competencies”. Public Health Nursing, 19(4)231-38
  13. Lohrmann,1998, German nursing students ‘ Knowledge and attitude to HIV/AIDS” Journal of advanced Nursing 1(3)686-703
  14. Boyer, E.T., 1989, The carnegic report revisited ;Directing the future of education” Administrator,22, 1-2
  15. Jan. E. Ritchie,(1994) Education for Primary Health Care, accommodating the new realities. World Health Forum, 15(2). 35-37
  16. Maryam Navaie Waliser,(2002) .Factors predicting completion of a Home visitation program by high risk pregnant Women; 90(3) 121-124
  17. Mary Louise Paynich (1963) .How Patients Compare Hospital and visiting Nurses. American Journal for Nurses 11(2) 234-236