Nursing Students' Attitudes towards the Nursing Profession in Relation to their Altruism Levels

Abstract

Aim: The study was conducted to determine the nursing students' altruism levels, attitudes towards the profession and the relationship between them. Method: The study was conducted on 336 students studying in the Nursing Department of the Faculty of Health Sciences at a state university in Turkey. Socio-demographic information form, the Altruism Scale, and the Attitude Scale for Nursing Profession were used to collect the data. Results: It was found that the average age of the students in the nursing department was 20±1.76 and their total score of Altruism Scale was 68.8±9.81, and their mean score of Attitude Scale for Nursing Profession was 4.10±0.37. The mean scores obtained by the nursing students from both the Altruism Scale and the Attitude Towards the Nursing Profession Scale were affected by the way of choosing the nursing profession and the satisfaction from studying in the nursing department. In addition, it was found that there was a positive weak relationship between the altruism levels of nursing students and their attitudes towards the profession. Conclusion: It was found that the students with high level of altruism had a more positive attitude towards the nursing profession than those with low altruism levels. It is thought that the use of training programs, which develop nursing students' altruism levels and attitudes towards the profession, during nursing education would contribute to increase the relationship level between the altruism and attitudes towards the profession.

Headnote

Abstract

Aim: The study was conducted to determine the nursing students' altruism levels, attitudes towards the profession and the relationship between them.

Method: The study was conducted on 336 students studying in the Nursing Department of the Faculty of Health Sciences at a state university in Turkey. Socio-demographic information form, the Altruism Scale, and the Attitude Scale for Nursing Profession were used to collect the data.

Results: It was found that the average age of the students in the nursing department was 20±1.76 and their total score of Altruism Scale was 68.8±9.81, and their mean score of Attitude Scale for Nursing Profession was 4.10±0.37. The mean scores obtained by the nursing students from both the Altruism Scale and the Attitude Towards the Nursing Profession Scale were affected by the way of choosing the nursing profession and the satisfaction from studying in the nursing department. In addition, it was found that there was a positive weak relationship between the altruism levels of nursing students and their attitudes towards the profession.

Conclusion: It was found that the students with high level of altruism had a more positive attitude towards the nursing profession than those with low altruism levels. It is thought that the use of training programs, which develop nursing students' altruism levels and attitudes towards the profession, during nursing education would contribute to increase the relationship level between the altruism and attitudes towards the profession.

Key words: Alturism, attitude towards nursing profession, nursing student

Introduction

Values are defined as ideals and beliefs that guide the behaviours and are committed by an individual (Geçkin, et el., 2012; Vezeau, 2006). Values have an important place in investigating and explaining human behaviours (Dilmaç, 1999; Sari, 2005). A person's requests, practices and preferences develop within the framework of values (Delgado-Antolin, 2014). There is not a single type of value but a set of values behind human actions, attitudes, and behaviours (Deliktas, et al., 2016). One of these values is altruism. Altruism is defined as the material or nonmaterial positive contribution to others' life without the expectation of a profit (Hung, et al., 2016). It includes many positive social behaviours such as helping, taking responsibility, donating. Throughout the history, nursing has been defined as one of the helping/altruistic professions. Florence Nightingale stated in her book "Notes on Nursing" in 1859 that "Nursing is to bring an individual to the best condition in order to make the effects of the nature on him/her positive and harmless. Fresh air, good light, adequate temperature, cleanliness, silence, and a well-chosen diet provided by the nurse give the patient the vigour of life (Velioglu, 1999; Can, 2012).

Florence Nightingale's this approach shows that the helping purpose of nursing is spread over a very wide base. Although there are different models, different theories and different definitions related to the profession in the history of nursing, being a help profession is one of the characteristics of the nursing that have not changed for the ages (Burkhardt, 2001; Dossey, et al., 2005). In the literature, it is stated that altruism is in the basis of nursing and individuals who have a high level of altruism choose this profession because they want to care for and help people (Balbal, 2010; Law & Arthur, 2003; Mimura, et al., 2009; Kırag, 2015; Zencir & Eşer, 2016).

Profession preference is one of the most important phenomena that shape one's life (Bozdogan, et al., 2007). Individuals make psychological loadings to their profession in terms of a number of intellectual and emotional aspects, reflect them to their behaviours, and develop an attitude towards their profession over time (Korkmaz, 2009). The attitude developed for a profession is one of the important determinants of the individual's success in that profession (Cakir, 2005; Durmusoglu, et al., 2009).

In the development, shaping, and change of an individual's attitude toward a situation, values play an important role (Bektas & Nalcaci, 2012). Therefore, it is thought that the examination of nursing students' values and their attitudes towards the nursing profession that serve to determine their world-views will shed light on determining the achievement and satisfaction, which they will provide in the profession, and contribute to the efforts for improving and developing the nursing profession.

The Purpose of the Study: Determining the nursing students' altruism levels and their attitudes towards the nursing profession and the relationship between them. Inaccordance with this objective, the study questions directed to nursing students were as follows:

What are the altruistic levels and the attitude towards nursing profession of nursing students?

Is there a relationship between the altruistic levels of nursing students and their attitudes towards the nursing profession?

Methodology

Type of study

The study was a cross-sectional descriptive study.

Location and time of the study

The study was conducted in the Faculty of Health Sciences in 2016-2017 academic year at a city centre in Central Anatolia in Turkey.

Population and sample of the study

The population of the study consisted of all the students studying in the Department of Nursing at the Faculty of Health Sciences in a city centre in Central Anatolia during the fall semester of the 2016-2017 academic year. Sampling selection was not performed but the entire population was included in the study. The study was conducted with a participation rate of 62%.

Data collection tools

A questionnaire which was prepared by the researcher upon the literature review and included 7 questions to determine the sociodemographic characteristics of the students as well as the Attitude Scale for Nursing Profession and Altruism Scale were used to collect the data.

Altruism Scale: The scale developed by London and Bower in 1968 was adapted to Turkish by Akbaba in 2001. The scale containing 20 items consists of 4 subscales: family, social, benevolence, and responsibility. There are 5 items in each subscales. In this five-point Likerttype scale, 1 signifies the least and 5 signifies the most. The highest score to be obtained from the scale is 100 and the lowest score is 20. Higher scores signify higher altruism level. The Cronbach's Alpha internal consistency coefficient of the scale's Turkish validity and reliability study is 0.85. For this study, the Cronbach's Alpha internal consistency coefficient was calculated as 0.79.

Attitude Scale for Nursing Profession (ASNP); The scale developed by Coban and Kasikci consists of 40 items and attitude subscales as properties of nursing profession, general position of nursing profession, and prefer to nursing profession. There are 18 items (1-18) for the properties of nursing profession, 13 items for prefer to nursing profession (19-31), and 9 items for general position of nursing profession (3240). In this five-point likert type scale, 1 signifies "I strongly disagree" and 5 signifies "I completely agree". 8 items containing negative statements are reversely scored. Higher scores obtained from the scale refer to increased positive attitudes towards the nursing profession. If the score of the scale is three or above, it is evaluated as positive attitude, and if the score is lower than three, it is evaluated as negative attitude (Coban & Kasikci, 2011). Cronbach's Alpha internal consistency coefficient of the scale is 0.91. The Cronbach's Alpha internal consistency coefficient was found as 0.87 for this study.

Data collection

Data were collected by the researcher using faceto-face interview method.

Statistical analysis

The data obtained in the study were assessed by using the SPSS 20.0 packaged software. In between-groups comparison, One-way ANOVA and t test were used for the normally distributed variables and Kruskal-Wallis H and MannWhitney U tests were used for the variables not meeting normal distribution. The significance level determined in the evaluation of the data was p<0.05.

Ethical implementations

In order to collect the data, necessary permissions were obtained from the ethics committee of a university located in Central Anatolia in Turkey (Issue: 2016/03) and from the university where the study was conducted. In addition, the nursing students were informed about the study and voluntary participation in the study was provided by taking verbal consents of those who agreed to participate in the study.

Limitations of the Study

The results of this study cannot be generalized to all nursing students since the study was conducted only with the students studying in the nursing department of a university in a city centre in Central Anatolia. The study was limited with the date, the data collection form used in accordance with the purpose, and the responses of the students.

Results

It was determined that the students in the Nursing Department of the Faculty of Health Sciences were aged between 17 and 30 and their average age was 20±1.76 and 37.1% of them are the firstyear students, 74.4% were female, and 43% were Anatolian high school graduates. 55% of the students participating in the study stated that they were willing to choose the nursing department and 48% stated that they were satisfied with studying in nursing department.

When the scores obtained by the nursing students from the Altruism Scale were examined, it was determined that the total score was 68.8±9.81 and the students were altruist above the medium level. When the scores of the nursing students from subscales of the scale were examined, it was determined that family subscale score was 18.77±3.01 and they perceived themselves, families and relatives as highly altruist, the social subscale score was 14.73±4.45 and their participation in the social activities was low, benevolence subscale score was 16.78±3.58 and they were moderately helpful for others, the responsibility subscale score was 18.39±2.94 and the rates of taking responsibility and their beliefs that others can take responsibilities were moderate. Table 1 shows the data related to the independent variables thought to affect the score obtained from the Altruism Scale. Score of family subscale of altruism scale was determined not to be affected by the variables such as gender, the status of choosing nursing profession, satisfaction of studying in the nursing department, and the level of feeling competent in understanding the served individuals. Social subscale score was affected by the level of feeling competent in understanding the individuals receiving service and it is determined to be lower in those who felt competent sometimes and rarely than those who felt competent usually and generally always (p<0.05). It was determined that benevolence subscale score was significantly lower in those who were not satisfied with studying in nursing department than those who were satisfied with studying in this department, it was only affected by the gender variable in the responsibility subscale and the responsibility subscale score of male students were lower than the female students (p<0.05). Total score of altruism scale was determined to show difference according to the level of satisfaction with studying in nursing department and the altruism scale total score was found to be significantly lower for those who were satisfied with studying in nursing department than those who were not (p<0.05). In addition, although it was not statistically significant, altruism scale total score of those who chose nursing profession willingly was found to be higher than those who chose nursing profession accidentally and by family orientation.

When the mean scores of the nursing students from the Attitude Scale for Nursing Profession were examined, it was found that the scale total mean score was 4.10 ± 0.37 and the attitudes of the students towards Nursing Profession were positive. When the mean scores obtained from the subscales of the scale were examined, it was determined that mean score of the subscale of the properties of nursing profession was 4.45±0.37, mean score of the subscale of prefer to nursing profession was 3.65±0.69 and the mean score of the subscale of general position of nursing profession was 4.03±0.42. Table 2 presents data on independent variables thought to affect the score obtained from the ASNP. Total mean scores of ASNP and mean scores obtained from its subscales were found to be lower in male students than females, in those who chose the nursing department accidently, by family orientation and due to other reasons than those who willingly chose the department, in those who were not satisfied with studying in the nursing department than those who were satisfied and in those who sometimes felt competent than those who felt mostly competent (p<0.05).

A statistically positive correlation was found between the total mean scores of the altruism scale and the Attitude Scale for Nursing Profession (r=0.336). It was determined that when the total score of the Attitude Scale for Nursing Profession increased, the total score of the altruism scale increased (Table 3).

Discussion

When the results obtained from the study conducted to determine the relationship between the altruism levels of nursing students, their attitudes towards profession in nursing students, and the relationship between them were examined, Altruism Scale total scores of the nursing students are determined as 68.68±9.81. Considering that the lowest score of the scale is 20 and its highest score is 100, it is determined that the altruism levels of the nursing students were above the medium level. In their studies, the Altruism Scale total score of the nursing students was determined by Arpaci and Ozmen (2014) as 72.85±8.18, Banbal (2010) as 67.21±10.42, and Pehlivan and Lafci (2014) as 66.28±10.29. The scores in these studies are similar to the results of the present study. In addition, in another study conducted on the nursing students' rating the occupational values altruism is reported to be in the 6th rank among 20 occupational values (Rassin, 2010). These results showed that altruism tendencies of people who chose the nursing profession were high. These results can be asserted to be positive when it is considered that nursing profession is based on altruism. Akbaba (1994) has stated that gender is not a determining variable when altruism is concerned. This finding was supported by the fact that the level of altruism did not differ in terms of gender in the studies conducted with adolescents and in the present study (Ma & Leung, 1992; Kee-Lee, 1998). Altruism levels of those who were satisfied with study in the nursing department were found to be higher in a statistically significant way than those who were not. In addition, although it was not statistically significant, the altruism levels of those who willingly chose the nursing profession were determined also to be higher. In the study of Duru (2002) it was reported that the altruism levels of the students who knowingly and willingly chose the nursing department were higher, which supported the result of the present study. These results supported the information that people with high levels of altruism chose nursing profession because they wanted to help people.

In the study, nursing students' attitude towards nursing profession was determined as positive. This result was considerably similar to two studies conducted by Zencir et al., (2016) and Miligi and Selim (2013) in Turkey and the results of studies conducted in other countries (Bjorkstrom, et al., 2003; Coverston 2004; Joolaee, et al., 2006; Koushali, et al., 2012; Miligi & Selim, 2013; Raghda, et al., 2013). The students who willingly chose the profession and were satisfied with studying in the nursing department affected the attitude towards the nursing profession. Attitudes towards nursing in those who willingly chose the profession and were satisfied with studying in the nursing department were more positive compared to those who accidentally chose and were not satisfied. A study questioning the relationship between choice of profession and occupational attitude among nursing students in Turkey was found and in the study it was stated that the attitudes towards the profession were more positive in those who chose the profession willingly (Zencir, 2016). In the studies conducted in Australia and Hong Kong, having positive nursing attitude affect positively the willing preference of nursing profession. (Law & Arthur 2003; Zencir 2016).

In the study, when the relationship between the altruism levels of the nursing students and their attitudes towards the profession was examined, it was found that there was a relationship in the same direction between these two variables. It was determined that students with high altruism levels had more positive attitudes towards nursing profession than students with low altruism levels. It is reported in the literature that altruistic behaviour is very important in healthcare occupational groups, such as medicine, nursing, and social service specialization, because the altruist people act for other people's benefits rather than their own interest (McGaghie, et al., 2002; Daehlen, 2008). In this study, the fact that the people having positive attitudes towards the nursing profession were more altruistic may be caused by that they comprehended the importance of acting for benefits of others in nursing profession. No study questioning the relationship between the altruism level and attitudes towards the profession among nursing students has been found in national and international literature. However, in a study conducted on teacher candidates in Turkey, it was stated that teacher candidates with high levels of altruism had more positive attitudes towards teaching than those with low levels of altruism (Ismen & Yildiz, 2005). In another study conducted with teacher candidates, it was found that there was a positive relationship between the individual values and the attitude towards the teaching profession (Bektas & Nalcaci, 2012).

Conclusions And Recommendations

When the results of this study conducted to determine the relationship between nursing students' altruism levels and attitudes towards the nursing profession were evaluated in general, they indicated that nursing undergraduates were altruist above moderate level and had positive attitudes towards the nursing profession. It was determined that those who willingly chose nursing profession and were satisfied with studying in this department had higher scores in both altruism scale and Attitude Scale for Nursing Profession. There was also a positive correlation between altruism and attitudes towards the profession. For these reasons, it could be recommend to develop altruistic behaviours of the nursing students during their education and increase their attitudes towards the profession. For this purpose, determining the altruism levels of nursing students and their attitudes towards the profession and conducting qualitative and quantitative studies that can reveal variables affecting them and using the results, to be obtained from these studies, in the planning related to nursing education may lead to useful results. In this way, it is possible to make the nurses, who will work as a member of the profession, become a willing and conscious professional member by determining the attitudes towards the profession during their student period and raising their awareness about this subject.

In addition, it is thought that the studies to be carried out about the determination of the relationship between the attitudes towards the nursing profession and the other individual values the nursing students have will make contribution to the development and improvement of the nursing profession.

Sidebar

Correspondence: İlknur Gol, Assistant Professor, Cankiri Karatekin University, Faculty of Heath Sciences, Public Health Nursing Department, 18200, Cankiri, Turkey.

E-mail: [email protected] [email protected]

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