A Study of the Perceptions towards Nursing Profession among B.Sc. Nursing Students Enrolled In Western Maharashtra

Dr. Mrs.Meharunnisa Iqbal Momin^*1, Dr.Jagan Karade²

^*1Principal, D.Y.Patil College of Nursing, Kolhapur, Maharashtra.

²HOD Sociology Department, Shivaji University, Kolhapur

*Corresponding Author Email:mominmi50@yahoo.co.in

ABSTRACT:

The health sector grew from 2.75(in 2008) to 4.8 lakh corers (in 2012) and is poised to grow to INR 9.64 lakh corers by 2017.Nurses comprise of 50-55% of health care workforce. By 2017, India need 17, 53,000 nurses and by 2022 there is need of 36, 45,000 nurses. According to the Union health ministry of India is currently facing a shortage of over 60% nurses. WHO said, "The states with the worst healthcare human resource shortages are also the ones with the worst health indicators and highest infant and child mortality. There is big gap in production –demand and supply, which is leading to shortage of nurses in all cadres. The number of students applying to degree nursing programs across the nation is decreasing. It is observed in Western Maharashtra that private Colleges of nursing who are offering degree courses in nursing, nearly 40% seats are remaining vacant (MUHS 2013.). One of the reasons could be the perceptions towards nursing profession. Therefore the researcher felt a need to determine the perceptions of B.Sc. nursing students towards nursing profession ‘of Western Maharashtra. The objectives of the study were: 1)To find out socio-demographic characteristics of students enrolled in B.Sc.Nursing colleges of western Maharashtra2)To assess the perception towards the nursing profession among B.Sc. Nursing students enrolled at selected nursing colleges of western Maharashtra. 3)To determine if association existed between perceptions of the B.Sc. Nursing students and selected demographical variables asadmission year ,age, gender, religion/casteplace of residence, percentageof marksin 12^th PCBE, andfamily income, 4) To identify the influencing factors / reasons for enrollment to B.Sc nursing programme at selected nursing colleges of western Maharashtra 5) Io identifies correlation between perceptions of B.Sc. Nursing students towards nursing profession and influencing factors to enroll at selected nursing colleges of western Maharashtra. Hypothesis:(H₁):There is significant relationship between perception and selected demographical variables of B.Sc. nursing students. (H₂): There is significant correlation between perceptions and influencing factors among B.Sc. Nursing students enrolled in western Maharashtra. Methods: The method of sampling was the systematic random sampling method. .Data was collected by using structured interview schedule. The tool consisted of 3 parts. First part consists of demographic data of the samples; Second part consists of structured Linkert scale statements elated to the perception of students and third part was Stem responses to identify the factors influencing for enrollment to nursing. The questionnaire contains fourteen stem responses (Yes, No and Not sure) Last one question was open ended. The data was analyzed by using descriptive and inferential statistics Results: The analysis shows that in all six colleges’ seats (mean 23.10%} were vacant among all the four batches of B.Sc. Nursing. As compared to constituent colleges of deemed universities, more vacancies were found in colleges affiliated to MUHS Nasik., May be due to complicated admission procedure through MH -CET and central admission procedure through rounds. However admission flow was increasing as of the year 2011-12 to 2014-15.This was mainly due to opportunity for Government jobs through competitive examination. DEMOGRAPHIC CHARACTERISTICS: Age; All students were between the ages from 18 to 21 years, Mean age for 440 subjects were 19 years and 76 subjects were above twenty-two years. Gender: oftwo third subjects were females whereas one third were males as this profession is dominated by females. Religion and Caste: Majority of the subjects (33.42%), about one third were from Hindu open caste,second majority were Christians (27.95%)then scheduled caste (22.27%) and other backward class (12.27%), Muslims were very minor (4.095%), Residence: Subjects from urban area were more (60%)as compared to rural residents(40%) especially number of females were significant.Marital Status: Hardly (9%) were married including (0.90%) divorced rest all was unmarried.Socio-economical status: Subjects were from (66.36 %) low Socioeconomic group income per annum was up to rupees one lakh(24.09%) were had income up to twolakh, hardly 09.55% were had income above 2 lakh. Levels of perception and factor analysis: Present study found tout of 440 subjects, (59.09%) had ‘Good’ perception (40.45%) had ‘Average’ perception and hardly (t00.46%)) had ‘Poor’ perception towards the nursing profession. the researcher used factor analysis to determine if underlying constructs could be identified in the data. The three sub-area were labeled as “Aspect of Care”, “the nursing as a profession”, and. ’Social status and socio-economic benefits’-(Futuristic perception) regarding ‘nursing care’ subject’s perception was found ‘good,’ (Strongly agree) ranging mean from 4.34 to 4.54. Perception regarding characteristics of the nursing profession such a ‘noble profession, dignified, respected profession and nurse is key person in health care system’ were also found good (strongly agree), whereas other statements were perceived as average, simply (agree). Perceptions regarding social status and socio economic benefits of nursing profession, subjects had’ good’ perception and they were strongly agreed for opportunities at regional, national and international level. Association between demographic variables and the level of perception: A Age and Senioritywere .increasing.Perception of the subjects were declining and those who had average perception at the time of admission, they were moving towards’ Good’ perception as they were becoming seniors. Other demographic variables and the level of perception had no association...The findings of the study support the research hypothesis. (H₁₎ is accepted.).Factors or reasons influencing to enroll to B.Sc. nursing: influencing factors were divided into two parts”internal environmental factors and external environmental factors. The theoretical framework of Pierre Bourdieu of social capital used in this study personal or group perception is determined by culture through process of socialization. This theory was supported as. Internal environmental factors like attitude, knowledge, motivation, experience, expectations and personal attributes. And external environmental factors like opportunities and availability of Jobs and job security, opportunities for personal fulfillment and advancement were dominating. Co-relation between perception towards nursing among B.Sc. nursing students and factors influencing to enroll in nursing colleges in Western Maharashtra. To find out main factors influencing to enroll (Y) for B.Sc. nursing at Western Maharashtra were calculated. by Karl Pearson correlation coefficient between (X) and (Y) and answer is 0.172, which is statistically significant (P value is less than0.0001). The findings of the study support the research hypothesis that there is correlation between perception towards nursing and factors influencing to enroll in B.Sc. nursing at nursing colleges of Western Maharashtra

KEYWORDS:Perception, nursing profession, care aspect, social and economical benefits, critical thinking, weaker section.

INTRODUCTION:

The history of nursing starts from the history of human kind. It was necessary to look after to those who are suffering from many illnesses, diseases or injuries and those who were dependent. It was essential to help them to carry out their daily activities, to take care of them and to care and provide comfort to them. The need of nursing profession is never ending till the human lives existence on this earth. Nursing is nurturing therefore from the dawn of civilization, evidence prevails to support the premise that nurturing has been essential for survival of the human race, therefore, is in inextricably interlinked and helped for the development of nursing.

Nursing is an art as well it is a science^.Nursing is an art and science of head, heart and hands. (Self-definition)Head is a knowledge, which helps you to answer why any procedure, treatment to be done for which a nurse need to have knowledge of scientific principles, formal training for all illnesses and diseases. For nursing care you need a heart. Each nurse has a heart but it should be filled in with sympathy and empathy for their Patients’/clients. It is necessary to know patientspsychological and, sociological and spiritual needs then only possible to give holistic care. For each nursing procedure it needs delicate handling as well as skill to be developed in easy and well manner. Nursing has been the oldest of the arts and the youngest of the profession.¹Nurse ´this word has come from the Latin word nutritious, it means nourishing. Nursing is defined by various authors at various times in various manners. Henderson says “nursing is primarily assisting the individuals (sick or well) in the performances of those activities, contributing or its recovery (or to a peaceful death) that he would perform unaided, if he had the necessary strength, will or knowledge. The unique contribution of nursing is to help the individual to be independent or such assistance as soon as possible”².

Nursing works for community health. Through home nursing and working in large community it diagnoses community problems like communicable diseases and preventive, primitive care is given. Nursing assists in family health care and community health care also in all settings either at home, school or hospital they never differ race or religion, rich or poor.Literate or illiterate, young or old. Nursing is one of the greatest of humanitarian services for all people.

The International Council of Nurses has accepted this definition. Nursing, besides being an honorable profession Nursing has its own body of knowledge scientifically based and humanitarianism that promises expanded benefits to people and society. It assists the individual or family to achieve their potential for self-direction for health.

Nursing provides skillful care for the sick in appropriate relationship with the patient, family, physician and with others who have related responsibilities. Nursing is concerned with the prevention of illness and the restoration of health. It is not concerned only with sick or disease oriented but it has holistic approach, which involves physical, mental, social, emotional and spiritual aspect. Skillful nursing care embraces total wellbeing as the whole person, ANA (2012)defines nursing as the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations as per this definition health continuum to be balanced as illnesses are prevented through preventive measures and promotion of health activities to gain optimum of health.³

NEED FOR THE STUDY:

The shortage of nurses is not a recent phenomenon, nor one restricted to a specific geographical location It is driven by the demand for growing healthcare needs. According to the World Health Organization, it is estimated that 10.43 lakh nurses would be required by 2012 in the country. Taking into account 3.72 lakh nurses available and 3.13 lakh nurse likely to be trained with the existing capacity, there would be shortfall of 3.50 lakh nurses. India will need 2.4 million nurses by 2012 to achieve the government's aim of a nurse-patient ratio of one nurse per 500 populations.”In India, nurse shortages occur at every level of the healthcare system. "The states with the worst healthcare human resource shortages are also the ones with the worst health indicators and highest infant and child mortality,"⁴

Nursing Colleges have to recruit and retain qualified applicants in order to confront the current challenge to nursing resources, in order to reduce the current nursing shortage and ensure the delivery of quality health care but. The number of students applying to degree nursing programs across the nation is decreasing. It is observed in Western Maharashtra that private Colleges of nursing who are offering degree courses in nursing, nearly 40% seats are remaining vacant (MUHS 2013.).⁵

One of the reasons could be the perceptions towards nursing profession. Therefore the researcher felt a need to determine the perceptions of B.Sc. nursing students towards nursing profession ‘of Western Maharashtra It. 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. The perception of nurses being not as professional as the other professions, the role of gender in the choice of a career is an extremely important concept, because men constitute nearly half of the potential recruitment pool. Noticing a male nurse being ridiculed would deter boys to think of a nursing career. The nursing profession in India lacks high professional status, has low and unattractive salaries, gets inadequate recognition from the community for the services provided by them and has little incentives for quality performance. It was important to know the perceptions of B.ScNursing students because they offer strategic clues towards successful recruitment of the next generation of nurse.

STATEMENT OF RESEARCH PROBLEM:

A study of the perceptions towards nursing profession among B.Sc. nursing students enrolled in western Maharashtra.

OBJECTIVES OF THE STUDY:

1. To find out socio-demographic characteristics of students enrolled in B.Sc. Nursing colleges of western Maharashtra

2. To assess the perception towards the nursing profession among B.Sc. Nursing students enrolled at selected nursing colleges of western Maharashtra.

3. To determine if association existed between perceptions of the B.Sc. Nursing students and selected demographical variables asadmission year ,age, gender, religion/casteplace of residence, percentageof marksin 12^th PCBE, andfamily income,

4. To identify the influencing factors / reasons for enrollment B.Sc. Nursing programme at selected nursing colleges of western Maharashtra

5. To identifies correlation between perceptions of B.Sc. Nursing students towards nursing profession and influencing factors to enroll at selected nursing colleges of western Maharashtra.

Definitions of Terms:

Perception:

As per oxford dictionary the word perception” is defined as the “ability to perceive and the result of perceiving, is to realize or become aware of something through the senses, an impression accompanied by an understanding of what it is. It is the receipt of the sensory stimuli by a person regarding objects, situation, person (s) or profession, interpretation of. The perceived stimuli add to a person’s knowledge, whereby their views are turned into attitudes Perception is the way in which something is regarded, understood, or interpreted Therefore nursing as a „concept’s more than just a definition”In this study perception is student’s personal ideas, views, beliefs and concepts that they have about the nursing profession.

Perception of Nursing Profession:

In this study, the researcher has categorized perception towards nursing profession in three subareas as: ‘Care aspect-“It includes nurses role in health care system and necessaryknowledge and technical skills required to accomplish her job/role as a professional. As a Nurse.

Social and Economic Benefits:

It includes social views, social status, job-and advancement opportunities, career avenues and economic benefits.

Level of Perception:

After statistical analysis of the scores in all the above three subareas,level of perception towards nursing profession will be categorized as good, average and poor according to mean level.

B.sc.Nursing Students:

After passing 12^thscience, with Physics, Chemistry,Biology subjects, those students who had taken admission to university degree course of four years and studying in first, second, third and fourth year in recognized institution.

Western Maharashtra:

In this study, four private unaided nursing colleges from Western region of Maharashtra- Kolhapur,Sangli,Karad and Pune constituent colleges of deemed Universities and two private unaided nursing colleges affiliated to Maharashtra Government University.(MUHS).

Weaker Section:

In this study, Students belonged to low percentage of marks- -below 50% marks in 12^th PCBE group, Low socio-economical group as Father’s/guardian’s income is below Rs.2 lakh per annum and belonged to scheduled. Caste.

Critical Thinking:

In the study ‘Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action.

Influencing Factors:

In this study, reasons or the influencing factors which forced or provoked the students to choose and enroll in B.Sc.nursing

Assumptions:

1. The students enrolling to the nursing colleges are from weaker section of the society.

2. The students enrolling to the nursing colleges are due to job opportunities in regional, national and international level

3. The Students perceive that being a nurse is not only taking care of patients, but it also requires critical thinking.

4. To prevent illnesses and conservation as well as promotion of health of self and others, it is necessary to acquire the latest introduction of technological advances.

Hypothesis:

(H₁): There is significant relationship between perception and selected demographical variables of B.Sc. nursing students.

(H₂): There is significant correlation between perceptions and influencing factors among B.Sc. Nursing students enrolled in western Maharashtra.

Delimitations:

1. Students studying in all six institutions at Kolhapur (2 institutions),Miraj, Sangli, Karad and Pune for B.Sc. Nursing Programmein the academic year of 2014-15 for first, second, third and fourth year.

2. Those who were present at the time of data collection. Shown willingness to participate in the study.

The Theoretical Framework:

Used in this study is based on theory stated by Pierre Bourdieu, (1986) a French Sociologist influenced by Karl Marx's concept of economic: capital., Pierre Bourdieu, distinguishes between three forms of capital, cultural capital and social capital. The underlying concept is that how personal or group perception is determined by culture through socialization. It is generated through family, friends, peer groups, neighbors and teachers or by social groups.

REVIEW OF LITERATURE:

Perception is the receipt of the sensory stimuli by a person regarding objects, situation, person (s) or profession, interpretation of these received stimuli adds to a person’s knowledge, whereby their views are turned into attitudes. A. S. Hornbey, 2000, postulated that” perception is conceived through a linear dynamics relationship between „description‟ (in the brain), the senses and the surrounding. It is bidirectional interplay that holds true to the linear concept of experience “. Perception by itself is merely defied as an idea, belief, or an image.⁶

Based on the reviewed literature the researcher of the current study would assume that perception of one’s professional identity changes over the course of the 4 years of the nursing programme.Changes have taken place in the last two decades in the way health care is being delivered and managed; these changes consist of a different way of practice and perception of the profession. Being a nurse is not only about taking care of patients, but it also requires knowledge of technology, more paper work and more stringent standards of care. Another way nursing has been changing over the years is the gradual increase in men entering the profession and, thus, introducing a new nuance to the meanings embedded in the profession. Bearing on these imminent transformations, nurses and nursing educators are compelled to assist students in their development of caring, nurturing and critical thinking, and to acquire the latest introduction of technological advances into the healthcare system. It is important to ascertain how students perceive nursing and the decision to choose nursing to be their career or any other career is highly influenced by one’s previous ideas about the career. Studies investigating student’s perception of nursing at the beginning of the nursing programme showed that the students had idealistic views of the profession with concepts of caring, compassion and nurturing but after the exposure to clinical experiences it shifted towards it being more of technical, documentation and procedural skills ⁷

In studies of nursing student’s perception of nursing, researchers examined perception of students at different points in a programme. Studies included exploration of student nurses beliefs and conceptions at entry to nursing programmes, shortly after clinical practice and before graduation. Moreover, prospective longitudinal studies were conducted to define and to understand changes occurring over time.

A quantitative descriptive study with a cross sectional study design was used for assessment of nurse’s perception towards nursing profession in public hospitals under Addis Ababa health bureau in Ethiopia by lay Wondwossenin May 2011. The sample size was determined by using a formula for estimating a single population proportion. Sample size was 264. Data collection was carried out using structured questionnaire. The analyses were verified using descriptive interpretation for demographic variables. Bi-variety analysis was done to look at relationship between independent variables of Socio –demographic characteristics with the perception of nursing. On this model of analysis, Asmara nurses were 4.5 more likely to have good perception than other ethnic groups (COR=4.5, 95% CI1.16 – 17.35). Nurses who had bachelor and masters of nursing had 1.76 times more likely to have good perception than nurses who had diploma educational level (COR=1.76, 95% CI 1.05 - 2.94). Nurses who had a monthly income above 2808ETB were 2.37 times more likely to have good perception than other nurses who had a monthly income of less than 2808 ETB(COR=2.37, 95% CI1.12 – 5.04). Professional Nurses at Gandi Memorial Hospital had slightly higher likelihood to have poor perception towards nursing profession than other nurses who work in other hospitals. (COR=0.20, 95% CI 0.08 – 0.49). After adjusting for all Socio – demographic characteristics, nurses who work in Gandi memorial hospital were also slightly more likely to have poor perception than other nurses who work in other hospitals. (AOR=0.15, 95% CI 0.05 – 0.43) Regarding the. Socio-demographic characteristics and perception of important aspects of nursing. Those nurses with Bachelor and Master’s Degree were found to be 1.99 times more likely to perceive important aspects of nursing than other group of nurses who had diploma qualification. (COR=1.99, 95% CI 1.06 – 3.74). After adjusting more educated nurses, those who held first degree and second degree, had 2.59 times more likely to perceive important aspects of nursing than diploma Nurses. (AOR=2.59, 95% CI 1.12 – 5.97).⁸

A study of perception about nursing is that it is regarded as a career more suitable for females than male and this was found out from a research made in the University of Ontario Canada,the research was made from female and male nurses and non-nursing university students. It was found out that it is generally perceived by the society and stereotypes that male nurses are for example, gay, effeminate, less compassionate and caring than female nurses and it contributes negatively to the recruitment and retention of the nursing.⁹

A study was conducted in 1998, by Huffstutle,on effects of nursing education on the image of nursing as a profession in Israel. The samples consist of 200 first year nursing students and 200 more advanced students. The result revealed that most of the students felt that nursing profession needs to undergo an image change, while first year students perceived nurses as more angelic than more advanced students, and there was positive correlation found between satisfaction with nurses in the field and image of nursing. Thus the study concluded that there is a need to reinforce a positive image of nursing as a career, nurse educators should alter negative stereotypes about the profession. The image of both nurses and nursing has been the focus of a number of research projects globally.¹⁰

RESEARCH METHODOLOGY:

Research Design:

To find out these factors research design considered an explorative and descriptive method as the best method to assess the perception towards nursing profession among B. Sc. Nursing Students enrolled in the academic year from 2011 to 2014, No studies found in Maharashtra

Variable under Study:

Variables in this study perceptions towards nursing profession among B.Sc. Nursing students, who were enrolled in six nursing colleges of western Maharashtra and other demographic variables included Age, Gender, Religion and caste, Nationality,, Place of residence marital status, Education, Percentage of marks in 12th PCBE or equivalent exam, Socio-Economic status including Father’s occupation, Income of the family, and any financial aid for nursing education by any agency.

Setting of the Study:

The study was conducted at six selected private unaided nursing colleges of western Maharashtra at Kolhapur, Sangli, Satara and Pune districts. These colleges were constituent colleges of Deemed University or affiliated to Government University (MUHS).

Population:

The target population was defined as students enrolled in private, unaided nursing colleges in western Maharashtra for a baccalaureate nursing program and currently studying in first, second , third and fourth year for the academic year 2014-1015. Districts selected were Kolhapur, Sangli,Satara and Pune.

Sampling Technique:

The method of sampling was the systematic random sampling method.

Description of the Tool:

A questionnaire was developed in three parts:

Part-I –Socio-Demographic data of students This was designed to elicit the demographic information from respondents consisting 12 items .It contained Age, Gender, Religion and caste, Nationality, Place of residence,marital status, Education, Percentage of marks in 12th PCBE or equivalent exam, Socio-Economic status including Father’s occupation, Income of the family, and any financial aid for nursing education by any agency.

Part II: Perception Scale-To assessesthestudent’s perceptions towardsnursing profession which was designed as five point Likert scale Instrument. A series of 20 statements of responses were prepared regarding perceptions towards the nursing profession. For each of the statements, the available responses and score given for statistical analysis were as follows; for each item range from Strongly Disagree “Score =1, “Disagree Score=-2”, “Not Sure score= 3” “Agree score= 4” and “Strongly Agree score = 5”. Not sure term was added as many students may not have knowledge regarding some responses. Questionnaire was prepared in English as medium of the B.Sc .Nursing programme is English.

Part III: Stem responses to identify the factors influencing for enrollment to nursing. The questionnaire contains fourteen stem responses (Yes, No and Not sure) to identify the influencing factors for enrolment to nursing. Last one answer was not structured and kept open ended if respondent wished to add her/his own reason other than in structured questionnaire.

Ethical Issue:

Ethical approval from the authority in written form of the Faculty of Nursing was obtained before attaining the participant’s voluntary involvement in research study. Principal’s written permission was sought. They were assured anonymity and confidentiality of the institution as well as students information.

At individual level after explaining the purpose of the study, informed verbal consent was obtained from all participants prior to their participation in this study. Participants were informed that privacy and confidentiality will be maintained. The study subjects were also informed that the study process will have no intended harm to them. All were ignore to participate in the study. Schedule of data collection for each institution was well planned as per conveniences of the institution which was followed strictly.

Reliability:

In order to test the reliability, relevance’s to the objectives and to refine the tool and technique, a pilot study was conducted on 22nd December, 2014 Total 44 students from same setting of D.Y.Patil College of Nursing were administered.Eleven students from each batch of first, second third and fourth year of B.Sc.Nursing were systematic randomly selected as per inclusive criteria. Willingness of them was sought.Explanation about the self-administered questionnaire was given to them. Data was collected as per the plan of data collection. It was found that subjects could understand the statements well, they were able to comprehend the questionnaire and supply the information. Responses in the structured questionnaire were checked through phrasing and counter phrasing statements. For example- “Nursing is well-respected career path.”, after some gap the rephrase statement was “Nursing is not prestigious job” and the answers were consistent. It was observed that two statements were difficult to understand due to unknown words to them. i.e. Nurses are more angelic and sympathetic .This statement was changed to “Nurses are kind and sympathetic” one statement in .part III was made short to” parental and peer encouragement” Accordingly the necessary modifications were made in the tool. The technique was found to be adequate and feasible. These subjects were excluded from the actual study. It was observed that to complete the structured questionnaire 20 minutes time was needed. To ensure achievements of the objectives of the study, data analysis of the pilot study was done.

RESULTS:

The data has been analyzed and presented in five sections.Section I: Deals with the chacteristics of the subjects:Out of 440 sample, the majority of the students (N=216) nearly half of the respondents (49.09%) were in 20-21 years age group, one third subjects (N=148) were (33-64%) in the age group of 18-19 years, and minimum (N=76) were (17.27%) above 232years.(Fig.1). Gender: (N=293) about two third (66.59%) were females, and (N=147) one third (33.41%} were male.(Fig.2). Religion: major group nearly one third subjects 147 (33.42) were fromHindu-open caste, followed by Christians were 123 (27.95%), then scheduled caste were 98 (22.27%) and 54 (12.27%) were from other backward class. Muslims were very min18(4.095%). (Fig.3)Nationality of subjects. There were hardly two non-Indians-f-2 (00.45 %), they were Nigerians. Both had their relatives taking education in other field at Maharashtra. Those two also wanted to tale admission in medical faculty but they could not get, therefore they had taken admission to B.Sc.Nursing .otherwise all 438 subjects were Indians (99.55).

Place of residence among subjects More than half group (N=246were from urban area (55.91%), whereas (N=194) subjects were from rural area. (44.99%), students residing in urban area were more as compare to rural.(Fig.4). Marital Status: Among 440 subjects, most (N=39) of the subjects (9o.45%) were unmarried, (N=38) were (8.64%) married Educational status:. Majority of the subjects (N=418) had passed 12^th science (94.99%) as per criteria for admission to B.Sc. nursing programme, surprisingly, (N=22) had taken admission after graduation. (0.5%).Percentage of marks in 12^thScience-: Out of 440 samples total (N=111) about one fourth subjects (25.28%) had scored 40-50% marks in PCBE, criteria for admission was 40% in PCBE of 12^th science for Scheduled caste and OBC; whereas 45% minimum in PCBE for open category, There were (N=200) subjects(45.45%) had scored more than 50-60%marks and hardly (N=29)subjects had (29.32%) scored above 60% of marks..(Fig.5). Occupation ofFather/Guardian: Maximumgroups (N-169) occupation was either farmer or agriculture worker (38.40 %.) .Second major group had private service (N=146) or own small business (33.18%), nearly one third (N=108) were in Government job (24.54%) and few (N=13) were pensioners02.97%), and hardly (N=4) had no work./jobs or Unemployed ( 00.91%)Annual Income of family. As per our assumption, out of 440 subjects almost whole group (N =398) were financially weaker (90.45%), their family income was less than Rs. two lac per annum. Nearly two third (n=292) of subjects( 66.36%)were from very weak income group ,below one lac per annum, and above two lac income group were (N=42) hardly (09.55%).(Fig.6). n which Christians (N=17 were (03.86%),Open Hindu (N=13) were (2.95%),Scheduled caste (N=8/1.8%) and others were (N=4) hardly(0.90%),very negligible. Financial Aid: Out of 440 subjects (N= 163) students had either applied or received educational scholarships (37.05%) others (N=165) had applied for bank loan (37.27%) and about one fourth N=112) responded as neither scholarship nor bank loan (25.68).

Figure 1: Age wise distribution of the subjects

Fig2: Gender wise distribution of Respondents.

Figure 3:Religion and Caste of the subjects

Figure 4: Place of Residence of the subjects

Figure 5:Percenage ofmarks of subjects infrequency

Figure 6:family Income Per Annum(Rs,)in Percentage.

SectionII:

Section II: Deals with the student’s perceptions towards nursing profession infive point Likert scale

Figure7: Level of Perception among subjects in percentage

Levels of Perception:

This perception scale had 20 statement and five point scale, where it could range from minimum20 (1x20+20}to maximum 100. (5x20+100) In the study, the scores ranged from 57 to 100. Mean score was 80.40 and S.D. was 6, 77 .therefore score was divided into three categories,“Good, Average and Poor.”Mean 80was categorized as goodperception,Mean60-80was categorized as average perception an <60 was categorized as poor perceptiontowardsnursing professionPresent study found that tout of 440 subjects, (59.09%) had ‘Good’ perception (40.45%) had ‘Average’ perception and hardly (t00.46%))(Fig.7).

Figure 8: Concept of perception of nursing profession in three: Sub-area

To further summarize the findings regarding the B.Sc. Nursing students’ perceptions of the nursing profession, the researcher used factor analysis to determine if underlying constructs could be identified in the data. The three sub-area were labeled by the researcher as “Aspect of Care”, “the nursing as a profession”, and.‘Social status and socio-economic benefits’-(Futuristic perception)(Fig.8).

Table No.1:Responses to the statement regarding Perceptions towards nursing profession.

Sl.No	Sub area-:Perception of “Aspect of Care” Statements	MaximumResponse/Category	F	%	Mean	SD
1	An opportunity to serve humanity	Strongly Agree	254	59.77	4.51	.717
2	Key role in prevention of diseases and promotion of health	Strongly Agree	287	57.73	4.54	.583
3	Nurses Need to acquire advance technology for prevention of disease and promotion of health	Strongly Agree	258	65,23	4.58	.690
4	It is not only taking Care but requires with critical thinking	Strongly Agree	229	58.64	4.50	.698
5	Nursing requires compassion, patience and strength.	Strongly Agree	329	52.o5	4.44	.662
6	Nursing involves caring of patients and teaching of health.	Strongly Agree	329	74.77	4.70	.600

Sub Area-: Perception regarding “Aspect of Care”

TABLE N0.2: perception towards nursing profession sub-area: “nursing as a profession” in mean, standard deviation

Sl.No	Sub area-:Perception of “nursing as a profession” Statements	MaximumResponse/Category	F	%	Mean	S.D
1	Nursing is a noble profession	StronglyAgree	284	64.55	4.55	.713
2	Profession is dignified, respectful as well as a way to get due recognition in the society	Agree	137	31.14	4.01	.925
3	A nurse is an important person and nursing is an equally important career to the health care system.	Strongly Agree	232	52.73	4.36	.868
4	Nursing is a medical technical activity	Strongly Agree	225	51.14	4.20	.765
5	A suitable profession for females	Agree	122	27.73	3.11	.892
6	Nurses are more kind and sympathetic.	Agree	196	47.33	3.99	.892
7	Nursing is not prestigious job	Agree	124	28.18	3.08	1.30
8	Nursing is autonomous.	Agree	210	47.73	3.81	1.31

TABLE N0.3: perception towards nursing profession sub area-“social status and socio-economic benefits in mean, standard

Sl. No	Sub area-:Perception of “social status and socio-economic benefits” Statements	Maximum Response category	F	%	Mean	S.D
1	Opportunities for personal advancement	Agree	225	51.14	4.08	.806
2	Opportunities to work in other countries	Strongly Agree	225	51.14	4.34	.833
3	Good salary, Stable Job, Low Stress and flexible working hours	Agree	164	37.27	3.82	1.13
4	Nursing is well respected career path	Agree	122	27.73	3.74	1.20
5	Nursing is for low academic achievers and dull students	Agree	122	27.73	3.26	1.53
6	Nurses are an auxiliary of the Physician	Disagree	130	29.55	2.92	1.24

Section III: Deals with association of demographic variables to Perceptions of students towards nursing

TABLE N0.4: Showing association of demographic variables to Perceptions of students towards nursing other all demographic characteristic were not significant statistically.

Sl. No	Demographic variables	Perception calculated x² value	Total value	Remarks
1	Admission Year	22.48*	15.51	Significant
2	Age	13.45*	9.49	Significant

18-19 Years 20-21 yrs22 and above yrs

Fig 09: Associationof Age to level of perception in percentage

Internal environmental factors like attitude, Interstand External environmental factorslike job surety and opportunities in abroad were influencing factors to enroll for B.Sc.Nursing

Section V: Explains correlation between perception and influencing factors for enrollment to B.Sc.

When statistically tested ,it was Calculated by Karl Pearson correlation coefficient method between sum and number of ‗Yes‘ were calculated It was found that .Observed value is 0.172 and it is statistically significant.(p-value is less than 0.0001) There is significant correlation between perception and influencing factors for enrollment to B.Sc.Nursingprogramme in Western Maharashtra.Hypothesis (H₂) is accepted.

CONCLUSIONS AND SUGGESTIONS OF STUDY:

Based on above findings the following conclusions are drawn by the Researcher.

1. 23 % seats were vacant in six nursing colleges of Western Maharashtra. Comparatively more vacancies in colleges affiliated to MUHS.

2. Major group were from Hindu open caste, female,, unmarried,middle level academic achievers and from low socio-economical section

3. Majorityhad ‘good’ perception initially about nursing profession but it was declining as age and seniority was increasing

4. The external environmental factors like job guarantee and opportunities for personal advancement at regional, national and international level were more influencing for enrollment to B.Sc. Nursing.

5. There was positive co relation between perception and influencing factors to enroll for B.Sc.Nursing in Western Maharashtra.

Suggestions-1)AdmissionprocedureunderMUHSshould besimplified.2) All nursing colleges shall be aided by the Government. Social welfare scholarships for all reserve categories irrespective of Government or Deemed University students3) Masspublicitytothenursingprogrammetoencouragethe students.4) further study is recommended to assess the factors influencing for deterioration of perception as age and seniority grows.

REFERENCES:

1. Aiken, L. (1982). Nursing in the 1980's. Philadelphia: Lippincott Lippincott publishing house, 7thedition, pp16-20

2. Nancy SR. Theories in nursing,Principles and practice of nursing. 5^th ed. Indore. NR publishing house; 2002: p 1-4

3. American Nurses Association, 2012. Nursing world: What is nursing http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing?accessed on 28 August 2013 at 10 p.m

4. Bulletin of the World Health Organization Volume 88: Number 5, May 2010, 321-400C6.

5. www.nursingschoolspath.com history of nursing.

6. A. S. Hornbey, 2000, The Advanced learner’sDictionary of Current English, 6th edition Oxford University press, p 864.

7. LliyaWondwossen (2011), Assessment of nurse’s perception towards nursing profession in public hospitals under Addis Ababa Health Bureau.

8. Safadi, R.R., Saleh, M.Y.N., Nassar, O.S., Amre, H.M. and Froelicher, E.S. (2011), nursing students' perceptions of nursing: a descriptive study of four cohorts. International Nursing Review, 58: 420–427. doi: 10.1111/j.1466 7657.2011.00897.

9. Mooney, M., Glacken, M., O. Brien, F. 2007. Impressions of nursing before exposure to the field,Journal of clinical Nursing17,1843-1850.

10. Huffstutler, S.Y., Stevenson, S.S., Mullins, I.L., Hackett, D.A. and Lambert, A.W.1998. Thepublic’s image of nursing as described to Baccalaureate pre nursing Students. Journal ofProfessional Nursing, 14(1): 7-1.

Received on 08.02.2017 Modified on 10.04.2017

Asian J. Nur. Edu. and Research.2017; 7(4): 534-544.

DOI:10.5958/2349-2996.2017.00105.7

S. no	Statements	Yes F	Response %	Mean	S.D.	Sub Factor
1	Service to mankind is service to God	393	89.32	1.86	.428	Attitude
2	Desire to help sick and help who are inneed	386	87.73	1.85	.434	Attitude
3	Personal liking, willing to work hard and Self –Confidence	326	74.09	1.69	.682	Attitude/Interest
4	Own interest/self motivated	328	74.55	1.67	.514	Interest
5	Parents/Relatives/friends are already in Nursing	243	55.23	1.40	.610	Motivation
		No Response

6	Religious influence	153	54.77	1.23	.532	Motivation
7	There was no other option /Choice than Nursing	192	66.36	1.23	.532	Interest
8	Pre-educational experience of nursing and Caring	205	46.59	1.53	548	Knowledge/Experience

S. no	Statements	Yes F	Response %	Mean	S.D.
1	Nursing profession gives 100% job guarantee and job security	354	80.45	1.70	.652
2	For further personal development	332	75.45	1.70	.566
3	Availability of jobs at regional, national and opportunities to work abroad	336	76.36	1.66	.637
4	Opportunities for Government job with good salary	310	70.45	1.59	682
5	Parental and peer encouragement(Social Pressure)	259	58.86	1.54	595
6	Attracted to the socio-economic benefits of the nursing career	226	51.36	1.30	.556