A Descriptive Cross-Sectional Survey on Public Attitude Towards Nursing Profession in India

 

Mohanasundari SK1, Joyce Joseph2, Raghu VA3, Dr Padmaja A4

1Ph.D. Scholar in INC, Faculty, College of Nursing, AIIMS Jodhpur, Rajasthan.

2Faculty, College of Nursing, AIIMS Jodhpur, Rajasthan.

3Ph.D. Scholar in INC, Faculty, College of Nursing, AIIMS Jodhpur, Rajasthan.

4Vice-Principal/Professor, College of Nursing, SVIMS, Tirupati. AP.

*Corresponding Author Email: raajinaidu@rocketmail.com

 

 

ABSTRACT:

Introduction: There has been a tremendous growth in the nursing profession over the past 100 years and the attitude of the society towards it has transformed significantly. The general public attitude can be viewed as positive or negative. Though, in India, this field is not receiving its required respect, which can be determined by various factors like its low reputation in the society, no specific job description, no syllabus or subjects for different administrative fractions in nursing, no fruition of higher degrees for influential post, the governance of doctors, nor the sovereignty to the field, unattractive salary packages for nurses and so on. This study was aimed to assess the attitude of general public towards nursing profession. Methodology: A descriptive cross sectional survey on 391 samples collected all over India through snow ball sampling technique. The tool contains 10 demographic variables and the 5 point Likert scale to assess the attitude of general public. Likert scale contains 10 items with maximum score of 50. The internal consistency of the tool was 0.731 and acceptable range was 0.65 to 0.75. The data was collected by face to face contact and through mobile app (watts app and survey monkey app). The data was collected from Jan to Feb 2019. The recorded responses were coded in excel sheet and computed in SPSS-16. Result: It showed that the general public attitude was favorable towards nursing profession (Mean =38.5 ±4.844). Geographical area and member in the family is a nurse has significant association with level of attitude towards nursing profession. Conclusion: In spite of favorable attitude, still public have undesirable attitude in certain point towards this profession. People are still uncertain about gender orientation of nursing profession, duty schedule and marital life of nurses. People still believes that nursing is a female oriented profession and only female can practice nursing, and shift duty in nursing puts female nurses at risk, as well as doing nursing duty will affect marriage life. So general public need more awareness about nature, benefit, value and scope of nursing profession in order to have transparent, pure and coherent attitude towards nursing profession.

 

KEYWORDS: Attitude, Public, Nursing, Profession.

 

INTRODUCTION:
Nurses are the key to quality medical care and save lives on a regular basis. Without nurses, it is unlikely that many would get the quality treatment at hospitals and clinics.1 Nursing is an art and science. Nursing requires skill as well as good scientific foundation to practice. Nursing is more respectable as it requires continuous and careful monitoring of patient health status throughout his/her stay in hospital/clinic, and it should be a more respectable profession as because nurses spend maximum time in patient care than any other professional workers. Despite this, many people look down on nurses or minimize what they do. A lot of this is caused by lasting misconceptions and stereotypes about nurses that are no longer (or were never) true. This profession has less credential, especially in India because of misconcepts which is deeply rooted in Indian public mind. In India about 90% of people have minimum knowledge regarding nursing2. The nursing profession is considered by the India society with poor image as it is considered as a job for those with low standing in the society. Furthermore, men would be discouraged to consider nursing as a career when they see a male nurse being teased in the community4.

 

NEED FOR THE STUDY:

India churns out the highest number of trained nurses in the world and is also amongst top 5 exporters of nurses. With > 75% of India’s healthcare workforce comprising of nursing staff alone, the role of nurses in healthcare delivery in terms of promotion, prevention, treatment, care and rehabilitation is very crucial to the smooth functioning of the health system. Nurses are frequently overlooked and often under-appreciated despite their critical role in health care. Nursing is not just the backbone of a patient care but the crown that decorate the head3. In spite of this reality, public believes that nursing requires no education and any one can practice nursing, nursing should be practiced by females only, it is female dominating profession and all nurses are same. Public also believes that nurses duty is to listen doctor’s order and follow, they apply no sense by their own on patient care and so on4. But the fact is nursing requires proper education, and training as it is an art and science. Almost all nurses purposefully chose nursing as a career and went through a rigorous degree program to qualify. Nurses do apply scientific principles in patient care, some nurses even work independently or have their own nurse practitioner practices and it’s not that they are completely dependent on doctor’s order. Each nurse has individual skills used in different ways. Even within a big hospital, nurses don’t just “do it all.” Each nurse has a specific role that he or she is passionate about. Nurses also apply their theoretical knowledge to diagnosis disease at earlier stage than doctors. Nurses teach, perform research, publish papers in journals, diagnose patients, participate in surgeries, treat illnesses, administer medication, and much more every day. Most of the nurses are more skillful in some invasive procedure than doctors and physicians too depend on nurses for certain area of patient care. Nurses are equally important like doctors in treating the patient. Along with those misconcepts another major tragic belief is about shift duty and its impact. General public over portrait the effect of night shift and believes that night duty puts female’s nurses when it is not true to the fact. Nursing is a challenging career at times, because of the complicated, highly skilled work they must carry out in a high-pressure environment where lives can be on the line5.

 

Attitudes, beliefs, and values are highly subjective areas, usually based upon perception and not facts. The existing 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 that the nurses receive. Perceptions held by the public about the nursing profession greatly influence the personal and public image of nursing.6

 

In current scenario literacy rate in India dramatically increased especially female literacy, women are prefer to go for job, ready to do shift duty, and public awareness about nursing profession and their role in patient care also increased, differently this might have changed the current perception of public toward nursing profession. This present survey was under taken to investigate the existing attitude toward nursing profession among general public in India. To improve nurse’s social image is to intervene in the social image of nursing that exists in the general public.

 

TITLE:

A descriptive cross sectional survey on public attitude towards nursing profession in India.

 

RESEARCH QUESTION, OBJECTIVES AND HYPOTHESIS:

·           Primary research question: What is the attitude of the general public towards nursing profession in India?

·           Secondary research question: Does association exist between selected demographic variables with level of attitude?

·           Primary Objectives: To assess general public attitude towards nursing profession

·           Secondary objectives: To associate the selected demographic variables with level of attitude towards nursing profession

·           Hypothesis: There will be a significant association exist between selected demographic variables and levels of attitude of general public toward nursing profession.

 

METHODOLOGY:

Under quantitative approach a descriptive cross-sectional survey was conducted in natural setting among Indian general public other than nursing personnel. A total of

391 [(N={Z2Xp (1-p) }/C2 formula was applied to calculate   sample  size   for   the  known Population  (p)- 701986819. The confidence level was 95%, Z value was 1.96, and Confidence interval (C) was ±5 (0.05)] people were accessed through snow ball sampling technique by direct contact, watts app, phone call and or other mode (survey money app). The tool was developed after obtaining suggestions from nurses, and few general public. Some relevant articles were referred to frame the suitable question. The tool has two sessions. Session -1 is about demographic variables such as state of living, sex, age in years, religion, place of living, occupation, education, and presence of any family member as nurse and cared by nurse at any time in life. Session -2 was about 5 point Likert scale to measure attitude of the general public, which covers total 10 statements with a maximum total score of 50 and minimum of 10.

 

Table-1: Score and interpretation of the scale

Over all Score

Score for each statement

Interpretation

Positive statement

Negative statement

41-50

5

1

Strongly favorable attitude

31-40

4

2

Favorable attitude

21-30

3

3

Neutral attitude

11-20

2

4

Unfavorable attitude

10

1

5

Strongly unfavorable attitude

 

The internal consistency of the tool was (0.731) in acceptable range and it was assessed by Cronbach alpha reliability test. Validity was obtained from expert and modifications were made as per suggestions. Ethical clearance was obtained from IEC of Dr SNMC Jodhpur. Through self-report technique (structured questionnaire) data was collected. The questionnaire was distributed through direct face to face contact, and survey monkey app link which was fed with two sessions of questions were forward via watts app, twitter, email Facebook etc.

After    obtaining    consent    from    the    participant the questionnaire was distributed to the sample in direct method. In survey monkey the questions was displayed after accepting consent. The data was collected from Jan to Feb 2019. The recorded responses were coded in excel sheet and computed in SPSS-16.

 

RESULT:

Objective-1: To assess general public attitude towards nursing profession

Table 2: Percentage distribution, mean, median and SD of general public attitude towards nursing profession          N=391

Score

Interpretation

Percentage (%)

Mean

Median

SD

41-50

Strongly favorable attitude (SFA)

41.43

38.5

 

38

4.844

31-40

Favorable attitude (FA)

28.13

21-30

Neutral attitude (NA)

12.27

11-20

Unfavorable attitude (UFA)

11.76

10

Strongly unfavorable

attitude (SUFA)

06.39

 

Total

100%

 

 

 

 

The table -2 suggests that the general public attitude was favorable towards nursing profession as the mean score was 38.5 with SD of 4.844 and the median was 38.

 

Figure -1: Frequency distribution of sample based on level of attitude

 

From the figure-1 it was interpreted that 162 samples (41.43%) were having strongly favorable attitude and only 25 samples (06.39%) were having strong unfavorable attitude towards nursing profession.

 

Objective-2: To associate the selected demographic variables with level of attitude towards nursing profession

Table-3: Frequency and percentage distribution of demographic variables and, X2 and ‘P’ value of demographic variables associated with level of attitude of public towards Nursing profession.                                        N=391

Demographic variables

Frequency

Percentage

X2

‘P’

Value

1. Geographic area

a)  North India

b) South India

c)  Western India

d) North East India

 

92

135

122

42

 

23.5

34.5

31.3

10.7

 

4.245

 

0.013*

2. Age in years

a)  <24 years

b) 24 to 36 years

c)  36 to 48 years

d) > 48 years

 

116

178

66

31

 

29.7

45.5

16.9

7.9

 

2.347

 

0.243

3. Sex

a)  Male

b) Female

 

256

135

 

65.5

34.5

 

4.545

 

0.103

4. Religion:

a)  Hindu

b)  Muslim

C) Christian

 

248

139

4

 

63.4

35.6

1.02

 

3.807

 

0.433

5. Place of living:

a)  Rural area (Village)

b) Semi urban area (Town)

c)  Urban area (City)

 

263

27

101

 

67.3

06.9

25.8

 

5.799

 

0.215

6. Marital status:

a)  Married

b) Single

 

279

112

 

71.3

26.7

 

2.954

 

0.228

7. Educational status:

a)   1-8th std

b)   10-12th std

c)   Graduation

d)   Post-graduation and above

 

85

77

105

124

 

21.7

19.7

26.9

31.7

 

6.373

 

0.383

8. Occupation:

a)   Unemployed

b)   Professional job

c)   Non professional job

d)   Others

 

128

112

39

112

 

32.7

28.6

10.0

28.6

 

8.966

 

0.175

9.Member in the family is a nurse:

a)   Yes

b)   No

 

108

283

 

27.6

72.3

0.381

0.027*

10.Cares by nurse at any time in life at clinical/home/hospital

a)   Yes

b)   No

 

 

252

139

 

 

64.5

35.5

 

 

0.270

 

 

0.874

Note: * Indicates significance

 

From the table -3 it was interpreted that geographical area has significant association with level of attitude towards chosen profession. Alone with geographic area, the member in the family is a nurse also had significant association with level of attitude. The other demographic variables had no significant association with level of attitude (P <0.05). It is also interpreted that majority of samples belongs to south India (135), and aged between 24 to 36 years (178), minority of the samples belongs to

Christian (4). Majority were married (279) and live in rural area (263), most of the samples were graduated (UG and PG together 229), More than half of the samples (64.5%) were cared by nurses at least once in life time, and 72.3% of samples have no any family member working as nurse.

 

From table-4 it was interpreted that majority of sample responses were strongly agree (1684/3910) and most of them were agree (1111/3910) with the statement about nursing profession. Very few were reported disagree (443/3910) and strongly disagree (192/3910) upon given statement.

 

From table -5 it was interpreted that general public have strongly favorable(positive) attitude on statement 1,2,3,4,6,7, and as the mean score was shown to be 4.66, 4,39, 4,47, 4,51, 4.23 and 4.39 respectively. For the statement 5 and 8 public have favorable (positive) attitude  as  the  mean  score was  shown  to  be  3.36 and

3.26. It is also interfered that public have neutral attitude on statement 9 and 10 as the mean score were 2.86 and

2.55. As the overall mean score was 38.5, it was interpreted that pubic had favorable attitude toward nursing profession.

 

Table-4: Frequency distribution of response to each statement N=391

S. No

Statement

Strongly agree

Agree

Neutral

Disagree

Strongly disagree

Total

+1

Nurses are the backbone of patient care

283

90

13

4

1

391

+2

Nursing is a respectable (noble) profession

236

104

28

13

10

391

+3

Nurses are equally important for patient care like doctors.

254

94

22

16

5

391

+4

Nursing profession Required more tolerance

242

116

27

3

3

391

+5

Nursing profession has scope to work all around the world

89

114

78

68

42

391

+6

Nursing profession has reasonable pay

177

150

46

12

6

391

+7

Nurses are more approachable than other health care team

223

118

33

15

2

391

-8

Nursing is a female oriented profession

44

74

71

140

62

391

-9

Practicing nursing affect social decisions like marriage

57

115

85

92

42

391

-10

Shift duty in nursing profession risk the female nurses life

79

136

77

80

19

391

 

Total

1684

1111

480

443

192

3910

 

Table-5: Score distribution of each statement and its mean. N=391

S.No

and Na

Statement

Strongly agree

Agree

Neutral

Disagree

Strongly disagree

Total

Mean

+1

Nurses are the backbone of patient care

1415

360

39

8

1

1823

4.66

+2

Nursing is a respectable (noble) profession

1180

416

84

26

10

1716

4.39

+3

Nurses are equally important for patient care like doctors.

1270

376

66

32

5

1749

4.47

+4

Nursing profession Required more tolerance

1210

464

81

6

3

1764

4.51

+5

Nursing profession has scope to work all around the world

445

456

234

136

42

1313

3.36

+6

Nursing profession has reasonable pay

885

600

138

24

6

1653

4.23

+7

Nurses are more approachable than other health care team

1115

472

99

30

2

1718

4.39

-8

Nursing is a female oriented profession

44

148

213

560

310

1275

3.26

-9

Practicing nursing affect social decisions like marriage

57

230

255

368

210

1120

2.86

-10

Shift duty in nursing profession risk the female nurses life

79

272

231

320

95

997

2.55

 

Total score

7700

3794

1440

1510

684

15128

38.5

DISCUSSION:

In this present study the attitude of the general public towards nursing profession was favorable as the mean score was 38.5/50 with SD of 4.844. Similarly, Manisha C (2014) assessed the knowledge and attitude of teachers towards nursing profession among teachers and knowledge and attitude was found to be equal and excellent 64(78.04%). And there is perfect correlation between knowledge and attitude 7. This study finding also concordance with Belete A (2015) study about attitudes towards nursing profession among nursing and non-nursing personnel. This study revealed that 64 (50%) of the respondents shown favorable attitude towards nursing profession and 64 (50%) shown unfavorable attitude and majority 4 (63.6%) of the physicians shown unfavorable attitude 8. Also this finding concordance with the study of result of Kaur L (2016), were the majority of nursing students 624 (90.83%) have a favorable attitude towards nursing profession 9.

 

In this present study the member in the family is a nurse had significant association with level of attitude of general public on nursing profession. Similarly, Loba (2011) conducted a descriptive study to assess the knowledge and attitude of public towards nursing profession in a selected hospital at Mangalore. The findings revealed that a significant association was found between attitude, knowledge and the presence of nurse in the family and source of information. 10

 

In this present study statement number 7 was “nurses are more approachable than other health care team”. It was strongly agreed by most of the public and the mean score was 4.39/5. Similarly, Thomas R (2018) undertook study to assess the attitude of public towards nursing in a selected community area, Punjab. It was suggested that the most adolescents are aware of the calling and helping nature of nursing but have little knowledge about the diverse nursing career opportunities in teaching, management and administration. 11

 

CONCLUSION:

The present study concludes that the general public have favorable attitude toward nursing profession. General public strongly agreed on statement such as 1) nurses are back bone of the patient care, 2) nursing is more respectable profession, 3) nursing required tolerance, 4) nurses are equality important in patient care like doctors and 5) nurses are more approachable than any other health care team. Also were partially aware about scope of nursing profession. In spite favorable attitude still public have undesirable attitude certain point towards this profession. People are still uncertain about gender orientation in nursing profession, duty schedule and marital life of nurses. People still believes that nursing is

a female oriented profession and only females can practice nursing, and shift duty in nursing puts female nurses at risk, as well as doing nursing duty will affect marriage life. So general public need more awareness about nature, benefit, value, and scope of nursing profession in order to have transparent, pure and coherent attitude towards nursing profession.

 

LIMITATIONS AND RECOMMENDATION:

The study is limited to 391 samples only and it is recommended conducting with large samples. The study focused on attitude of public towards nursing profession and it is recommend that the study can be conducted to assess knowledge aspects of public towards nursing profession.

 

ACKNOWLEDGEMENT:

We thank the following research assistant who aided in data collection: A. V Roshini, Mrs, Anumol, Mrs. Rosellin Ganesh, Mrs, Ramya Vasanth, Ms, sridevi, Ms Roja, Mr. Sheshkumar and Ms. Annu

 

CONFLICT OF INTEREST:

No.

 

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2.          Thomas R. A Study to Assess the Attitude of Public toward Nursing in Selected Community of District Patiala, Punjab, 2018:7 (3), 48-54.

3.          Banerjee U. Nurses are backbone of a hospital, India is grappling with shortage. May 12, 2018

4.          Mu K, D’Silva JJ, Lobo JM, Sequera SK. A study to assess the attitude towards nursing profession among the nursing students in the selected college at Mangalore. Int J Health Sci Res 2015; 5:217-20.

5.          Major Misconcepts about nursing” Purdue university global

6.          Swamy, D.S.V. Attitude of people towards nursing, Nightingale Nursing Times. 2009: 5(9), 33-35.

7.          Manisha C. G, Vaishali R. M and Mahesh B. C. Study to Assess the Knowledge and Attitude towards Nursing Profession among College Teachers in Karad, IJSR, 2014: 3 (4), 891 to 894.

8.          Belete A Lamaro T and Henok A. Assessment of Attitudes towards Nursing Profession among Nurses and Non-Nursing Health Professionals Working in Mizan-Aman General Hospital, Southwest Ethiopia. 2015. Research gate.

9.          Kaur L, Kanika and Kumar A. Assess the attitude of nursing students towards nursing profession International Journal of Applied Research 2016; 2(6): 738

10.        Loba, and Roshal S. A study to access the knowledge and attitude of pre-degree student towards nursing as a profession in selected pre-university colleges at Mangalore. 2011.

11.        Thomas R. A Study to Assess the Attitude of Public toward Nursing in Selected Community of District Patiala, Punjab, 2018:7 (3), 48-54.

 

 

Received on 29.05.2021                Modified on 24.06.2021

Accepted on 10.07.2021            ©A&V Publications All right reserved

Asian J. Nursing Education and Research. 2021; 11(4):510-514.

DOI: 10.52711/2349-2996.2021.00121