Transcription
بسم ﷲ الرحمن الرحيم An-Najah National UniversityFaculty of NursingFactors that Affect Nursing Perception as a Career ChoiceAmong Scientific High School Students in Hebron CitySubmitted by 4th years students:AHMAD ALASWEDAMOHAMMAD MOUSA MANASRARAAFAT SHAHERABD-ESALAM ALSOUFISupervised by:Miss. MARIAM ALTELLMiss. SHUROUQ QADOSE1st semester 2008 20091
OUTLINES: Acknowledgement 4 Abbreviations .5 Introduction 6 CH 1: literature review 9 Socio-demographic factors 11 Students’ perception of nursing as a career .13 Security and economic factors 14 Desire and respect factors 14 CH 2: Methodology: .16 Purpose .17 Problem statement .17 Hypothesis .18 Population .18 Sample 192
Data collection 19 CH 3: Data analysis and results 21 Results collecting and analysis 26 CH 4: discussion and conclusions .30 Discussion .31 Conclusions 36 Recommendations .38 Budget 39 References .403
AcknowledgementTo our fathers and mothers who were the kind embrace for their sons, whosupported their sons financially and emotionally to the last day of their study. To theuniversity to which we belong “An-NAJAH NATIONAL UNIVERSITY”represented by Dr.RAMI HEMDALLAH who always support us and our faculty. Tothe Dean of our faculty which we appreciate for its support Dr. ADNAN SARHANthe person who was the kindhearted father for all of his students. To the person whotaught us the principles of research Dr. AIDA ALQAISI. To the person who taught usthis material Miss MARIAM AL TELL from whose experience we were benefited.To the kind smile, to the affectionate lady who supervised our work and was the bestsupervisor, to Miss SHOROUQ QADOSE who supported us by her kindness andexperience to finish this work perfectly. To the ministry which accepted us in itsschools as guests, to the department of education in Hebron city represented by itsdirector Mr. Mahmud Manasra all of our colleagues from whom we were benefited inour working the project, the students who were friends and brothers. To all of thesepeople we present this work.4
AbbreviationsHere are the abbreviations in the project which may not be understood by thereader: QN: Question number No: Number SD: Standard deviation DF: Degree of freedom RL: Reference level T: T.test Bet: Between5
Factors that affect nursing perception as a career choice amongscientific high school students in Hebron cityIntroductionCareer which is considered to be the future for every school student especially in the highschool stage. The student in this stage starts to think about his\her future career? What is the bestcareer to earn much money? How will he/she be rich person?The ideal career differs in its meaning from one person to another, some persons see that theideal career is the one by which he will earn much money and good income and be wealthy person,whereas others see that the ideal career is the one which has a great deal of humanity and by whichhe can give a service for people. So every one sees the ideal career from his point of view.The nurse is the single most important frontline health worker. Without nurses the clinics,community health centers and hospitals cannot function. It is therefore critical that nurse educationand the supply of nurses form an integral part of transformation of health services in Palestine.Attracting new recruits to the profession is an integral part of increasing production.Nursing is a career and it is considered to be a human one because every one entering thiscareer feels that he gives a medical and nursing service for people and doesn’t ask for richness fromit, although it is hard and exhausting one. The only thing the person will obtain from nursing is high6
self esteem, because when the nurse saves a life in intensive care unit for example, he will feel thathe has made a very great job and so he will feel that he has high self-esteem.In Palestine especially in Hebron, this perception is not found in a great deal, so we find ashortage in nursing profession and nurses which affects the public health in this community. Thisshortage may be noticed because of many factors like gender, norms attitudes and habits, age, thejob of the mother and many other factors that will be discussed later.The most important factor that affects nursing perception in Hebron is the values and habitswhich prevent females from working in nursing aspects and so lead to gender factor. That isbecause the Hebron’s citizens are religious and consider the night shift work for their girls is shamewhich leads to risen male nurses in Palestinian universities .In medical aspects the medical team and the well educated persons know that nurses arecomplementary agents for physicians, but this perception is not clear for ordinary citizens whobelieve that nurses are cleaners or something like that, the thing that prevents them from enteringnursing profession, and this is another important factor leads to nurses shortage in Palestine.There is another perception for nursing that is the nurse is beautiful girl with short skirt andsexy body and behavior, and does sex with everyone who wants. This perception spreads in thewestern countries especially in USA and Europe. It is true that this perception is not found inPalestine but ordinary citizens see the western movies and may be affected by this perception thething which adds another factor for not applying nursing by high school students and their parentsespecially in Hebron city.For all of these factors, the nursing perception among high school students in Hebron ismisleading by their parents, families, and community. And most of this city’s students don’tconsider nursing as ideal career inspite of their desire to give a human service to any person of the7
population and their desire to study in nursing profession. So most of Hebron’s high school studentsare forced to study another specialization such as engineering, arts and science .Despite the absence of previous researches and studies about this subject especially in Palestine,This paper was prepared to add some insight to nursing profession and its importance toindividuals, families, and community. it will also add an insight about the factors that lead to highpercentage of male nursing students in Palestinian universities and why females have lowpercentage in the classes of nursing profession. This paper will also discuss how we can encouragenursing profession study in Hebron and how to prevent norms and habits from restricting our highschool students to choose their ideal career.8
Chapter one:Literature review9
Many studies worldwide report that interest in nursing as a career is low. Only 5.2% of asample of high school respondents in Saudi Arabia intended to pursue nursing after school (AlOmar, 2004). A study in Tanzania showed that, of all the medically related professions (includingVeterinary medicine), nursing was the least popular with only 9% of students expressing aninterest (Kikwilu et al, 2000), whilst amongst Asian students in Australia less than 10% wereinterested in nursing as a profession (Rossiter et al, 1998). In Kuwait, however, 19% of femalehigh school students interviewed were considering nursing as a career (Al-Kandari & Lew, 2005)and in Hong Kong, this figure rose to 28% (Law & Arthur, 2003).The reasons for the perceived lack of interest in nursing as a career are multi-factorial, andmay differ from context to context. In South Africa, the low status of the profession, heavyworkloads, and poor access to personal development programmes have been proposed as someof the reasons learners are not attracted to nursing as a career (Department of Health, 2006).Other negative perceptions about nursing are that the workload is physically demanding, and thatthe shortage of nurses increases the stress of the work (Buerhaus et al, 2005). Of concern is thatsome of the perceptions about nursing do not reflect reality (Kohler & Edwards, 1990); theseneed to be corrected in order to attract more high school leavers to the profession. Positiveperceptions include that nursing offers good job security, and that the shortage of nurses will leadto pay rises and wider choice of jobs (Buerhaus et al, 2005).Nursing is a profession that combines physical science, social science, nursing theory, andtechnology, in the care of others (www.nursingsociety.org). Many years ago nursing was seen tohave numerous career advantages. These included that there is a large demand for nursesnationwide, many job opportunities, various nursing career choices, good benefits, many choicesboth in terms of specialty areas and opportunities for advancement (www.nursejobs.com).10
A comprehensive literature review revealed that the perception of nursing as a career choiceis influenced by many factors worldwide and several articles have been written about nursing as acareer, but there were no studies related to the Palestinian situation.The following literature that related to why high school students choose or refuse nursing as acareer suggests that what motivates an individual to choose a career is influenced by a multitude offactors. These factors classified into 4 categories that are: socio- demographic factors, students’perceptions of nursing as a career, security and economic factors and desire and respectfactors.1.1 Socio-demographic factorsThe decision to choose nursing as a career was found to be significantly influenced bydemographic characteristics in several studies where there were significant differences found indemographic groups for positive attitudes and interest in nursing as a career (Barkley andKohler, 1992)( Boughn, 1994) (Lerner, 1991) (May et al., 1991) (Tang et al., 1998) (Williams etal., 1991).1.1.1 GenderGender is a very powerful factor in the choice of nursing as a career. Nursing has remaineda highly female dominated profession, and men constituted a very small percentage of the nursingwork force. Some authors suggest that more females than males have been employed in the nursing11
discipline because females have a more positive attitude toward nursing (May et al., 1991)(Tang etal., 1998)(Williams et al., 1991).1.1.2 Parents’ education level and occupationIn a cross-sectional study conducted among Dade County senior high school students(Grossman and Northrop, 1993), it was found that the occupation of students’ mothers had a moresignificant impact on their choice of a career than the occupation of their fathers.The variable of parents’ education was identified in the study of (May et al,1991). When using ascale for measuring altitudes toward nursing as a career. Ratings for nursing were summed so that ahigher score indicated a more positive attitude toward nursing and a lower score indicated a morenegative attitude. The results showed that adults with high school education or less had significantlymore positive attitudes toward nursing than those with a bachelor degree.In the study of(Lerner,1991), who conducted a statewide survey of 2315 RNs taking the statelicensure examination, the constructed questionnaire elicited data pertaining to the RNs’demographics, educational and employment characteristics as well as their subjective perceptions ofwork and the profession. With a 97% response rate, it was noted that 60% of the RN’s mothers and50% of their fathers had more than a high school diploma. From the study it could be assumed thatas the education level of the parent increases, the students’ interest in a nursing career increases.So the decision about nursing studying is affected by social influences like parents, school careermasters and friends (law, 2002).12
1.1.3 Community perceptionThe perception of nursing profession among the ordinary citizens and the community hasgreat affect on the perception of high school students to a attend nursing and to choose it as futurecareer. The perception of nursing profession among Palestinian community is misleading .It isthought that it is just performing clean up tasks (Jeanette Ive Erickson, 1999). The students haveless positive perception about public opinions of nursing profession (Kari E.Sand Jechlic, 2001).1. 2 Students’ Perceptions of nursing as a careerPerceptions of nursing as a career are thought to be related to choices made by high schoolstudents when entering into the nursing profession (Steven and Walker, 1993), and the decision tochoose or refuse nursing was significantly influenced by the congruence between students’perception of an ideal career and nursing as a career (Reiskin and Haussler, 1994).1.2.1 Who influenced students’ career choice?Advice from family, friends, school career masters and nurses, interaction with nurses inpractice, interaction with sick people and interaction with students already enrolled in a nursingeducation program were found to be common major influencing agents for a student’s image of thenursing profession and career choice of nursing (Grossman and Northrop, 1993) ( Kersten et al.,1991) ( Rawlins et al., 1991) ( Williams et al., 1991) ( Smadu, 1996).13
1.3 Security and economic factorsNursing profession is a human one so no one attend this profession and starts to think aboutsalary or economic benefits because the nursing career doesn’t afford happiness at work oreconomic benefits (Jeanette Ive Erickson, 1999). So nurses will not be rich or poor people, theyhave ordinary salaries like or less than other professionals. In spite of this it may be the ideal careerfor many persons because of its humanity. Security in the job is one of the most importantcharacteristics of the ideal career, every person should be secured during his job and after leavingthis job ( Mary et al, 2005) and only nurses were perceived as having job security that matched theideal career ( Mary et al , 2005) .1.4 Desire and respect factorsDesire to apply a career is a good way to succeed it. The opinions of nursing career in severalvariables are influenced significantly by the students’ desired occupation (DG, Northrop, 1993).This desire may increase or decrease after starting studying or attending nursing profession. Themajority of students believe that their perception changed after their first clinical experiences (KariE. Sand Jecklin, 2001).The respect from the community for nurses also has an affect on an attending nursing profession.The factors for not applying nursing profession are poor stuffing and lack of respect from doctorsand patients (Jeanette Ive Erickson, 1999).A study by Jane Hensley et al in 2006 in the university of Southampton showed that majority ofyoung people career choice don’t regard to salary and base their decision on interest and desire tohelp people .These study findings indicate that although young people expressed admiration for the14
work of nurses. This was rarely matched by an envy of nurses, or a desire to become a nursethemselves.15
Chapter two:Methodology16
2.1 PurposeThe principal aim of the research was to investigate the factors and perceptions of high schoolstudents around nursing as a career choice, the research also aims to identify the characteristics ofthe ideal career among high school students in Hebron city. The following objectives guided thestudy: To assess the high school students perception about nursing profession . To identify the factors on which the high school students are depending in their careerchoice. To promote the positive points of view about nursing as a career. To falsify negative points of view about nursing as a career.2.2 Problem statementThrough the researchers’ experience and after inspection of literature review the researchersfound that most of the scientific stream high school students have negative perception about theideal career they may attend in the future, and they have misleading perception about nursingprofession as future career. The researchers think that many factors lead to this problem which willbe explained later.17
2.3 Hypothesis There are no differences about nursing perception and perception of ideal career among highschool students in Hebron city due to gender. There are no differences about nursing perception and perception of ideal career among highschool students in Hebron city due to residence. There are no differences about nursing perception and perception of ideal career among highschool students in Hebron city due to family income. There are no differences about nursing perception and perception of ideal career among highschool students in Hebron city due to a parent work in health care sector. There are differences about nursing perception and perception of ideal career among highschool students in Hebron city due to family member admission to a hospital.2.4 PopulationThe population for this study was all Hebron’s secondary schools which include secondsecondary class \ scientific stream. The schools were 3 for males and 5 for females. All the schoolswere phoned by the researchers and the supervisor to know the number of scientific high schoolstudents they include. The male students in 3 male schools were 322 students in scientific streamand the female students were 333 students in the scientific stream in 5 female schools. Thepopulation was 655 male and female scientific stream high school students. The percentage of maleschools in the city was 37.5% and the female percentage was 62.5 % in the same area so the range18
of male to female schools was 1:2. There were 20 classes in all the schools, 10 for males and therest for females.2.5 SampleA representative sample was chosen from the male and female schools. First, 3 schools werechosen randomly from 8 ones, one male school and 2 female schools. The male school chosen wasAl-Hussein Ben Ali secondary school, and the female schools were Al-Okhwa and Wedad NaserAddinn secondary schools. But Al-Okhwa school was difficult to reach because the police closedall the ways reaches to that school, so the researchers reselect the schools and choose KhadijaAabdin secondary school instead. After that the student’s sample was chosen randomly. Arepresentative sample consists of 60 scientific stream high school students, 30 males and 30females. The male students were selected from one class of 6 because the headmaster of the schoolrefused to let the researchers meet 5 students from each class. The female students were selectedfrom 2 classes in Khadija Aabdin and from 3 classes in Wedad Naser Addin school.2.6 Data collectionThe data were collected by questionnaire distributed for the sample. The questionnaire includes30 questions, the first 10 questions talk about the ideal career and the other 20 questions talk aboutthe perception nursing career choice for high school students in Hebron city. The questionnaireincludes 3 pages, the first page includes welcoming paragraph and some general information, theother 2 pages include the questions about ideal career and nursing as career choice. The answersconsist of 5 scales which are: strongly agree, agree, uncertain, not agree, and strongly not agree.19
All the sample students were met in their classes and have the questionnaire to fill by theresearchers. They also were insured to fill all questionnaire features. They also ensured not to writeany special information that may lead to the participant. They were given all the time they want toanswer the questions. After completing this, the questionnaires were collected and the schools werethanked.20
Chapter three:Data analysis and results21
This chapter includes a show for procedure, population, sample, reliability and validity of thestudy. It includes also the statistical analysis for the results as the following: The procedure: The researchers used the procedure of field description which isconsidered to be appropriate for this study ( descriptive inquiry ) Population: All Hebron’s scientific stream high school students. Sample: The sample consists of 60 high school students chosen randomly from thepopulation, 30 males and 30 females.These tables show the distribution of the study sample according to its variables.Table No (1): The sample distribution according to tal60100%Table No (2): Distribution according to the work of a parent in health care sittingWorkNumberPercentageYes58.3%No5591.7%22
Total60100%Table No (3): Distribution according to residence Camp11.7%Total60100%Table No (4): Distribution according to family incomeFamily incomeNumberPercentageLess than 1000 NIS46.7%1000-2000 NIS2135%More than 2000 NIS3558.3%Total60100%23
Table No (5): Distribution according to a family member admission to a tal60100%Table No (6): Distribution according to ageAgeNumberPercentageLess than 1860100%More than 1800%Total60100%** Since the age variable has one probability which is “less than 18 years “, the researchersexcluded this variable and didn’t test it.Table No (7): Distribution according intention to apply a universityIntentionNumberPercentageYes60100%24
No00%Total60100%** Since the variable of intention to apply a university has one probability which is “yes “, theresearchers excluded this variable and didn’t test it. Methodology: The researchers developed the method of their research after review relatedliteratures. Reliability: The researchers made sure that the study is reliable by presenting it to manyexperts who represented that it is reliable and valid. Study procedure: The study procedures were done according to the following steps: Final preparation of the study parts. Determination of the study sample. Distribution of the study questionnaire. Collecting the questionnaire from the sample, computerizing the results and analyzingthem using SPSS program. Documenting the sample results.25
Results collecting, and analysis,1. Statistical processingFor processing of data the researchers used SPSS program using the following statistical ways: Frequencies and percentages. Means and standard deviations. T. test for 2 independent groups One way ANOVA Krounpakh α test for test stability which was (0.6322) which is considered to be acceptablefor this test.2. Study questionnaire resultsThis study aimed to know the nursing perception as a career choice and the ideal career amonghigh school students in Hebron city. It aimed also to know the study variables which are: gender,residence, previous family member admission to a hospital, family income, and apparent work inhealth care sector.For achieving the study goals the researchers developed a questionnaire consists of 30 questionsand then they exposed it to many experts to make sure that it is reliable, next they distributed it tothe sample and then collected, computerized, and processed the results using SPSS program.Here are the results according to its questions’ arrangement and its hypothesis:26
o The results related to study questionnaire: for answering the study questions and thencollecting the percentages, means and standard deviations, the researchers suggested thefollowing grades:Less than 2: low gradeFrom 2-3: moderate gradeMore than 3: high gradeThe following table shows these resultsTable No (8): The questionnaire results, means, standard deviations, and gradesQNQuestionMeanSDGrade1.Ideal career means to me people care4.280.7612High2.Ideal career means to me high income3.21.14High3.Ideal career means to me leadership in work place3.781.59High4.Ideal career means to me to be respectful4.410.74High5.Ideal career means to me to make my own decision4.051.17High6.Ideal career means to me to work hard3.861.01High7.Ideal career means to me to be active and energetic4.310.72High8.Ideal career means to me to have university degree4.430.90High27
QNQuestionMeanSDGrade9.Ideal career means to me to use technology and3.351.13Highminimum hand using10.My parents affect me in choosing future career3.411.19High11.Nursing can be my ideal career2.850.98Moderate12.Nursing career is important to individuals and4.340.81Highcommunity members13I have the desire to study nursing in future2.761.30Moderate14.Community perception of nursing career is positive3.751.12High15Nursing is female exclusive career2.481.17Moderate16.Nursing is a human career more than its economic one4.230.96High17.Nursing studding is costly3.261.11High18.There are many jobs related to nursing career3.550.90High19.Nursing career brings high income3.350.95High20Nursing career is exhausting one3.810.81High21.Nursing career is dangerous one3.311.06High22.Nursing level is good in Palestine3.360.95High23Political situations has affected nursing perception4.230.85High28
QNQuestionMeanSDGrade24Nurses behavior with citizens is acceptable3.310.99high25Nursing career is important for Palestinians4.161.15High26Nurse has effective role in health care providing40.9High27Nurse’s role is equal to physician one in the community3.161.09High28Nursing future will be better than now4.10.93High29.Hospitals’ distribution in Palestine ia appropriate for3.251.21High2.71.23moderate3.720.41highhealth care providing30Palestinian citizen has enough medical information thathelps him in all his life aspectsTotalThe previous table shows the following conclusions:o Most questions have high response grade which means positive trends for these studentstoward nursing career.o There are some questions have moderate response grade which are (11, 13, 15, and 30) thething which indicates moderate desire from these students to study nursing and the nursingcareer isn’t female exclusive in our community. Another conclusion is negative perceptionof nursing future and the Palestinian citizen has enough medical informationo Total grade is (3.72) which considered to be high.29
Chapter four:Discussion, conclusions and recommendations30
DiscussionFirst hypothesis:For testing the accuracy of hypothesis said that “there are no statistical differences nearα 0.05 about nursing perception and perception of ideal career among high school studentsin Hebron city due to gender “ t.test was made for the sample and the results were as thefollowing:Table No (9): t. test for gender 810.777Female303.700.3654.727 ــــــــ ـــــــــــ The previous table shows that reference level is 0.777 which is greater than level assumedin hypothesis (0.05). So we accept the hypothesis and say that “there are no statisticaldifferences near α 0.05 about nursing perception and perception of ideal career among highschool students in Hebron city due to gender”.The table also shows that males’ mean is 3.74 whereas females’ is 3.70 the thing whichmeans males and females approximation in the perception of nursing career and ideal careerin Hebron city.31
Second hypothesis:For testing the accuracy of hypothesis said that “ there are no statistical differences nearα 0.05 about nursing perception and perception of ideal career among high school studentsin Hebron city due to residence” ANOVA test was made for the variable alternatives whichare , city (55), town (4) and camp ( 1) the results were as the following:Table No (10): ANOVA test for residence factorTotalDFANOVABet classes0.0736720.03684Inner class10.076570.177Total10.105059 ـــــــــ F0.208RL0.813 ــــــــــــ ـــــــــــــ ــــــــــــ ـــــــــــ The previous table shows that reference level is 0.813 which is greater than assumedgrade in hypothesis (0.05). So we accept the hypothesis and say “there are no statisticaldifferences near α 0.05 about nursing perception and perception of ideal career among highschool students in Hebron city due to residence”.Third hypothesis:For testing the accuracy of hypothesis said that “there are no statistical differences nearα 0.05 about nursing perception and perception of ideal career among high school students32
in Hebron city due to family income” ANOVA test was made for the variables which are:less than NIS 1000, NIS 1000-2000, and more than NIS 2000. The results were as thefollowing:Table No (11): ANOVA test for family income factorTotalDFANOVAFRLBet classes0.29320.1460.8470.434Inner class9.85757 ــــــــــ ـــــــــــ ــــــــــــ Total10.1559173 ــــــــــــــ ــــــــــــ The previous table shows that reference level is 0.434 which is greater than the assumed gradefor hypothesis (0.05). So we accept the hypothesis and say that “there are no statistical differencesnear α 0.05 about nursing perception and perception of ideal career among high school students inHebron city due to family income”.Forth hypothesis:For testing the accuracy of hypothesis said that “ there are no statistical differences near α 0.05about nursing perception and perception of ideal career among high school students in Hebron citydue to a parent work in health care sector” t.test was made for the variables which are “ yes(5)” and“no ( 55)” and the results were as the following:33
Table No (12): t.test for a parent work in health care 0.608No553.710.414.81 ــــــــــــ ـــــــــ The previous table shows that reference level is 0.608 which is greater than the assumedhypothesis grade (0.05). so we accept the hypothesis and say “ there are no statistical differencesnear α 0.05 about nursing perception and perception of ideal career among high school students inHebron city due to a parent work in health care sector.The table also shows that the mean for variable “ yes “ is 3.76 and the mean for “no “ is 3.71which indicates an approximation b
interested in nursing as a profession (Rossiter et al, 1998). In Kuwait, however, 19% of female high school students interviewed were considering nursing as a career (Al-Kandari & Lew, 2005) and in Hong Kong, this figure rose to 28% (Law & Arthur, 2003). The reasons for the perceived lack of interest in nursing as a career are multi-factorial, and
