INTRODUCTION METHODS KEy RESULTS ...

P097M

Becoming nurses:

a multi-centric four years cohort study on students’ professional identity development D. Ausili , F. Cifarelli , M. Brivio , S. Marchetti , S. Di Mauro (1)

(2)

(3)

(4)

(5)

RN, MSN, PhD. Nurse Researcher, MultiMedica Group & University of Milan-Bicocca, Sesto San Giovanni, Italy. CNAI Italian National Nurses Association Board Member. (2) RN, MSN. Head Nurse, “La Nostra Famiglia” Association, Lecco, Italy. (3) RN, MSN, Clinical Nurse, Niguarda Hospital, Milan, Italy. (4) RN, MSN, Clinical Nurse, San Vincenzo Cooperative, Seveso, Italy. (5) RN, MSN, Associate Professor in Nursing Science, Dean of Nursing and Midwifery Education, Department of Health Sciences, School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy. (1)

Introduction

Supporting nursing students and nurses in the development of a positive professional self-concept within complex evolving settings, represents an actual issue for nurse educators and administrators worldwide. Nurse Self-Concept (NSC) has been defined as a multidimensional psychological construct that represents nurses’ perception of themselves in relation with their work environment (Cowin, 2001). As shown by the literature, Nurse Self-Concept is developed by nursing students during undergraduate nursing education. NSC can be shocked by the first contact with real work environments evolving continuously during different work and post-graduate education experiences or in relation to critical points in the working life of a nurse (Schmalenberg, Kramer, 1979; Lo, 2002; Cowin et al., 2006). A positive selfconcept leads to a sense of self-worth and self-confidence and helps nurses to act at a superior level in their professional practice (Cowin, Hengstberger-Sims, 2006). Furthermore, several studies’ results suggest that NSC is connected to occupational choice, self-image, professional identity, job satisfaction and staff retention (Cowin et al., 2006). Although the development and maintenance of a positive self-concept has been recognized as an important goal for nurses both in educational and in working settings, a lack of data concerning Italian nurses’ self-concept has been found in the literature. The aim of this study was to describe students’ Nurse SelfConcept development and modifications from the beginning of nursing education till one year of work experience in the Italian healthcare context.

Key Results

Conclusions

A total of 204 nursing students (out of 224 eligible ones) accepted to enter the study at Time 1 and 120 of them (out of 174 still eligible candidates) concluded the study completing NSCQ at Time 4. Sample sizes and respondent rates for each time of data collection are shown in Figure 1. A progressive increase was observed during nursing education both in NSCQ overall score and in CARE, COMM, KNOW and LEAD dimensions scores (Graph 1 and Table 1). A significant improvement in NSCQ overall score was found at second year of education (CI 95% = +0,05 to +0,4; p = 0,01) (Table 1). Although decreased scores were observed at Time 4, no statistically significant differences were found in NSCQ overall score after one year of work (CI 95% = - 0,3 to 0,03; p = 0,1; Graph 1 and Table 1). Significantly lower scores were found in all four measurements for the LEAD dimension (CI 95% = -1,73 to -1,92; p < 0,001; Graph 2).

The study provided a first description of Nurse Self-Concept development in Italian nursing students and nurses. Study results should not be generalized for possible distortions due to the limited sample size and to the decreased respondent rate in the fourth phase of data collection. However, the use of strict sample inclusion and exclusion criteria in all research phases, the administration of a valid and reliable tool, the length of observation, and the involvement of students coming from five different teaching hospitals, represent some strengths of this study. Confirming literature, study results show that Nurse SelfConcept is progressively developed by nursing students during their undergraduate education. Clinical courses and clinical trainings - core elements of the second year of education in all five teaching hospitals involved - seem to be relevant for nurses’ self-concept development in the Italian nursing education. Unexpected data suggest that Nurse Self-Concept may not be significantly affected by the impact with real work environments in the Italian context at one year of work experience. Considering study TOTAL NGSC CARE STAFF COMM KNOW thisLEAD NGSC CARE STAFF COMM nurses KNOW struggle LEAD to TOTAL results, nursing students and registered Mean Mean Mean Mean Mean Mean Mean recognize themselves as leaders and key decision-makers Mean Mean Mean Mean Mean Mean Mean (SD) (SD) (SD) (SD) (SD) (SD) (SD) (SD) (SD)multi-professional (SD) (SD) (SD) (SD) within the Italian(SD) healthcare team. 5,97 6,78 6,28 to understand 6,07 6,20 4,14 TimeFurther 1 6,35 research is needed factors that 5,97 6,78 6,28 6,07 6,20 4,14 Time 1 6,35 (1) (0,9) (0,9) (0,9) (0,8) (1,6) (0,8) can affect(0,9) the development positi- (1) (0,9)and maintenance (0,9) (0,8) of a(1,6) (0,8) 6,22* 6,50*especially 6,41* for 6,40* 4,51* Timeve 2 nurse 6,92 6,61* in Italy, self-concept the leadership 6,22* 6,92 6,50* 6,41* 6,40* 4,51* Time 2 6,61* (0,9) (0,9) (0,7) (0,8) (0,8) (1,6) (0,7) dimension role of the educators (0,9)of the(0,7) (0,7) nurse. (0,8)Nurse(0,8) (1,6) and (0,9) 6,26 6,91 6,47 study 6,45 6,41 4,62 Timeadministrators 3 6,71 consider could results to implement 6,26 6,91 6,47 6,45 6,41 4,62 Time 3 6,71 (0,9) (0,9) (0,8) (0,8) (0,7) (1,4) (0,7) strategies(0,9) for assessing and students’ and (0,8)improving (0,8) (0,7) (1,4) nur- (0,9) (0,7) 6,1 6,78 6,40 6,33 6,38 4,67 Timeses’ 4 6,60 professional self-concept. 6,1 6,78 6,40 6,33 6,38 4,67 Time 4 6,60

TIME 1 n = 204 TIME 1 RR = 90,6% n = 204 RR = 90,6%

TIME 2

TIME 2 n = 175 RR = 86,6%

n = 175 RR = 86,6%

TIME 3

TIME 3

(0,31) (0,31)

n = 189 RR = 93,5% n = 189

RR = 93,5%

Methods

(0,19) (0,19)

(0,27) (0,27)

(0,48) (0,48)

(0,36) (0,36)

(0,78) (0,78)

Table 1 – Total and single dimensions Nurse Self-Concept Questionnaire score Table 1 – Total and single dimensions Nurse Self-Concept Questionnaire score means of data data collection collection(* (*pp