Evaluation of Knowledge, Attitude and Practices of Nurses Regarding Professionalism in Main Primary Health Care (PHC) Centers and Hospitals in Erbil City/Iraq

: Background and objectives: The term 'professionalism' refers to the conduct, qualities, and goals that characterize a profession and usually describes behaviors that are expected of the members of the profession. Healthcare suppliers demonstrate expertise by attitudes, knowledge, and behaviors that reflect a multi-faceted approach to the regulations, principles, and standards underlying successful clinical practices . The objective of this study is to identify knowledge, practices and attitudes of nurses regarding professionalism and to identify association between variables and (knowledge, practices, attitudes) of nurses regarding professionalism. Methods: Research design: it is a descriptive cross sectional design. The study conducted in main primary health care centers and hospitals in Erbil city. The study was conducted from 1-6-2018 to 1-10-2018. Non- probability sampling technique was done for data collection, the estimated sample size included (100) nurses out of 400 nurses who work in health care centers and hospitals. Data were collected with interview technique with nurses, using the standardized questionnaire. The questionnaire consists of four main parts. The data was analyzed through the application of SPSS program version 23. (Statistical Package for social Science), Results: The results of this study revealed that majority of nurses have (44%) fair knowledge (50%) fair practices and (87%) fair attitudes regarding professionalism and also there was significant association between their level of education and professionalism about (knowledge, practices and attitudes) which represented (P-Value= 0.001) while there was not significant association between other variables and professionalism as for knowledge, practice and attitude (P-value <0.05). Conclusion: The outcomes of this study revealed that majority of nurses have fair knowledge, practices and attitudes regarding professionalism and also there was significant association between their level of education and professionalism while there was not significant association between other variables and professionalism.


Background
The professionalism in nursing is essential to practice nursing services. Nurses put themselves in positions of trust each and every day, and therefore it is essential that the people that rely on the care of nurses are confident that they are being cared for by professionals. There are barriers to professionalism in the nursing, but they can be overcome if nurses work together toward a common goal. Nursing educators and leaders need to emphasize the fact that they can establish professional tendencies that will follow them throughout their career [1]. Nurses have a task to play in making professionalism; there square measure some barriers that substitute the approach. One of the most important barriers could be a distinction in academic background among nurses. Different nurses have different levels of education, but nurses ought to work to minimize the effects of educational disparity among them. Further, gender problems will function a barrier to expertness. Nursing has long been thought of as female-dominated (or "women's work"), but now more than ever, men are entering the profession, and equality among the sexes in the profession is something that may serve to extend expertness still. These square measure simply 2 of main barriers that substitute the approach of expertness in nursing, however these barriers et al don't substitute the approach of expertness, rather they are just reasons for nurses to work harder for the benefit of the reputation of their profession [2]. The term 'professionalism' refers to the conduct, qualities, and goals that characterize a profession and usually describes behaviors that are expected of the members of the profession. Healthcare suppliers demonstrate expertise by attitudes, knowledge, and behaviors that reflect a multi-faceted approach to the regulations, principles, and standards underlying successful clinical practices [3]. Professionalism is a multi-dimensional concept that provides nurses with opportunities to grow personally and professionally Professionalism in nursing results in enhanced patient care and greater job satisfaction among nurses, and nurse retention [4,5]. Professionalism in nursing has not been without its challenges from inception to today. These challenges include educational preparation, diversity in the nursing population, lack of leadership skills, and the nature of the job. It is only through identification and continued work to resolve these conflicts that nursing will proceed to gain the full recognition and respect of a profession [6][7]. In 1971 Ronald M. Pavalko offered eight dimensions to describe a profession. This scale allows professions to exhibit various degrees of these attributes and possess most, if not all, of these dimensions [8][9]. These are theoretical framework as a basis for practice, relevance to social values, (educational) period, autonomy, commitment to lifelong work, a common identity and distinctive subculture, a code of ethics [10,11]. Nurses demonstrating the attributes of expertise impact completely on patient satisfaction and health outcomes [12, 13, and 14]. This study was conducted to identify knowledge, practices and attitudes of nurses regarding professionalism and association between variables and (knowledge, practices, attitudes) of nurses regarding professionalism.

Methods:
1. The aim of the study: Is to identify levels of nurses regarding professionalism; it is a descriptive cross sectional design. The study conducted in main primary health care centers and hospitals in Erbil city, achieved from 1-6-2018 to 1-10-2018.

Sample of the study:
Non-probability sampling technique was done for data collection, the estimated sample size included (100) nurses out of (400) nurses who work in primary health care centers and hospitals. The 2. Nurses who have desire to participate in this study.

Exclusion criteria:
Nurses who have not desire to participate in this study.

Tools and methods of data collection:
Data were collected with interview technique with nurses, using the standard  keep the information confidential, and use these data for this study only, then he explained the purposes of this study to each nurses before collection the data.

Data analysis:
The data was analyzed through the application of SPSS program version 23.
(Statistical Package for social Science) and included descriptive statistical analysis, frequency and chi-square.

Results
: Table  1 shown          Table 6 shown there was significant association between education level and practice of professionalism which represented 0.001% while there was no significant association between other variables and professionalism.    [1]. The limitation of the study was included that some of the nurses have not participated in the study.

Conclusion:
The outcomes of this study revealed that

Acknowledgements:
The author would like to thank all nurses who were involved in this study, thanks for all managers and staffs who supported the author to achieve this study.

Availability of data and materials:
Included 100 nurses in hospitals and primary health care centers in Erbil city.

Ethics approval and consent to participate:
Ethical consideration was provided and supported by college of nursing/ Hawler medical University. Consent for publication: Not applicable.