DOI: https://doi.org/10.21203/rs.3.rs-961501/v1
Nursing professional is an art of calling which requires unconditional devotion in caring for those who are in need. Motivation to join the nursing profession is a question that warrants further study. However, there is a dramatic increase in population who join the profession as an opportunity for stable employment and benefit. Intrinsic and extrinsic key elements of motivation are to be examined to determine the art of joining the nursing profession. This study intended to assess baseline motivation in clinical learning from a quasi-experimental study that aimed to design and test the effect of an interactive web-based clinical practice monitoring system toward improving clinical meta-competencies among nursing students in Tanzania
This is the analysis of baseline data from an interactive web-based clinical practice monitoring system of 589 randomly selected undergraduate nursing students in Tanzania. Baseline data were collected using a self-guided questionnaire on the Academic motivation Scale adopted from previous studies. Both descriptive and inferential statistics were adopted using Statistical Product for Service Solution version 23. The confidence interval was set at 95% with a significance level of 5%.
Findings show that 65% of the nursing students were male while 79.6% of them were younger than 24 years. Baseline finding of motivation in clinical learning revealed that 80.6% of nursing students were not motivated in clinical learning of which 19.4% of motivated nursing students, 5.3% were intrinsically motivated against 14.1% were extrinsically motivated in clinical learning. Extrinsic factors such as opportunity to travel around the world, generous salary and employment benefits, and perceiving nursing as a secure profession were significantly associated with low motivation in clinical learning (p<0.05)
The problem of low motivation in clinical learning among nursing students seems to persist among undergraduate nursing students in Tanzania. Many enrolled nursing students are forced to join the profession by extrinsic factors than intrinsic ones. This study recommends innovative clinical nursing education pedagogical in enhancing motivation in clinical learning among nursing students in Tanzania.
Changes in population demographics, technological advancements, and the increased communicable and non-communicable diseases, have resulted in the need for changing the healthcare delivery system(1). The uncertain nature of the health environment requires professional health care providers with immense clinical meta-competencies to rapidly address and manage the situation. However, owing to the shortage of competent and experienced professional nurses, the healthcare system is forced to hire newly graduated nurses by hoping that, they have achieved a maximum level of clinical meta-competencies to function independently, in delivering quality and cost-effective care among people (2).
Motivation is essential to learning to enhance the individuals’ education, whereas important attention has been to be paid to nursing education to deliver quality and cost-effective care in contemporary society. Motivating nursing students to learn is an essential component to ensure competent graduates can exhibit safe, ethical, and legal practice as the backbone and critical issues in nursing education (3). The revised portions of literature disclose that students’ motivation in nursing is obsessed by asking the reason for doing a thing that can drive students to study as the associated external stimuli. There has been a reported louder volume that, clinical learning environment triggers nursing students dogging in their clinical rotation due to the mismatch between theoretical and clinical practice, which are associated with a limited number of clinical instructors that might smoothen the learning environment as the major eagles as the extrinsic motivation among nursing students
On the other hand, motivation in clinical teaching has been experienced to be outdated due to various models of clinical monitoring strategies that are not smooth among nursing students (4). Based on the quality of nursing program delivery, and the ability of nurse students to meet the required clinical learning outcomes, motivation to learn plays a crucial component surrounding the lack of interest exhibited by some nursing students, to adhere to their clinical placements(5). According to (6) attendance by nursing students has been reported by various previous studies to be a prevailing problem. The situation provides insight into whether the existing monitoring system does not work effectively, in motivating nursing students to attend their clinical learning sessions.
Absenteeism during classroom and clinical sessions becomes an important aspect to be looked at the emerges, when addressing the issue of motivation among nursing students (7). Of interest to note, a limited number of previous studies have been published that examined clinical absenteeism as an indicator of students’ motivation to attend clinical tutorials and practicals. As found by (8), the clinical environment plays an integral part in the academic achievements of nursing students. Their findings reveal that nursing students learning motivation were positively correlated with an improved and well-organized clinical learning environment. It was recommended that through their study that, the clinical learning environment needs to be qualified to foster motivation among nursing students.
In the same way, (9) noted in their study finding that, majority of nursing students lack clinical learning motivation during their clinical practice because the clinical learning environment does not motivate them to learn. They argued that a favorable clinical environment for nurses’ students needed a continuous innovative collaboration model among institutional staff, academic faculty, clinical instructors’ skill to mentor, with adequate medical supplies and equipment, which tally with the number of students and their needs.
Moreover, it has been demonstrated by Nasri et al., (10) that clinical environments are the most significant blockades to be considered in nursing education that are counted as the external factors for the student's lack of motivation and interest. It also forms the students’ major parts of clinical teaching and supervision as the positive or the negative influence counted the educational perception among nursing students.
All the same, owing to the shortage of competent and experienced mentors and an unfriendly clinical environment, the authentic clinical learning environment will continue to be low (11). Contrariwise, clinical mentoring, support, monitoring supervision, and evaluation embedded in multimedia-assisted approaches such as the use of mobile phones and computers, promises to enable learning motivation in their clinical placement(12).
Mobile phone usage has been recently adopted in most health programs and interventions in low and middle-income countries. The majority of people in Tanzania for example, own mobile phones including students in high learning education. However, designing and an authentic clinical environment using an interactive web-based clinical practice monitoring system, is often limited in Tanzania by the availability of the published literature, inadequately trained mentors who are proportional to a large number of enrolled nursing students (13).
Worth noting, the use of technology in the form of Web-based learning (WBL) is widely used as a sustainable and vital instructional tool in nursing education. The system offers academic potentials by enhancing academic motivation among nursing students to improve clinical competence. Despite its popularity, classroom motivation has been discussed in many studies but scholarly works on clinical learning motivation content are limited in Tanzania. Little has been demonstrated on its application and use in the Tanzanian nursing education system. Therefore, this study intended to explore the baseline information regarding clinical learning motivation among nursing students in Tanzania.
The current study employed a descriptive cross-sectional survey design among 589 randomly selected nursing students in higher and lower nursing training institutions and training health facilities in the Dodoma region, the central zone of Tanzania. The cross-sectional survey was the baseline finding from the pre-post-test un-controlled sequential mixed quasi-experimental design used to test the efficacy of an interactive web-based clinical practice on motivation in clinical learning and clinical meta-competencies among nursing students.
The study was conducted from higher and lower training institutions whereas institutions A and B were higher training institutions with the capacity of 968 and 998 respectively. On the other hand, institutions C and D were the lower training institution that is the governments and private-owned with the capacity of 368 nursing students and 121 nursing students respectively. The enrolled and consented nursing students who stayed in or off-campus were eligible to participate in the study. However, the study excluded nursing students having cognitive impairment, pregnant or breastfeeding mothers, and postgraduate nursing students.
The intervention of the main study was done in the nature of a web-based system that is proposed to serve as an innovative pedagogical clinical mentoring, supporting, monitoring, supervising, and evaluating nursing students in their clinical settings. The system was organized into nodes including a web desktop that served as a system server, (to facilitate interactive communication between the nursing departments), clinical instructor’s node, nursing student’s node, academic faculty node, and clinical min-library node. The clinical min-library contained clinical nursing procedures for nursing students to learn and clinical guidelines including videos that were used as the clinical teaching and learning reference among nursing students and clinical instructors.
They recruited study participants were registered into the system to give them access to log in the nodes respectively to access clinical system services. Nursing students and clinical instructors were followed for a total of eight hours whereas the first four hours they are required to give the summative clinical evaluation on their clinical learning and clinical teaching activities while the next four hours they are required to give their clinical summative and formative evaluation. By doing so students clinical absenteeism and dogging among nursing students were improved as the indicator of low motivation in clinical learning.
The interviewer-guided self-administered structured questionnaires adopted from Haugan et al.(14) and Mukwato et al., (15), were used to collect quantitative information from nursing students. The research assistant was oriented about the tools and the process of data collection to familiarize them before the actual data collection. Before administering the questionnaires, study participants were asked for informed consent, seated on chairs in an unoccupied separate room, and given brief instructions on how to fill them.
The researcher and assistants supervised the filling process, respond to any queries from the students accordingly, and collect the filled questionnaires. The learning motivation questionnaires consisted of two parts including the sociodemographic characteristics part (49 items), and the second part addressed information about learning motivation (28 items). The was characterized by a dichotomized response (Yes and No) whereas, a “Yes” response was describing the action that applies to an individual and scored “1” while “No” scored “0” in a sense that, the action/behavior does not correspond to an individual. The tool had three subscales including intrinsic, extrinsic, and amotivation.
The intrinsic motivation consisted of three subscales including the knowledge about what to learn (4 items), the accomplishment of learning activities (4 items), and stimulation to learn (4 items). On the other hand, extrinsic motivation consists of three subscales as the identified regulation to learn (4 items), introjected regulation to learn (4 items), and extrinsic regulation to learn (4 items). In contrast, amotivation has only one subscale, which is the amotivation itself (4 items). For analysis, the subscales of motivation will be reduced into three levels including Intrinsic (12 items), Extrinsic (12 items), and Amotivation (4 items). Moreover, scoring motivation in clinical learning was adopted from the study done by (16) that nursing students who scored 0 to 16 were categorized into low motivation in clinical, those who scored 17 to 24 had moderate learning motivation, and nursing students who scored 25 and above demonstrate high motivation in clinical learning.
As recommended by previous studies (17), before being subjected to the actual field for data collection, all methods were shared with supervisors and other experts on the area under study for their technical and academic support. Their inputs, advice, and comments were addressed accordingly to help improve tools and then re-shared with them for their approval for them to be used during data collection.
A descriptive statistical analysis was conducted via a statistical package and service solutions computer software program version 23 (SPSS v. 23) to establish socio-demographic characteristics of nursing students and their levels of motivation in clinical learning. Before data analysis, manual cleaning was performed to assure their completeness, accuracy, and clarity of the information in the questionnaires. Chi-square tests were used to assess the relationship between the levels of motivation in clinical learning and their selected socio-demographic characteristics among nursing students. Moreover, further analysis was done on binary and multiple logistic regressions to determine the association between the levels of motivation in clinical learning and their associated factors.
Findings in Table 1 indicate that 65.0% (n = 383) of the nursing students were male while 79.6% (n = 469) of the sample had age younger than 24 years with a mean age of 23±2.689, minimum = 19 years and maximum = 50 years. Of the total nursing students 40.6%% (n= 239), was from the training institution B, while 63.7% (n = 375) were studying Bachelor of Science in nursing whereas 33.6% (n = 198) were studying fourth-year Bachelor of Science in nursing with 71.5% (n = 421) were accommodated within the training institutions’ hostels. However, a majority of nursing students 69.4% (n = 406) were not interested to join nursing programs. On the other hand, 74.2% (n = 502) and 85.2% (n = 437) of nursing students demonstrated habits of visiting institutional skill laboratories and libraries for their studies. Other characteristics profiles were found as shown in the Table 1 (Insert Table 1 here).
This part presents the overall levels of motivation in clinical learning among nursing students. Motivation in clinical learning was measured by using an Academic Motivation Scale by Haugan et al., (2016). The tool consisted of 28 items with a 4 Likert scale response (Strongly Agree and Strongly Disagree) whereas, as a finding was dichotomized into “Agree” response that described the action applies to an individual and who scored “1” while “Disagree” scored “0” in a sense that, the action/behavior does not correspond to an individual.
Moreover, the findings from the Table 2, revealed that the overall motivation in clinical learning shown that the majority of nursing students 80.6% were not motivated in clinical learning while only a few of them 5.3% and 14.1% were respectively motivated intrinsically and extrinsically in clinical learning (Insert Table 2 here).
This part presents the findings on the findings on the socio-demographic profiles that show the relationship between the motivations in clinical learning among nursing students. However, the motivation was measured into three domains including extrinsic motivation, intrinsic motivation, and Amotivation. The findings from Table 3 indicate that there was no significant relationship between the factors including age group, sex, and accommodation with the levels of motivation in clinical learning among nursing students. On the other hand, the significant relationship and higher proportion between the level of motivation were observed on training institution A (n = 119; 20.2%, X2 = 11.985; p<0.054), those nursing students who are in diploma level (n = 183; 31.0%; X2 = 8.570; p<0.014), those nursing students who are studying second year diploma in nursing (n = 91; 15.4%; X2 = 11.996); p<0.051) and nursing students who are accommodated in the institutional training hostels (Insert Table 3).
Simple and multivariate logistic regression was performed to determine the influence of socio-demographic characteristics and the levels of motivation among nursing students in Tanzania. As shown in table 4 the study established the presence of the determinants of baseline motivation in clinical learning among nursing students that would then be controlled during the post-intervention analysis. The findings of the simple binary regression analysis indicate that there was no association between age group, sex, a program of study and year of study, and the levels of motivation but there is a statistically significant association between those who are interested to join nursing due to some of the intrinsic and extrinsic factors that influence the motivation in clinical learning among nursing students. Intrinsic factors including nursing is an art of calling (OR = 2.948; p<0.041: 95%; 1.875, 4.581) and Autonomy to practice (OR = 2.989; p<0.032; 95%CI; 1.359, 5.675) caring to serve life (OR = 2.948;p<0.026, On the other hand extrinsic factors that show an association including generous salary and employment benefit (OR = 2.34; p<0.009;95%CI; 1.238,4.581), Growing demand (OR = 2.446;P<0.029;95%CI;1.725,5.886), Secure profession (OR = 2.864;p<0.041;95%CI; 1.895,3.982), Job availability (OR = 0.360;p<0.043; 95%CI; 0.133,0.967).
Furthermore, multiple logistic regression analysis was to adjust the control of the other factors including, opportunity to travel around the world (AOR = 2.869; p<0.048; 95%CI; 0.712, 2.340), generous salary and employment benefits (AOR = 0.570; p<0.05; 95%CI: 0.327, 0.994), Secure profession (AOR = 2.956; p< 0.043; 95%CI; 1.948, 4.687) as the extrinsic factors that shows a significant association with the level of motivation in clinical learning among nursing students. Moreover, the intrinsic factors that shows significance after adjusting other factors including nursing is art of calling (AOR = 2.647; p< 0.054; 95%CI; 1.908, 7.138), Caring to serve people (AOR = 3.247; p<0.031; 95%CI; 1.974, 8,426) an autonomy to practice (AOR = 3.092;p<0.021;95%CI; 2.580, 6.054). Other variables were not associated with motivation in clinical learning among nursing students (p>0.05) (Insert Table 4 here)
The baseline findings of this study showed that very few of them have been intrinsically motivated. Nursing students who were interested to join nursing programs for salary and employment benefits were found to be less motivated to learn than those who were intrinsically motivated. Moreover, those nursing students who were interested to join nursing due to job availability, secure profession, and opportunity to travel around the world were highly extrinsically motivated in clinical learning than those who were intrinsically motivated. Findings may imply that being intrinsically attracted to join a nursing program may be a positive predictor of motivation in clinical learning among nursing students than being influenced by extrinsic factors. Additionally, findings may indicate that the existing clinical pedagogical approaches are inadequate and insufficient to motivate nursing students to learn during their clinical placements.
Moreover, owing to the increased enrolment of nursing students into higher and low nursing training institutions and the scarcity of training health facilities and their associated medical supplies and equipment, findings may imply that academic faculty and clinical instructors may fail to manage large groups of them during clinical teaching, support and supervision. The findings are supported by some previous studies including the work of Doyle et al., (18) who raised a concern that the majority of nursing students perceive clinical attendance as one’s choice rather than a mandatory obligation. Such a perception has been associated with their low motivation in clinical learning.
Moreover, findings by Sommer et al., (19) indicated that the greater the non-clinical attendance among nurse students the poor the low motivation in clinical learning was observed among them and thus poor clinical meta-competencies they acquire and the clinical performances they demonstrate. Nevertheless, Aktas and Karabulut (8) claimed that although the clinical environment plays an integral part in the academic achievements among nursing students motivation in clinical learning is positively correlated with the adequate number of competent and qualified clinical instructors who use innovative clinical pedagogical approaches.
In the same way, Sercekus and Baskale (9) noted that the majority of nursing students lack motivation in clinical learning during their clinical placement practices because the clinical learning environment does not motivate them to learn. The findings of this study and previous studies appear to emphasize that a favorable clinical environment for nursing students can promote motivation in clinical learning among nursing students.
Based on the observed findings, this study proposes the adoption of pedagogical innovations in clinical nursing education that integrate the use of technology to help address both, the shortage of competent and qualified academic faculty and clinical instructors and the increased enrolment rate of nursing students in higher and low nursing training institutions. There is a need for a consistent unit between academic faculty, clinical staff, instructors, and well-trained mentors who can adopt and continuously use innovative clinical pedagogical approaches in the nature of the web-based system to address the trend of increased enrolment rate of nursing students among nursing training institutions in Tanzania.
The problem of low clinical learning motivation among nursing students persists in higher and low nursing training institutions in Tanzania. This study recommends the adoption of innovative clinical pedagogical approaches to monitor, mentor, support, and supervise nursing students during their clinical placements.
Ethics approval and consent to participate: The study was conducted in accordance with the University guideline and all protocol were approved by an institution research review committee with an ethical approval no MA.84/261/02/81. Moreover, informed consents were obtained from all subjects involved in all study participants
Consent for publication: Not applicable
Availability of data and materials: Data will be accessed from the institution website repository.udom.ac.tz
Competing interests: The authors declare that there are no conflicts of interest in this study.
Funding: The study does receive any external funds and the authors have not been awarded a grant for this study. The work is privately sponsored.
Author’s contributions: Patricia Herman coined the research hypothesis and development of the proposal after reviewing the different works of literature concerning clinical education towards improving motivation in clinical learning among nursing students. Dr. Stephen Kibusi contributed to the development of the conceptualized research designing, reviewed, and shaped the research ideas, planning and directing the responsibility for the research activities and planning. The authors have read and approved the manuscript
Acknowledgments: Dr. Stephen Kibusi (PhD), Supervisor, other staff, and nursing students from the University of Dodoma, ST.John University of Tanzania, Mirembe Institute of health and Decca collage of health Science and clinical instructors from Dodoma Reginal Referal hospital.
Table 1: Socio-demographic Characteristics of nursing students (n = 589)
|
Variable |
n (%) |
|
Age in years |
Mean 23±2.689 Minimum=19 Maximum=50 |
|
Age |
|
|
<24 years |
469(79.6) |
|
25 to 34 years |
115(19.5) |
|
>35 |
5(0.9) |
|
Institution |
|
|
Training institution A |
232 (39.4) |
|
Training institution B |
239 (40.6) |
|
Training institution C |
88 (14.9) |
|
Training institution D |
30 (5.1) |
|
Sex |
|
|
Male |
383 (65.0) |
|
Female |
206 (35.0) |
|
Marital status |
|
|
Single |
543(92,2) |
|
Married |
46(7.8) |
|
Religion |
|
|
Christian |
509(86.4) |
|
Muslim |
80(13.6) |
|
Accommodation |
|
|
In-campus |
421(71.5) |
|
Off-campus |
168(28.5) |
|
Program of study |
|
|
Diploma in nursing and midwifery |
214(36.3) |
|
Bachelor of Science in nursing |
375(63.7) |
|
Year of study |
|
|
Second-year diploma in nursing |
89(15.1) |
|
Third-year diploma in nursing |
125(21,2) |
|
Third-year bachelor of science in nursing |
177(30.1) |
|
Fourth-year bachelor of science in nursing |
198(33.6) |
|
Fathers education |
|
|
Never gone |
54(9.2) |
|
Primary |
222(37.7) |
|
Secondary and above |
313(53.1) |
|
Fathers occupation |
|
|
Not working |
78(13.2) |
|
Self-employed |
353(59.90 |
|
Mothers occupation |
|
|
Not working |
90(15.3) |
|
Self-employed |
414(70.3) |
|
Employed |
85(14.4) |
|
The use of institutional library |
158(26.8) |
|
Yes |
502(85.2) |
|
No |
87(14.8) |
|
The use of institutional skills lab |
|
|
Yes |
437(74.2) |
|
No |
152(25.8) |
|
Family type |
|
|
Nuclear |
377(64.0) |
|
Extended |
212(36.0) |
|
Generously salary and employment benefits |
|
|
Yes |
438(74.4) |
|
No |
151(25.6) |
|
Growing demand for nurses |
|
|
Yes |
472(80.1) |
|
No |
117(19) |
|
Multiple working experience |
|
|
Yes |
567(96.3) |
|
No |
22(3.7) |
|
A respected professional in the society |
|
|
Yes |
567(96.3) |
|
No |
22(3.7) |
|
Opportunity for continuing education |
|
|
Yes |
525(89.1) |
|
No |
64(10.9) |
|
Autonomy to practice |
|
|
No |
478(81.2) |
|
Yes |
111(18.8) |
|
Presentable smart uniform |
|
|
No |
354(60.1) |
|
Yes |
235(39.9) |
|
Caring to save peoples life |
|
|
No |
491(83.4) |
|
Yes |
98(16.6) |
Source: Field data (2021)
Table 2: Level of motivation in clinical learning and its subscales among nursing students in Tanzanian higher training institutions (n =589)
|
Variable |
Frequency (n) |
Proportion (%) |
|
Overall motivation in clinical learning |
|
|
|
No |
475 |
80.6 |
|
Yes |
114 |
19.4 |
|
Domains of motivation |
|
|
|
Intrinsic motivation in clinical learning |
|
|
|
No |
558 |
94.7 |
|
Yes |
31 |
5.3 |
|
Extrinsic motivation in clinical learning |
|
|
|
No |
506 |
85.9 |
|
Yes |
83 |
14.1 |
Source: Field data (2021)
Table 3: Relationship between the motivation in clinical learning and socio-demographic profile among nursing students (n = 589)
|
Variables |
Motivation in clinical learning |
Chi-square |
p-value |
||
|
|
Amotivation f(%) |
Extrinsic f(%) |
Intrinsic f(%) |
|
|
|
Age group |
|
|
|
|
|
|
<24 Years |
230(39.0) |
189(32) |
50(8.5) |
2.663 |
0.616 |
|
25 to 34 Years |
63(10.8) |
43(7.4) |
9(1.5) |
|
|
|
>35 Years |
2(0.3) |
3(0.5) |
0(0) |
|
|
|
Sex |
|
|
|
|
|
|
Male |
151(25.6) |
113(19.2) |
23(4.0) |
2.995 |
0.224 |
|
Female |
144(24.4) |
122(20.7) |
36(6.1) |
|
|
|
Training institution |
|
|
|
|
|
|
Institution A |
119(20.2) |
98(16.6) |
16(2.6) |
11.985 |
0.054 |
|
Institution B |
69(11.7) |
53(9.0) |
12(2.0) |
|
|
|
Institution C |
24(4.1) |
23(4.0) |
3(0.5) |
|
|
|
Institution D |
83(14.1) |
61(10.4) |
28(4.8) |
|
|
|
Program of study |
|
|
|
|
|
|
Diploma |
183(31.0) |
159(27.0) |
48(8.1) |
8.570 |
0.014 |
|
Bachelor |
112(19.1) |
76(13.0) |
11(1.8) |
|
|
|
Year of study |
|
|
|
|
|
|
Second year DSN |
91(15.4) |
85(14.4) |
20(3.4) |
11.996 |
0.051 |
|
Third year DNS |
89(15.1) |
71(12.0) |
28(4.9) |
|
|
|
Third year BSN |
88(14.9) |
61(10.5) |
11(1.8) |
|
|
|
Fourth year BSN |
25(4.3) |
18(3.0) |
2(0.3) |
|
|
|
Accommodation |
|
|
|
|
|
|
In campus |
213(36.2) |
168(28.5) |
42(7.1) |
0.046 |
0.977 |
|
Off campus |
82(13.9) |
67(11.4) |
17(2.9) |
|
|
Source: Field data (2021)
Table 4: Determinants of motivation in clinical learning among nursing (n = 589)
|
Variables |
OR |
p-value |
95%CI |
AOR |
p-value |
95% CI |
||
|
Lower |
Upper |
Low |
Upper |
|||||
|
Institution |
|
|
|
|
|
|
|
|
|
Institution A |
0.713 |
0.722 |
0.111 |
4.581 |
1.796 |
0.680 |
0.111 |
29.170 |
|
Institution B |
.946 |
.953 |
0.150 |
5.976 |
3.975 |
0.330 |
0.248 |
63.830 |
|
Institution C |
3.954 |
0.212 |
0.457 |
34.192 |
2.720 |
0.483 |
0.166 |
44.543 |
|
Institution D(Ref) |
|
|
|
|
|
|
|
|
|
Sex Male |
0.793 |
0.723 |
0.219 |
2.864 |
1.179 |
0.509 |
0.723 |
1.924 |
|
Female(Ref) |
|
|
|
|
|
|
|
|
|
Marital status |
|
|
|
|
|
|
|
|
|
Single |
0.849 |
0.108 |
0.463 |
1.058 |
1.502 |
0.387 |
0.597 |
3.778 |
|
Married(Ref) |
|
|
|
|
|
|
|
|
|
Religion |
|
|
|
|
|
|
|
|
|
Christian |
0.134 |
0.997 |
0.254 |
5.265 |
1.546 |
0.231 |
0.758 |
3.156 |
|
Muslim(Ref) |
|
|
|
|
|
|
|
|
|
Accommodation |
|
|
|
|
|
|
|
|
|
In-campus |
0.681 |
0.545 |
0.197 |
2.359 |
0.841 |
0.562 |
0.469 |
1.508 |
|
Off-campus(Ref) |
|
|
|
|
|
|
|
|
|
Program of study |
|
|
|
|
|
|
|
|
|
Diploma in nursing and midwifery |
5.211 |
0.117 |
0.662 |
4.996 |
0.429 |
0.505 |
0.036 |
5.159 |
|
Bachelor of Science in nursing(Ref) |
|
|
|
|
|
|
|
|
|
Year of study |
|
|
|
|
|
|
|
|
|
Second-year DN |
1.152 |
0.898 |
.131 |
10.107 |
1.289 |
0.852
|
0.090
|
18.478
|
|
Third-year DN |
1.189 |
0.876 |
0.136 |
10.437 |
2.895 |
0.425
|
0.213
|
39.398
|
|
Third-year BSc.N |
0.783 |
0.487 |
0.365 |
2.576 |
1.392 |
0.535 |
0.489 |
3.958 |
|
Fourth-year BSc.N(Ref) |
|
|
|
|
|
|
|
|
|
Fathers education |
|
|
|
|
|
|
|
|
|
Never go to school(Ref) |
|
|
|
|
|
|
|
|
|
Primary |
0.785 |
0.468 |
1.565 |
1.354 |
0.823 |
0.651 |
0.355 |
1.912
|
|
Secondary above |
0.049 |
0.896 |
0.564 |
2.063 |
0.647 |
0.300 |
0.284 |
1.474 |
|
Mothers education Never go to |
|
|
|
|
|
|
|
|
|
the school(Ref) |
|
|
|
|
|
|
|
|
|
Primary |
0.631 |
0.481 |
0.285 |
0.537 |
0.850 |
0.673 |
0.401 |
1.803 |
|
Secondary and above |
0.192 |
0.603 |
0.263 |
1.038 |
1.185 |
0.690 |
0.514 |
2.731 |
|
Fathers occupation |
|
|
|
|
|
|
|
|
|
Not working(Ref) |
|
|
|
|
|
|
|
|
|
Self-employed |
0.192 |
0.603 |
0.400 |
1.703 |
0.915 |
0.808 |
0.449 |
1.868 |
|
Employed |
0.124 |
0.876 |
0.244 |
5.263 |
0.587 |
0.205 |
0.258 |
1.338 |
|
Mothers occupation |
|
|
|
|
|
|
|
|
|
Not working(Ref) |
|
|
|
|
|
|
|
|
|
Self-employed |
0.105 |
0.771 |
0.546 |
2.261 |
0.894 |
0.752 |
0.447 |
1.789 |
|
Employed |
|
|
|
|
1.046 |
0.925 |
0.408 |
2.685 |
|
Family type |
|
|
|
|
|
|
|
|
|
Nuclear |
0.670 |
0.512 |
0.202 |
2.221 |
0.843 |
0.465 |
0.532 |
1.335 |
|
Extended(Ref) |
|
|
|
|
|
|
|
|
|
Generously salary and employment benefits |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
2.381 |
.009 |
1.238 |
4.581 |
0.570 |
0.048 |
0.327 |
0.994 |
|
Growing demand for nurses |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
2.446 |
0.029 |
1.725 |
5.886 |
0.929 |
0.840 |
0.456 |
1.894 |
|
Opportunity to travel around the world |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
0.756 |
0.665 |
.214 |
2.678 |
2.869 |
0.014 |
1.215 |
6.758 |
|
Multiple working experience |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
0.691 |
0.341 |
0.323 |
1.478 |
1.290 |
0.401 |
0.712 |
2.340 |
|
A respected professional in the society |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
1.605 |
0.270 |
0.692 |
3.723 |
0.974 |
0.934 |
0.522 |
1.818 |
|
Nursing is the secure profession |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
2.864 |
0.041 |
1.895 |
3.982 |
2.956 |
0.043 |
1.948 |
4.687 |
|
|
|
|
|
|
|
|
|
|
|
Opportunity for continuing education |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
1.091 |
.864 |
.404 |
2.941 |
1.089 |
0.831 |
0.496 |
2.391 |
|
Job availability |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
2.898 |
0.043 |
1.476 |
4.697 |
3.065 |
0.020 |
0.647 |
1.753 |
|
Nursing is the art of calling No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
2.827 |
0.043 |
1.480 |
6.198 |
2.647 |
0.054 |
1.908 |
7.138 |
|
Caring people to serve life |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
2.948 |
0.026 |
1.875 |
7.109 |
3.247 |
0.031 |
1.974 |
8.426 |
|
Autonomy to practice |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
2.985 |
0.032 |
1.359 |
5.675 |
3.092 |
0.021 |
2.580 |
6.054 |
|
Positive feeling about the nursing profession |
|
|
|
|
|
|
|
|
|
No(Ref) |
|
|
|
|
|
|
|
|
|
Yes |
0.360 |
0.045 |
0.133 |
0.976 |
1.075 |
0.831 |
0.552 |
2.097 |
Source: Field data (2021)