Survey and analysis of the current situation of humanistic care ability of first-year nursing students after COVID-19

Qing-Qing Li,Yi-Jing Wang,Fei-Fei Hong,Yu-Zi Zhong,Peng-Xi Liu*

1Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China.

Abstract

Background:Humanistic care ability is the core of nursing work.Improving humanistic care ability can improve patient satisfaction and the development of a nurse-patient relationships.

Objective:To understand the current situation of humanistic care ability of first-year nursing students at Tianjin University of Traditional Chinese Medicine in the post-pandemic,and analyze its influencing factors.

Methods:The Caring Ability Inventory scale(CAI)is used to survey 343 first-year nursing students.Descriptive analysis,t-test,analysis of variance,and multiple linear regression were used for data analysis.At the same time,the humanistic care ability of first-year nursing students before and after the COVID-19 was compared.

Results:The average score of humanistic care ability of first-year nursing students is 173.23±11.288.Through multiple linear regression analysis,whether to hold a position has an impact on the humanistic care ability of nursing students after the COVID-19(P＜0.05).Before and after the COVID-19,there were significant differences in total score and each dimension of humanistic care ability of first-year nursing students(P＜0.001).

Conclusion:The CAI score of the surveyed nursing students is at an intermediate level.In the post-pandemic,the courage dimension of nursing students has improved significantly.But the level of humanistic care ability still needs to be improved.Therefore,in the teaching process,a variety of teaching methods could be applied to improve nursing students'sense of responsibility,understanding and patience with humanistic care,so as to improve their humanistic care ability.

Keywords:First-year nursing students;humanistic care ability;influencing factors

Background

With the development of society,especially after Coronavirus Disease 2019(COVID-19),nurses with high humanistic quality are urgently needed.Humanistic care ability,as one of the cores of humanistic quality,is not only the national requirement for medical services at this stage,but also determines the satisfaction level of patients[1-2].As the core and essence of nursing,care is to help people.While humanistic care is not only the attention to people’s spiritual values,but also the fundamental concern for human nature,which reflects the comprehensive attention to the patient’s biology,psychology,society,and living environment.The connotation of nursing is to take care of life,so humanistic care ability as a core skill has been urgently needed by contemporary nurses[3-5].Therefore,nurses with strong humanistic care ability show high nursing quality in the hospital,which has a positive impact on patient satisfaction and nurse-patient relationship[6].

Since the outbreak of COVID-19 at the end of 2019,patients have felt more anxious during medical treatment in the hospital.Studies have shown that nurses with high humanistic care ability can solve contradictions with patients using various methods and skills of humanistic care,like calm,tolerant,intelligent attitude,and so on[7-8].Therefore,nurses with high humanistic care ability can help improve patients'medical experience,improve patients'compliance,deepen their trust in medical staff,and meet the growing nursing needs.

Many studies have proved that the influence of the environment and the cultivation of education can improve the ability of humanistic care[9-10].Understanding humanistic care ability of freshmen and the factors affecting their humanistic care ability can help teachers choose targeted teaching methods to help nursing students improve their humanistic care ability in the whole process of undergraduate learning.Therefore,this study will investigate the current situation of nursing humanistic care ability of first-year nursing students after the COVID-19,so as to analyze and explore the relevant influencing factors.The scores of first-year nursing students’humanistic care ability were compared with the scores of first-year nursing students before COVID-19 to explore the impact of the epidemic on the humanistic care ability of nursing students,so as to provide a reference for the curriculum reform to improve humanistic care ability under the background of COVID-19.

Methods

Subjects of the survey

The subjects of this study were 544 nursing students who enrolled in the school of nursing of Tianjin University of Traditional Chinese Medicine in 2021.This survey produced the questionnaire of the web version.The convenient sampling method was used to distribute the questionnaire link to the class QQ group for the online survey,which was conducted from February to May 2021.The questionnaire is filled in online in an anonymous way and submitted through the internet.In total,377 questionnaires have been collected,and 343 questionnaires are valid.The effective rate of questionnaire collection is 90.98%.The participants in this study voluntarily participated after understanding the purpose of the investigation,and this survey was approved by the ethics committee of Tianjin University of traditional Chinese medicine(Grant No:2020JY041).

Survey tool

The general information included the gender of the nursing students,their age,whether they were only children,whether they held a position,whether they had participated in social practice,and their reasons for choosing the nursing profession.The 37-item Caring Competency Assessment Inventory(CAI)developed by Nkongho is used to investigate nursing students'humanistic care competencies.The scale is divided into three dimensions,including cognition,courage,and patience.The Cronbachs’α coefficient of the scale is 0.71-0.84 and the retest reliability is 0.80-0.94,so this assessment tool has good reliability and validity[11].Finally,the survey results are compared with 119 first-year nursing students in Jiangsu from September to December 2018,and try to analyze the impact of the COVID-19 on the humanistic care competencies of nursing students[12].

Statistical methods

After collecting the questionnaire,the data were checked and sorted out.SPSS 25.0 software was used for statistical analysis.After testing,the data is the normal distribution.The counting data is described and analyzed by percentage;the measurement data is described by Mean±Standard Deviation.The single factor analysis is described by t-test and ANOVO tests.The statistically significant factors in the single factor were analyzed by multiple linear regression.The mean of the two samples was compared by an independent sample t-test.If thePvalue is less than 0.05,the difference is statistically significant.

Results

Characteristics of survey respondents

Among the survey respondents,46 students are male,and 297 students are female.Five students are younger than 18 years old,275 students are between 18 to 19 years old,and 63 students are between 20 to 21 years old.One hundred twelve students are only children,and 231 students are non-only children.One hundred ninety-five students hold a position,and 148 students don’t hold a position.Eighty-four students had participated in social practice,while 259 students had not.For the reason of choosing nursing as their major,37 students’parents are supported,forty-four students like being a nurse,fifty-seven students deemed that being a nurse will have a good employment prospect,one hundred and seventy-six students were transferred from other major,four students thought nursing is well paid,and twenty-five students chose other reasons(See Table 1).

Single factor analysis of first-year nursing students’humanistic care ability

The results of this study showed that,there were differences in cognitive dimension and total score of humanistic care ability between holding the positon or not(P＜0.05).The reasons for choosing a nursing major had significant differences in cognitive dimensions(P＜0.01),and also had differences in the total score of humanistic care ability(P＜0.05)(See Table 2).

Multiple linear regression analysis of first-year nursing students'humanistic care ability

In this study,the CAI score was taken as the dependent variable,and whether held a position and the reason for choosing nursing were taken as independent variables in the regression equation.Through multiple linear regression analysis,the main factor affecting the score of humanistic care ability is whether or not to hold a position in school(P＜0.05)(See Table 3).

Comparison of humanistic care ability of first-year nursing students before and after COVID-19

There were statistically significant differences in the total score and dimensions of humanistic care ability before and after the COVID-19(P＜0.001).While the cognitive dimension score,patience dimension score,and total score of humanistic care ability of first-year nursing students after the COVID-19 were lower than those before the epidemic.However,in the dimension of courage,the scores of first-year nursing students after the COVID-19 were higher than those before the epidemic(See Table 4).

Table 1 Characteristics of survey respondents

Table 2 Scores and significant differences(t/F-values)for each dimension under different comparison items

Table 3 Multiple linear regression analysis of first-year nursing students'humanistic care ability

Table 4 Comparison of humanistic care ability of first-year nursing students before and after COVID-19

Discussion

The level of humanistic care ability in China is divided into three levels according to the CAI score.A score below 171.55 represents a low level,a score between 171.55 and 210.53 is a medium level,and a score higher than 210.53 represents a high level[13].In this study,the humanistic care ability of the surveyed nursing students(173.23±11.288)is at the medium level.The results of the study indicated that whether hold the position or not is the influencing factor of humanistic care ability(P＜0.05),which is consistent with previous studies[14].Holding a position at university means taking on more responsibility,and they often have to deal with various tasks.Therefore,they need to communicate with their classmates and teachers to solve the problem,so as to cultivate their interpersonal communication skills.A study has also proved that the interpersonal communication ability of nursing students is positively correlated with CAI scores[15].Interpersonal communication skills can provide humanistic care for patients as much as possible through effective communication and maintaining empathy.What’s more,this group of nursing students develops the ability to be patient and proactive,and have a stronger sense of responsibility and mission.Studies have shown that the stronger the sense of responsibility of nurses,the more confident they would have to face problems,and their humanistic care ability score is higher[16-18].Based on the result,educators should focus on interpersonal communication skills,incident management skills,and teamwork skills,in order to provide targeted training for nursing students to improve humanistic care ability.Cultivating humanistic care ability through a variety of formats and flexible teaching mechanisms could be considered,instead of electives[19-20].

This study showed that the gender and the reason for choosing nursing had no effect on nursing students'humanistic care ability(P＞0.05),which has been confirmed by one study[12].However,some researchers have different results,which showed that the humanistic care ability of male nursing students might be slightly lower than that of female nurses[21-23].But in recent years,male nurses'advantages and professional identity in clinical work have been enhanced.It indicated that the increasing sense of male nursing in clinical work could improve the ability of humanistic care[24].What’s more,some researches indicated that the reason for choosing nursing had a significant effect on nursing students'humanistic care ability[25-26].However,with the outbreak of COVID-19,nursing students understand the content of nursing through the continuous positive reports of the media.It could improve the professional identity of nurses by enhancing the professional honor and pride of nursing students[27].The sense of professional identity caused by the COVID-19 may have an impact on humanistic care ability for different reasons in the initial professional choice.

The humanistic care ability of 343 first-year nursing students surveyed in this study is compared with the first-year nurses in Jiangsu before COVID-19[12].It is found that the scores in the courage dimension are much higher than those before COVID-19,while the cognitive dimension and the patience dimension are lower than those before COVID-19.This may be related to the social impact of the COVID-19 outbreak at the end of 2019,where most health care workers performed their vocation of saving lives regardless of personal gains or losses.They are fully demonstrating the spirit of Nightingale,and also conveying to the whole society the sense of responsibility,mission,and value of nurses[28-29].Nurses gave a vivid ‘practical lesson’about the courage to the first-year nursing students,which makes nursing students have a deeper orientation and reflection on nursing.From the deeds of their predecessors who rushed to Wuhan,nursing students realized the important role played by the nursing industry in the face of public health emergencies,improved their sense of professional satisfaction,recognized the significance of nursing work,and mapped their retrograde courage to themselves.Therefore,their courage to act and take responsibility is greatly improved.Nursing students realized the importance of nursing from the deeds of their predecessors who rushed to Wuhan,and mapped nurses’retrograde courage to themselves.Therefore,their courage to take action and take responsibility has improved greatly.Although the scores in the courage dimension are higher,the score in the cognition dimension,patience dimension,and total score is lower than those before COVID-19(P＜0.05).This showed that teaching through the internet makes the training of nursing students lack systematism and standardization.Nursing students'understanding of nursing specialty still stays at the level of technology and knowledge.So they may not deeply perceive the charm and profound connotation of nursing,which showed low humanistic care ability.Therefore,in the cultivation of the humanistic care ability of first-year nursing students,educators should pay more attention to nursing students'understanding of humanistic care,and cultivate their patience when facing problems and try to use the mixed teaching form of online and offline to deeply guide nursing students to improve humanistic care ability[30-33].

Strengths and limitations of this study

This study investigated the humanistic care ability of first-year nursing students,and compared the data with the humanistic care ability of first-year nursing students before the COVID-19,so as to explore and analyze the impact of the COVID-19 on the humanistic care ability,in order to provide scientifically constructive suggestions and basis for the teaching reform in the field of nursing humanities.However,due to the use of a network surveys,the questionnaire recovery rate is low.In the later research,the form of questionnaire distribution should be changed to avoid errors and bias.In addition,the statistical methods used are relatively limited,and the number of general data included is limited.In the later research,the number and dimension of independent variables should be increased,so as to have a more comprehensive understanding of the influencing factors of humanistic care ability.

Conclusion

According to the data survey,the humanistic care ability of first-year nursing students is at the medium level.After the COVID-19,whether to hold the position has become a factor affecting the ability of humanistic care.Comparing the humanistic care ability of first-year nursing students before and after the COVID-19,it is found that the outbreak of the epidemic can increase the courage of nursing students,but has a negative impact on the dimensions of cognition and patience,resulting in a low overall humanistic care ability.Therefore,nursing students should be helped to improve their awareness of ability of humanistic care.In the future educational reform,nursing educators can constantly adopt new educational methods to help nursing students build confidence and guide them to understand their roles.