Research Article Volume 1 Issue 2
Department of Medical Surgical Nursing, Dasmesh College of Nursing, India
Correspondence: Virendra Singh Choudhary, Department of Medical Surgical Nursing, Dasmesh College of Nursing, India
Received: October 17, 2016 | Published: November 23, 2016
Citation: Choudhary VS. Assessment of the knowledge and attitudes of staff nurses on nursing care of cancer patients undergoing chemotherapy at selected cancer hospitals of Punjab. Nurse Care Open Acces J. 2016;1(2):18-24. DOI: 10.15406/ncoaj.2016.01.00009
Many antineoplastic drugs used to treat cancer are known to be teratogenic and mutagenic to patient as well as to staff who administer, handle it. So care by nurses is an important perspective for cancer patients. A non experimental descriptive research design was used. Structured self-administered questionnaire schedule to assess the knowledge and developed 4 point likert scale was used on 50 staff nurses of selected with convenience sampling technique from cancer hospitals of Punjab. The results of the study shown that mean score of staff nurses regarding knowledge was average (14.94) and mean score of their attitude comes out to be positive(59.70). The association between knowledge and attitude with their selected socio-demographic variables was calculated by chi square test and revealed statistically non significant relationship (p>0.05 ).The intention of this study was to assess the knowledge and attitude of nurses’ on nursing care of cancer patients undergoing chemotherapy. Overall, nurses appear to have average knowledge and a positive attitude towards nursing care of cancer patients undergoing chemotherapy. So enhancement in knowledge aspects is required and CNE program me or knowledge updating program me should be held time to time.
Keywords: CNE, knowledge, chemotherapy, cancer, hippocrates
Health is an ideal state of physical and mental well being: something to strive for but never to attain. Being healthy is very important to live happily and to run a family in good way. Severe illness or injuries can have a very detrimental effect on the family.
The word “CANCER” in Greek language means a crab, which Hippocrates thought a tumor resembled, medically known as a malignant neoplasm, term for group of different disease. Cancer is commonly referred to abnormal unlimited growth or multiplication of immature cells.
“World Cancer Day” is celebrated on 4 February for preventing cancer and raising quality of life of cancer patients.
In 2008 approximately 12.7million cancers were diagnosed and 7.6million people died due to cancer worldwide.1,2
In Punjab, cancer registry programme in 2004-2005 found that whole Malwa region of a population of about 1.5core, there ought to be about 12,000 cancer patients.3
Based on the GLOBOCAN, about 12.7 million cancer cases and 7.6million cancer deaths occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. It is estimated that about 9 million cancer cases are diagnosed every year.3 Cancer prevalence in India is estimated to be around 2.5 million, with over 8,00,000 new cases and 5,50,000 deaths occurring each year due to this disease.4 More than 70% of the cases report for diagnostic and treatment services in the advanced stages of the disease, which has lead to a poor survival and high mortality rate.5 The survey conducted in Punjab, from October to December 2012, has covered 2,64,84,434 people in 50,53,447 households in 12,603 villages and 217 cities and towns. This is 97.78 per cent of the population of the Census data. While 23,874 cases of people suffering from cancer have been detected, the numbers of persons complaining of cancer symptoms were 84,453.
“Assessment of the knowledge and attitudes of staff nurses on nursing care of cancer patients undergoing chemotherapy selected Cancer Hospitals of Punjab.”
The main objective of the study to explore the knowledge and attitude of staff nurses regarding care of patient undergoing chemotherapy treatment.
There will be good knowledge on nursing care of cancer patients undergoing chemotherapy among staff nurses in selected cancer hospitals of Punjab.
There will be positive attitude on nursing care of cancer patients undergoing chemotherapy among staff nurses in selected cancer hospitals of Punjab.
There will be significant association between the knowledge and attitude among staff nurses with their selected socio-demographic variables.
The conceptual framework chosen for this study is based on health belief model. This model was developed in early 1950 by Becker and Rosens stock.
In the present study:
Target population-Target population included staff nurses of selected cancer hospitals of Punjab:
The tool consisted of 3 parts:
Part-1: consisted of socio - demographic data.
Part-2: consisted of structured knowledge questionnaire.
Part-3: Developed Attitude assessment scale.
Reliability of the instrument was established by using split half technique.
Reliability of knowledge questionnaire
Knowledge questionnaires were 30. They were split in half of original number and then co-relation between both the halves was found. By applying split half method correlation coefficient was calculated i.e. r=0.6, r1 i.e. estimated reliability of entire test was also calculated: r1=0.70.
Reliability of attitude scale
Total items of the attitude scale was 22 by applying split half method correlation coefficient was calculated i.e. r= 0.5 r1 i.e. estimated reliability of entire test was also calculated. r1=0.68 both tools were found to be reliable.
The researcher collected the data from 03 February 2016 to 19 April 2016 in selected cancer hospitals of Punjab.
As study was descriptive in nature so does not need any special ethical clearance from any ethical review board. Data collection permission was obtained from concern authority. Written inform consent obtained from subject and their anonymity and confidentiality of data obtained will be maintained.
The Descriptive and inferential Statistical measures was used to analyze the data. For example percentage, Mean, SD was used to assess the knowledge and attitude of staff nurses and Chi square, item analysis was used to check the association of knowledge and attitude with its socio-demographic variables Tables 1-7.
S.No |
Socio-Demographic Variables |
Frequency |
Percentage |
1 |
Age (in years) |
||
|
31 |
62% |
|
|
15 |
30% |
|
|
2 |
4% |
|
|
1 |
2% |
|
|
1 |
2% |
|
2 |
Gender |
||
|
2 |
4% |
|
|
48 |
96% |
|
3 |
Marital status |
||
|
15 |
30% |
|
|
35 |
70% |
|
|
0 |
0% |
|
|
0 |
0% |
|
4 |
Habitat |
||
|
29 |
58% |
|
|
21 |
42% |
|
5 |
Religion |
||
|
4 |
8% |
|
|
45 |
90% |
|
|
1 |
2% |
|
|
0 |
0% |
|
|
0 |
0% |
|
6 |
Professional qualification |
||
|
38 |
76% |
|
|
9 |
18% |
|
|
3 |
6% |
|
|
0 |
0% |
|
7 |
Years of experience in cancer unit |
||
|
21 |
42% |
|
|
24 |
48% |
|
|
5 |
10% |
|
|
0 |
0% |
|
8 |
Have you ever attended CNE programme related to chemotherapy |
||
|
7 |
14% |
|
|
43 |
86% |
Table 1 Describing Socio demographic distribution of study subjects.
N=50
Level of Knowledge Score |
Range |
N |
Percentage |
Very poor |
0-6 |
1 |
2% |
Poor |
12-Jul |
7 |
14% |
Average |
13-18 |
21 |
42% |
Good |
19-24 |
20 |
40% |
Very good |
25-30 |
1 |
2% |
Table 2 Frequency and percentage distribution of knowledge on nursing care of cancer patients undergoing chemotherapy among staff nurses.
N=50
Knowledge |
Total samples |
Range statistics |
Minimum statistics |
Maximum statistics |
Mean |
Std error |
Std deviation |
50 |
19 |
6 |
25 |
14.94 |
0.613 |
4.335 |
Table 3 Knowledge Mean scores of staff nurses on nursing care of cancer patients undergoing chemotherapy.
S. No. |
Levels of Attitude |
Range |
No. of Respondent |
Percentage |
1 |
Negative |
22-38 |
0 |
0 |
2 |
Mild negative |
39-54 |
11 |
22% |
3 |
Mild positive |
55-71 |
37 |
74% |
4 |
Positive |
72-88 |
2 |
4% |
Table 4 Frequency and percentage distribution of the attitude on nursing care of cancer patients undergoing chemotherapy among staff nurses.
Attitude Scales |
Total Samples |
Range Statistics |
Minimum Statistics |
Maximum Statistics |
Mean |
Std Error |
Std Deviation |
50 |
34 |
46 |
80 |
59.7 |
0.904 |
6.393 |
Table 5 Attitudes Mean scores of staff nurses on nursing care of cancer patients undergoing chemotherapy.
S/N |
Attitude Statement |
Strongly Agree |
Agree |
Disagree |
Strongly Disagree |
||||
N |
% |
N |
% |
N |
% |
N |
% |
||
1 |
I don't have a problem to give chemotherapy |
5 |
10% |
15 |
30% |
22 |
44% |
8 |
16% |
2 |
I follow the orders as doctor has given |
1 |
2% |
20 |
40% |
23 |
46% |
6 |
12% |
3 |
It is easy to inform patients about |
0 |
0% |
4 |
8% |
37 |
74% |
9 |
18% |
4 |
Administering/handling chemotherapy |
8 |
16% |
22 |
44% |
18 |
36% |
2 |
4% |
5 |
Communicating with patients about their treatments |
5 |
10% |
23 |
46% |
17 |
34% |
5 |
10% |
6 |
I do not find administering/handling |
3 |
6% |
11 |
22% |
33 |
66% |
3 |
6% |
7 |
I have poor interest in acquiring |
14 |
28% |
24 |
48% |
10 |
20% |
2 |
4% |
8 |
I feel burn out syndrome is more common |
6 |
12% |
24 |
48% |
17 |
34% |
3 |
6% |
9 |
It is more interested to care of |
5 |
10% |
12 |
24% |
31 |
62% |
2 |
4% |
10 |
I think other units are safer than chemotherapy units. |
2 |
4% |
15 |
30% |
24 |
48% |
9 |
18% |
11 |
I think administering chemotherapy |
2 |
4% |
17 |
34% |
24 |
48% |
4 |
36% |
12 |
I feel that policies made for administering |
10 |
20% |
24 |
48% |
8 |
16% |
8 |
16% |
13 |
I feel staff need not to check CBC |
12 |
24% |
19 |
38% |
14 |
28% |
5 |
10% |
14 |
It does not affect when again patient |
1 |
2% |
9 |
18% |
29 |
58% |
11 |
22% |
15 |
I lost my interest in work due to poor |
6 |
12% |
33 |
66% |
11 |
22% |
0 |
0% |
16 |
I do not like long discussions with |
6 |
12% |
31 |
62% |
11 |
22% |
2 |
4% |
17 |
If I asked to change the ward |
6 |
12% |
27 |
54% |
15 |
30% |
2 |
4% |
18 |
I avoid to work in cancer department |
5 |
10% |
31 |
62% |
13 |
26% |
1 |
2% |
19 |
To work with chemotherapy patients |
3 |
6% |
24 |
48% |
19 |
58% |
5 |
10% |
20 |
I think patient who are undergone |
7 |
14% |
28 |
56% |
15 |
30% |
0 |
0% |
21 |
I avoid to give chemotherapy to |
8 |
16% |
30 |
60% |
10 |
20% |
2 |
4% |
22 |
Knowledge given to patients |
2 |
4% |
3 |
6% |
18 |
36% |
27 |
54% |
Table 6 Item analysis of the attitude regarding
nursing care of cancer patients undergoing
chemotherapy.
S.N |
Socio- Demographic Variables |
Level of Knowledge Score |
Chi Square |
Df |
Level of Attitude |
Chi- Square |
Df |
|||||||||||||||||
|
|
Very Poor |
Poor |
Average |
Good |
Very good |
|
|
-Ve |
Mild -Ve |
Mild +Ve |
+Ve |
7.54* |
12 |
||||||||||
1. |
Age in years |
9.25* |
9 |
|
||||||||||||||||||||
a |
21-25 |
01 |
08 |
16 |
06 |
00 |
00 |
08 |
22 |
01 |
||||||||||||||
b |
26-30 |
00 |
04 |
08 |
02 |
01 |
00 |
03 |
12 |
00 |
||||||||||||||
c |
31-35 |
00 |
01 |
00 |
01 |
00 |
00 |
00 |
01 |
01 |
||||||||||||||
d |
36-40 |
00 |
00 |
01 |
00 |
00 |
00 |
00 |
01 |
00 |
||||||||||||||
e |
>40 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
01 |
00 |
||||||||||||||
2. |
Professional qualification |
|
|
|
9.89* |
6 |
||||||||||||||||||
a |
G.N.M |
01 |
13 |
17 |
07 |
00 |
19.77* |
12 |
00 |
09 |
27 |
02 |
||||||||||||
b |
Basic Nursing |
00 |
01 |
06 |
02 |
00 |
00 |
02 |
07 |
00 |
||||||||||||||
c |
Post-Basic Nursing |
00 |
00 |
02 |
00 |
01 |
00 |
00 |
03 |
00 |
||||||||||||||
d |
M. Sc. Nursing |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
||||||||||||||
3. |
Years of experience in cancer unit in years |
|
|
|
|
|
||||||||||||||||||
a |
<1 |
01 |
05 |
12 |
03 |
00 |
6.61* |
8 |
00 |
06 |
15 |
00 |
4.65* |
6 |
||||||||||
b |
1-5 |
00 |
06 |
11 |
06 |
01 |
00 |
04 |
18 |
02 |
||||||||||||||
c |
6-10 |
00 |
03 |
02 |
00 |
00 |
00 |
01 |
04 |
00 |
||||||||||||||
d |
10-15 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
||||||||||||||
e |
>15 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
00 |
||||||||||||||
4. |
Have you attended CNE programme related to Chemotherapy |
|
|
|
|
|
||||||||||||||||||
a |
Yes |
00 |
02 |
02 |
03 |
01 |
3.868* |
4 |
00 |
01 |
05 |
01 |
6.896* |
3 |
||||||||||
b |
No |
01 |
12 |
23 |
06 |
00 |
00 |
10 |
32 |
01 |
Table 7 Association of Knowledge and Attitude score with selected demographic variables.
* Non-significant
Wiseman T has shown in her study oncology nurses have good knowledge.6 In contrast to the study of results shown poor knowledge of staff nurses on chemotherapy.7 This finding is important for nursing care to cancer patients because if oncology nurses did not have adequate knowledge and not competent in their skills will be considered as unsafe for providing chemotherapy administration to cancer patients and chances for medication errors can be high as various studies in past already highlighted these points. Statistical analysis has shown that staff nurses has mild positive attitude i.e., mean scores were 59.7. Many previous researches have shown nurses have positive attitude towards nursing care of cancer patients undergoing chemotherapy. As in study by Verity and Damrosch also shown positive attitude towards chemotherapy among staff nurses.
In this study, experiences, professional education about chemotherapy appear to have had no effect. These finding contradicted by Verity’s study on staff nurses on chemotherapy, results showed that factors influencing patient care included; staff education and experience other than that nurses receiving regular knowledge updates affect the nursing practice and attitude of staff nurses towards chemotherapy.
The intention of this study was to assess the knowledge and attitude of nurses’ on nursing care of cancer patient undergoing chemotherapy. Overall, nurses appear to have average knowledge and a positive attitude towards nursing care of cancer patient undergoing chemotherapy. So to improve their knowledge CNE program me or knowledge updating program me should be regularly conducted for the Nursing fertility.
There is no conflict of interest as researcher was not received any financial support from institute or individual. Project was self financed.
I acknowledge my sincere thanks to my loving parents Mr. & Mrs. J.R Choudhary, my loving wife Mrs. Geeta Choudhary, Associate Professor Dept. of OBG Nsg. for her valuable guidance and support at every movement of this work and Two little star of my family Pari & Geetesh for understanding my busy schedule and adjusted themselves with that. At the end I thanks to Dr. Gursevak Singh Director DCON, for his unconditional support for me on each stage of my carrier.
©2016 Choudhary. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.