|Year : 2016 | Volume
| Issue : 3 | Page : 118-124
Attitudes of Saudi nursing students toward nursing research
Jehad O Halabi
College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia
|Date of Web Publication||14-Dec-2016|
Jehad O Halabi
College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Mail Code 6565, P.O. Box 9515, Jeddah 21423
Kingdom of Saudi Arabia
Source of Support: None, Conflict of Interest: None
Background: The role of research was supported by faculty, researchers and professional organizations as an essential standard for practice and professional accountability. It is important to equip students with a strong research foundation to facilitate judging applicability of findings to clinical settings, and conducting research and eventually improving the quality of health-care. Increasing attention is directed to students' attitudes and involvement in research, however, no previous studies were located on the attitudes of Saudi students towards research. Aim: To investigate the attitudes of nursing students toward research in Saudi Arabia. Materials and Methods: A descriptive design with convenient sample of 244 senior students at a three-campus college of nursing in three regions in Saudi Arabia using a 22-items self-administered 4-point likert type attitude questionnaire. Results: Majority of students reported positive attitudes toward research with highest scores for 'usefulness of research' and 'personal interest in research' and lowest scores for 'using research in clinical practice'. Research attitudes significantly correlated with students' seniority and having completed a research course. Conclusions and Recommendations: Assessing students' attitudes towards research enhances implementation of findings in patient care and proposes means for developing positive attitudes and raising students' awareness of future role as practicing nurses. Students had positive attitudes toward research and its usefulness in professional work and less positive attitudes toward using research in practice. Faculty should develop students' knowledge and attitudes while studying at the college. Nursing and health-related professions researchers should direct attention to promoting the ultimate implementation of evidence-based practice by students as well as nurses
Keywords: Attitudes, nursing, nursing students, research, Saudi Arabia
|How to cite this article:|
Halabi JO. Attitudes of Saudi nursing students toward nursing research. Saudi J Health Sci 2016;5:118-24
| Introduction|| |
Research facilitates knowledge generation, increases cost savings by assuring a healthier workforce, supports better decision-making, and contributes to the development of research skills among nurses. Nursing research is a systematic inquiry designed to develop knowledge about issues that are important to nursing practice, education, and management.  Research improves nursing care, credibility of the profession, accountability for practice, and documentation of the cost-effectiveness of care. 
Smirnoff et al., 2007, traced the historical role of research in the literature and highlighted the roots of research in the development of the code of ethics and scope of practice by the American Nurses Association.  The scope of practice emphasized that the registered nurse is required to integrate evidence and research findings into practice. Therefore, an introductory research course became mandatory in most baccalaureate nursing programs around the world to increase students' participation in research and implementation of research findings in practice.
Nursing organizations supported making research a standard for practice as well as promoting research environments that support professional accountability. ,, Therefore, it is important to equip students with a strong foundation in research to allow them to evaluate research, judge research findings for possible application to clinical settings, and to participate in research studies. They are expected to take part in the production of new knowledge which will eventually improve the quality of health care and develop the nursing profession in general. ,
Nurse educators shape future nurses' beliefs and interest in research, which are essential to the development of the profession. They encourage nurses to utilize and be actively involved in research. Application of research findings improves patient care and signifies nurses as valuable health-care members. Faculty members at nursing colleges should facilitate students' involvement in research early in their basic educational program. , The previous studies supported the value of research in improving patient care. 
Students' attitudes are linked with their involvement in research as future nurses. , Another study found that even though students were concerned about the difficulty of conducting research in clinical areas, they expressed positive attitudes toward research in general and willingness to conduct research in practice.  Having positive attitudes motivates students to participate in research involving patients and provide evidence-based health care. Possessing positive attitudes toward research increases effective utilization and application of research findings and improving patient's outcomes. ,,, However, the lack of exposure to research courses was a barrier to using research in practice. 
Researchers gave attention to the importance of students' attitudes and involvement in research. Students' attitudes toward nursing research were studied in several countries worldwide indicating the significance of such assessment. However, literature reported that BSc students were not adequately equipped to analyze research studies or to use the results in practice. Recommendations highlighted the importance of enhancing students' attitudes and their involvement in research as well as their beliefs in the role of research in professional development through reading and utilizing research findings. The literature supports the importance of providing nursing students with opportunities for utilizing research and applying significant findings in practice and recommended that preparation should start early at the basic undergraduate level and continue throughout graduate levels. 
Encouraging scientific research was set by the Saudi Commission for Health Specialties as an important aim for professional development.  The Ministry of Education in the Kingdom of Saudi Arabia (KSA) emphasized the importance of involving university students in research and designated incentives for that purpose.  A National Committee organizes an annual contest among university students willing to submit research proposals with the goal of involving students in research activities and creating a culture of research. Several conferences have been conducted to enable Saudi university students to present their research projects. The university of the current study established Students Research Units at the college level to assist students with research. However, the lack of studies was located to date on the attitudes of Saudi nursing students toward nursing research. One study was located about nurses' utilization of research in KSA.  Lack of such information prompted the researcher to conduct this study since insight into students' attitudes will assist their facilitators to promote interest in conducting research and utilizing results among students.
The aim of this study was to investigate the attitudes of nursing students toward research at a college of nursing located in three campuses affiliated with a health sciences university in three regions of KSA. Furthermore, the study determined whether demographic and educational background characteristics influence students' attitudes toward research.
The results of this study would be used to propose some suggestions and strategies to promote the students' interest in research as early as possible during their study at the college. A positive attitude toward research is required to achieve evidence-based practice.
| Materials and Methods|| |
The study was approved by the Research Committee of the participating college of nursing. Students were assured anonymity and confidentiality as well as the right to refuse participation and to withdraw from the study without penalty.
A descriptive study design was utilized to provide baseline information about attitudes and explore the relationship between variables. This design helps describe two or more variables in one population and the relationships between a single variable in two populations. ,
This design intends to answer the following research questions:
- What are the nursing students' attitudes toward research?
- What is the relationship between attitudes of nursing students toward research and each of the following: Grade point average (GPA) and age?
- What is the difference in attitudes of nursing students toward research based on their type of nursing education program (the traditional vs. accelerated), level of education (senior vs. junior), and having completed a research course?
Attitude is defined conceptually as an expression of favor or disfavor toward a person, place, thing, or event (the attitude object).  This shows the attitude to be a bipolar concept where there are two sides or aspects of the attitude; positive or negative, favorable or unfavorable.  Operationally, attitude was defined as an agreement with any of the given statements in the research attitude scale as an indication of a favor or disfavor of the statement.
The data were obtained from senior nursing students registered at a college of nursing affiliated with a university for health sciences that has three campuses (Jeddah, Riyadh, and Al-Hasa) to assure an adequate number of students affiliated with this institution. The colleges follow a unified curriculum and award a bachelor of science in two educational levels stream-1 (high school graduates following 4-year program) and stream-2 (bachelor of science graduates following a 2-year accelerated program).
All senior final year and junior first-year entry-level students registered for the semester, in which data were collected, were eligible to participate in the study [Table 1]. A convenience sample of 244 female students from the three campuses participated. Most (77%) were from stream-1 and 79% were senior students. Age ranged between 19 and 30 years (x̄ = 23 ± 2.33). The average GPA was 3.5 out of 5 and 44% had good GPA (2.75-3.74). About 27% were studying the research course when the study was conducted, 35% studied research previously, while the rest have not studied research yet.
|Table 1: Demographic data on the study sample of female Saudi nursing students (N=244)|
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The instrument had two parts: sociodemographic data and a 4-point Likert scale directed at attitude that was developed by Larson and modified by Halabi and Hamdan-Mansour. , The 22-items tool had four subscales: research abilities (7 items), usefulness of nursing research (5 items), personal interest in research (3 items), and using research in clinical practice (7 items). A high score indicated positive attitude. Reliability was Cronbach's alpha (α) = 0.74 for the original scale and α = 0.64-0.76 for subscales. In this study, the overall reliability was α = 0.83, and the subscales reliability ranged from α = 0.70 to α = 0.83 as follows: Research abilities (α = 0.74), usefulness of nursing research (α = 0.78), personal interest in research (α = 0.83), and using research in clinical practice (α = 0.70).
Data were collected over 4 months after securing approval, and arrangements were made with course instructors to distribute the questionnaire to their students. Information was given about the study and completing and returning the questionnaire were considered consent for participation.
SPSS version 20 (SPSS, Inc., Chicago IL) was used to analyze the data using descriptive statistics. The independent sample t-test, bivariate analysis, and multiple regression analysis were conducted to identify the most important predictor variable for attitudes. Pearson correlation coefficient was used to test the relationship between demographic variables and attitudes toward research. The level of significance was set at P < 0.05.
| Results|| |
Overall students' attitudes toward research
The first research question inquired about the nursing students' attitudes toward research. [Table 2] presents the mean, standard deviation, and percentage of agreement on single item. [Table 2] presents the five items that students perceived as the top tanking with the highest score in the overall attitudes scale and were underlined with double lines. Furthermore, the five items that scored the lowest rank were underlined with a single line. The cut off point was two. All scores higher than two indicate positive attitudes. Overall, the results showed positive attitude (x̄ = 2.72) with a P < 0.001, and the majority (74.8%) of students agreed with this overall positive agreement. Furthermore, the overall positive agreement was reported about usefulness of research, personal interest in research, research abilities, and using research in clinical practice, respectively.
|Table 2: Descriptive statistics and ranking of individual attitude scales items (N=244)|
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The correlation between the overall scale and each subscale was tested, and the results showed significant high correlation with research abilities (r = 0.85), usefulness of research (r = 0.75), and personal interest in research (r = 0.75). However, the correlation was weak (r = 0.46) though significant (P < 0.000) with using research in practice.
Attitudes toward research and students' age and grade point average
Age of students
Pearson correlation showed weak but significant negative correlation (r = −0.241, n = 239, P < 0.000) between age and research attitudes. Younger students (stream-1) were more positive about research than older ones.
Students' grade point average
The overall GPA average was 3.46 (±0.51). Pearson correlation revealed no significant correlation between students' GPA and overall attitude score (r = 0.111, P < 0.08). However, there was a weak negative relationship between GPA and subscale "using research in clinical settings" (r = −0.174, P < 0.007) in favor of those who obtained lower GPA. The rest of the subscales had no relationship with the GPA.
Type of nursing program, exposure to research, and level of education
Type/stream of program admission
The independent sample two-tailed t-test was conducted to identify the factors affecting the students' attitudes [Table 3]. Stream-1 students had a higher mean score on the attitude scale than stream-2 with significant differences (P < 0.000). There was a significant difference between streams, in favor of stream-1, in the following three subscales: usefulness of research (P < 0.000); personal interest (P < 0.000), and research ability (P < 0.001).
|Table 3: Independent Samples T-test of attitudes scales and subscales in relation to students' stream, seniority, and exposure to research (N=244)|
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Student's level of study (junior vs. senior students)
The independent samples t-test [Table 3] shows that the mean score on the overall scale of senior students was higher than junior students with a significant difference (P < 0.001) indicating that senior students had more positive attitudes toward research than junior students. There were also significant differences among the two groups in relation to attitudes subscales in favor of senior students, in the three subscales (usefulness of research, personal interest, and research ability), and no significant differences among students in the subscale "using research in practice." There was a weak significant correlation (r = 0.242, P < 0.000) between students study level and the overall attitude score in favor of students in higher the level of study who reported higher mean score on the attitude scale.
Students' exposure/studying research courses
The independent samples t-test [Table 3] showed that the mean score of students taking research course during the study semester was higher than those who were not taking research with a significant difference (P < 0.005), indicating the research course promoted the development of positive attitudes toward research. Participants' responses on the subscales usefulness of research, personal interest in research, and research abilities were significantly different.
Bivariate analysis of predictors variables (GPA, age, level of study/seniority, stream), which showed significance using t-test analysis, were further included in a multiple regression analysis. Level of study significantly predicted attitudes scores (β = 5.732, t = 2.873, P < 0.004) and explained a significant proportion of variance in attitudes scale score (R2 = 0.11, F (3,235) = 9.242, P < 0.000).
| Discussion|| |
This study assessed nursing students' attitudes toward research. The importance of this study comes from being the first in KSA to explore nursing students' research attitudes, in addition to the significant role nurses have in research and its enhancement in the health-care system.
Nursing students have positive attitudes toward research in general where the majority of students agreed and strongly agreed with the statements presented in the attitude scale. This was consistent with the previous studies that reported positive attitudes toward research, and particularly the "usefulness of research," which was the most contributing to the overall positive attitude. ,, This might reflect the colleges of nursing efforts to orient students about the research benefits for nursing practice. Furthermore, the curricula of most colleges are promoting the values of evidence-based practice, and research findings are implemented in different courses offered throughout the program.
All scale items scored above two indicating students had positive attitudes toward research. Students expressed higher positive attitudes related to aspects of "usefulness of research" and "personal interest in research" than their "ability to do research" and "using research in clinical practice." This might be justifiable and attributed to the fact that before graduation, students may not be confident or equipped with the necessary tools to conduct research and an indication that students are not ready to apply research in clinical practice. They might not clearly see their role in research and its importance in facilitating patient care, or probably, they were not clearly oriented on how to utilize research findings in nursing practice.
Even though students showed a positive attitude toward research and acknowledged having a personal interest in research and its usefulness in patient care, but having inadequate clinical exposure to real patient care in which research is utilized, might have limited their ability to appreciate the benefit and usefulness of research in clinical practice. The negative correlation between participants' GPA and subscale "using research" in a clinical setting was surprising because there was a significant difference in favor of those who obtained lower GPA.
The positive correlation between students' attitudes and their exposure to research indicates that offering the research course to nursing students as a compulsory course facilitates developing a more positive attitude among students. It emphasizes the notion of international nursing organizations that nurses have a role in research depending on their level of preparation.  The current study supported that role where nursing students rated items related to this basic role as the highest including teaching nurses/nursing students how to read and utilize research findings, the importance of conducting research in developing the nursing profession, the role of research in improving patient care, and the need to involve nurses in research so as to further enhance the development of nursing profession.
The correlation, even though not significant, between the two subscales "personal interest" and "using research" in clinical practice indicates that students who lack interest in research may not have the attitude and ability to use the evidence-based practice guidelines. However, the high and strong correlation between "personal interest" and "usefulness of research" indicates that if students can see research usefulness, they become capable of developing an interest in research. Faculty members need to show students the benefits and uses of research to develop their future role in research.
Students' background was variably related to research attitudes. Stream-1 students had significantly more overall positive attitudes than stream-2. They are younger students and join the college after high school, therefore, spend more years in the program and might have more socialization into nursing and their roles. This might explain the negative correlation between age and research attitudes. Likewise, all research subscales, except "using research in practice," showed significant difference among the two groups in favor of stream-1. This indicates that nursing students, regardless of their age and program, are not ready to comprehend the implications of research into practice because of their limited clinical experience. Clinical teachers need to focus on this matter when training students in clinical areas. Giving students more assignments, necessitating reading, and using research findings should be further emphasized and followed up when graduates are in actual patient care settings.
In general, the study showed that as student progress to the higher level of study, the mean score for overall research attitudes and three subscales was significantly increasing. The domain of "using research" was not significantly different between senior and junior students and among those who studied research or not. The results further supported the importance of introducing students to research and its concepts while studying for their degree. The previous studies indicated that having positive attitudes among nurses did not mean they have good application in daily work. , They concluded that even with a positive attitude, 46% of nurses reported seldom or never utilized research results in their practice. Similar results were reported about acupuncture oriental medicine students. 
Generalizing the results should be done with caution. Limitations of this study could be using self-report tool for data collection and using convenience sample which might limit generalization of the findings.  However, having students from three regions strengthened the representation of Saudi nursing students' populations.
Assessing students' attitudes toward research is an important aspect to be studied to support and enhance the implementation of research findings when caring for patients. Furthermore, it could be a diagnostic tool to assess the contribution of research courses in the development of positive attitudes toward research and in raising students' awareness toward their future role as practicing nurses.
| Conclusion and Recommendations|| |
The study findings showed that students had positive attitudes toward nursing research. They had an agreement about all statements in the attitudes scales including the importance and usefulness of research for professional work, having a personal interest in research, ability to do research, and using research in practice, respectively. There were differences among students in relation to their study program, age, and level of study. GPA was inconclusive in relation to their attitudes. The level of study is predictive of attitudes toward research.
Faculty members need to put more emphasis on engaging students in reading and using research results, especially when working with patients in clinical situations. They may engage them in their research projects to capture the research process such as conducting literature review, collecting data, and entering data. Nurse educators need to prepare students to meet the expectations from Saudi nurses in relation to research to keep high standards of care and implementing evidence-based practice principles. In addition, nurse managers need to stress on more continuing education and training workshops related to the research process to encourage nurses to use research and assist students by engaging them in different research activities, such as identifying researchable problems, before graduation. This might encourage students' involvement in research and using research findings in practice. This is extremely important if we need to improve research attitudes among future nurses.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]