Desiani S, et al.
Belitung Nursing Journal.
2017 October.
:612-620
Received: 14 August 2017 | Revised: 2 September 2017 | Accepted: 17 September 2017 http://belitungraya.
org/BRP/index.
php/bnj/ A 2017 The Author.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.
International License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ORIGINAL RESEARCH
ISSN: 2477-4073
HOW DO KNOWLEDGE AND SELF-EFFICACY OF INTERNSHIP
NURSING STUDENTS IN PERFORMING CARDIOPULMONARY
RESUSCITATION?
Selly Desiani1*.
Aan Nuraeni2.
Ayu Prawesti Priambodo2 Faculty of Nursing.
Universitas Padjajaran.
Indonesia Critical Care Nursing Department.
Universitas Padjajaran.
Indonesia *Corresponding author:
Selly Desiani Faculty of Nursing.
Universitas Padjajaran Gedung.
L1 Lt.
Jl.
Raya Bandung - Sumedang No.
KM.
Hegarmanah.
Kec.
Jatinangor.
Kabupaten Sumedang.
Jawa Barat 45363.
Indonesia.
E-mail: sellydes94@gmail.
ABSTRACT
Background: Cardiopulmonary Resuscitation (CPR) is the emergency first aid in cardiac arrest.
CPR delivery is influenced by knowledge and self-efficacy.
Internship students can be the first responders of cardiac arrest in hospital and they are expected having knowledge and high self-efficacy of CPR.
However, there is no data on self-efficacy of internship students in performing CPR.
Objective: The purpose of this research was to identify knowledge and self-efficacy of the internship students in performing CPR.
Methods: The method in this research was descriptive quantitative with cross-sectional approach on 76 internship students selected by simple random sampling.
Knowledge questionnaire and Resuscitation SelfEfficacy Scale instrument were used, with validity score of 0.
84 (=0.
Data were analyzed using descriptive statistics.
Results: The results showed that 49 respondents .
5%) had moderate knowledge and 73 respondents .
1%) had high self-efficacy.
The lowest domain in the knowledge was conceptual knowledge, while in the self-efficacy were reporting, debriefing and recording.
Conclusions: Therefore, it becomes important to increase the information on the conceptual knowledge as well as to enhance training on the self-efficacy domains: reporting.
debriefing and recording.
Keywords: cardiac arrest.
CPR, internship nursing students, knowledge, self-efficacy INTRODUCTION The effort in returning circulation immediately when cardiac arrest and/or breathing failure and preventing death is called cardiopulmonary resuscitation (CPR).
1 Giving high quality CPR in golden minutes .
-2 minute.
will Belitung Nursing Journal .
Volume 3.
Issue 5.
September-October 2017 EditorAos Note: This article has been updated on 9 July 2020 in terms of the completeness of correspondence address and minor changes in the reference and layout The update is according to BNJ Policy on article correction.
increase survival rate of cardiac arrest 2 Internship nursing students can be the first responder of cardiac arrest in Before starting to give CPR in golden minutes, nurses are influenced by various factors.
Some of these factors are knowledge of CPR, nursesAo attitude, nursesAo awareness, and nursesAo selfefficacy in performing CPR.
Out of the factors that influence the nurse in providing CPR, knowledge and selfefficacy are factors that need to be Knowledge of CPR related to the standard of care and the effectiveness of CPR performance.
3 If the nurse's knowledge of CPR was good then nurseAos awareness was also good.
In addition, according to Turner et al.
person is not sufficient to have knowledge .
, skills .
ble t.
, and the right attitude .
repared t.
to effectively handle cases of cardiac arrest, but also sufficient belief in their ability .
elf-efficac.
is needed to perform CPR in cardiac arrest This is strengthened by Ornato and Peberdy in their book which stated that one of the predictor of CPR ability is selfefficacy.
11 Further.
Maibach.
Schieber, and Carroll12 stated that health workers with knowledge and skills of CPR may fail to perform CPR if they have no confidence in their abilities.
This is also supported by Gusnia and Saragih13 who stated that self-efficacy is the dominant factor associated with the adaptation process of novice nurses.
When a person has a good self-efficacy, that person will have a tendency attitude and behavior that support the assistance of cardiac arrest patients.
7-10 It can be inferred that knowledge and self-efficacy are the important factors that influence the delivery of CPR and can predict a person's CPR ability.
Therefore, it becomes important to prepare the knowledge and self-efficacy of internship nursing students in performing CPR.
METHODS
The design used in this research was descriptive quantitative with cross sectional approach.
Ethical clearance for this research was given by Medical Research Ethics Commission.
Faculty of Medicine.
Universitas Padjadjaran with 186/UN6.
C1.
10/PN/2017.
Random sampling technique was used to select 76 respondents from 142 internshipnursing students at Faculty of Nursing.
Universitas Padjadjaran.
Indonesia, on April 2017.
The studied variables were knowledge and self-efficacy.
In this research knowledge is defined as the cognitive ability of internship nursing students Faculty of Nursing Universitas Padjadjaran about factual, conceptual and procedural knowledge on CPR up to C2 level of knowledge (Understandin.
Self-efficacy is defined as the internship nursing studentsAo beliefs about their capabilities in performing CPR.
First instrument used CPR knowledge questioner consisting of 24 questions with multiple choices of a, b, c, d and e which developed by the researchers.
The researchers adapted six questions from the Basic Emergency Care Course Questionnaire developed by Bhoi, et al, adopted one question from National Council Licensure Examination (NCLEX), adjusted to the AHA 2015 guideline, and applied the depth of knowledge to the appropriate level of understanding (C.
according to revised Belitung Nursing Journal .
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Issue 5.
September-October 2017 bloom taxonomy.
CPR knowledge questionnaire had been tested by using content and face validity.
The second instrument was Resuscitation Selfefficacy Scale (RSES) developed by Roh.
Issenberg.
Chung, and Kim with the validity value 0.
84 and alpha value 14 Afterward, the data were analyzed Knowledge score divide into three categories: good knowledge .
f total score is 76-.
, moderate .
f total score 56-.
and low .
f total score <.
Self-efficacy is low if the total score < mean and selfefficacy is high if the total score Ou mean.
RESULTS
Table 1 Characteristics of the respondents No.
Research Respondents Age Age < 25 years old Age Ou 25 years old Working History Not working yet Working .
t the hospital, clinic, or Primary Health Care/ Community Health Cente.
History of Following CPR Training Following 1 CPR Training Following Ou 2 BLS Training History of Performing CPR Never Ever History of Observing CPR Never Ever Traumatic History Related to CPR No, nothing Yes, there was Frequency .
Percentage (%) Belitung Nursing Journal .
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September-October 2017 Figure 1 Characteristics of the respondents Figure 2 Knowledge of respondents From the figure 2 & 3 above can be seen that from 76 respondents, 49 respondents .
5%) had moderate knowledge and 73 Figure 3 Self-efficacy of respondents respondents .
1%) had a high selfefficacy.
Table 2 Knowledge and self-efficacy of respondents Variable Knowledge domain Factual knowledge Conceptual knowledge Procedural knowledge Self-efficacy domain Recognition Debriefing & Recording Responding & Rescuing Reporting In Table 2 it was known that the lowest knowledge domain was conceptual knowledge, and the two lowest domains of self-efficacy were: reporting and debriefing and recording domain.
DISCUSSION & CONCLUSION
Moderate knowledge in this research was caused by nearly half of respondents failed answered 10 items of questions, i.
neonatal pulse examination, pregnant women position, chest compression location, pulse and breathing examination time.
DNAR, indication of defibrillator.
Mean chain survival, principle of 3A, the purpose of defibrillation and things to consider in using a defibrillator.
addition, more than half of respondents failed to answer 4 question, there were the process of care during CPR, the principle of rescue breathing, the purpose of repositioning pregnant women, and the compression ratio in children under 1year-old.
Due to the mean score of these four items were the lowest mean score.
The level of knowledge about CPR is influenced by several factors including age, education, experience, and the Most Belitung Nursing Journal .
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September-October 2017 resuscitation skills were adults, as many as 58 respondents .
3%) were in the early adult age category .
-25 year.
Adults have a greater inherent need to know why they must learn something, they have more life experiences that serve as potential sources of learning, they become ready to learn things when reallife problems demand new knowledge and skills, they are self-directed, and they are more responsive to internal factors as motivators for learning.
At the beginning of 20 years-old there is a very wide cognitive change.
In these early becomes richer, more complex, and dynamic, and individuals will play a greater role with other individuals in different contexts to produce systematic and dynamic variations.
16 It showed that developed, ready, and mature to receive information cognitively.
is the relationships between basic elements with a larger structure that enable them to function together, which contain classifications and categories.
principles and generalizations.
knowledge of theories, models, and 17 According to Han et al.
,18
four thinking processes of decisionmaking by nurse in clinical nursing practice are: reviewing, validation, consideration, and rationalization.
The rationalization process is used to justify a person thoughts and actions, and is the basic for problem solving and decisionmaking.
Rationalization includes the making of conclusions, noting reasons and objectives that should guide actions, setting up oneAos position and inferring to general cases which really depends on one's conceptual knowledge.
18 This indicated that in the next internship nursing students, conceptual knowledge needs to be improved.
Through the interview with the respondents, during the education process, the information about CPR for pregnant women.
DNAR, the treatment process during resuscitation, and how to conduct inadequate, while information about other question items was adequately addressed, but that information had just received almost three months ago.
Partiprajak et ,3 revealed that CPR training has a significant direct effect on knowledge, but knowledge decreased significantly after 3 months post-training.
This indicated that the knowledge of internship nursing students tended to decrease.
the training evaluation and repetition were expected to be conducted periodically.
In this research, respondents .
7%) had a history of observing CPR and had done CPR .
7%).
The experience of observing and performing CPR was one of the respondents' knowledge sources.
Passali, et al.
,19 revealed that nurses and doctors who had experience delivering CPR and were in a high risk area for cardiac arrest had better knowledge than nurses and doctors who were not in that However, the results of this research were not in line with research of Srinivas et al.
,6 which stated that the knowledge of nursing students about basic live support is still low.
It should be noted, that the respondents in Srinivas et ,6 research were fresh graduate, whereas in this research the research respondents were internship nursing students who mostly had experience.
Furthermore, out of the knowledge domain, the conceptual knowledge was the lowest domain.
Conceptual knowledge Belitung Nursing Journal .
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September-October 2017 Furthermore, the high level of selfefficacy is formed from inactive mastery experience, vicarious experiences, verbal persuasion, physiological and affective states, and influenced by knowledge, education/training system.
12,20 As many as 72 respondents .
7%) had experience observing CPR and 53 respondents .
7%) had experience in performing CPR, and only 7 respondents .
2%) had traumatic experience related to CPR.
This showed that most respondents had direct experience and indirect experience .
bserving other peopl.
, therefore the sources that composed the self-efficacy of this research were already adequate.
Afterwards, as many as 61 respondents .
3%) were convinced to be very confident to be able to demonstrates staying calm and focusing on required It showed that respondents had a tendency to control their anxiety or sense of distress and had a tendency to be able to show performance in accordance with the ability when performing CPR.
Based on the explanation above indicated that the sources that make up the self-efficacy were adequate.
it would encourage the internship students to choose to perform CPR in cases of cardiac arrest they In addition to the experience of factors self-efficacy, according to Alavi et al.
,21 was an efficient knowledge, motivation, and education/training The respondents' knowledge about CPR in this research was in moderate category thus this good knowledge also influenced the high self-efficacy in performing CPR.
addition, the high self-efficacy was also affected by the respondentsAo education process that had used High-Fidelity Manikins as well as undergone a critical and emergency simulation with HighFidelity Simulation.
It was reported to have a positive impact on knowledge acquisition, retention of knowledge and self-efficacy.
The low self-efficacy in the 3 respondents was due to the self-efficacy statement of the ability to demonstrates staying calm and focusing on required tasks, the three respondents answered least confident, not confident, and lack of confident.
This showed that the source of self-efficacy of the ability to control the physical and emotional state is needed to be improved because the three respondents had a tendency to not be able to control their anxiety or sense of distress when CPR In terms of the self-efficacy domains, reporting, debriefing and recording domain were the two lowest domains.
After a review of the respondents' answers, almost half of the respondents were still lack of confident to least confident about debriefing or solving problem after the incident, as many as 27 .
5%).
correct management of defibrillator as many as 35 respondents .
1 %).
explaining the clinical findings and critical values of laboratory as many as 29 respondents .
1%).
and utilizing existing resources and external experts as many as 23 respondents .
2%).
In addition, the nurses at the respondent's practice area stated that the debriefing activity was still quite rare, therefore even while practiced, the respondents did not see or participate in debriefing activities.
Whereas in the process of debriefing allows every member to give verbal persuasion to each other for re- Belitung Nursing Journal .
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September-October 2017 establishing the self-efficacy of its Debriefing practice has been done during the learning process, but is still limited to one method with oral debriefing and directed.
There are quite a number of debriefing methods that can be used to improve the knowledge and quality of CPR, such as oral debriefing, oral debriefing coupled with sound recording when action, self-debriefing or with instructor, and debriefing combined with video during action until debriefing that preceded by conducting a literature review at home or home research.
research conducted by Chronister et al.
,23
showed that the method of debriefing using video and verbal can improve response time and using the oral debriefing method can increase the retention of knowledge.
This suggested that oral debriefing with video could be an appropriate choice to improve the quality of action.
Exposure to defibrillator usage was still lacking, which results in most respondents being unsure of the use of defibrillators.
Less experience in the use of defibrillators can also reduce knowledge and selfefficacy.
Lack of availability of tools can lower individual knowledge due to lack of application of such knowledge.
15 And the low self-efficacy in explaining the clinical findings and critical values of laboratory and utilizing existing resources and external experts caused by the low conceptual knowledge.
Therefore, to increase self-efficacy of respondents in 4 aspects above, it can be done by strengthening the sources and factors that influence self-efficacy, specifically by improving the experience of internship nursing students related to debriefing activities, defibrillator usage interpretation of the clinical findings and critical values of laboratory, and increased conceptual knowledge related to these four aspects.
The results of this research were not in line with research conducted by Waloyo24, which stated that the self-efficacy of most nurses .
%) are in adequate category.
When compared with this research, it was important to note that the respondent characteristics were different and the instruments used in the WaloyoAos research studies focused on the self-efficacy dimension while in this research the instruments used in measuring selfefficacy focused on the treatment process during CPR.
Declaration of Conflicting Interest None declared.
Funding This study was supported by Faculty of Nursing.
Universitas Padjajaran.
Indonesia.
Authorship Contribution All authors have equal contribution in this References