The role of professional attitudes in shaping care behaviors: insights from Iranian nursing students | BMC Medical Education

According to our study, the mean score of professional attitudes for student nurses was 94.7 ± 17.3. Recent research has indicated similar levels of professional attitudes. In research conducted by Sümen et al. [17], this score was 106.708 ± 20.24 among nursing students. The present study’s findings indicate a positive correlation between students’ professional attitudes and their caring behaviors.

Ak et al. reported a mean score of 113.43 ± 15.39. This study aimed to investigate the effects of the COVID-19 pandemic on the professional attitude of nursing students in Turkey. The overall professional attitudes exhibited by nursing students during the COVID-19 Pandemic period were positively high [21].

Furthermore, Durmus and Erdem reported a mean score of 110.13 ± 15.73 for professional attitudes among 3rd and 4th year nursing students. This means that students’ general attitude toward professionalism was found to be at a high level [22].

However, in the study of Shohani et al. [23], which was conducted on nursing students in Iran, they reported a lower mean score of 91.01 ± 15.7. This indicated a moderate level of professionalism among Iranian nursing students.

There are several reasons and justifications for the lower average score of nursing students’ professional attitudes in our society compared to other societies, such as the job conditions and relatively low income of nurses in hospitals. Moreover, the profession’s social position, nurses’ professional independence, and the clinical atmosphere contribute to the lower average score of professional attitudes. This impact is felt by students, especially those who are in the process of acclimating to clinical environments. Universities directly provide instruction in professional knowledge and skills but not attitudes. It would be great if any courses were designed to address nursing students’ professional attitudes. Also, the professional attitude of nursing instructors will have a significant impact on the attitude of students. Therefore, training trainers with an acceptable professional attitude can somewhat solve this problem [24]. Throughout their education, students should be exposed to teachings on professional attitudes and values to ensure the cultivation of competent professionals in nursing education [16, 25]. Therefore, educators can enhance students’ professional attitudes by organizing the educational environment, creating role models, and providing advice [11].

Regarding the questionnaire dimensions used, the mean score of the “contribution to the increase of scientific information load” subdimension of the scale was 18.8 ± 6.6. However, similar studies obtained scores higher than 20 [17, 21, 22]. Shohani et al.‘s study showed lower figures concerning this subdimension [23]. The comparison of our study’s findings with those of similar studies highlights the relatively weaker performance of Iranian students. The study mentioned above, conducted in Iran, suggested that students be given feedback on their performance to be persuaded to increase scientific knowledge [23]. Regarding other dimensions, the results of our study are almost the same as those of other similar studies [17, 21,22,23].

The CBI-24 score of the students had a mean value of 96.5 ± 26.2. The results demonstrated that nursing students in the investigated community displayed noteworthy caring behavior. Other studies in this field have shown similar results [17, 26, 27]. The study found that nursing students obtained high scores in the subdimensions of the CBI-24. Regarding the subdimensions, the highest score was obtained for respectfulness, whereas the lowest score was observed for assurance. Sümen et al. ‘s findings align with our own [17].

Several approaches have been assessed to enhance caregiving behavior. According to a study conducted by Elahi et al., a care workshop can potentially improve care behaviors among nurses [28]. Moreover, a significant correlation has been found between the caring behaviors displayed by instructors and the subsequent positive influence on the caring behaviors demonstrated by nursing students. The competence of caring can be fostered in nursing students by implementing positive faculty modeling and role modeling [29].

The findings of our study indicated a positive and statistically significant correlation between the total scores of the two questionnaires utilized. However, this relationship was not strong. The results of our study were in line with those of Sümen et al. [17]. This means that with any improvement in students’ professional attitudes, an improvement in caring behavior can be achieved. However, few studies have investigated the relationship between these two phenomena [4, 12]. Given the low R² value of 0.11, it is clear that the regression model explains only a minimal amount of variance in caring behaviors. This suggests that other important factors that could impact caring behaviors may not have been included in the model. Therefore, the model’s explanatory power is limited, and this finding raises concerns about the adequacy of the included variables. Future studies can confirm and emphasize the need to increase professional attitudes to improve care behavior. If such a hypothesis is confirmed, changes should be made in educational policies to improve students’ professional attitudes.

Limitations and future research

Although the regression model provided valuable insights, we acknowledge that the omission of a comprehensive set of control variables may have limited the scope of our findings and affected the validity of the conclusions drawn. The decision to limit the number of control variables was based on the available data and the scope of this study. However, we agree that including additional control variables—such as psychological factors, socioeconomic status and personal experiences—could improve the robustness of the findings. The low R² value (0.11) further highlights the need for a more comprehensive modeling approach or additional variables to better explain the variance in caring behaviors. Future research should consider incorporating these additional variables to better capture the complexity of the relationship between professional attitudes and caring behaviors.

Additionally, it is important to note that our study excluded first-year nursing students due to their limited clinical experience, which may affect the generalizability of our findings. While this approach aimed to include only students with sufficient clinical exposure, future studies involving students at different stages of their education could provide a more comprehensive understanding of professional attitudes and caring behaviors across the entire academic trajectory.

In addition, the cross-sectional nature of this study limits our ability to establish causality between professional attitudes and caring behaviors. Longitudinal studies, which follow nursing students over time, could provide more comprehensive insights into how professional attitudes evolve and how they impact caregiving behavior in the long term. Further, increasing the sample size could enhance the representativeness of the study and improve the generalizability of the findings.