Professional values of the nursing students ’ Perspective in Jahrom University of medical sciences , 2017

Background and Aim: The main goal of nursing is to promote the value of human beings and the dignity of all those who need care. Nursing should not only include scientific knowledge and technical skills, but also a professionin which professional values are acknowledged. The aim of this study was to determine the professional values from the viewpoint of nursing students in Jahrom University of Medical Sciences. Materials and Methods: In this descriptiveanalytical study, 120 students of Jahrom Nursing and Midwifery Faculty were selected through census sampling. A two-part questionnaire was used to assess the students’ viewpoints toward professional values: Part I: Social-demographic characteristics and Part Two: Nurses professional values scale Revised survey tool, which consists of 26 items from professional ethics codes of the American Nursing Association and includes the following items: care (9 items), activity (5 items), trust (5 items), professionalization (4 items) and justice (3 items). The options are expressed on the basis of a five-option Likert scale, so that the option with the least importance gets score 1 and the option with the most importance gets the score 5. The range of grades will be from 26 to 130, and a higher score indicates that they are more familiar with professional values. Results: 120 nursing students participated in the present study. Mean scores of dimensions of care, pragmatism, trust, professionalism, and justice were 3.50, 3.20, 3.65, 3.45, and 3.75, respectively. Maintaining competency in the clinical setting (dimension of trust) was the most important componentand activities in professional nursing and research affairs associations (pragmatic dimension). Conclusion: In order to promote the professional development and transformation of today’s students into future capable nurses, it is imperative to develop planning and teaching methods tailored to the existing conditions and facilities, as well as to consider areas of strength and weakness in the area of professional value.


Introduction:
Nursing is a field full of values. The main goal of nursing is to promote the value of human beings and the dignity of all those who need care 1 . Florentine Nightingale in the nineteenth century found that nursing should not solely include scientific knowledge and technical skills, instead it is a profession that puts an emphasis on particular human values 2,3 .
Understanding how to grow and replenish professional values in the future of nursing is important 4 . In order to identify ethical issues in the 21st century, nurses and their associates need to turn to professional values that will guide their performance, behaviors, and decision-making 5 . In order to ensure the future of nursing, targeted integration of professional values in nursing education is essential, which is rooted in the concept of care through the use of value-based behaviors. Although nursing programs may have credible guides to put professional values into account, very few have knowledge or evidence about the success rate in achieving the learning outcomes related to professional values 6 . Due to the emphasis on ethics and values, it can not be expected that nurses and nursing students can properly, only with personal experience, perform their duties in this field. 7,8 . Faculty members are responsible for helping to recognize and begin to gain professional nursing values 9,10 . They should place ethics and critical thinking in the curriculum in order to teach how to make ethical decisions and protect the patient and caregivers . 11 One of the important factors that influence the values of nursing is culture and vocational education 1 . Education has the greatest impact on the ethical and spiritual development of nurses and nursing schools have a key role in shaping the students' ethical framework. Creating this framework can help them to make ethical decisions and ultimately make the nurses have enough power to make decisions. 12 . Current nursing education programs emphasize cognitive and psycho-motor skills and the effective skills required in patient-nurse communication. A review of the literature reveals the benefits of applying knowledge and coordinating performance in relation to professional values for nurses in educational programs 13 . Although professional values are considered an integral part of nursing ethics planning, the focus of research on them is rare and this area of training has been neglected. There are no specialized studies about the professional values of nursing in Iran. Currently, there is no specific nursing ethics curriculum with emphasis on professional value components in colleges, which in turn can lead to their lack of knowledge as responsible nurses in the future. The socialization process in nursing education involves modifying personal values and internalizing professional nursing values 9 . The Association of American Nursing Schools in the United States reported that the need to put values into undergraduate nursing education programs has become a growing concern for educators 14 . The development of long-term professional values has been continually taking place, which has begun professionally with nursing education and continues throughout nursing years 15 .
Considering the above mentioned issues, as well as the importance of familiarizing, institutionalizing and applying professional values and ethical principles, we decided to study the perspective of nursing students toward professional values at Jahrom Nursing Faculty.

Method:
Research & Sampling Society: This is a descriptiveanalytic study. The study population consisted of all undergraduate nursing students studying at the Nursing and Midwifery Faculty of Jahrom University of Medical Sciences during the first half of the school year of 2017-2018. After obtaining an agreement for conducting the study from the Research Council of the University and the permission of the relevant field, nursing students were selected from the Nursing and Midwifery faculty of the Jahrom University of Medical Sciences. The total number of students studied was 120. Data Gathering Tools: In order to assess the students' view of professional values, a two-part questionnaire was used in which the first part dealt with the socio-demographic information consisted of 13 questions and the second part included the Nurses Professional Values scale (Revised survey tool), which consisted of 26 items from professional ethics codes of the American Nursing Association, including the following: care (9 items), activity (5 items), trust (5 items), professionalization (4 items), justice (3); the options were expressed on the basis of the five-option Likert scale, so that the option with the least importance got the score 1 and the option with the highest importance got the score 5. The scores range from 130 to26, and a higher score reflects the students' higher familiarity with professional values. The questionnaires were distributed and collected by the researcher as much as possible. Validity and reliability of the questionnaire: The revised professional nursing values tool was first designed by Dr Shank and Weiss who has reported high validity and reliability. The questionnaire was developed by a panel of professionals in the field of professional values and the alpha level Cronbach is reported to be 0.92 16 . In Iran, Hosseini et al. (2012) made the validity and reliability of this questionnaire. Initially, the questionnaire was translated to Farsi and again to the original version. The formal and content validity of the questionnaire was completed by 7 experts of the Faculty of Nursing in Tabriz. The reliability of the questionnaire was verified by a pilot study on 72 nursing students and Cronbach's alpha has been approved, 0.92 17 . Inclusion criteria in this study include: The students should be an undergraduate nursing. They are satisfied to to participate in the research Exit criteria include: A record of training courses related to professional and nursing values Employment in educational and therapeutic centers Guest or TransferStudent Information analysis method: The data were analyzed using SPSS19 software. For reporting the results, descriptive statistics (percentage, frequency, mean, standard deviation, ...) was used and T-test was used for comparisons. Results: In this study, 120 nursing students from Jahrom participated. 80.8% of them were female and male. 85 percent were single and 15 percent were married. Also, the mean scores related to different dimensions of professional values, along with their components, are given in sections 1 to 5. The highest score is related to the dimension of justice and the lowset is related to the pragmatic dimension.      18 .
In the study of Alfred et al. American nursing students also identified the components of maintaining competence and competence in the clinical setting as one of the most important components of trust dimension 19 .
Today's nursing students will be tomorrow's nurses who will decide on medical treatments, interventions, health care, etc. 20 . Students with a set of ethics, personal values and beliefs enter the nursing school, which is constantly growing and changing with any new experience 11 . Ethical education alone does not guarantee professional ethical behavior, but without familiarizing with ethical codes and the ability to make ethical decisions, students find it difficult to perform logical exercises 21 . Eligibility and competency of nursing students in clinical trials are correlated with the development of ethical behavior in them (adherence to codes) 7 .
Like the present study, in most conducted studies, pragmatic dimension and its related components have the lowest mean scores and value priorities from the viewpoint of nursing students. The results show that most nurses consider those nursing values important that are directly related to their job 18 .
Other values that may require participation of outside of the time frame are not considered to be important from their perspective. Research has shown that an appropriate curriculum can enhance students' perspective on this dimension. 4 .Creating motivation to engage in these activities can be enhanced by establishing professional values, encouragement from coaches or colleagues, and more. Similarly, the values include the emotional dimension 22 . If a value only evolves in one or two of the first stages of emotional learning during formal education, it may be diminished if it is not encouraged or highlighted, and, eventually, it is likely that the values of professional development in nursing are not fully integrated and appreciated by the nurses at the time they are students 23 .
In the studies conducted on the professional values the average range of total nursing students' grades was based on the five-optionLikert scale in a relatively important or important range, which is in line with the current study, however, the average of the total students' in the present study is somewhat lower than in other studies 19 .
Since education plays a major role in the student's view of professional education, this study examined and highlighted educational needs by examining the views of students on professional curriculum. Precise knowledge of the qualitative and quantitative status of providing educational services in the faculties and medical universities of the country is considered as the first planning step in comparison with each other 24,25 . In this study, it should be noted that although students generally had a positive attitude towards their professional vales, the need to pay more attention and support to different areas of professional duties and to raise awareness about the importance of some professional values in their curriculum is felt.

Conclusion:
Professional values are the basis of nursing practice. Therefore, in order to promote the professional development and transformation of today's students into future capable nurses who, in addition to the direct care responsibilities of the patient, are able to perform a wide range of nursing activities and roles, it is imperative to develop planning and teaching methods tailored to the existing conditions and facilities, as well as to consider areas of strength and weakness in the area of professionalvalues. Suggestions and Applications of the Project Findings: The results of this research can help develop a coherent curriculum that improves the quality and quantity of educational process in the field of professional values and, by providing an appropriate context for internalizing knowledge about professional values, leads to the training of nurses who are responsible for their professional commitment, which will enhance the quality of care and develop professional responsibility. Ethical clearence:We obtained an agreement for conducting the study from the Research Council of the University and the permission of the relevant field. Source of Funding:None Author contribution: Study conception and design (MK, FP), statistical expertise, analysis and interpretation of data and supervision (SP.FH), manuscript preparation (ZM), supervision, administrative support and critical revision of the paper (MK, FM).