Abstract
BackgroundThe shift in healthcare to extramural leads to more patients with complex health problems receiving nursing care at home. However, the interest of baccalaureate nursing students for community nursing is moderate, which contributes to widespread labour-market shortages. This study investigates the effect of a more ‘community-care-oriented’ curriculum on nursing students’ perceptions of community care.MethodsA quasi-experimental quantitative survey study with a historic control group (n = 477; study cohorts graduating in 2015, 2016, and 2017; response rate 90%) and an intervention group (n = 170; graduating in 2018; response rate 93%) was performed in nursing students of a University of Applied Sciences in a large city in the Netherlands. The intervention group underwent a new curriculum containing extended elements of community care. The primary outcome was assessed with the Scale on Community Care Perceptions (SCOPE). The control and intervention group were compared on demographics, placement preferences and perceptions with a chi-square or T-test. Multiple regression was used to investigate the effect of the curriculum-redesign on nursing students’ perceptions of community care.ResultsThe comparison between the control and intervention group on students’ perceptions of community care shows no significant differences (mean 6.18 vs 6.21 [range 1–10], respectively), nor does the curriculum-redesign have a positive effect on students’ perceptions F (1,635) = .021, p = .884, R2 = < .001. The comparison on placement preferences also shows no significant differences and confirms the hospital’s popularity (72.7% vs 76.5%, respectively) while community care is less often preferred (9.2% vs 8.2%, respectively). The demographics ‘working in community care’ and ‘belonging to a church/religious group’ appear to be significant predictors of more positive perceptions of community care.ConclusionsGraduating students who experienced a more ‘community-care-oriented’ curriculum did not more often prefer community care placement, nor did their perceptions of community care change. Apparently, four years of education and placement experiences have only little impact and students’ perceptions are relatively static. It would be worth a try to conduct a large-scale approach in combination with a carefully thought out strategy, based on and tying in with the language and culture of younger people.
Highlights
The shift in healthcare to extramural leads to more patients with complex health problems receiving nursing care at home
Aim of this study The aim of this study is to investigate the effect of a longitudinal curriculum-redesign with extensive elements of community care on baccalaureate nursing students’ perceptions of community care
Multiple regression was used to investigate the effect of the Response rate and comparison on demographics Data from three respondents were excluded from the analysis as they only filled in a small part of the questionnaire
Summary
The shift in healthcare to extramural leads to more patients with complex health problems receiving nursing care at home. The shift from intramural to extramural healthcare in many Western countries is resulting in increasing numbers of patients receiving care in their own home environment [1] These patients are, on average, growing increasingly older with more complex healthcare problems and chronic diseases [2]. This patient group is fast becoming an important population for healthcare professionals, resulting in an increase of care provided outside of a facility [3] This development leads to the problem of labour market shortages, in part because many graduating students do not see the area of extramural or primary care as their preferred career choice [4,5,6]. Working in primary care and/or community care seems undervalued: students underestimate the qualifications and high academic standards required to ensure appropriate caregiving in this area [9, 16,17,18]
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