Determine the Association Between Nurses Self-Concept and Clinical Performance Among Nursing Students

The University of Lahore ABSTRAC Self-concept in clinical performance had an important role in applying competencies and self-concept in clinical performance influenced to quality care of nursing students. Self-concept is the key point for patient care by the student nurses which is established with continues education, gaining knowledge, learning skills and making attitudes. The purpose of the study is to determine the association between nurses self concept and clinical performance among nursing students. Descriptive cross sectional study was conducted in the school of nursing at Jinnah hospital Lahore. The study data were collected using a questionnaire which consisted of Nursing Self Concept Questionnaire (NSCQ) and Six Dimension Scale of nurse performance 6-(DSNP). Pearson Correlation test was used to explore the relationship of variables. The results of the study show that clinical performance and professional self-concept are related. These findings can be helpful to teachers, authorities at nursing colleges, and nursing managers.


Introduction
Self-concept is a multidimensional ideology consisting physical, emotional, social and spiritual aspect that make up who we are. Self concept reforms and regulate over self as we grow based on the knowledge we gain in over life. Self concept starts developing since childhood. Good environment among the colleagues in the clinical side will promote the self-concept of the nursing students (Gunawan, Aungsuroch, Sukarna, & Efendi, 2018).
Self-concept in clinical performance had an important role in applying competencies and self-concept in clinical performance influenced to quality care of nursing students. Self-concept is the basic self perception of any individual through which he takes any decision (Albloushi, 2017).
Self-concept is the key point for patient care by the student nurses which is established with continues education, gaining knowledge, learning skills and making attitudes. The expectation can be made for the students to have a high level of confidence (Skoglund, Holmström, Sundler, & Hammar, 2018).
Before entering in the clinical practices nursing student should be guided by simulation method in medical techniques. Moreover it is found repetitions of these practices improve their capabilities for practical work (Mohamadirizi, Kohan, Shafei, & Mohamadirizi, 2015).
Nursing students develop self concept regarding this profession in their study tenor. They like it as they join this profession by their own will. With the lapse of time the positive self concept develops in this profession. Moreover, there is a group of students which develop a negative self concept due to their experiences during training regarding staff nurses and comments from the other people regarding this profession. This attitude develops a misconception for the nurses (Parandavar, Rahmanian, & Jahromi, 2016).
There are different categories in confidence, education, skills and knowledge of Self-concept in nursing students. Most of the nurses think themselves with an excellent confidence for the care of the patients. In the opinion of some nurses the lack of education leads to a low level of self confidence (Gunawan et al., 2018).
The study was conducted in the department of nursing school. In this study Pearson correlation showed a positive correlation between scores of clinical performance and clinical Self-concept in a way that an increase in score of clinical performance increases score of clinical Self-concept, P=0.001 (Mohamadirizi et al., 2015).
The cross sectional study was conducted in the university. In this study 48 of the participants (55.8%) were junior and 38 (44.2%) were senior nursing students. The majority of the students were female (65.1%) and single (79.1%).The results shows that there is a relationship between the students' clinical performance and professional self-concept was slight (Poorgholami, Ramezanli, Jahromi, & Jahromi, 2016).
A study conducted on 150 of nursing and midwifery students in Isfahan University of Medical Science, selected through two stage sampling. The students who take part in this study complete questionnaire regarding personal/educational attitude about nurse's clinical performance. The findings show 50% and 37.4% nurse students have good excellent clinical competence and clinical self performance (Mohamadirizi et al., 2015) The study was conducted in private nursing school to show the Deeping of communication was permitted as a competence of nurses. This is essential for leadership development (Andrade Vasconcelos et al., 2017).
The study conducted to summarize the means of perceptions in nurses and hinders for communication with families in critical care unit. There is need to enhance the skills and knowledge for a effective communication with a family (Adams et al., 2017).

Significance of the study
This study will provide information to the nursing school administration to understand the importance of self-concept that effect on the clinical performance of the nursing students. The finding of this study will enable the policy makers and higher authority of the hospital to build self-concept to improve the nurse's clinical performance through seminars, workshops and personal counseling, provide comfortable environment which ultimately enhance the quality care of the organization which will improve the image and repute of the organization.

Theoretical Framework
Theoretical framework employed in this research work will be shown, according to this model the independent variable is a set of four profile factors (age, sex, marital status and academic year. The dependent variables are self-concept and job performance. Self concept is also effect on job performance. Self-concept is composed of the following six dimensions according to Paso (Ng, 2014).

Materials and Methods
A quantitative cross-sectional research design was used for this study

Independent Variables
 Self Concept

Sample Size & Sampling Techniques:
Data was collected from the participant through questionnaire and the participants were selected through convenient sampling method, the sample size for this study were 200 nurses students which is calculated from the Slovene's formula.

Inclusion Criteria
 Following students from school of nursing in Jinnah hospital Lahore were included in data collection, those who were present at the time of data collection, and those who were willing to participat Students and who were 16-25 years old

Exclusion Criteria
 Following students from school of nursing in Jinnah hospital Lahore will be not included in data collection, those who were not present at the time of data collection and those who were not willing to participate and Students, who were less than 16 year and more than 25 years old  .000 N 110 110 **. Correlation is significant at the 0.01 level (2-tailed). Table 4 shows the Pearson correlation between the nurse self concept and clinical performance was slight but statistically significant r=.000 and p=0.01

Conclusion
The results of the study show that clinical performance and professional self-concept are related. Accordingly, attempts should be made to enhance students' professional self-concept during their education that will enhance students' clinical performance. These findings can be helpful to teachers, authorities at nursing colleges, and nursing managers.