The Correlation Between Self Efficacy and Nurse’s Motivation with The Implementation of Nursing Care in Patient Wards in Islamic Hospital Purwokerto

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INTRODUCTION
Every nursing service is an important component of the health care system organized by the hospital.Nursing services provided can meet the needs and demands of the community for professional medical care.The nursing profession faces challenges in achieving its goal of making professional nursing care a demand in today's society.When carrying out nursing duties in accordance with the code of nursing ethics.Professional nursing is characterized by a thorough presentation [10].
In carrying out the nursing care process, nurses need to have confidence, or self-confidence; this confidence is also known as self-efficacy.Self-efficacy is a feeling that refers to a person's belief in his own ability to organize and carry out the actions needed to achieve the desired goals.that the level of self-efficacy ISSN: 2808ISSN: -1021 Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/3099 can determine how much the nurse believes in her abilities, and this belief will determine the quality of the implementation of nursing care [5].
Nurses who have a high level of self-efficacy will influence nurses to have more caring and attentive attitudes when providing nursing care to patients, so that patient satisfaction will increase.But if the nurse has low self-efficacy, then she tends to avoid the task and is less able to give good results in the task being done.This will disrupt the process of implementing care and hamper a sales goal [7].
In carrying out nursing care, another factor that can influence the implementation of nursing care is the desire or motivation of the nurse herself.Nurse motivation can be seen in the implementation of nursing care on time and with full responsibility, supervision from superiors in implementing it, giving incentives fairly and in accordance with work performance, and comfortable environmental conditions while working [1].Nursalam (2016)explains that motivation is divided into two parts: intrinsic motivation, namely, motivation that comes from within the person himself, for example, job satisfaction, capacity, or self-ability.Meanwhile, extrinsic motivation is motivation that exists outside of oneself, for example, money, honor, status, or position [1][14].
The objectives to be achieved in this study are: 1) knowing the characteristics of the respondents; 2) Knowing the self-efficacy of nurses in the inpatient room of Purwokerto Islamic Hospital 3) Knowing the motivation of nurses in the inpatient room of Purwokerto Islamic Hospital 4) Knowing the implementation of nursing care in the inpatient room of Purwokerto Islamic Hospital 5) Knowing the relationship between selfefficacy and the implementation of nursing care in the inpatient room of Purwokerto Islamic Hospital 6) Knowing the relationship between the motivation of nurses and the implementation of nursing care in the inpatient room of Purwokerto Islamic Hospital.

RESEARCH METHOD
This research is a quantitative study using a correlation analytic design with a cross-sectional approach.In this study, there are two variables: the independent variable, namely self-efficacy and nurse motivation, and the dependent variable, namely the implementation of nursing care.The sample for this research is 45 respondents, who are nurses in the inpatient room of the Purwokerto Islamic Hospital.The sampling technique used is total sampling.Methods of data collection using observation sheets and questionnaires.The data in this study were not normally distributed, so researchers conducting data analysis used non-parametric statistics, namely bivariate analysis using the Spearman's Rho test, to determine the relationship between self-efficacy and motivation of nurses with the implementation of nursing care in inpatient rooms at Puwokerto Islamic Hospital.1, it shows that most of the respondents were aged less than 30 years, with as many as 27 respondents (60.0%).Most of the research respondents were female, with as many as 34 respondents(75.6%).The majority of respondents with DIII nursing education were 40 (88.9) with a length of work of less than 5 years, as many as 32 (71.1%).

3.1.Univariat
Based on the results of the study showed that most of the respondents were aged less than 30 years as many as 27 respondents (60.0%).These results indicate that the majority of respondents were of a young and productive age.Humans who are in a productive period will be able to optimize their abilities to produce a result ISSN: 2808-1021 Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30100 from what they do.Pieter (2017) also said that at this time they already have a fairly mature mind and can easily understand any changes that occur to themselves and others.Most of the respondents are female.In this study, both male and female nurses were relatively similar in carrying out the nursing care process.Gender is only a biological categorization that can be known from self-identity [15].
Based on recent education, most of the respondents had D3 education backgrounds, as many as 40 (88.9%).According to Gibson's opinion in Suratun (2016), a high level of education generally causes a person to be more willing to accept responsibility; the higher a person's education, the greater the desire to utilize knowledge and skills [16].
Meanwhile, based on the length of work, the results of the study showed that the highest number of respondents worked for less than five years, with 32 (71.1%).This shows that the respondent already has sufficient experience in providing nursing care.This is in accordance with the opinion of Robbins in Suratun (2016), which states that the longer a person works, the more skilled and experienced the person is in carrying out his work [16].Based on Table 2, it is known that the majority of respondents have good self-efficacy, with as many as 29 respondents (64.4%) and self-efficacy is poor for as many as 16 respondents (35.6%).Self-efficacy is a feeling that refers to a person's belief in his own ability to organize and carry out the actions needed to achieve the desired goals [5].
Good self-efficacy will lead to strong self-confidence, especially when nurses carry out nursing care.The higher the self-efficacy of a nurse, the job will get better results, the nurse will be more committed to her work, and she will be more able to overcome the difficulties encountered in her work (Melnikov et al., 2013).This is supported by research by Idah (2018), which says that nurses who have high self-efficacy will be able to carry out quality nursing care; nurses will be more committed, carry out tasks confidently, carry out all obligations towards their work, and are better able to overcome difficulties encountered at their job.Individuals with high self-efficacy will show commitment and self-motivation to perform the expected nursing care [3].
Based on table 2, it is known that most of the respondents have motivation in the good category, with as many as 18 respondents (40.0%), sufficient category with as many as 11 respondents (24.4%) and a less sufficient category with as many as 16 respondents (35.6%).
This motivation is an accumulation of various processes that influence and direct individual behavior to achieve certain goals (Negussie 2012).Similar research was conducted by Fazriannor (2018), who explained that motivation is one of the things that increases a nurse's sense of responsibility for completing a given task.Based on Hasniah's (2013) research, it is explained that high motivation of nurses will have a good impact on the process of implementing nursing care, while low motivation of nurses will have a negative impact on the process of implementing nursing care.This is in accordance with the theory presented by Triwibowo (2013), which explains motivation as part of a person's strength or drive to achieve an achievement, which is influenced by internal and external factors.
Based on table 2, it is known that most of the implementation of nursing care in the inpatient room of the Purwokerto Islamic Hospital is included in the complete category of 29 respondents (64.4%) and incomplete category, with as many as 16 respondents (35.6%).
The results of the implementation of nursing care were obtained from direct observations of the actions of nurses in carrying out nursing care and observing the medical record data of patients who were going home.From these results, it can be interpreted that there are still some nurses in the inpatient room of Puwokerto Islamic Hospital who pay little attention to the completeness of the nursing care process.
From the results of the research that has been done, it is obtained that the implementation of incomplete nursing care includes incomplete assessment aspects of 22.2%, incomplete diagnostic aspects of 11.9%, ISSN: 2808-1021 Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30101 incomplete planning aspects of 19.2%, incomplete action aspects of 23.1%, incomplete evaluation aspects of 7.8%, and incomplete documentation aspects of 25.8%.Incomplete implementation of parenting is mostly found in the documentation aspect.In this study, the relationship between self-efficacy, nurse motivation and the implementation of nursing care was examined using the Spearman correlation analysis method.The initial stage of this research used the normality test.The results of the data normality test using the Shapiro-Wilk test obtained an alpha of less than 0.05, meaning the data was not normally distributed, so further analysis tests were carried out using non-parametric tests.In this study, the conditions for using the Spearman rank test were fulfilled.

Bivariat
Based on table 3, it is known that the Spearman rank correlation coefficient is 0.840.This means that the level of strength of the relationship (correlation) between the variables of nurse self-efficacy and the implementation of nursing care is very strong.Supported by a p-value of 0.000 and less than 0.05, it can be ascertained that there is a relationship between self-efficacy and the implementation of nursing care.This is in line with Handayani's (2018) research.The results of research on bivariate analysis stated that there was a significant relationship between self-efficacy and the implementation of nursing care (p value = 0.0000.05).Based on the results of this analysis, the odds ratio value is 18.417, meaning that nurses who have high self-efficacy have 18.4 times the chance of carrying out good nursing care compared to nurses who have low self-efficacy.In addition, Sri Rahayuningsih's research (2016) also explained that nurses who have selfefficacy will have feelings of being able to do work, have better abilities, enjoy work challenges, and be satisfied with the work being undertaken [7][8].
Based on Table 3, it is known that the Spearman rank correlation coefficient is 0.762.This means that the level of strength of the relationship (correlation) between the variables of nurse motivation and the implementation of nursing care is strong.Supported by a p-value of 0.000 and less than 0.05, it can be ascertained that there is a relationship between nurse motivation and the implementation of nursing care.This means that there is a strong relationship between motivation and the implementation of nursing care in the inpatient room of Purwokerto Islamic Hospital.In this case, it can be concluded that strong motivation greatly influences the implementation of nursing care.If a nurse has strong motivation, then the implementation of nursing care can be carried out fully.Mudayana (2010) said that the high motivation of a nurse makes the nurse have a high level of enthusiasm to provide good nursing care to patients [11].This is in line with Miladiyar's (2015) research in this study, which shows that there is a relationship between motivation and the implementation of nursing care (p value = 0.000 <0.05).This study shows that nurses who have good motivation have the opportunity to show good care implementation five times more than nurses who have less motivation (OR = 5.235).From these results, it can be concluded that there is a positive relationship between nurse motivation and the implementation of nursing care.Kriska (2018) argues that motivation is the main key that determines the success of implementing nursing care [9][11].

CONCLUSION AND RECOMMENDATION
Based on the results of the study, it can be concluded that most of the respondents were aged less than 30 years, with the majority being female, with D3 education and working experience of less than 5 years, and most ISSN: 2808-1021 Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30102 of the respondents had good self-efficacy and motivation with the implementation of complete nursing care.There is a very strong relationship between self-efficacy and the implementation of nursing care in the inpatient room of Purwokerto Islamic Hospital.And there is a strong relationship between nurse motivation and the implementation of nursing care in the inpatient room of the Purwokerto Islamic Hospital.
In this research, nurses in particular are expected to be able to further increase their self-efficacy and motivation, especially in terms of carrying out the process of implementing nursing care, especially at the documentation stage.It is hoped that nurses will pay more attention to writing documentation that is clear, concise, and uses standard and correct terms.So that nurses can carry out the process of implementing nursing care in a professional manner.Secondly is for further research.It is hoped that this research can add reference material regarding self-efficacy and motivation in the implementation of nursing care.It is hoped that this research can be further explored by looking at what factors can influence the implementation of nursing care apart from self-efficacy and motivation factors.

Table 2 .
Frequency Distribution of Self-Efficacy, Nursing Motivation and Implementation of Nursing Care in the Inpatient Room of Purwokerto Islamic Hospital(n=45)

Table 3 .
The Relationship Between Self-efficacy, Nursing Motivation and The Implementation of Nursing Care in the Inpatient Room at Puwokerto Islamic Hospital