Enhancing Nurses' Proficiency: A Study on the Impact of Caring Education Booklets

ABSTRACT


INTRODUCTION
Many factors influence the smooth running of health services in hospitals, one of which is health services, which cannot be separated from health services.Medical services play an important role in determining health service standards; the majority of health services (60%) are provided by nurses, who meet 24 hours a day with patients [1].The caring behavior of nurses influences patient satisfaction; this is an illustration of the quality of hospital services.Nurses have a major role in fulfilling patient satisfaction [2] Caring is a common phenomenon in nursing; it can be understood as a fundamental principle of knowledge and expertise in nursing practice.Nursing experts reveal that caring is an important component of the nursing profession [3].The State of Indonesia describes the number of nurses who show a caring attitude, as the results of a study in the city of Jakarta show that out of 81 nurses, 64.2% of them do [4] Another study conducted in the city of Semarang, Java Island, showed that 60% of 50 nurses were caring [5] According to Dwiyanti,E (2018) [6], caring is an expression of concern for others, focusing on others, respecting dignity and humanity, having a commitment to preventing things that are detrimental, giving ISSN: 2808-1021 Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30232 attention and focus, respecting individuals and human life, loving and building bonds , recognizing power and existence, always supporting, feeling sympathy, having knowledge, appreciating, and giving happiness.
[7]In his study of the factors associated with the caring attitude of implementing nurses in the inpatient room of the Jakarta Friendship Hospital, showed that 51.9% of nurses showed a caring attitude that cared about, while the other 48.1% had a caring attitude that was less concerned [8].To improve nurse caring behavior, the steps that need to be taken are increasing nurse understanding of the importance of caring behavior, motivating nurses to increase their knowledge and quality of caring in providing nursing care, and monitoring the caring behavior of nurses in providing nursing care by prioritizing the principles of caring [5] Nursing care is a series of nursing practice actions that are directly provided to patients in various types of health services.The implementation of nursing care is based on the principles of nursing as a profession based on nursing knowledge and skills, with a humanistic approach, and focuses on the client's objective needs in overcoming the problems they face [9] In providing quality nursing care services, knowledge is very important as a guide and basis for providing nursing interventions.However, sometimes nurses don't realize how important this is.Without adequate knowledge, an action cannot be implemented optimally.Therefore, the provision of nursing care must be supported by knowledge about spiritual nursing care by nurses [10] According to Notoadmodjo,2012 [11], knowledge is the result of the process of understanding most of the information that humans obtain through the senses of sight and hearing.When an action is based on knowledge, it tends to be more consistent and sustainable, but if it is not based on knowledge and awareness, it tends not to last long.In the development of nursing, the therapeutic relationship between nurses and patients has become very important, so that patients are no longer passive recipients of nursing care.Patients have the right to receive better information about their nursing care and to demand standards of quality nursing care.Quality nursing care can be provided by nurses who have undergone clinical rotation.If nursing students understand and have a deep understanding of caring in nursing care, then there will be no phenomena in the field that indicate that nurses are not caring when providing nursing care.
Providing health information about caring education with nurses' knowledge in providing nursing care to patients, one of which is using media that is interesting and easily accepted by inpatient nurses, The use of media aims to maximize the senses to capture messages in order to increase knowledge related to health through communication, information, and education programs such as flip sheets, flip charts, posters, pamphlets, and booklets.
According to research conducted by Edgar Ch.Q.W [12] regarding the relationship between the caring behavior of nurses and the level of patient satisfaction at the GMIM Pancaran Kasih General Hospital, Manado, The results of this study describe 90 respondents who were research subjects; the majority of them felt satisfied (60%) and the majority also thought that nurses had caring behavior (58.9%), with a p-value of 0.04, which is smaller than the significance level of 0.05.
Based on the results of the pre-survey conducted by the researchers at Ajibarang Hospital, it was found that the number of nurses was 203, with an undergraduate education level distribution of 78 people, while D3 nursing was 125 people.Based on the distribution, there were 101 male nurses and 102 female nurses in this study.Based on the number of nurses working in the internal medicine ward, there are 32 people.Which consists of the Upper Cendrawasih Room with 11 nurses, the Lower Kenari Room with 11 nurses, and the ICU Room with 10 nurses.
Researchers conducted interviews with education and training (diklat) officers and found that in-house training had been carried out, namely in 2021 attended by 103 nurses and in 2022 attended by 87 nurses.Based on the results of interviews with nurses, training and increasing knowledge about caring have not been carried out optimally.The author conducted interviews with patients and found that the problem of caring behavior that emerged was a lack of empathy, as indicated by the fact that there were still nurses when providing medical services who only provided action without asking about the news and feelings felt by the patient, did not provide a therapeutic touch when implementing it, and lacked alertness in assisting clients with toileting activities.Based on this data, it was found that there were still nurses who had not participated in therapeutic communication training.
Apart from that, the implementation of caring education using booklets to facilitate the delivery of information to nurses is not yet available.It is hoped that the optimal use of booklets about caring for nurses can provide changes in understanding, attitudes, and behaviors in nurses' skills in carrying out caring actions for patients.Based on the explanation above, researchers are interested in conducting research on the effect of caring education using booklets on nurses' knowledge when providing nursing care to patients in the Internal Medicine Ward of Ajibarang Regional Hospital.

RESEARCH METHOD
This study used a non-randomized pre-experimental research design and a post-test without control group design.The research was conducted in July 2023 in the internal medicine ward of Ajibarang Regional Hospital and involved 32 respondents who were selected using total sampling techniques.The research instrument used was a modified questionnaire.The data that has been collected is then analyzed using the Spearman-rank test.

RESULT AND DISCUSSIONS
This research began in July 2023 in the Internal Medicine Ward of Ajibarang Regional Hospital.The total population of this study included 32 nurses, with the sampling technique being total sampling.Data analysis was carried out using the Spearman rank test.The results of the research are as follows: The research results show that the average age is 35 years, and many problems encountered by nurses and how to respond to them are influenced by age.This can happen because age influences the development of individual emotions.Indilusiantari's opinion (2017) states that generally adults are categorized into 3 types of adults, namely early adulthood, middle adulthood, and late adulthood, namely early adulthood (18-35 years) with unstable emotional development, middle adulthood (35-45 years) with ups and downs in the development of emotions, and late adulthood (46-60 years) with stable emotional development.According to [13], people of productive age often face challenges.If they can't handle it, they may experience stress.However, personality factors play an important role.In the presence of stressors, someone of productive age more often responds effectively to the situation being considered.
The research results related to the most dominant gender, namely women, were 17 nurses (53.1%).Gender is a biologically determined difference that is physically attached to the respective sexes of males and females.Women tend to be raised to be more emotionally involved with other people but are also prone to emotional exhaustion.This research is in line with another study conducted by Research (2013), which shows that the majority of respondents are female, totaling 104 people.In this case, the role of the male and female nurses is to carry out the work and job functions at the same level in serving the patient according to the standard operating procedures owned by the hospital.
The most dominant level of education is in the nursing profession, with 19 nurses (59.4%).The higher the individual nurse's level of education, the greater their ability to think, apply, and be creative in carrying out services to clients because they do not experience many difficulties, so the level of stress is reduced.Professionals with high levels of education have ideal hopes or ambitions, so when they are faced with the reality that there is a gap between their ambitions and reality, they will have anxiety and disappointment, which can lead to increased workload [13].The research results showed that there was an influence of caring education using booklets on nurses' knowledge in providing nursing care to patients in the Internal Medicine Ward of Ajibarang Regional Hospital, with a p value of 0.016 (p < 0.05).

CONCLUSION AND RECOMMENDATION
The average age is 35 years, the most dominant gender is female (53.1%), and the most dominant level of education is the profession of nurse (59.4%).Nurses' caring knowledge when providing nursing care to patients before caring training had an average value of 16.25.Meanwhile, after training, nurses' caring knowledge when providing nursing care to patients had an average score of 19.28.There is an influence of caring education using booklets on nurses' knowledge when providing nursing care to patients in the Internal Medicine Ward of Ajibarang Regional Hospital, with a p value of 0.016 (p < 0.05).

Table 1 .
Distribution of nurses' characteristics in providing nursing care to patients at Ajibarang Regional

Table 2 .
Distribution of nurses' caring knowledge in providing nursing care to patients before and after being given caring training at Ajibarang Hospital The research results showed that nurses' caring knowledge when providing nursing care to patients before being given caring training had an average value of 16.25 (sufficient category).Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/30234 A study was conducted to see the impact of caring knowledge training on the caring attitude of nurses when providing nursing care to patients.This study concluded that after training, the average value of nurse caring behavior increased to 19.28 from a maximum scale of 20, which indicates the category of nurse caring behavior as "good".

Table 3 .
Distribution of the influence of caring education using booklets on nurses' knowledge in providing nursing care to patients in the Internal Medicine Ward of Ajibarang Regional Hospital