The Effect of Anxiety on Student Nurses' Performance When Administering Intramuscular or

87 Pages·2017·1.85 MB·English

by  Sandra L. Osborne

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1992
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Sandra L. Osborne
Grand Valley State University
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Osborne, Sandra L., "The Effect of Anxiety on Student Nurses' Performance When Administering
Intramuscular or Subcutaneous Injections" (1992). Masters Theses. 96.
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THE EFFECT OF ANXIETY ON STUDENT NURSES' PERFORMANCE
WHEN ADMINISTERING INTRAMUSCULAR OR SUBCUTANEOUS
INJECTIONS
By
Sandra L. Osborne
A THESIS
Submitted to
Grand Valley State University
in partial fulfillment of the requirements for the
degree of
MASTER OF SCIENCE IN NURSING
Kirkhof School of Nursing
1992
Thesis Committee Members
Emily Droste-Bielak, R.N., Ph.D.
Donna Larson, R.N., Ph.D.
Richard Paschke, Ph.D.
ABSTRACT
THE EFFECT OF ANXIETY ON STUDENT NURSES' PERFORMANCE
WHEN ADMINISTERING
INTRAMUSCULAR OR SUBCUTANEOUS INJECTIONS
By
Sandra L. Osborne
The purpose of this study was to determine what the
relationship was between levels of trait and state anxiety
and performance when giving intramuscular or subcutaneous
injections. It was a replication of a study by Megal,
Wilken, and Volcek (1987).
In May, 1990, the STAI Form Y-2 was used to assess
trait anxiety of 17 students at a community college in the
Midwest. State anxiety was measured by using the STAI Form
Y-1 immediately before: 1) laboratory performance
examinations and 2) giving first injections to clients.
Instructors completed Injection Skill Check Lists to
measure performance.
Students reported high levels of anxiety. No
significant relationships were found between anxiety and:
1) performance scores, 2) age, or 3) length of time between
experiences. A significant difference between trait and
state anxiety scores was found. No significant difference
between instructors and state anxiety scores or performance
scores were revealed.
ii
This is dedicated to all nurse educators who facilitate the
teaching-learning process by treating each student as an
individual with unique learning needs.
Ill
Acknowledgements
I want to thank the chairperson of my committee. Dr.
Emily Droste-Bielak, R.N., Ph.D. who spent many hours
critiquing my endeavors and guiding me throughout the
research process. Appreciation is also extended to Dr.
Donna Larson, R.N. Ph.D. and Dr. Richard Paschke, Ph.D. who
willingly shared their time and expertise with me.
Throughout this lengthy experience, several collègues,
friends, and family members have been supportive along the
way. It seemed that whenever I began to falter, there was
always someone to give a little push and get me back on
track.
Finally, my deepest appreciation is extended to my
husband, Ozzie, and children, Joshua, Jeffrey, Joseph,
Jennifer, and Julia, who never lost faith in my ability to
complete this project. A very special thank-you to Joshua,
who climbed out of bed many nights to assist me with the
computer and to Ozzie, who encouraged me throughout this
endeavor.
IV
Table of Contents
List of Tables.......................................... vii
List of Appendices......................................viii
CHAPTER
1 INTRODUCTION.......................................1
2 LITERATURE AND CONCEPTUAL FRAMEWORK..............4
Review of Literature..........................4
Conceptual Framework ..................... 10
Research Questions...........................17
Definitions...................................18
3 METHODOLOGY............ 20
Design........................................20
Setting.......................................21
Sample........................................23
Instruments.................................. 24
Procedure.................................... 27
4 RESULTS.......................................... 31
Data Analysis................................ 31
Characteristics of the Subjects.............33
Research Question One....................... 33
Research Question Two....................... 34
Research Question Three.....................35
Research Question Four...................... 35
Research Question Five...................... 35
Research Question Six....................... 37
Research Question Seven.....................38
Other Findings............................... 38
5 DISCUSSION/LIMITATIONS/IMPLICATIONS.............. 44
Discussion........ 44
Limitations.................................. 53
Implications/Recommendations/Conclusion 56
References ............................................. 74
VI
List of Tables
Table 1 - Correlations Between Anxiety and
Performance Scores..............................34
Table 2 - Paired T-Test Analysis of Trait and State
Anxiety Scores................... 36
Table 3 - Analysis of Variance Between State
Anxiety and Instructor......................... 37
Table 4 - Instructor, Route, and Medication
Percentages.....................................39
Table 5 - Comparison of Medication Route with
State Anxiety and Performance Scores..........40
Table 6 - Item Analysis of Incorrect or
Omitted Behaviors...............................42
Table 7 - Analysis of Variance Between Performance
Scores and Instructor.......................... 43
VI1
List of Appendices
Appendix A - Injection Skill Check List..................59
Appendix B - Verbatim Instructions................ 62
Appendix C - Approval Form............ 66
Appendix D - Injection Skill Check Lists Results........ 68
Appendix E - Present Study State Anxiety and
Performance Scores Compared with
the Findings of Megal, Wilken, &
Volcek (1987)................................ 69
Appendix F - Performance Errors from Present Study
and Study by Megal, Wilken, & Volcek
1987)......................................... 70
Appendix G - Correlations of State Anxiety and
Performance Scores from Present Study
and Study by Megal, Wilken, & Volcek
(1987)........................................ 72
Appendix H - Correlations of Variables in the
Present Study and the Study by Megal,
Wilken, & Volcek (1987)...................... 73
Vila
CHAPTER ONE
INTRODUCTION
In order for educators to prepare graduates who can
perform competently as beginning practitioners, essential
technical skills must be learned. Thirty-three nursing
interventions were identified by the American Association of
Colleges of Nursing (1986) as being essential for a graduate
nurse to perform proficiently. Calculation of medication
dosage and administration of medications were two of these
skills. In a study by Sweeney, Regan, O'Malley, and
Hedstrom (1980), 91 essential skills were identified by both
nursing faculty and nursing service. Administration of an
injection was one of these skills. Keiffer (1984) found
that injections were rated in the top 25% of the most
frequent/most important nursing skills by nurses in 16
metropolitan hospitals.
Anxiety is an emotional response within a person to
real or imagined threats to one's security. It may be a
destructive or motivating force, and it affects one's
ability to learn. Optimal learning takes place when one is
mildly anxious (Campbell, 1985) and decreases in the
presence of high levels of anxiety (Spielberger, 1966) .