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             \author[1]{Gerezgiher Buruh  Abera}

             \author[2]{Zaid Tadesse  Gebrezgabher}

             \affil[1]{  Mekelle University}

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\date{\small \em Received: 7 December 2016 Accepted: 4 January 2017 Published: 15 January 2017}

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\begin{abstract}
        


 Background:  In health related areas it is clear that there are different perceptions of nursing. Perception by itself is merely defied as an idea, belief, or an image you have as a result of how you see or understand something. The Perception of nursing may vary depending on age, educational level, social and professional experience.Objective: To assess Nurses' knowledge and Attitude towards Nurses Profession in public hospitals in Mekelle Town, Tigray, Ethiopia.Methods: Institution based cross sectional study design was conducted used to assess knowledge and attitude of nurses towards the nursing profession. Sample size was calculated using a formula for estimating a single population proportion. Accordingly, sample sizewas 135. The dependent variable was attitude of nurses. Simple random sampling techniques were used to select the desired institutions and population proportion to size allocation was done to select the intended study subjects. Data was collected by 10 professional nurses for 1 week using structured self administer questionnaire. Data was entered and analyzed using SPSS version 16.

\end{abstract}


\keywords{nurse, public hospitals, nursing profession.}

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\let\tabcellsep& 	 	 		 
\section[{a) Background}]{a) Background}\par
Whatever notion or idea best describes nursing and whatever set of activities it is defined, it is clear that there are different perceptions of nursing. Perception by itself is merely defied as an idea, belief, or an image you have as a result of how you see or understand something \hyperref[b2]{(3)}. More importantly, Perception of nursing may vary depending on age, educational level, social and professional experience and occupational and social factors. My personal and professional experiences have revealed that there are different angles in which people perceive nursing. Some assume nursing as if "it is a vocation and doesn't have its code of ethics" others consider it as "it is only for females" and most assume nursing as "it is only concerned with bed making". The question is how people really perceive nursing particularly the actual perception among professional nurses. The study conducted in UK and Spain by involving nurses, nursing students, patients and non nursing students have revealed that the perception of nursing across all participating groups is largely the same and some changes in the perception of nursing takes place in nursing students. This means, the important Objective: To assess Nurses' knowledge and Attitude towards Nurses Profession in public hospitals in Mekelle Town, Tigray, Ethiopia.\par
Methods: Institution based cross sectional study design was conducted used to assess knowledge and attitude of nurses towards the nursing profession. Sample size was calculated using a formula for estimating a single population proportion. Accordingly, sample size was 135. The dependent variable was attitude of nurses. Simple random sampling techniques were used to select the desired institutions and population proportion to size allocation was done to select the intended study subjects. Data was collected by 10 professional nurses for 1 week using structured self administer questionnaire. Data was entered and analyzed using SPSS version 16.\par
Result: According to the findings 135 nurses were participated with a response rate of 92\%. Accordingly, socio-demographic characteristics, more than half, 75(55.5\%) of the respondents were females. About 48(35.6\%) of the respondents age lies 36-40. Nearly half, 112(81.7\%) of the respondents were married and the majority of the respondents, 117(86.6\%) were orthodox followers. About 67(\%) of the respondents were diploma graduates in Nursing. Fifty six of them get monthly salary of 774-1644 ETB. The majority, 117 (86.6\%\%) of the respondents primary work place were government hospitals and 86 of them had more than ten years of work experience. Out of 135 nurses, 124 (91.8\%) of them had a favorable attitude for nursing profession. Majority of them, 99 (73.3\%) have good knowledge towards nursing profession. 
\section[{Conclusion and recommendation:}]{Conclusion and recommendation:}\par
Majority of the respondents like and had a favorable attitude towards nursing profession. Majority of them also have good knowledge towards nursing profession. Regional health beuro need to provide training for nurses to increase knowledge and change attitude of nurses. he definition of Nursing defers from theory to other theory so is not an easy activity to define, but effort has been made by many scholars and health organizations to define it. Among those definitions Virginia Handerson's definition of nursing is more elaborated definition. Virginia Handerson defined Nursing practice as the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge, and to do this in such a way as to help him to gain independence as rapidly as possible \hyperref[b0]{(1)}. The other known definition of nursing is by American Nurses Association (ANA), Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in health care for individuals, families, communities, and populations \hyperref[b1]{(2)}. aspects of nursing are perceived more coherently by all the participant groups in the present study as evidenced by the derivation of an internally consistent factor (Factor 1: Important aspects of nursing) from all participant groups.\par
The second factor (Factor 2: Unimportant aspects of nursing) was not as clearly perceived and was only internally consistent for the diabetic outpatients. This suggests that there may be some difference in the perception of nursing by the diabetic outpatients from the other participant groups. They used the 35-item Nursing Dimensions Inventory (NDI-35) stem questions to gather perception of UK nursing students throughout their education program, qualified UK nurses and Diabetic out patients \hyperref[b3]{(4)}. Generally Nurses are well thought of by the public, and their image is very positive. In a Harris poll taken in July 1999, more than 1,000 people were surveyed about their attitudes toward nursing. The poll showed that 92\% of those polled trust information about health care that provided by RNs and 85\% would be pleased if their son or daughter became a RN. If we seriously entertain the views of people outside the field of nursing, we can decide collectively on an agenda that will put the best possible public face on nursing. It is important that we do this because nurses are the health care providers involved with the patient throughout the care continuum they manage the journey of patients under their care on a daily basis \hyperref[b4]{(5)}.\par
By other study it has also been demonstrated that unless public misconceptions of the nursing profession are not corrected nursing schools continue attract some students who do not have the academic and technical aptitudes to meet the nursing education requirement and unless staff nurses and other stakeholders work together to address the critical issue the goal of reducing the nursing shortage through recruitment and retention will remain a distant one \hyperref[b5]{(6)}.\par
Authors from various fields since Abraham Flexner (1910) have provided different perspectives on what professionalism means, including knowledge based on scientific principles, accountability, autonomy, inquiry, collegiality, collaboration, innovation, ethics and values \hyperref[b6]{(7)}.\par
Since Florence Nightingale published her 19thcentury book "Notes on Nursing," the nursing profession has developed from a low-paying, undesirable career into a highly acclaimed and respected profession. According to the American Nurses Association (ANA), professional nursing excellence centers on prevention of illness, alleviation of suffering, diagnosis, treatment and advocacy in the care of persons, families and communities. 
\section[{Professional Development}]{Professional Development}\par
Nursing is a challenging profession that tends to attract self-motivated, lifelong learners. A nurse's education never ends, because of the need to stay in progress on health care issues and changes in medical theory and practice \hyperref[b7]{(8)}. 
\section[{b) Statement of the Problem}]{b) Statement of the Problem}\par
Since the development of Florence Nightingale, each generation of nurses, in its own way, has fostered the movement to professionalize the image of nurses and nursing. The struggle to change the status of nurses from that of female domestic servants to one of high-level health care providers has been a primary goal of nursing's leaders for many years \hyperref[b8]{(9)}.\par
Researchers have revealed a number of negative societal perceptions of nursing related to gender stereotyping, subordination to doctors, low academic standards, limited career opportunities and poor pay and conditions, and importantly how these perceptions may affect levels of recruitment into nursing. Focusing specifically on nurses, research has also considered the extent to which these societal perceptions are realities in their workplaces, and the direct experiences that contribute to attrition from both nursing courses and jobs. However, to date, little research has actually bridged the above approaches and considered the perceptions that nurses \hyperref[b5]{(6)}.\par
In addressing the negative images of nursing, directors of nursing must develop strategies to at a local level before launching any national campaign to improve nurses' image. But the pilots have indicated the need to improve nurses' sense of their own work first \hyperref[b9]{(10)}.\par
How individuals perceive themselves and how they are perceived by others are an important part of the relationships between maternal health educators, nurses, other health-care providers, and the families they serve \hyperref[b10]{(11)}. A study conducted on the professional self-image, nurses employed in 22 Belgian general hospitals with the goal of identifying problems affecting recruitment and retention. Nurses reported having a positive self-image. Most were proud to be a nurse and considered themselves as competent health professionals and having great responsibility \hyperref[b11]{(12)}.\par
This area of study, Perception of nursing, has not been researched in developing countries. Thus, it is high time to carry out scientific inquiry to have new insight in Sub Saharan Countries such as Ethiopia where perception is remarkably affected by many social, economical, cultural and spiritual factors. Hopefully the finding of this research will fill the existing knowledge gap and contribute to educators and policy makers for creation of better awareness among the wider community. Though the perception of nursing could have impact on the coordinated work of the health care providers this study will focus only on the knowledge and attitude of nursing nurses towards nursing profession. Assessing knowledge and attitude of nurses to their profession may indirectly assess their motivation and deviation to give a service for the entire beneficiary.\par
This study have an expected input for any health professionals especially for nurses. Besides In the age of technological advances and economical complexes to health profession it is necessary to assess the perception of nurses to their protection. More ever this study has importance for patients, and the community at large in which they all are service takers in which it may be influenced by nursing professionals. It may also have significant input for policy makers and researchers in which may be used as base line data. 
\section[{II.}]{II.} 
\section[{Chapter two -Methods and Materials}]{Chapter two -Methods and Materials}\par
An institution based cross-sectional study was conducted from May to December 2016. There are four governmental hospitals in Mekelle. Two of them are under RHB (Quiha and Mekelle hospital), one under the ministry of defense (North command referral hospital), one referral hospital (Ayder referral hospital). There are also four other private hospitals in the town. In addition there are eight health centers and 38 private clinics in Mekelle (35).\par
The source of population was all nurses who are working under Public hospitals in Mekelle town and a sampled eligible nurse with six months and above work experience in their respective public hospitals. The sample size has determined using a formula of single population proportion. Prevalence was taken as 56 \% n = (Z ?/2 ) 2 p (1-p) d2 n = (1.96) 2 x 0.56(1 -0.56 Since the study population was less than 10,000 finite population correction formulas was applied:\par
)/(0.05) 2 =378 nf = 1+ (n/N) n nf = 1+ (378/220) 378 nf = 140 Adding 5\% non response rate, the total sample size required for this study appears to be 147 nurses. 
\section[{Data collection techniques, Instrument}]{Data collection techniques, Instrument}\par
This study was conducted using a structured, quantitative self administered questioner among public hospital in Mekelle town. A structured questionnaire has designed by reviewing previous similar studies in such a way that consists all the variables that can meet the objectives of the study. It includes all questions related to knowledge and attitude. The questionnaire was translated into Amharic language. The data was collected by 10 professional nurses with good data collection experience; two supervisors were selected from the group members. The data collectors were not staff members of the participants to ensure confidentiality. The supervisors was strictly followed the overall activities on daily base to ensure the completeness of the questionnaire, to give further clarification and support for data collectors. Training was given to data collectors for three days. In the training session, the data collectors were oriented on the objectives of the study, how to collect data and confidentiality of information was obtained. All the collected data were checked for completeness, accuracy and consistency by the principal investigators and supervisors. Five percent of the questionnaires were pre-tested at Wukro hospital for individual nurses with the same criteria and necessary corrections was done accordingly. 
\section[{Study variables Dependent variables: Attitude of nurses Independent variables}]{Study variables Dependent variables: Attitude of nurses Independent variables}\par
? Socio demographic factor: Sex, Age, Marital status, Religion, Profession ? Individual Factor : Knowledge , previous experience, training, work experience 
\section[{Data processing and analysis}]{Data processing and analysis}\par
The data was checked in the field to ensure that all the information if properly collected and recorded. Before and during data processing the information was checked for its completeness. Data was analyzed using scientific calculator. All data was coded in terms of numbers. The collected data was summarized and presented using measure tables and charts, all of which are instruments for interpretation of the collected data.\par
To assess attitude of nurses towards nursing profession was developed by presenting respondents with a series of negative and positive statements that reflect different aspects of the underlying attitude in a variety of ways. Attitude statements have five possible responses. The responses was labeled as "favorable" or "unfavorable" as follows; "favorable" responses were responses including strongly agreeing and agree for positive statements and strongly disagree, disagree for negative statements. "Unfavorable" responses' are responses including "strongly agree", "Agree" and uncertain for negative statements, and disagree, strongly disagree and uncertain for positive statements. Marking the total attitude score out of hundred, those K with scores of greater than 50\% was rated to have favorable attitude and those with a score below 50\% as unfavorable attitude.\par
Knowledge of the respondents towards safe abortion was measured by marking the correct answers of subjects out of a hundred. Knowledge scores 50\% or less was labeled as "poor knowledge", knowledge scores between 50\% and 70\% was labeled as moderate knowledge" and knowledge score above 70\% was labeled as "good knowledge" (37). 
\section[{Ethical Considerations}]{Ethical Considerations}\par
The study proposal was approved by the ethical clearance committee of Sheba University College. Written permission of these hospitals was secured for their employees to participate in the study and; each nurse within these hospitals was given a written consent to participate in the study after a thorough explanation of the objectives and the procedures of the study. Specifically, respondents was informed about the objectives of the study and that their participation be purely voluntary and they can be free to decline or withdraw at any time during the course of the study. So only those willing to participate were included in the study. Confidentiality was insured by making the questionnaires anonymous. Personal identification of the respondents was not asked. They were also assured that the information provided in writing would be used only for research purpose and would therefore be strictly anonymous. 
\section[{III.}]{III.}\par
Chapter Three: Result a) Socio -Demographic Characteristics About 147 self administered questionnaire were prepared to be distributed into respondents of all public hospitals in Mekelle town. About 135 of nurses were participated with a total response of 92\%.\par
According to the findings of socio-demographic characteristics, more than half, 75(55.5\%) of the respondents were females. About 48(35.6\%) of the respondents age lies 36-40. Nearly half, 112(81.7\%) of the respondents were married and the majority of the respondents, 117(86.6\%) were orthodox followers. About 67(\%) of the respondents were diploma graduates in Nursing. Fifty six of them they get monthly salary about 774-1644 ETB. The majority, 117 (\%) of the respondents primary work place were government hospitals and 86 (\%) of the respondents had more than ten years of work experience (Table  {\ref 1}). IV.\par
Chapter Four: Discusstion\par
In this study about 135 of nurses were participated with main purpose assessing nurse's attitude towards nursing profession at public hospitals, in Mekelle town.\par
According to the results that were trying to assess the attitude of nurses towards nursing profession, majority of the respondents 91.8\% had a favorable attitude. This result is high when we compare to a study done at Addis ababa in which about 56\% of the respondents have positive perception for nursing profession. This gap may be due to although respondents on both studies have same salary but there is a big gap on their daily personal expenses that is high expense for living in Addis compare to Mekelle. So it is difficult to live with this professions salary in which this resone may indirectly affect their attitude towards their profession.\par
Majority of the respondents 106 (78.5\%) like nursing profession. About 40 (29.6\%) of the respondents didn't like their profession due to low payment compare to their efforts, bad administrative system in the environment they work with, due to it has not grantee and work over load 19(14.1\%), 5(3.7\%), 3(2.2\%), 2(1.5\%) respectively. Majority of the respondents, 99 (73.3\%) have good knowledge towards nursing profession.\par
V. 
\section[{CHAPTER FIVE CONCLUSION AND RECOMMENDATION}]{CHAPTER FIVE CONCLUSION AND RECOMMENDATION}\par
? Majority of the respondents had a favorable attitude towards nursing profession ? Of those didn't like their profession due to low payment compare to their efforts and bad administrative system in the environment they work with, due to it has not grantee and work over load were the main reasons they hate their work 
\section[{Recommendation}]{Recommendation}\par
According to the conclusions the following recommendations are drown Regional government need to provide training for nurses to have consistent good knowledge for their profession. ABBRIVATION AND ACRONYMS ANA American nursing association CI confidence interval P Prevalence PI Principal investigator UK United kingdom WHO World health organization \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{}
\end{longtable} \par
 
\caption{\label{tab_0}}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{-} \par 
\begin{longtable}{P{0.677544704264099\textwidth}P{0.12744154057771664\textwidth}P{0.008768913342503439\textwidth}P{0.030983493810178817\textwidth}P{0.005261348005502063\textwidth}}
Primary work place of the respondents\tabcellsep \tabcellsep \\
1. Governmental Hospital\tabcellsep \tabcellsep 117\tabcellsep 86.6\\
2. Private hospital\tabcellsep \tabcellsep 1\tabcellsep .7\\
3. Governmental health center\tabcellsep \tabcellsep 13\tabcellsep 9.6\\
4. Private higher clinic\tabcellsep \tabcellsep 1\tabcellsep .7\\
Current work place\tabcellsep \tabcellsep \\
1. Mekelle hospital\tabcellsep \tabcellsep 54\tabcellsep 40\\
2. Queha hospital\tabcellsep \tabcellsep 38\tabcellsep 28.1\\
\multicolumn{2}{l}{3. North command referral hospital}\tabcellsep 43\tabcellsep 31.8\\
b) Nurses attitude towards nursing profession As shown below, out of the 135 nurses, 124 (91.8\%) of them had a favorable attitude for nursing\tabcellsep \multicolumn{3}{l}{the respondents, 95 (70.3\%) like nursing profession. About 40 (29.6\%) of the respondents didn't like their profession due to low payment compare to their efforts,}\tabcellsep Year 2017\\
profession [Fig. 3].\tabcellsep \multicolumn{3}{l}{bad administrative system in the environment they work}\\
\multicolumn{4}{l}{Variable Sex of the respondent Female Male Age category 20-25 26-30 31-35 36-40 41-45 46-50 >50 Marital status of the respondent Married Divorced Cohabiting Widowed Single Religion of the respondent Orthodox Muslim Protestant Work experience of the respondent (in years) 6 month -1year 1-3 3-5 5-10 good knowledge towards nursing profession Majority of with, due to it has not grantee and work over load Frequency Percent 75 60 55.5 44.5 6 10 15 48 37 15 4 4.4 7.4 11.1 35.6 27.5 11.1 2.9 112 4 1 4 16 81.7 2.9 0.7 2.9 11.8 117 15 3 86.6 11.1 2.2 7 18 11 11 5.18 13.3 8.1 8.1 Volume XVII Issue 1 Version I ( D D D D ) K c) Knowledge and feeling for nursing profession Majority of the respondents, 99 (73.3\%) have 19(14\%),5(3.7\%),3(2.2\%),2(1.5\%) respectively (table 3).}\\
>10\tabcellsep \tabcellsep 86\\
\tabcellsep \tabcellsep \tabcellsep © 2017 Global Journals Inc. (US)\end{longtable} \par
 
\caption{\label{tab_1}Table - 1}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{-} \par 
\begin{longtable}{P{0.6435714285714286\textwidth}P{0.08803571428571429\textwidth}P{0.11839285714285715\textwidth}}
Do you like your nursing profession\tabcellsep frequency\tabcellsep Percent\\
Yes\tabcellsep 106\tabcellsep 78.5\\
No due to low payment\tabcellsep 19\tabcellsep 14.1\\
No due to work overload\tabcellsep 2\tabcellsep 1.5\\
No due to bad administrative system\tabcellsep 5\tabcellsep 3.7\\
No due to it has not guarantee\tabcellsep 3\tabcellsep 2.2\\
Total\tabcellsep 135\tabcellsep 100\\
Knowledge\tabcellsep \tabcellsep \\
Poor knowledge\tabcellsep 13\tabcellsep 9.7\\
Moderate knowledge\tabcellsep 23\tabcellsep 17\\
Good knowledge\tabcellsep 99\tabcellsep 73.3\\
Total\tabcellsep 135\tabcellsep 100\end{longtable} \par
 
\caption{\label{tab_2}Table - 3}\end{figure}
 			\footnote{© 2017 Global Journals Inc. (US)} 		 		\backmatter  			  				\begin{bibitemlist}{1}
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