ATTITTUDE FORMATION AND NURSING
"Caring and science were traditionally taught as distinct
aspects of nursing practice. While caring, often regarded as the
art of nursing, science was look upon as having the rational basis.
New understandings of 'caring science', re-ignites connections
between science, art, values, and ethics" (Watson, 2005).
Health professionals need to understand and change their attitudes
and beliefs as it makes a significant contribution in determining
whether people will adopt healthy behaviours and how they will
respond to illness.
This paper outlines the development of self concept in nurses as
individuals, its subsequent relationship in the formation of
attitude and behaviours and processes in attitude change.
Identity and self conception
Development of the 'Self' is first and foremost linked to our
genes or dispositions like moods, personality, etc. But the actual
self or the 'identity of self' arises out of human interaction.
Mead (1934) says, "Self conception comes from seeing ourselves as
others see us."
It is fundamental for every human being to identify the self in
the context of the environment because knowing about oneself allows
understanding of what one should think and do just as knowing
others allows us predict what they think and what they do.
Fiske (2004) adds, "A person not only perceives people has having
spatial and physical properties, but also can grasp even such
intangibles as their wishes, needs, and emotions by some form of
immediate apprehension". Although people's perception of themselves
and others is immediate, it is in fact filtered through
psychological lens or perceiving apparatus. This makes them aware
only of the end product, their experience. In other words, the
actual reality is much vast than the reality perceived by a human
This perceived reality resulting from mediation of psychological
lens gives rise to what is called as an
Dual process model
Dual process model is based on the assumption that people employ
two modes of thinking. When people are alert and active, they apply
'systematic' mode and the other is called the 'heuristic' mode.
Heuristics are most likely to be used when people do not have time
to think carefully, are overloaded with information/ unimportant
information, have little knowledge or apply whatever comes quickly
to mind (Heuristic systematic model- Chaiken, 1993).
The dual process model may abstract, but it has everyday life
practical implications. For example, knowing that change in
attitude can be brought about by thinking systematically, the nurse
can observe such behaviours as alertness, thoughtfulness,
attentiveness in the patient and talk about behaviour change at
Given that humans have limited capacity to process information,
they attempt to adopt strategy that simplifies complex problems.
People develop attitudes and behaviours to ignore information and
reduce cognitive overload or overuse information at other times to
keep from having to search more. For this people are often willing
to accept less than perfect alternative. Similarly, attitude is
energy saving behaviour as people do not have to figure out from
the scratch how they should relate to the object or situation in
The strategies of the cognitive misers make fairly good use of the
limited cognitive capacity to process near infinite world of
information-but can lead to serious errors, biases and attitudes.
Any attempts to make changes in the biases or attitudes do not
necessarily change the behaviours. For example, people may have
positive attitude towards condom use but yet not used themselves.
Many smokers are well aware of the health risks of smoking yet do
not change their behaviour.
Thus research on attitude provides set of issues to be considered
when making attempts to change behaviour. But it needs to be
remembered that if attitude and behaviour change were easy, then
people would have very different social world with very different