Introduction
It is essential for nursing science to make innovations in its field and reflect these innovations in its practices in order to enhance the quality of the service it provides in the field of health [1]. Innovation, innovativeness or producing something that does not yet exist with available resources is indispensable for the nursing profession. The concept of innovation can be defined as the change of the existing situation and the willingness to adopt this change in a rapid process [2].
Bricolage, as an extension of innovation, indicates creative and functional innovation by taking advantage of existing resources in cases where resources are limited. Bricolage was first defined by French Anthropologist Levi Strauss in 1966. According to this definition, it is explained as people making innovations by evaluating the resources they have [3]. Baker and Nelson defined bricolage as attempting to cope with new problems by integrating existing resources [4]. The ability of an individual to produce something new, to create a design that does not yet exist by using available resources in line with needs, facilitates the solution process of problems.
One’s innovative approach to events has been associated with organizational ethical climate perception, organizational support, quality expectation of care, cooperation, job satisfaction, professional competence, and general self-efficacy [5].
An individual’s self-efficacy, creativity and motivation are closely related to the innovation process. As a result, innovative behaviors are considered an important motivational factor [6].
Self-efficacy can be defined as the ability and competence to perform a task by adapting to existing conditions. At the same time, a person’s competence is closely related to their individual judgments [7]. Individuals with self-efficacy expect positive returns from the actions they take and easily display their innovative behavior in the next process [8]. Self-efficacy beliefs have an impact on a person’s decision to take action. Making an effort during action and struggling against difficulties are important factors that determine a person’s behavior. In this context, a person’s participation in innovative studies has a positive effect on the perception of self-efficacy and the development of this perception [9].
Based on all these reasons, it is very important for individuals to realize and develop their self-efficacy during the undergraduate education phase, where the foundation of the nursing profession is laid, and to be open to innovation in order to find solutions more easily in times of crisis. Obtaining new material by using existing situations and producing alternatives in patient care are indispensable for the nursing profession.
Aim of the work
In this study, which aims to evaluate the relationship between the concept of bricolage, which is still not very common today, and the self-efficacy of nursing students, answers to the following questions will be sought:
Material and methods
Type, place and time of research
This research was conducted according to an analytical, cross-sectional snowball (chain) sampling method and an online survey with undergraduate nursing students between October 1, 2022 and April 1, 2023.
Population and sample of the research
The research cohort consisted of students receiving undergraduate nursing education. The sample of the study was 103 nursing students who met the inclusion criteria.
Criteria for inclusion in the study:
Data collection tools
To collect the data, a “Personal Descriptive Form” prepared by scanning the literature, two sub-dimensions “General Self-Efficacy Scale” and “Bricolage Scale” were used.
Personal identifier form
Personal identifier form was created by researchers to determine the socio-demographic characteristics of nursing students. This area of the form includes questions about age, gender, place of residence, grade, high school graduated, feelings of suitability for the nursing profession, belief that the nursing profession is open to innovation, and familiarity with the term “bricolage” (Appendix).
General Self-Efficacy Scale
General Self-Efficacy Scale (Appendix), developed by Sherer et al., consists of 23 items [10]. The validity and reliability of the scale in Turkish was determined by Yıldırım and İlhan [11]. The scale consists of a two-factor structure: General Self-Efficacy and Social Self-Efficacy. Since the first factor of the scale does not fall into the field of specific behavior, the expression “General Self-Efficacy” was used. It refers to the Social Self-Efficacy factor since the social situations in the scale meet the sufficiency expectations. This scale, which was originally a 14-degree Likert type, was later converted to a 5-degree Likert type [12]. In this study, the question “To what extent does it describe you?” was answered on a 5-point Likert scale between “not at all” and “very well”. The answers to each question were created by the researchers to be scored between 1 and 5. Items 2, 4, 5, 6, 7, 10, 11, 12, 14, 16 and 17 in the scale are scored reversely. The total score of the scale ranges between 17-85; the higher the score, the stronger the self-efficacy belief. In this study, the Cronbach Alpha coefficient of the scale was found to be 0.898.
Bricolage Scale
The scale consisting of bricolage activities includes 8 items in total (Appendix). The scale questions are on a 5-point Likert type, including the options “I don’t know” and “always”. In this scale, which does not include reverse coding, the total score is between 0-40. The higher the score, the more the bricolage activities [13]. The Turkish validity and reliability of the Bricolage Scale developed in 2014 was conducted by Öztaş et al. in 2018 [14]. In Öztaş et al.’s study on the Turkish validity and reliability of the Briclage Scale, the Cronbach’s alpha value of the scale was found to be 0.90 [14]. In this study, the Cronbach Alpha coefficient of the scale was found to be 0.921.
Analysis of data
This snowball (chain) sampling type study was conducted online between October 1, 2022 and April 1, 2023. Research forms were given to students who met the inclusion criteria for the study. The forms were filled out online by the participants.
Evaluation of data
Analysis of data: 9 different statistical analyses, including frequency, percentage, Pearson Product Moment correlation analysis, Linear Linear Regression analysis, Durbin Watson test, t test, Mann Whitney U test, Kruskal Wallis H test and Cronbach Alpha analysis, were performed by computer using the SPSS 22.00 package program. When these analyzes were examined, the following results were obtained with Skownes-Kurtosis analysis. It was determined whether the data conformed to normal distribution. According to Skownes-Kurtosis values, being in the range between +1.96 and -1.96 is considered a normal distribution. The skewness and kurtosis values of the General Self-Efficacy Scale and Bricolage Scale variables were within the normal range. It can be said that all values of the scales show normal distribution. Since the findings of the study comply with normal distribution, parametric analyses were used in data with more than 30 groups.
Results
The distribution of the nursing students included in the research according to their descriptive characteristics is given in Table 1.
Table 1
Findings regarding the descriptive characteristics of the nursing students included in the research (n=103)
When the table is examined, 65% of the nursing students included in the study are women, 70.9% are 18- 21 years old, 46.6% live in a metropolitan city, 44.7% are in their first year, 68% are graduates of Anatolian high school, 88.3% feel suited to the nursing profession, 93.2% think that the nursing profession is open to innovation, and 97.1% had not heard of the term “bricolage” before (Table 1).
When the table is examined, the following mean scores may be observed: 32.93±7.27 for the initiation dimension, 17.79±3.87 for the persistence dimension, 9.85±2.51 for the maintenance effort persistence dimension, 60.57±11.61 for the General Self-Efficacy Scale, and 30.66±5.32 for the Bricolage Scale (Table 2).
Table 2
Arithmetic mean and standard deviation values for General Self-Efficacy Scale and Bricolage Scale scores
Significant positive relationships were found between the Bricolage Scale and the „Perseverance Dimension” and the „Persistence of Maintenance Effort Dimension” at a significance level of p<0.05. According to this result, it can be said that the higher the Bricolage Scale scores, the higher the “Persistence Dimension” and the “Maintenance Effort Persistence Dimension” too (Table 3).
Table 3
Correlation values between General Self-Efficacy Scale and Bricolage Scale scores
| Correlation values | Bricolage Scale | |
|---|---|---|
| Starting Size | r | 0.062 |
| p | 0.535 | |
| Perseverance Dimension | r | 0.303* |
| p | 0.002 | |
| Maintenance Effort Persistence Dimension | r | 0.203* |
| p | 0.040 | |
| General Self-Efficacy Scale | r | 0.184 |
| p | 0.064 | |
A Durbin-Watson (DW) test was performed to detect the presence of autocorrelation in the model. Since the DW value was close to 2 at 1.984, it was determined that there was no autocorrelation. For the multi-connection problem tolerance values were examined and it was seen that all tolerance values were greater than (1- R2). The analysis continued after it was clear that there were no autocorrelation and multicollinearity problems (Table 4).
Table 4
Linear regression analysis of the General Self-Efficacy Scale and the Bricolage Scale
As the table indicates, the variables of the “Initiation Dimension”, “Persistence Dimension”, “Maintenance Effort Persistence Dimension” and General Self-Efficacy Scale were compared with the Bricolage Scale. This gives a significant relationship with (R=0.348, R2=0.121, p<0.05). The variables of the “Initiation Dimension”, “Perseverance Dimension”, “Maintenance Effort Persistence Dimension” and General Self-Efficacy Scale explain 12% of the total variance of the Bricolage Scale. According to the standardized regression coefficient (β) and the predictor variable, bricolage in the “Perseverance Dimension” variable was found to be effective, the “Initiation Dimension”, “Maintenance Effort Persistence Dimension” and General Self-Efficacy Scale score variables were not found to be effective. When the t test results regarding the significance of the regression coefficients were examined, it was determined that only the “Perseverance Dimension” variable was significant on Bricolage (Table 4).
The t values of the difference between the nursing students’ scores in terms of the “Initiation Dimension”, “Persistence Dimension”, “Maintenance Effort Persistence Dimension”, General Self-Efficacy Scale and Bricolage Scale according to their gender were found to be insignificant at a significance level of p>0.05 (Table 5).
Table 5
Nursing students’ differences in General Self-Efficacy Scale and Bricolage Scale scores according to descriptive characteristics
The KW values of the difference between the scores of the nursing students in terms of their “Initiation Dimension”, “Persistence Dimension”, “Maintenance Effort Persistence Dimension”, General Self-Efficacy Scale and Bricolage Scale according to their ages, places of residence, grade level and the type of high school they graduated from were found to be insignificant at a significance level of p>0.05 (Table 5).
U values of the difference between nursing students in terms of their feeling of being suited to the nursing profession in terms of the “Initiation Dimension”, “Persistence Dimension”, “Maintenance Effort Persistence Dimension” and General Self-Efficacy Scale scores were found to be significant at a significance level of p<0.05. These findings show that there is a difference between nursing students in terms of their “Initiation Dimension”, “Persistence Dimension”, “Maintenance Effort Persistence Dimension”, and General Self-Efficacy Scale scores, depending on whether they feel suited to the nursing profession (Table 5).
It may be observed that the average scores of the nursing students who feel suited to the nursing profession are higher in the “Initiation Dimension”, “Persistence Dimension”, “Maintenance Effort Persistence Dimension”, and General Self-Efficacy Scale than for those who do not feel suited to the nursing profession (Table 5). As a result, it can be said that the general self-efficacy status of nursing students who feel suited to the nursing profession is better than those who feel unsuited.
The U values of the difference between the scores of the nursing students in terms of the “Initiation Dimension”, “Persistence Dimension”, “Maintenance Effort Persistence Dimension”, General Self-Efficacy Scale and Bricolage Scale, depending on whether they think that the nursing profession is open to innovation and whether they have heard the term “bricolage” before, were found to be insignificant at a significance level of p>0.05.
Discussion
In this study, which was conducted to evaluate the relationship between bricolage and self-efficacy in nursing students, 65% of students were female and 70.9% were between the ages of 18-21 (Table 1). In studies conducted on self-efficacy with nursing students, the majority of the students are female and in a similar age range [15-19]. The total score average of nursing students on the General Self-Efficacy Scale and its subscales is 60.57±11.61 (Table 2). The highest obtainable score on the scale is 85, which shows that students exhibit above-average general self-efficacy. Similar to this study findings, in a study conducted by Açıksöz et al. with nursing students, the students’ self-efficacy perception was found to be high [15]. In a study by Göger and Çevirme, examining the effect of self-efficacy level on educational stress in nursing students, the students’ self-efficacy total score average was found to be high at 61.46±11.94 [17]. An investigation of the literature also reveals studies that examine the self-efficacy levels of nursing students using different scales. In Bıyık Bayram’s study, the self-efficacy value of nursing students was determined to be at a medium level [16]. In a study by Çıtlık Sarıtaş et al., it was stated that the level of self-efficacy was high [20], and in a study by Dikmen et al., it was stated to be above the medium level [21]. The concept of self-efficacy, which is expressed as an individual’s belief in their competence in coping with difficult and stressful life situations [22], is important for nursing students who will work in a hospital environment and encounter different patient profiles to have this belief and to have high levels of self-efficacy.
The average score of the nursing students on the bricolage scale was determined as 30.66±5.32 (Table 2). Since a maximum of 40 points can be obtained with the researchers’ responses to the Bricolage Scale, it shows that the nursing students who participated in this study actively engage in bricolage. In the literature, there are mostly studies conducted with nurses practicing their profession. In the studies conducted by Ayhan and Yılmaz, Kronkoft et al. and Öztaş et al. the total score of the nurses’ bricolage scale was determined to be high [1,14,23]. Nursing students, who will be the health professionals of the future, adopt an innovative approach and use their current scientific knowledge and clinical experience. Performing bricolage activities using resources is important in terms of providing quality care.
Significant positive relationships were found between the Bricolage Scale and the General Self-Efficacy Scale sub-dimensions of the “Perseverance Dimension” and “Maintenance Effort Persistence Dimension” at a significance level of p<0.05. It was determined that the higher the Bricolage Scale scores, the higher the “Perseverance Dimension” and “Maintenance Effort Persistence Dimension” scores too (Table 3). Bandura claims that self-efficacy, which is cognitive in nature, means being open to changes in the future [24]. The nursing profession, as a scientific discipline, attracts students who will take on new roles and form innovative perspectives as they practice the profession, thanks to increasing knowledge and developing technology. It can be said that the implementation of the concept of bricolage, which is referred to as combining the existing resources with the power of creativity, when the available resources are limited, also positively affects self-efficacy.
No significant difference was observed between the gender of nursing students and their Bricolage Scale (Table 5). Studies have been conducted with nurses showing that the average bricolage score is higher in male nurses [23] or female nurses [25]. When the average scores of the General Self-Efficacy Scale obtained according to the gender of the students in our study are examined, the difference between the scores is not statistically significant (Table 5). In a study by Dikmen et al., it was stated that the self-efficacy scores of female students were higher than those of male students [21]. In a study conducted by Zhang et al., the self-efficacy level of male nursing students was determined to be higher than female students. When we examine the literature, there are many studies with findings similar to ours. In research conducted by Pozam and Zaybak, examining the self- efficacy of nursing students regarding their clinical performance, no significant difference was found between the self-efficacy score averages according to gender [18]. In a study by Abdal et al., it was stated that there was no relationship between self-efficacy scores and gender [26]. In research conducted by Albagawi et al., Okçin and Gerçeklioğlu, Kızılcı et al. and Bilgiç et al., there is no significant difference between self-efficacy level and gender [27-30]. This situation can be explained by the fact that, although the nursing profession is associated with the female gender, there are also male nurses in the nursing profession and male students embrace the profession as much as female students.
A non-significant relationship was found between the Self-Efficacy Scale and the Bricolage Scale according to the students› grade levels (Table 5). In a study by Karadağ et al., the mean self-efficacy score of first-year nursing students was found to be higher than that of fourth-year nursing students [31]. In research conducted by Sevindik et al., it was determined that the self-efficacy score average of 4th grade students was higher than that of 1st grade students [32]. In a study by Koraş Sözen et al., the self-efficacy total score averages of 1st and 2nd grade students were found to be statistically higher than the 3rd and 4th grade students› average scores [33]. In research conducted by Çıtlık Sarıtaş et al., no statistically significant difference was found in the self-efficacy total score averages of nursing students according to grades [20]. Studies conducted with different student groups also state that there is no significant difference between grades [28,34,35]. It is thought that the difference in the study results arises from the education model in the schools, cultural differences, sociodemographic characteristics and experiences of the students.
According to our study results, it was determined that the general self-efficacy status of nursing students who felt suited to the nursing profession was better than those who did not feel suited to the nursing profession (Table 5). In a study by Açıksöz et al., it was stated that there was a significant difference between the Self- Efficacy Scale average scores of nursing students in terms of whether they felt suited to the profession [15]. In similar studies conducted with students, the average self-efficacy score of students who voluntarily chose their department was found to be high [20,21,28,36]. It can be said that students› own willing choice to study a profession that suits them has a positive impact on self-efficacy.
Conclusions
No publications have been found in which the Bricolage Scale was used in relation to nursing students. We are of the opinion that nurses and nursing students can work together on bricolage applications in the clinical field, so that the students can become solution-oriented professionals while still at the undergraduate stage. Accordingly, it can be expected that nursing students’ self-confidence and sense of professional belonging will increase, and the position of nurses in the healthcare team will be strengthened.
In line with the findings obtained as a result of the research:
theoretical knowledge can be supplemented at school by adding the concept of bricolage to the nursing curriculum;
the concept of bricolage and field applications can be disseminated by organizing in-service training, courses, seminars and congresses;
in order to develop these practices, identification of clinical needs and search for solutions can be supported by nursing research;
introducing the concept of bricolage to the health literature, especially when performed by nurses, will strengthen the scientific aspect of the profession.
Our study is a pioneer for future research in the field of nursing. We strongly believe that it will contribute to the existing literature and raise awareness about the integration of bricolage into work areas within the scope of an innovative approach.
