Survey of knowledge and attitude regarding induced abortion among nurses in a tertiary hospital in Thailand after amendment of the abortion act: a cross-sectional study

Abstract

Background The abortion act in Thailand is approximately 60 years old. However, because of increasing problems due to unsafe abortions, the act was recently amended to accord a legal status for abortions. In the southernmost provinces of Thailand, most people follow the Islamic faith, according to which induced abortion is a sin for both the providers and the pregnant women. This may affect the attitude of the medical staff, such as registered nurses, who play an important role in abortion services. Our study aims to evaluate the knowledge of the amended abortion act, attitude toward abortions and the intentions behind them, and willingness to perform abortions among registered nurses. Methods A cross-sectional study was conducted from January 2022 to February 2022 wherein a self-administrated questionnaire was electronically distributed to 450 registered nurses practicing at a tertiary hospital in the southernmost province of Thailand. Linear regression analysis and Fisher’s exact test were conducted to evaluate the association between basic characteristics, knowledge scores, and attitudes toward induced abortion. Results A total of 375 nurses (83.3%) completed the survey. Most participants were Muslim (58.9%), and 18.7% of them correctly answered > 80% of the knowledge questions. Among all the participants, 41.4% had a favorable attitude toward induced abortion, of which 21.3% were willing to provide safe abortion services. Knowledge scores were independently associated with practicing in obstetrics-gynecology departments and a lower age. Participants practicing Buddhism and having good knowledge scores tended to have favorable attitudes toward abortion. Conclusions Nurses in the southernmost province of Thailand lack knowledge regarding the amended abortion act and do not have a favorable moral attitude toward abortion. Favorable attitudes toward abortions, support toward intentions behind abortions, and a willingness to provide abortion services were all lesser among the Muslim participants than among the Buddhist participants. Compared with participants who scored lower, those with higher knowledge scores had a better moral attitude toward abortion and, in turn, demonstrated a greater intention to provide abortion services. Encouraging nurses to gain better knowledge may improve their attitude toward abortion, which may positively influence future medical practices.

Knowledge, Moral Attitude, and Practice of Nursing Students Toward Abortion

“…This version of the questionnaire was previously used in a study describing knowledge, attitude, and practice toward abortion in nurses. 10 …”

“…The modified version of the questionnaire was validated in a previous study; the internal consistency reliability Cronbach’s alpha coefficient was .70 and test-retest reliability was .90. 10 The knowledge part of the questionnaire consisted of 10 questions that were graded on a 3-point scale (agree, disagree, or unsure). Higher scores indicate better knowledge of abortion legislation and a score of >80% was considered good knowledge.…”

“…This version of the questionnaire was validated in a previous study; Cronbach’s alpha coefficient and test-retest reliability value were .8 and .9, respectively. 10 …”

“… 9 A previous study in Southern Thailand showed that while most nurses can identify conditions where abortion would be legal under the previous law, only a fifth were knowledgeable about the reformed, less restricted abortion law. 10 Religious context also plays a role as Muslim and Buddhist nurses have differing attitudes toward safe abortion care. 10 Other studies show that nursing students exhibit different attitudes toward learning about abortion care based on diverse societal backgrounds.…”

“… 10 Religious context also plays a role as Muslim and Buddhist nurses have differing attitudes toward safe abortion care. 10 Other studies show that nursing students exhibit different attitudes toward learning about abortion care based on diverse societal backgrounds. 11 Several misconceptions in abortion care still exists in Thailand both on the healthcare provider and patient side, including post-abortion contraception.…”