Knowledge and awareness of nursing students on the use of nanotechnology in healthcare

Abstract

Objective

To determine nursing students’ awareness of nanotechnology usage in healthcare and to increase their sensitivity to the subject in the coming years.

Methods

This descriptive study was developed with 523 undergraduate nursing students. Data were collected using an online questionnaire between January and February 2018.

Results

The mean age of the students was 21.7 ± 3.9 years; 61.6% were female. According to 29.4% of students, nanotechnology should be used in medicine and for 38.0%, it should be especially used in the diagnosis-treatment of diseases and the production of new medical equipment. The highest percentage (38.8%) of students affirmed that time saving is the advantage of nanotechnology, while 39.1% mentioned its toxic effects as a disadvantage. Students also stated it should be used in the diagnosis and treatment of osteoporosis, cardiovascular diseases, diabetes mellitus, wound healing, and the production of new materials.

Conclusion

According to results of the study, students achieved the information about nanotechnology with their efforts. They thought nanotechnology should be used more in medicine, especially in the diagnosis-treatment of diseases and in the production of new medical equipment. They determined that time-saving and toxic effects are the top advantage and disadvantage of nanotechnology, respectively. We suggest the importance of including this technology in service training in hospitals and in curricula of faculties.

Nanotechnology; Healthcare; Students, nursing

Resumo

Objetivo

Verificar o conhecimento dos estudantes de enfermagem sobre o uso da nanotecnologia na área da saúde e aumentar sua sensibilidade para o assunto nos próximos anos.

Métodos

Estudo descritivo realizado com 523 estudantes de graduação em enfermagem. Os dados foram coletados por meio de um questionário online entre janeiro e fevereiro de 2018.

Resultados

A média de idade dos alunos foi de 21,7 ± 3,9 anos; 61,6% eram do sexo feminino. 29,4% afirmaram que a nanotecnologia deve ser utilizada na medicina, e 38,0% afirmaram que ela deve ser utilizada especialmente no diagnóstico, tratamento de doenças e na produção de novos equipamentos médicos. O maior percentual (38,8%) afirmou que a vantagem da nanotecnologia é a economia de tempo, enquanto 39,1% apontaram como desvantagem os seus efeitos tóxicos. Os alunos também afirmaram que ela deve ser utilizada no diagnóstico e tratamento de osteoporose, doenças cardiovasculares, diabetes mellitus, cicatrização de feridas e na produção de novos materiais.

Conclusão

De acordo com os resultados do estudo, os alunos chegaram às informações sobre nanotecnologia com seus esforços. Para os alunos, a nanotecnologia deveria ser mais utilizada na medicina, especialmente no diagnóstico-tratamento de doenças e na produção de novos equipamentos médicos. Eles determinaram a economia de tempo e os efeitos tóxicos como a principal vantagem e desvantagem da nanotecnologia, respectivamente. Sugerimos a importância de incluir esta tecnologia em treinamentos em hospitais e no currículo das faculdades.

Nanotecnologia; Atenção à saúde; Estudantes de enfermagem

Resumen

Objetivo

El objetivo de este estudio fue verificar el conocimiento de los estudiantes de enfermería sobre el uso de la nanotecnología en el área de la salud y aumentar su sensibilidad para el asunto en los próximos años.

Métodos

Estudio descriptivo realizado con 523 estudiantes universitarios de enfermería. Los datos fueron recopilados por medio de un cuestionario realizado en línea entre enero y febrero de 2018.

Resultados

La edad promedio de los alumnos fue de 21,7 ± 3,9; el 61,6 % era del sexo femenino. El 29,4 % de los alumnos afirmó que la nanotecnología debe ser utilizada en la medicina, mientras que el 38,0 % afirmó que debe ser especialmente utilizada en el diagnóstico, en el tratamiento de enfermedades y en la producción de nuevos equipos médicos. El mayor porcentaje (38,8 %) afirmó que la ventaja de la nanotecnología es el ahorro de tiempo, mientras que el 39,1 % afirmó que sus efectos tóxicos son una desventaja. Los alumnos también afirmaron que se debe utilizar en el diagnóstico y tratamiento de la osteoporosis, enfermedades cardiovasculares, diabetes mellitus, cicatrización de heridas y en la producción de nuevos materiales.

Conclusión

De acuerdo con los resultados del estudio, los alumnos llegaron a la información sobre nanotecnología mediante sus esfuerzos. Los alumnos consideraban que la nanotecnología debería ser más utilizada en la medicina. Expresaron que se debe usar especialmente en el diagnóstico-tratamiento de enfermedades y en la producción de nuevos equipos médicos. Determinaron las principales ventajas y desventajas de la nanotecnología, como el ahorro de tiempo y los efectos tóxicos, respectivamente. Sugerimos que es importante incluir esta tecnología en capacitaciones en servicio en hospitales y en diseños curriculares de las facultades.

Nanotecnología; Atención a la salud; Estudiantes de enfermería

Introduction

A nanometer is a unit of measure that represents one-billionth of a meter. Through the Nanotechnology discipline, it is possible to perform physical, chemical, and biological events at the nanometer scale and to build materials with new properties by intervening in the structure of matter at the atomic and molecular levels.(¹-⁴)

Nanotechnology is used in many areas such as diagnosis, treatment, prevention of tissue injuries, production of patient tracking devices, pain control, drug development, and drug delivery systems, protection and improvement of health, water decontamination, information, communication technologies, and production of light and durable materials. The importance of nanotechnology, which finds solutions to many problems in healthcare, continues to increase in parallel with the increase in its usage areas.(⁵-⁸)

Nanotechnology has a wide range of users all over the world, especially in the field of healthcare, and it brings significant benefits to nursing practices as a result of the increase in its use in medicine.(⁴,⁹,¹⁰) It is expected that bacteria and viruses will be detected faster and its control with appropriate treatment will be possible thanks to microchips developed in the field of microbiology. From patients’ perspective, unnecessary drug use can be prevented while from nursing’s perspective, unnecessary drug administration and invasive interventions can be avoided until the results are clear.(¹¹,¹²)

When using drugs produced with nanotechnology in the treatment, nano-sized capsules are developed to provide the desired effect on the target organ and tissue. There is no unnecessary dosage and drug use-related side effects, so nurses do not have to struggle with the related problems.(¹,¹⁰,¹³,¹⁴)Likewise, the problems that can be brought by invasive procedures and use of opioid analgesic will be prevented by relieving pain with topical applications in pain management.(⁴,¹⁰)

Nanotechnology is becoming a very effective method, especially in the prevention of infectious diseases. There is no space for the reproduction of microorganisms as a result of the use of silver powders in surface coatings. When the infection can be stopped, it significantly relieves the burden of nurses as it prevents nosocomial infections.(⁷,¹⁵) With the use of nanotechnology in cancer treatment, the negative side effects of chemotherapy can be prevented, and the elimination of such side effects facilitates the daily life of patients and the management of their treatment by nurses.(¹,¹²)

As nanotechnology is a new technology, there is need for information in terms of healthcare and nursing, as well as in other fields. The awareness of nanotechnology in nurses and other healthcare professionals should be increased, and studies on the knowledge level about nanotechnology are insufficient.(¹²)

This study was conducted to determine nursing students’ awareness of nanotechnology usage in healthcare.

Methods

The nursing students from the Near East University, Faculty of Nursing, Northern Cyprus constituted the universe of this descriptive study. In total, 523 first, second, third, and fourth-year students who voluntarily accepted to participate in the study were included. Data were collected using an online questionnaire between January and June 2018.

A questionnaire prepared by the researchers(⁴,¹²,¹⁶,¹⁷) was used in data collection. It consisted of two parts; the first part comprised questions on the characteristics of participants while the second part consisted of questions about their knowledge and opinions on nanotechnology. We also obtained the expert opinions from five faculty members, experts in the field, using the same questionnaire.

The statistical analysis of the data was conducted with the statistical package program SPSS 17.0 (SPSS Inc., Chicago, IL, USA). Mean, standard deviation, number, and percentage were calculated.

Approval by the ethics committee was obtained from the Research Ethics Committee of the University (YDU/2017/52-480); the required permission was also obtained from the dean of the nursing faculty. Students were informed about the study and gave their informed consent.

Results

The mean age of students was 21.7 ± 3.9 years; 61.6% were female; 40.0% graduated from regular high schools; 76.5% stated they were aware of nanotechnology; 45.0% knew the usage areas; 37.5% defined nanotechnology as biological methods and systems in nature. Only 21.4% of participants stated they received information on nanotechnology; 69.6% of them obtained this information from the internet; 29.0% stated that nanotechnology is used in medicine; 44.1% said nanotechnology should be used in the treatment of diseases and healthcare; 39.1% stated that nanotechnology should be used in the production of new drugs (Table 1).

Table 1
General characteristics

General characteristics	n(%)
Mean age 21.7±3.9
Gender Female Male	322(61.6) 201(38.4)
Alma mater (High school) Anatolian high school Regular high school Vocational high school Medical vocational high school Basic high school Other	207(39.6) 209(40.0) 14(2.7) 17(3.3) 10(1.9) 66(12.5)

For 38.8% of students, nanotechnology prevents the loss of time; 39.1% stated it may have toxic effects; 93.7% considered that nurses should know about nanotechnology; 47.0% stated that nanotechnology is used in pain management; 80.7% of them thought it is used in medical imaging; 75.1% considered it is used in diagnosis; 60.0% stated it is used in the treatment of viral diseases (Table 2).

Table 2
The knowledge level about nanotechnology

Characteristics	n(%)
Awareness of nanotechnology Know Not know	400(76.5) 123(23.5)
Knowledge level about nanotechnology Know its usage areas Know its harms Know its benefits	180(45.0) 155(38.7) 65(16.3)
Definition of nanotechnology according to students Biological methods in nature Small molecule technology Production technology based on molecular machine systems The way monomolecular components transform themselves into some useful form The way for transforming small components into more complex components Other	196(37.5) 133(25.4) 45(8.6) 29(5.5) 23(4.4) 97(18.6)
The status of receiving information about nanotechnology Yes No	112(21.4) 411(78.6)
Information source for nanotechnology (n=112) Internet Lessons Magazines Brochures Congress Other	78(69.6) 10(8.9) 4(3.6) 5(4.5) 6(5.4) 9(8.0)
Usage fields of nanotechnology Medicine Physics Chemistry Biology Pharmacy Engineering	154(29.4) 47(8.9) 24(4.6) 97(18.6) 125(23.9) 76(14.6)

In this study, 73.0% of students thought it should be used in cancer diagnosis methods; 69.2% stated it should be used in the treatment of cancer; 60.4% stated it should be used in the prevention of genetic diseases. Students affirmed they did not have information about the use of nanotechnology in the treatment of diabetes (45.9%), heart (48.0%), and osteoporosis (45.7%) as chronic diseases. They stated that nanotechnology should be used in wound healing (54.3%), infection prevention (55.8%), disinfection methods (62.3%), and sterilization (57.9%). Students mostly stated that nanotechnology should be used in the production of new materials used in medicine. These materials were considered as artificial red blood cells (42.3%), operating room materials (68.8%), dressing materials (56.6%), and gloves (45.9%) (Table 3).

Table 3
Students’ opinions on the use of nanotechnology in healthcare

Characteristics	n(%)
Healthcare fields in which nanotechnology is used* Treatment Diagnosis Production of medical materials Other Not know	233(44.5) 91(17.4) 117(22.4) 77(14.7) 5(1.0)
Special healthcare fields in which nanotechnology is used Cancer Microbiology Novel drug production Wound healing Other	127(24.2) 145(27.7) 205(39.1) 32(6.1) 14(2.6)
Benefits of nanotechnology Increase in quality of life Low cost job Production in high quantity Prevention of time loss Other	76(14.5) 87(16.6) 138(26.3) 203(38.8) 19(3.6)
Harms of nanotechnological products Possible toxic effects DNA damage Inflammatory effect Possible harmfulness to beneficial bacteria Possible harmfulness to organs Other	205(39.1) 126(24) 45(8.6) 23(4.3) 67(12.8) 57(10.8)
Nurses should have knowledge about nanotechnology Yes No Not know	490(93.7) 12(2.3) 21(4.0)
Nanotechnology is used in pain management Yes No Not know	246(47.0) 59(11.3) 217(41.7)
Nanotechnology is used in medical imaging. Yes No Not know	422(80.7) 19(3.6) 82(15.7)
Nanotechnology provides saving of time in diagnosis Yes No Not know	393(75.1) 39(7.5) 91(17.4)
Nanotechnology is used in the treatment of viral diseases Yes No Not know	314(60.0) 45(8.6) 164(31.4)
Nanotechnology is used in the diagnosis of cancer Yes No Not know	382(73.0) 39(7.5) 102(19.5)
Nanotechnology is used in the treatment of genetic diseases Yes No Not know	362(69.2) 128(16.3) 33(24.5)
Nanotechnology is used to prevent genetic diseases Yes No Not know	316(60.4) 60(11.5) 147(28.1)
It is used in the treatment of diabetes Yes No Not know	93(37.1) 190(17.0) 240(45.9)
It is used in the treatment of osteoporosis. Yes No Not know	222(42.4) 62(11.9) 239(45.7)
It is used in the treatment of cardiovascular diseases Yes No Not know	213(40.7) 59(11.3) 251(48.0)
It is used to stop bleeding Yes No Not know	210(40.2) 97(18.5) 216(41.3)
It is used in wound healing Yes No Not know	284(54.3) 69(13.2) 170(32.5)
It is used in infection prevention Yes No Not know	292(55.8) 66(12.7) 165(31.5)
It is used in sterilization Yes No Not know	326(62.3) 71(13.6) 126(24.1)
It is used in disinfection Yes No Not know	303(57.9) 68(13.0) 152(29.1)
It is used in artificial erythrocytes Yes No Not know	221(42.3) 50(9.5) 252(48.2)
It is used in surgical robots Yes No Not know	360(68.8) 51(9.8) 112(21.4)
It is used surgical textiles Yes No Not know	296(56.6) 78(14.9) 149(28.5)
It is used in surgical materials Yes No Not know	353(67.5) 47(9.0) 123(23.5)
It is used in medical gloves Yes No Not know	240(45.9) 94(18.0) 189(36.1)
It is used in medical dressing materials Yes No Not know	270(51.6) 74(14.2) 179(34.2)
It is used in urinary catheters Yes No Not know	254(48.6) 60(11.4) 209(40.0)
It is used in branules Yes No Not know	237(45.3) 66(12.6) 220(42.1)
It is used in orthopedic implants Yes No Not know	288(55.1) 57(10.9) 178(34.0)
It is used in dental implants Yes No Not know	297(56.8) 54(10.3) 172(32.9)
It is used in cardiovascular catheterization materials Yes No Not know	286(54.7) 41(7.8) 196(37.5)
It is used in plastic and reconstructive implants Yes No Not know	254(48.6) 56(10.7) 213(40.7)
It is used in medicines Yes No Not know	332(63.5) 54(10.3) 137(26.2)
It is used in insulin pumps Yes No Not know	231(44.2) 64(12.2) 228(43.6)
It is used in compression socks Yes No Not know	229(43.8) 66(12.6) 228(43.6)
It is used in mouthcare products Yes No Not know	227(43.4) 74(14.2) 222(42.4)

• *More than one choice was selected

Discussion

This study was conducted to gain a better understanding on the knowledge of students’ perceptions of the risks and benefits of nanotechnology applications. Nanotechnology has taken its place in the field of medicine, started to be developed and been used in a multidisciplinary approach. Nurses’ benefit from nanotechnological developments to provide safe, effective, and quality care to their patients.(¹⁰,¹²,¹⁶) In this study, the knowledge and opinions of nursing students about nanotechnology were evaluated and we found that only a small portion of students received information about nanotechnology from the internet. Sayılan and Mercan (2016) conducted a study on the knowledge level of nursing students in terms of nanotechnology. They stated that only a small number of students had received information and their source was the internet.(¹²) The concept of nanotechnology is not a term or concept that persons often encounter. As nanotechnology is a very new area, most people have only limited knowledge of this subject, except scientists in the field.(¹⁸-²⁴)The literature supports this finding of the study. Nursing students had a lack of knowledge on the subject.

For 29.4% of students, nanotechnology should be used in medicine. Pektas et al. (2015) investigated the opinions of student teachers on nanotechnology; the participating teachers had information that nanotechnology should be used first in medicine, and then in the textile field.(²⁵)In the studies of Sayılan and Mercan (2016), more than half of students stated that it should be used in medicine and healthcare.(¹²) The change in the preference of nanotechnology usage areas in the studies may be related to the specializations of participants.

The opinions of students regarding its use in healthcare were examined; 38.0% of them thought it should be used in diagnosis, treatment, and medical devices. Harman and Şeker (2018) reported that science teacher candidates agreed on its use in healthcare areas such as diagnosis, drug production, and operating rooms.(²⁶) The use of nanotechnology in the diagnosis and treatment of many chronic diseases is a totally novel approach. Now, it is more commonly thought to provide advantages in terms of treatment without damaging the target organ and surrounding tissues, fast diagnosis, and ease of use in pharmacology.(⁴,²²)

The students stated that nanotechnology should be used mostly in the production of new drugs, microbiology, and the diagnosis and treatment of cancer. Considering the literature, the most striking finding is the use of nanotechnology in healthcare. Nanotechnology is frequently used in medical imaging, pharmacology, microbiology, wound healing, tissue regeneration, treatment of some chronic diseases, vaccination, and genetics.(⁷,¹⁰) The benefits of new drug production, microbiology, and its use in the treatment of cancer in particular are often mentioned.(¹,³,⁷,²⁷)The fact that the students’ sources of information about nanotechnology were the internet and activities such as conferences shows their comprehensive knowledge of the literature.

According to results of the study, students mentioned that nanotechnology has benefits such as saving time in applications and being able to produce more. In the literature, opportunities such as low cost of nanotechnology, increase in the quality of life, and more production possibilities are mentioned.(²⁸-³⁰) Alpat et al. (2017) and Sahin & Ekli (2013) conducted studies to raise awareness of middle and high school students about nanotechnology; their findings support our results such as saving time and increasing the quality of life.(³¹,³²)

The risk perception of nanotechnology is limited but growing rapidly.(²²) Students’ opinions about the harms and benefits of nanotechnology were questioned, and they responded that nanotechnology may have toxic effects. Ateş and Üce (2017) investigated the awareness of nanotechnology in high school students, who mentioned that it provides a new competitive environment for countries in terms of its advantages but it may also harm other countries.(¹³)It was also mentioned that it may cause negative results such as its use in war technology. In the results of the study of Alpat et al. (2017), students stated that it may have chemical danger and unwanted harmful effects when used in the war sector. When people have more awareness of nanotechnology, they have more information about its benefits or harms. It is argued that this technology should be included in formal education to teach it more comprehensively as a technology of the future.(²⁶,³¹)

In our study, students supported the use of nanotechnology in the diagnosis and treatment of diseases with significant prevalence such as, viral diseases, diabetes mellitus, cancer, cardiovascular diseases, pain management, and wound healing. It is expected that nanotechnology will have an important place in the treatment of osteoporosis, diabetes, wound healing, and infectious diseases, and our study results are consistent with this expectation.(¹⁶,³³,³⁴) The adoption of these innovations in nursing will increase the quality of care and provide more patient care potential.(¹²)

The fact that participants of the study were composed solely of nursing faculty students of the university, without including students of other health fields, is considered as a limitation. As results are limited to the university where this study was conducted, they cannot be generalized to all universities.

Conclusion

We determined that a small part of participating students received information and accessed the information on the internet with their efforts. Students thought nanotechnology should be used more in medicine. They expressed that it should be used especially in the diagnosis and treatment of diseases and in the production of new medical devices. Most of them argued that time-saving is the most important benefit of nanotechnology, while its toxic effects are its most important harm. Students also stated that it should be used in the diagnosis and treatment of many diseases (osteoporosis, cardiovascular diseases, diabetes mellitus, etc.), wound healing, and the production of new materials. Nanotechnology related topics should be included in nursing curricula, address societal impacts and promote an understanding of particular risks and benefits involved in each application of nanotechnology. In addition, further studies on the use of products produced by nanotechnology and their benefits in terms of satisfaction should be conducted.

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Edited by

Associate Editor (Peer review process): Edvane Birelo Lopes De Domenico (https://orcid.org/0000-0001-7455-1727) Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Publication Dates

• Publication in this collection
  12 Dec 2022
• Date of issue
  2022

History

• Received
  16 May 2021
• Accepted
  11 Apr 2022