ASSESSMENT OF NURSE-PATIENT RELATIONSHIP AND ITS IMPACT ON PATIENT CARE IN SPECIALIST HOSPITAL IN MAIDUGURI
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Abstract
This study was based on an assessment of nurse-patient relationship and its impact on patient care using specialist hospital in Maiduguri as a case study. The study’s population included all nurses and patients at specialist hospital in Maiduguri. For the study, a random chance sampling technique was employed to sample 83 people, including 68 patients and 15 nurses. To gain in-depth understanding, a case study sample design was adopted. Data was acquired utilizing questionnaires and observation as data collection strategies. The findings indicated the impact of nurses’ and patients’ socio-demographic variables on the caring and curing connection. There was no significant association found between the demographic characteristics of nurses and the type of contact they provide. However, several variables, particularly patient sex, indicated a considerable influence on their interaction with nurses. The study found that female patients cooperate more and pay more attention to nurse instructions than male patients. The research discovered three types of nurse-patient partnerships. There were three types of nurse-patient relationships revealed: positive relationships, bad relationships, and over-involved relationships. Negative nurse-patient relationships have been shown to slowly kill patients, deteriorate patients’ physical, psychological, and emotional states (depression, anxiety, and stress), and worsen patients’ adjustment to illness, whereas positive nurse-patient relationships have been shown to ensure greater adherence to treatment, increase patients’ recovery rate, improve patients’ satisfaction, and ensure patients’ sense of safety and protection. According to the study’s findings, it is advised that the hospital setting not be overly professional, with everything being done in a formal manner. As a result, the environment should be casual in order to put the patients at ease. This will relieve any undue stress that could aggravate their disease.
TABLE OF CONTENTS
DECLARATION…………………………………………………………………………………………………………….. i
DEDICATION………………………………………………………………………………………………………………. ii
ACKNOWLEDGEMENT……………………………………………………………………………………………… iii
ABSTRACT………………………………………………………………………………………………………………….. iv
TABLE OF CONTENTS………………………………………………………………………………………………… v
LIST OF TABLES…………………………………………………………………………………………………………. ix
CHAPTER ONE…………………………………………………………………………………………………………… 1
INTRODUCTION………………………………………………………………………………………………………….. 1
- BACKGROUND OF THE STUDY……………………………………………………………………………. 1
- STATEMENT OF THE PROBLEM……………………………………………………………………………. 2
- OBJECTIVES OF THE STUDY………………………………………………………………………………… 3
- RESEARCH QUESTIONS………………………………………………………………………………………… 3
- SIGNIFICANCE OF THE STUDY……………………………………………………………………………. 3
- SCOPE OF THE STUDY…………………………………………………………………………………………… 4
- DEFINITIONS OF CONCEPTS………………………………………………………………………………… 4
- STUDY METHODOLOGY……………………………………………………………………………………….. 5
- Research Design…………………………………………………………………………………………………… 5
- Sources of Data……………………………………………………………………………………………………. 6
- Primary Data……………………………………………………………………………………………………….. 6
- Secondary Data……………………………………………………………………………………………………. 6
- Study Population………………………………………………………………………………………………….. 6
- Sample Size…………………………………………………………………………………………………………. 7
- Sampling Procedure……………………………………………………………………………………………… 7
- Data Collection Method……………………………………………………………………………………….. 8
- Data Analysis………………………………………………………………………………………………………. 9
- ETHICAL CONSIDERATION………………………………………………………………………………….. 9
- LIMITATION OF THE STUDY…………………………………………………………………………….. 10
- ORGANISATION OF THE STUDY………………………………………………………………………. 10
CHAPTER TWO………………………………………………………………………………………………………… 12
LITERATURE REVIEW………………………………………………………………………………………………. 12
- INTRODUCTION…………………………………………………………………………………………………… 12
- CONCEPT OF NURSE-PATIENT RELATIONSHIP………………………………………………… 12
- COMPONENTS OF THERAPEUTIC NURSE-PATIENT RELATIONSHIP………………. 15
- TYPES OF RELATIONSHIP…………………………………………………………………………………… 20
- EFFECT OF NURSE-PATIENT RELATIONSHIP ON PATIENT……………………………… 22
- PATIENT‟S PERCEPTION OF NURSE-PATIENT RELATIONSHIP……………………….. 23
- DISCUSSION………………………………………………………………………………………………………… 24
- THEORETICAL PERSPECTIVE…………………………………………………………………………….. 28
CHAPTHER THREE………………………………………………………………………………………………….. 32
DATA ANALYSIS AND PRESENTATION………………………………………………………………….. 32
- INTRODUCTION…………………………………………………………………………………………………… 32
- DEMOGRAPHIC CHARACTERISTICS OF RESPONDENTS…………………………………. 32
- RELATIONSHIP THAT EXIST BETWEEN PATIENTS AND NURSES…………………… 36
- Nurses understand your ideas expressed about your feelings and ………………….. 37
- Nurses recognize that patients desire happiness and not suffering in the caring process 38
- Nurses listen to you attentively to identify thinking, feeling and behavior disturbance.. 38
- Nurses praise and encourage your attempts to take a better care of your health………….. 39
- Nurses keep patient’s personal information confidential………………………………………….. 39
- Nurses Do Not Maintain Good Eye Contact with You…………………………………………… 39
- Nurses Lean Forward toward You and Comfortably Talk to You……………………………. 40
- You Feel Uneasy and do not Co-operate Wholeheartedly When a Nurse of the Opposite Sex Care For You…………………………………………………………………………………………. 40
- You Feel To Show the Nurses What to Do Because You Know Your Health Problem . 41
- Crosstab Analysis between the Sex of Patients‟ and Patients‟ Co-operation in the Caring Relationship……………………………………………………………………………………………………… 41
- Cross tabulation between Patients Educational Level and Patients‟ Co-operation with Nurse of Opposite Sex…………………………………………………………………………………………. 42
- Cross tabulation between Marital Status of Patients and Patients Instructions of Nurses about Their Health Needs…………………………………………………………………………………. 43
- EFFECTS OF NURSE-PATIENTS RELATIONSHIP………………………………………………… 44
and Protection……………………………………………………………………………………………………………. 46
- Positive Nurse-Patient Relationship Improves the Levels of Patient Satisfaction……….. 46
- Positive Nurse-Patients Relationship Ensures Greater Adherences to Treatment………… 47
- Negative Nurse-Patient Relationship Can Kill Patients Slowly………………………………… 47
- Negative Nurse-Patient Relationship Increases the Emotional, Physical and Psychological States (Stress, Anxiety and Depression) of Patient…………………………………….. 48
- TYPES OF NURSE-PATIENT RELATIONSHIP……………………………………………………… 48
- NURSES ATTITUDES IN THE RELATIONSHIP……………………………………………………. 49
- You Do Not Ensure Appropriate Care for Difficult Patients……………………………………. 49
- You are More Attracted to Neat Patients and Communicate with Respect in the Nurse- Patient Relationship…………………………………………………………………………………………. 50
- You Recognize That Patients Desire Happiness and Not Suffering………………………….. 50
- Management of insult from patients……………………………………………………………………… 51
- Cross tabulation between Sex of Nurses and their Management of Patients Insult……… 51
- Cross tabulation between Age Group of Nurses and their Management of Patients Insult
………………………………………………………………………………………………………………………………… 52
- Cross tabulation between Work Experience of Nurses and their Level of Attention for Neat Patients……………………………………………………………………………………………………………… 53
- Treatment of Patient of the Same Ethnicity…………………………………………………………… 54
CHAPTER FOUR………………………………………………………………………………………………………. 56
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS…………………. 56
- INTRODUCTION…………………………………………………………………………………………………… 56
- SUMMARY OF KEY FINDINGS……………………………………………………………………………. 56
- CONCLUSION………………………………………………………………………………………………………. 58
- RECOMMENDATIONS…………………………………………………………………………………………. 59
REFERENCE………………………………………………………………………………………………………………. 60
APPENDIX…………………………………………………………………………………………………………………. 65
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Several factors can influence nurses’ attitudes and interactions with patients. These include their degree of education and training, experience caring for patients, perceptions of the success of prevention initiatives, and organizational support for the services they provide. An effective nurse-patient relationship is essential in nursing care because it allows the patient to feel at ease in and out of the hospital setting. It represents an agreement between the nurse and the patient to collaborate for the patient’s benefit. Good communication between nurses and patients is required for a therapeutic nurse-patient relationship. Good communication skills make the difference between average and excellent nursing care. A good nursing care is distinguished by good communication abilities.
Patients are regarded as having less authority in the nurse-patient relationship, which might increase their vulnerability if nurses do not treat them with respect. Patients’ emotional, physical, and mental problems might make it challenging for nurses to manage them in the relationship. In light of this, nurses must develop their interpersonal relationships and professional standards by demonstrating the therapeutic relationship principles to the greatest extent possible.
Regardless of the amount of contact, the essential components of the therapeutic relationship remain the same: respect, authenticity, empathy, active listening, trust, and confidentiality. The therapeutic connection exists to help the patient, facilitate healing, and encourage or enhance functioning. A therapeutic connection is distinct from a social relationship in that it is health-centered and patient-centered, with clearly defined boundaries. According to Peplau (2011), the nurse’s primary interest in the patient is described as “professional closeness.”
Regardless of qualification, the facilitation of a therapeutic nurse-patient connection has always been the cornerstone of nursing and comprises self-awareness as well as knowledge of the important components of therapeutic communication. These components include the patient’s unconditional acceptance, the ability to listen and hear, constructive nonverbal skills, and vocal communication approaches. This procedure is made possible by the employment of rapport and alliance, which provide support, stability, and dependability in patient care (Gilbert 2009).
The quality of treatment delivered by nurses and other healthcare professionals is significantly impacted by attitude. The beliefs, values, and feelings that affect how people view and react to a particular event or object are referred to as attitudes (Fishbein & Ajzen, 2010). The way nurses treat their patients and how they interact with them may affect their capacity to deliver high-quality care and enhance patient outcomes. Nevertheless, the bureaucratic environment in hospitals is driven by technology and a primarily medical paradigm of treatment, making it difficult for nurses to develop therapeutic relationships with their patients. The goal of communication in the nurse-patient interaction is to meet the requirements of the patient and provide patient-centered care.
1.2 Statement of the Problem
Nursing care literature states that nurses have a duty to treat patients with the utmost respect and compassion. Attending behavior is a patient-centered activity, and the basic criteria for attending to occur on the part of the nurse are authenticity, warmth, and empathy (Burnard, 2000; Stein-Parbury, 2013). It is the nurse’s obligation to be conscious of the power imbalance, to acknowledge the possibility of clients feeling intimidated, and to establish a therapeutic relationship. As a result, this knowledge aids in the establishment and maintenance of appropriate limits. However, studies, news reports, and the experiences of some patients show that the nurse-patient interaction does not result in good patient care (Reininghaus et al., 2016; Cattan et al., 2019; Jacobs et al., 2020).. Patients frequently lack defenses and may rely on nurses to take care of their fundamental requirements. Patients who do not have a network of loving relatives and friends might prefer to rely on the nurse outside of the doctor’s office. Some patients may be especially vulnerable, such as those with mental health issues or those who require continuing care. To solve this problem, a number of tactics may be used, such as providing nurses with specialized training and education, making sure they have access to enough resources and support, and fostering an environment that encourages teamwork and collaboration at work (Sirey et al., 2018; Jacob et al., 2019; Salzer et al., 2021). It was because of this discrepancy that the study was conducted at specialist hospital in Maiduguri to find out the kind of relationship between nurses and patients. This will help to improve upon the nurse-patient relationship in the hospital. The study on an assessment of nurse-patient relationship and its impact on patient care in specialist hospital in Maiduguri intends to fill these gaps.
1.3 Objectives of the Study
The main aim of this study is on an assessment of nurse-patient relationship and its impact on patient care in specialist hospital in Maiduguri. This study look into the following sub objectives:
- To determine whether the socio-demographic characteristics of the nurse and the patients influence the type of relationship between the two.
- To examine the effects of nurse-patients relationship on the health of the patients.
- To find out the various types of nurse-patients relationship.
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