Patients' perceptions of nurses' skill

Nurses experience with body care among palliative care patients: a phenomenological study

BACKGROUND

Palliative care is defined as active and global care that provides holistic care integrating the body, mind and spirit of the dying person. A person's health deteriorates at the end of life and nurses facilitate patients to manage their personal body care. Knowing and considering the impact of disease on individuals' lives, how they adapt to cope with it, and the meaning they give to it, can help nurses. This is because of the embodiment concept of living in and through our bodies. The aim of the study is to explore palliative care patients' experiences with nurses during body care.

METHODS

A descriptive phenomenological approach based on Husserl's philosophical perspective was used. A purposive sample of eight palliative care patients were enrolled in the study. Semi-structured interviews were conducted between November 2018 and January 2019, in an Italian hospice. The interviews were about patients' feelings during nursing body care. The transcripts were analysed using Giorgi's phenomenological method. Several strategies were used to ensure the study's reliability.

RESULTS

The qualitative analysis revealed six categories that converged in three themes: 1) body care requires a specific competence; 2) patients experience difficulties during care by nurses; 3) compassionate care relationships help patients to find wellbeing and balance.

CONCLUSIONS

People at the end of life find the deterioration of their body distressing and a reminder that they are about to die. These considerations give us an understanding of patient embodiment and the significance of a patient's lived experiences at the end of their life. This phenomenon in nursing should be explored further in future research, to help inform more targeted care strategies.

Discussion Surrounding Theory, Knowledge, and Practical Applications for Clinical Nurse Specialists to Aid Them in Caring for Parents with Cancer Who Have Young Children

PURPOSE

To identify the theory, knowledge, and practical applications that clinical nurse specialists should consider adding to their "toolkit" to support them in caring for people affected by cancer with young children.

DATA SOURCES

Expert opinion and relevant studies on the topic formed the basis of this article.

CONCLUSION

A conversation with experts identified five key areas of knowledge important to supporting clinical nurse specialists in caring for people affected by cancer with young children: family-centered and systemic practice, nursing responsibilities and competencies, trauma-informed practice, adult life stages, and stages of child development. Key areas identified have relevance to all healthcare professionals working in cancer care.

IMPLICATIONS FOR NURSING PRACTICE

This article provides a useful overview of psychological theories important to supporting healthcare professionals in caring for people affected by cancer. A discussion on the boundaries and competencies of the nursing role led to agreement about practical advice rooted in theory and knowledge that could benefit clinical practice. Concepts of emotional labor and the wounded healer were identified as important to inform reflection and supervision when caring for a parent affected by cancer who has a young family.

The relationship between the level of trust in nurses and nursing care quality perceptions of patients treated for Covid-19

BACKGROUND

During the pandemic process, nursing care has gained more importance. So, it is critical to evaluate the level of trust in nurses and the perception of care in terms of the patient, in order to improve the care service provided, to achieve the desired successful patient results, to ensure patient satisfaction in nursing care and to create a healthy society in the long term.

AIM

This study aimed to examine the relationship between the level of trust in nurses, care perceptions of patients receiving care with the diagnosis of Covid-19, and the level of trust in nurses and care quality perceptions of patients.

METHODS

This descriptive, cross-sectional, correlational study was conducted in the Covid-19 unit of a state hospital in the Western Black Sea Region of Turkey between May and October 2021. The sample size was calculated as 227 using the sample calculation formula whose population is unknown in the literature. 'Personal Information Form', 'Trust in Nurses Scale' and 'Patient Perception of Hospital Experience with Nursing (PPHEN)' was used to collect data. Ethical approval was obtained from the clinical research ethics committee, RESULTS: The total mean score of the patients' trust in nurses scale was 27.67 ± 3.29 (min: 15, max: 30); the mean score of the patients' Perception of Nursing Care scale was determined as 69.52 ± 12.51 (min:15, max:75). It has been determined that the level of trust in nurses and the perception of nursing care of patients receiving Covid-19 treatment are high. A positive, significant and weak relationship (r = 0.348, p < 0.01) was found between the patients' level of trust in nurses and their perceptions of nursing care.

CONCLUSION

During the pandemic process, trust in the patient-nurse relationship increases the patient's perception of nursing care and positively affects the quality of care.

The Servqual Method as an Assessment Tool of the Quality of Medical Services in Selected Asian Countries

Introduction: The Servqual (an acronym from the words “service” and “quality”) method is used to assess the quality of provided services on the basis of standardised evaluation parameters. This method is based on five gaps resulting from the discrepancy between expected and received service quality. The aim of this meta-analysis and the systematic review was to view and assess the major differences in the five dimensions of the Servqual method used to evaluate the quality of delivered health care services in selected Asian countries. Another goal of the study was to confirm the use of the Servqual method as a suitable tool for assessing the quality of health care services. Methods: This study followed the PRISMA guidelines for systemic reviews and meta-analyses. The following electronic databases for medical publications were used: PubMed, Medline, Scopus, and Cochrane were searched for articles published from January 2000 to April 2020. The databases were explored with original search queries containing the following terms: “Servqual”, “service quality”, “Servqual model”, “servqual questionnaire”, “health service quality”, “health care services”, “patients’ expectation”, “patients’ perception”, “expectation”, “perception”, and “health care services”, in combination using “AND” and “OR”. In order to minimize bias, two researchers (PK and DK) independently performed an online search for peer-reviewed papers, using the combinations of the above-mentioned words. In addition, references of eligible publications were checked. All disagreements, regarding the inclusion or exclusion of specific studies, were resolved through consultations among all the authors. Results: A total of 96 reports were identified and submitted to a preliminary screening selection. As a result of the pre-screening stage, 64 papers were qualified to further evaluation. The output of the evaluation brought 15 reported studies, meeting the pre-defined inclusion/exclusion criteria. The total number of participants was 5903 (ranging from 20 to 439 in individual reports), and 54% of them were women. Eight studies (53%) were from Iran, two from Pakistan (13%) and one each from Arabia, Malaysia, South Korea, Bangladesh, and Iraq (each-about 7%). The results showed gaps between patients’ expectations and perceptions in all five dimensions of Servqual in almost each analysed study. The highest and lowest values of the gaps in quality scores were associated with the dimensions of reliability, tangibility, empathy, and responsiveness, respectively. Conclusions: The study demonstrated that the method of Servqual is broadly used in various medical sectors to assess the quality of medical services provided. In addition, the study demonstrated that patients had significantly higher expectations of the medical services offered in the five dimensions studied. The results, obtained through the Servqual method, may help improve and monitor the quality of services provided by different institutions.

Nurse Listening as Perceived by Patients: How to Improve the Patient Experience, Keep Patients Safe, and Raise HCAHPS Scores

OBJECTIVE

The purpose of this qualitative research study was to ascertain which nurse behaviors a subsection of adults 50 years and older who had had a recent inpatient admission believed conveyed nurse listening.

BACKGROUND

Listening by nurses has been identified as one of the factors with the greatest impact on patients' overall rating of their hospital experience. The behaviors of nurses that lead to patients' perceptions that listening has occurred have been unexamined, thus hampering attempts at improvement.

METHODS

Because of lack of literature support, a qualitative study using interpretative phenomenological analysis was undertaken to elicit a rich description of patients' lived experiences related to nurse listening behaviors.

RESULTS

Study participants provided specific behaviors, both verbal and nonverbal, which led them to believe the nurse was either listening or not. These perceptions affected their sense of safety and ability to trust.

CONCLUSIONS

Embracing these described behaviors could significantly impact patients' safety and recovery.

Nurse with smile: Does it make difference in patients' healing?

Smiling is a highly significant component of nurses' caring behavior. Nurses have to deal with too many people at workplace and interpersonal relation building is the key secret for quality work and also enhances job satisfaction. A genuine smile given by a nurse can do wonders as it conveys acceptance, builds trust and establishes inter-personal relationship. It also helps nurses to feel better and avoid anxiety or stress burnout in clinical situation. This paper of ours highlights the importance of nurses' smile in patients' recovery and important research literature to support smiling culture among health-care professionals.

Nurses' perceptions of caring activities in nursing

Aim

This study aimed to determine nurses' perceptions of caring activities in nursing.

Design

A descriptive study design.

Methods

A Turkish translation of the 25-item version of the Caring Dimensions Inventory was completed by 260 nurses working in one university hospital. Data were analysed using Mokken scaling.

Results

Technical aspects of nursing were highly endorsed items such as "observing the effects of a medication on a patient, measuring vital signs, being technically competent with a clinical procedure, consulting with the doctor" except for the item "providing privacy for a patient" which is a psychosocial item. The range of items included in the Mokken scale with "providing privacy for a patient" (mean = 4.31) as the most endorsed, and "exploring the patient's lifestyle" (mean = 2.60) being the least endorsed item. Listening to patients and involving them in their care are not considered as caring.

Exploration of service recipients' image of a perfect nurse: A qualitative descriptive study

AIM

The aim of this study was to explore the image of the perfect nurse from service recipients' perspective.

BACKGROUND

The public image of nursing is one of the long-term challenges of this profession. Specific cultures affect the views and satisfaction of nursing service recipients.

METHODS

This study was a qualitative descriptive study conducted in 2018. Purposive sampling was used and continued until saturation. Twelve semi-structured interviews were conducted with service recipients who had experience in using nursing services in the past six months. Participants were 5 men and 7 women. Interviews transcript verbatim and analyzed by qualitative content analysis.

RESULTS

Four themes emerged from the perspective and experience of the participants concerning perfect nurse including the followings: affable (compassionate, sympathetic and good-tempered), responsive (answering questions, answering requests), tower of strength (listener, being patient, understanding and attention) and efficient (providing careful care, providing timely care, providing proper care).

CONCLUSION

From the participants' perspective, a perfect nurse should be responsive to the patient and be well-mannered and patient with them in addition to providing expert care. Therefore, nurses should not only improve their skills in providing care but also focus on the communication dimension and respond to the patients. Identifying communication barriers with the clients in the context of the study is also suggested.

The communication experience of tracheostomy patients with nurses in the intensive care unit: A phenomenological study

OBJECTIVES

To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit.

RESEARCH METHODOLOGY/DESIGN

Benner's interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses.

SETTING

The intensive care unit of a hospital in Northern Italy.

FINDINGS

Eight patients and seven nurses were included in this study. Two main themes were identified 1) feeling powerless and frustrated due to the impossibility to use voice to communicate; 2) facing continual misunderstanding, resignation, and anger during moments of difficulty and/or communication misunderstandings. The main communication discomfort factors were: struggling with not knowing what was happening, feeling like others had given up on me, living in isolation and feeling invisible. The main comfort factors were: being with family members, feeling reassured by having a call bell nearby and nurses' presence.

CONCLUSIONS

This study highlights the important role of communication in tracheostomy patients in intensive care and how closely it is linked to all the aspects of a person's life, which cannot be underestimated as just not being able to use one's voice.

Service Quality Assessment of Hospitals in Asian Context: An Empirical Evidence From Pakistan

Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients’ perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling. The developed scale was then validated by identifying service quality gaps and ranking the areas that require managerial effort. The findings indicated that all 5 dimensions of SERVQUAL are valid in Asian countries such as Pakistan, with 13 items retained. Reliability, tangibility, responsiveness, empathy, and assurance were ranked first, second, third, fourth, and fifth, respectively, in terms of the size of the quality gap. The gaps were statistically significant, with values ≤.05; therefore, hospital administrators must focus on each of these areas. By focusing on the identified areas of improvement, health care authorities, managers, practitioners, and decision makers can bring substantial change within hospitals.

The Experience of Intense Pain: Nursing Management and Interventions

Personal stories of illness give depth to otherwise clinical descriptions of diagnoses. This article offers an autobiographical narrative of complications after total knee replacement surgery. Diagnosis and nursing management of acute compartment syndrome, nociceptive and neuropathic origins of pain, pharmacologic and nursing interventions for pain, the use of prayer in illness, and compassionate caring from a Christian perspective are discussed.

Emotional Labour and Wellbeing: What Protects Nurses?

Although compassionate care has wide-ranging benefits for patients, it can be emotionally demanding for healthcare staff. This may be a particular problem for those with little experience in a caring role. This study utilises the job demands-resources model to examine links between “emotional labour” and emotional exhaustion in student nurses. In line with the triple-match principle—whereby interactive effects are more likely when job demands, resources, and outcomes are within the same qualitative domain—the protective role of emotional support and emotion-focused coping (i.e., emotional venting) in the relationship between emotional labour and exhaustion is also explored. An online questionnaire was completed by 351 student nurses with experience working in healthcare settings. A strong positive relationship was found between emotional labour and emotional exhaustion, and some support was found for the moderating effects of emotional support and emotion-focused coping. Ways to help student and qualified nurses develop the emotional resilience required to protect their wellbeing, while providing high-quality compassionate care to patients are considered.

Quality of an Informed Consent Prior to a Surgical Intervention? Experience of a Teaching Hospital

Objective:

To determine how far the information given by the physicians for the informed consent prior to the surgical intervention is comprehended by the patients.

Methods:

The study was carried out between July 1^st, 2012 and July 1^st, 2013 at Gulhane Medical Faculty. A total of 400 patients, who were in the third postoperative day after various surgical procedures (orthopedics, urology, ophthalmology, plastic surgery and breast surgery), were included in the study.

Results:

Of all the patients, 73.5% stated that the operative information was provided by physicians, whereas 22.7% claimed that no information was given in this regard. The patients who knew the name of the disease was 78%, while 18.3% did not know. Of all the patients, 25.7% knew the name of the operation, in contrast to of 52.3% who did not know it. About 12.5% of patients stated that they were not informed about the likely complications during the surgery, whereas 13.7% of patients reported that they were not informed about the post-operative complications.

Conclusion:

The verbal information and the written texts, different approaches such as drawings and visual materials (i.e. video’s and photographs) should be considered while providing information to the patients. While doing so the level of education of the community should also be taken into account.

Attributes of a good nurse

Background:

The opinions of students regarding the attributes of a good nurse can make a major contribution to the planning and the conducting of professional education. There are few studies which aim at identifying the qualifications of a good nurse from the perspectives of nursing students.

Objectives:

To determine the opinions of first- and fourth-year nursing students concerning the ‘attributes of a good nurse’, and whether and how their views change depending on their year of study.

Research design:

Descriptive research.

Participants and research context:

This study was conducted in the nursing department of a vocational school of health in the 2010/2011 academic year. The study participants consisted of first-year and intern students. A survey form was used to identify characteristics of participants, and students were asked the following open-ended question about their opinions related to the attributes of a good nurse.

Ethical considerations:

The permission was taken from the school administration. Informed consent was obtained, and anonymity was ensured for participating students.

Findings:

A total of 120 students participated in this study. Most frequently expressed attributes were ‘professional competence’ in first-year and ‘responsibility’ in fourth-year students. While first-year students placed a greater emphasis on the attributes of ‘geniality’, ‘patience’, ‘calmness’, ‘love of nursing’, ‘loyalty to nursing’ and ‘not attaching importance to material values’, fourth-year students emphasized the attributes of ‘empathy’, ‘honesty’, ‘responsibility’ and ‘scientific curiosity’ significantly more.

Discussion and conclusion:

Fourth-year students placed a greater emphasis on the attributes which the students are expected to acquire through a nursing program and clinical experience. However, they mentioned the attributes related to a good nurse–patient relationship and communication significantly less. Appropriate ethical training methods and good role models can help students acquire attributes that are important for the nursing profession and combine them with the attributes they already have.

The emergency department: experiences of patients, families, and their nurses

Research regarding the triad of nurses, patients, and family members looking at the lived emergency department experiences and their perspective of each from the other is notably absent. In this study, M. van Manen's (1990) hermeneutic phenomenological approach was used to explore, understand, and describe the lived experiences of nurses, patients, and family members during critical illness in the emergency department. Data were collected over a 6-month period by means of in-depth interviews. While nurses perceived that addressing the patient's physiological deficit promptly is paramount in the emergency department, they also indicated that including family members as coparticipants in the care is equally important. Patients and family members perceived that communication, critical thinking, sensitivity, and caring are necessary for emergency department nurses. The study supports recognizing the patient and family as active participants in the patient's medical care, encouraging family member presence, and creating institutional policies for patient- and family-centered care.

Factors affecting patient satisfaction with emergency department care: an Italian rural hospital

BACKGROUND

In the emergency department satisfaction is strictly linked to the role of the nurses, namely the first interface between patients and hospital services.

OBJECTIVES

The purpose of the study was to identify areas of emergency nursing activity associated with minor or major patient satisfaction.

METHODS

A descriptive cross-sectional study was conducted from December 2010 - May 2011, in the rural hospital of Orbetello, Tuscany (Italy). Convenience sampling was used to select patients, namely patients presenting at the emergency unit in the study period. The Consumer Emergency Care Satisfaction Scale was used to collect information on two structured subscale (Caring and Teaching).

RESULTS

259 questionnaire were collected. Analysis indicated that only two characteristics significantly influenced overall satisfaction: "receiving continuous information from personnel about delay" positively effect (OR=7.98; p=0.022) while "waiting time for examination" had a negative effect (OR 0.42; p=0.026).

CONCLUSIONS

The study was the first conduced in Italy using this instrument that enabled to obtain much important information about patient satisfaction with nursing care received in the emergency department. The results showing improvements must be related to educational aspects, such as explaining patients the colour waiting list, and communication towards patients, such as informing about emergences that cause queue.

Using the synergy model of patient care in understanding the lived emergency department experiences of patients, family members and their nurses during critical illness: a phenomenological study

Despite many studies conducted aimed to understand and improve emergency care, research on the triad of nurses, patients, and family members looking at the lived emergency department experiences and their perspective of each from the other is notably absent. In a hermeneutic phenomenological study using van Manen's method, a sample of 10 patients, 5 family members, and 8 nurses of a nonprofit community hospital was recruited and interviewed in 2010 to 2011 to explore, understand, and describe their lived experiences during critical illness in the emergency department. The nurses perceived that addressing the patient's physiologic deficit promptly is vital in the emergency department as well as including family members as coparticipants in the care. Patients and family members perceived that communication, critical thinking, sensitivity, and caring are essential for emergency department nurses. The American Association of Critical-Care Nurses' Synergy Model for Patient Care was applied in conceptualizing the findings and served as a framework in recommending practices and interventions geared toward improving competencies required in caring for critically ill patients and their families in the emergency department. The study supports recognizing the patient and family as active participants in the patient's medical care; encouraging family-member presence and creating institutional policies for patient- and family-centered care, as well as encouraging the development of ongoing programs that will recognize, enhance, and support the psychological and emotional well-being of emergency department nurses.

Image is more than a uniform: the promise of assurance

OBJECTIVE

The purpose of this qualitative study was to explore the meaning of the phrase "image of the nurse" in the context of the desired brand experience of assurance.

BACKGROUND

A brand is a promise that lives in the minds of consumers. Nurses play a key role in delivering on the brand promise of a hospital.

METHODS

Using focus groups, the authors applied a deductive approach to generate data. Discussion transcripts were analyzed by establishing codes and identifying themes.

RESULTS

The most frequent comment from participants was that for nurses to communicate assurance, they must 1st be clean, well groomed, and understated in overall appearance. Nurse behaviors that reassure patients include being present with patients, helping patients know what to expect, and demonstrating a consistent team approach.

CONCLUSIONS

Overall appearance and behaviors define the image of nurses and contribute significantly to the brand of assurance.

What is nursing in the 21st century and what does the 21st century health system require of nursing?

It is frequently claimed that nursing is vital to the safe, humane provision of health care and health service to our populations. It is also recognized however, that nursing is a costly health care resource that must be used effectively and efficiently. There is a growing recognition, from within the nursing profession, health care policy makers and society, of the need to analyse the contribution of nursing to health care and its costs. This becomes increasingly pertinent and urgent in a situation, such as that existing in Ireland, where the current financial crisis has lead to public sector employment moratoria, staff cuts and staffing deficits, combined with increased patient expectation, escalating health care costs, and a health care system restructuring and reform agenda. Such factors, increasingly common internationally, make the identification and effective use of the nursing contribution to health care an issue of international importance. This paper seeks to explore the nature of nursing and the function of the nurse within a 21st century health care system, with a focus on the Irish context. However, this analysis fits into and is relevant to the international context and discussion regarding the nursing workforce. This paper uses recent empirical studies exploring the domains of activity and focus of nursing, together with nurses perceptions of their role and work environment, in order to connect those findings with core conceptual questions about the nature and function of nursing.

Perceptions of nursing care quality, in acute hospital settings measured by the Karen instruments

AIMS

The objectives of this study were to measure the quality of nursing care from the perspectives of patients and personnel and to compare these perspectives.

BACKGROUND

The perception of quality in nursing care is affected by patient needs and it is common that patients and personnel disagree on the nature of the quality. Thus, it is important to measure the quality from both perspectives.

METHOD

A total of 95 patients and 120 personnel from surgical and medical wards at a hospital in Sweden participated. The Karen instruments were used for data collection. A scale index was used for comparison of the perspectives.

RESULTS

The patients and personnel were satisfied with the quality of care and there were no obvious differences in the total index. The different subscales indicated areas of lower care quality in need of improvement.

CONCLUSION

The quality of the care seemed to be satisfactory from the perspectives of both the patients and the personal. Further analysis from the subscale or a variable level is needed to define areas of lower care quality.

IMPLICATIONS FOR NURSING MANAGEMENT

Measurements have to be carried out continuously to guarantee care quality over time, as a result of organisational changes and financial cutbacks.

Trauma patient satisfaction with physician assistants: testing a structural equation model

OBJECTIVE

Physician assistants (PAs) are increasingly utilized in the health care workforce and should be aware of how their interpersonal and technical skills are perceived by patients. The purpose of this study was to test associations among Perceived Interpersonal Care, Perceived Technical Care, and Global Satisfaction.

METHODS

This cross-sectional telephone survey of recently discharged trauma patients tested a structural equation model which hypothesized that interpersonal satisfaction ratings predicted technical care and global satisfaction ratings.

RESULTS

A total of 251 completed surveys were analyzed. Results indicated a relationship among interpersonal care, technical care, and global satisfaction. Satisfaction with interpersonal care predicted satisfaction with technical care.

CONCLUSION

In this study of how satisfied recently discharged trauma patients are with care by physician assistants, perceptions of technical care were associated with perceptions of interpersonal care, or how the patient was treated as a person. Since physician assistants have direct patient contact, this association demonstrates the strength of the PA-patient relationship as an asset to the health care organization.

The need for critical care nursing skills in an acuity-adaptable care delivery system

With the relentless pursuit of patient care quality and patient safety, one has to explore every possible avenue to transform and redesign care delivery to remain solvent and meet the health care needs of patients in the future. Keeping patients undergoing renal transplantation in the same room from admission to discharge positively impacts clinical care outcomes on length of stay and cost. The success of this kind of care delivery lies on 1-week didactic structured training of the transplant nurses based on critical care concepts to manage fluctuations in patients' condition. With an added 3 months clinical rotation in the critical care areas, the competent transplant nurses were able to care for the patients undergoing renal transplantation in the acuity-adaptable medical-surgical transplant floor with confidence. A hybrid nurse was created who possessed both critical care and medical-surgical skills. This can be a potential trend in the professional nurse model to address the health care challenges we face today in terms of nursing shortage, abbreviated plan of care, and facility operation efficiency. Thus, the need for critical care nursing skills is invaluable to the success of an acuity-adaptable care delivery system.