RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE.

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 NAME OF THE CANDIDATE AND

ADDRESS

( IN BLOCK LETTERS)

MR.ARUNKUMAR .G. DASHAVANT.

1ST YEAR M. Sc NURSING,

S.D.M INSTITUTE OF NURSING

SCIENCES, SATTUR,

DHARWAD -580009.

2 NAME OF THE INSTITUTION S.D.M INSTITUTE OF NURSING

SCIENCES, MANJUSHREE NAGAR,

SATTUR, DHARWAD

3 COURSE OF STUDY AND SUBJECT 1ST YEAR M.Sc. NURSING,

MEDICAL SURGICAL NURSING

SPECIALITY.

4 DATE OF ADMISSION TO THE COURSE 01-06-2012

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5 TITLE OF TOPIC:

“DETERMINE THE LEVEL OF SATISFACTION TOWARDS NURSING CARE

AMONG HOSPITALIZED PATIENT’S”

6 BRIEF RESUME OF THE INTENDED WORK

Introduction :

“Satisfaction lies in the effort, not in the attainment, full effort is full victory.”

-Mahatma Gandhi

Nursing profession is considered as a caring profession. To begin with it was an art

and a vocation. Now it is considered as a scientific profession, nursing care is defined as the

care of the patient with regard to nursing needs. With ever increasing dimension of medical

sciences quantitatively and qualitatively nursing care is becoming more and more complex

with its management services. Nursing service plays a pivotal role in health organization

which aims at satisfying the nursing needs of the patients/community. 1

The significance of patient satisfaction in the hospital business is that a satisfied

patient will be a positive asset for the hospital that may encourage return visits or positive

word of mouth. On the contrary, a dissatisfied patient will tell people about their

dissatisfaction, which could become a real burden to the hospital in terms of losing the

patients’ loyalty. Patient feedback is important because dissatisfaction provides

opportunities for improvement and gives the staff a chance to respond immediately.2

Ford, Bach and Fottler (1997) noted that patient satisfaction has emerged as an

important factor in measuring the quality of care provided by healthcare organizations. It is

not only important for gaining insight into customers’ perception of healthcare services, but

it is also a key outcome of care (Donabedian, 1998). Low patient satisfaction may result in

poor compliance, potential waste of resources and suboptimal clinical outcomes. As

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pointed out by McKinley et al. (1997), satisfaction of the patient’s legitimate demands

should be the expected outcome of all medical care.2

In India, a recent survey conducted by the high power health commission showed

that nearly 45% of patients admitted in hospitals for various reasons are found to be

unsatisfied with services provided by the health team members. This is due to increasing

demands of health care services, shortage of health care providers and lack of time.3

As the hospital serves all the members of the society, the expectations of the

consumers differ from one individual to another because everyone has got his/her own

individual preferences. Therefore nurses play a vital role in satisfying patients’ expectations

as they are the primary point of contact between patients and the world of healthcare. 4

6.1 Need for the study :

Changes in the health care industry brought about by globalization, technological

and scientific developments have and will continue to greatly influence the education,

theory and practice of nursing as in other health professions. Nursing, therefore, must

continue to examine its practice in the face of these developments in order to ensure that its

practice is in consonance with global standards and the satisfaction of its consumers

(patients) in maintaining its relevance in the healthcare industry and the society. The

public is becoming increasingly interested in, and knowledgeable about health and health

promotion activities through motivation from information technology (Berman et al.,

2008).Computers, the internet and world wide web have now made access to

medical/nursing information easy to clients that they are now more health conscious and

have come to believe that quality healthcare constitutes a basic right rather than a privilege

for a chosen few (Creel et al., 2009, 2002). Indeed access to quality care has become

enshrined in most national constitutions as the right of every individual.5

A nurse’s role is to restore health and alleviate patient suffering. They are the main

personnel who directly provide nursing services to patients. Their main responsibilities are

to provide primary treatment care and coordinating with other healthcare professionals in

caring for patients. Hence, the measurement of patient satisfaction regarding nursing care is

important.2

In this modern era of acute advancements in medical sciences and technology, it is

the right of every patient to demand the best possible care in the hospitals. It is the duty of

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every staff member of nursing science to deliver to his/her optimum effort to the entire

satisfaction of their patients. Therefore patient satisfaction has a special consideration in

treatment.6

Healthcare team basically refers to an inter-disciplinary network, which includes

members of different disciplines; each providing specific services to the patient. The

various health team members include doctors, nurses, paramedical staff, hospital help etc. It

is crucial for health care organization to identify the factors that enhance consumer

satisfaction and build loyalty.7

A questionnaire survey was conducted on patients' and nurses' perceptions of the

quality of nursing services, satisfaction and intent to revisit the hospital in Kyeonbuk,

Korea. SERVQUAL scale method was used. The sample consisted of 272 patients and 282

nurses. Results of the study was there was a strong positive relationship between patient

satisfaction with nursing and medical care and intent to revisit the hospital.8

A study was conducted in Germany on patient satisfaction, was assessed with

determinants like physicians, nurses, hi-tech appliances and food services, It is proved that

level of patient satisfaction was highly associated with the educational qualification and

experience of the primary care providers such as physicians and nurses.9

A cross sectional study was conducted to measure the patient satisfaction with

nursing care among patients admitted in the medical wards of the Philippine General

Hospital in 2006. The aim of the study was to determine patient satisfaction with nursing

care in the medical wards using a valid and reliable locally developed UP-PGH PSNC

questionnaire. A total of 237 patients were included in the survey. The result of the study

was the patients were satisfied with the nursing care provided in two dimensions: The nurse

as a caring person and the nurse as a skilled and competent health care provider.10

High level of satisfaction with nursing services is the main key for the success of a

hospital. The nurses need to be aware about various factors that might improve or detoriate

the level of satisfaction by the patients. The satisfaction of the patients is a good parameter

of quality services provided by the hospital, but care providers are negligent about

estimating the level of satisfaction of their patients. The continuous evaluation of patients’

satisfaction can be helpful for the improvement of overall functioning of the health care

organization, to refine the existing skills and also for improving the output of the nurses.4

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The investigator had come across a lot of hospital circumstances, both personally

and professionally, where the health care consumer’s attitude and satisfaction regarding

nursing services were neglected. Very few studies have been conducted in India that

measure patient satisfaction with the nursing services provided. This instigated the

investigator to undertake a study to determine the level of patient’s satisfaction regarding

nursing services.

6.2 Review of literature

This review of literature is classified under following headings:

1) Patients level of satisfaction

2) Factors affecting patient satisfaction

1) Patients’ level of satisfaction :

A cross sectional survey study was conducted on patient safety, satisfaction, and

quality of hospital care in Europe and United States. Participants were 33659 nurses and

11318 patients in Europe; 27509 nurses and more than 120000 patients in the US. The

result of the study showed deficits in hospital care quality were common in all countries.

Improvement of hospital work environments might be a relatively low cost strategy to

improve safety and quality in hospital care and to increase patient satisfaction.11

A prospective study was conducted on patient’s perception on nursing care at a

large teaching hospital in India over a period of one year. Sample size consists of seven

percent of patients each admitted as emergency and routine. All the randomly selected

patients were administered questionnaires, thus obtaining a sample size of 2600. The results

of the study revealed a relatively higher percentage of patients with poor perception

regarding ‘explanation and information’, and ‘caring attitude’ aspects of nursing care

(31.6% and 11.5% respectively).12

A study was conducted to identify the degree of patient satisfaction in hospital,

Kangar in Malaysia. The specific objectives of this study was to identify the degree of

patient satisfaction towards nursing care, to identify the degree of expectation towards the

elements and dimensions measured to identify the degree of perception after patient

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received the service. The data was collected from 100 patients. Two sets of questionnaires

were used to measure expectations and the perception of the patient. The result derived

from this study was that the nursing service level in hospital was not of satisfactory level.13

A cross-sectional survey was conducted on patient experience of nursing quality in

a teaching hospital in Saudi Arabia. Examining the quality of nursing care from the

patient's perspective is an important element in quality evaluation. A convenient sample of

448 patients using a 42-items questionnaire was used to assess the six dimensions of the

nursing care provided during hospitalization. The findings of the study demonstrate

negative experiences of patients with nursing care in dimensions of information, caring

behaviour, and nurse competency and technical care.14

A cross-sectional descriptive study was conducted on patient satisfaction with

nursing care in Jordan. The Newcastle Satisfaction with Nursing Scale and a demographic

form were used to collect the data. The study indicated that the level of satisfaction of

Jordanian patients with nursing care was moderate and their experiences of nursing care

were positive.15

2) Factors affecting patients’ satisfaction :

A study was conducted on inpatients satisfaction with nursing services at king Khalid

university hospital, Riyadh, Saudi Arabia. The sample consisted of randomly selected 450

inpatients with probability proportion to the size of the wards. The data was collected by

personal interviews using a 21-item structured questionnaire pertaining to nursing services.

The study concluded that sex, age, marital status and duration of stay are the most

important predictors. Females, young, married and short duration of hospital stay have the

highest satisfaction score. 16

A literature study which includes a bulk of literature from UK, Sweden and USA

on patient satisfaction with nursing care in the context of health care. The aim of the

literature study was to describe the influences on patient satisfaction with regard to nursing

care in the context of health care using Henderson’s nursing care model. The result

described eight domains that have an influence on patient satisfaction with nursing care.17

A cross-sectional study was conducted on patient satisfaction with nursing care and

its relationship with patient characteristics at an 1100-bed tertiary care teaching hospital in

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Turkey. Data were collected using the Newcastle Satisfaction with Nursing Care Scales and

a patient information form. Overall, data indicated a high level of patient satisfaction. The

study suggests that there is a relationship between patient satisfaction and patient

characteristics.18

A comparative study was conducted on patient satisfaction on two orthopaedic

wards in Brisbane. The Patient satisfaction survey (Greenhill and Henderson 1997) was

used in this study to encompass the aspects such as patients' feelings and perceptions;

nurses' skills, behaviour and attitudes; nurses' communication and education skills; and

continuity of care experienced. The results indicated that there were significant

relationships between patient satisfaction and patients' characteristics such as age,

education and health status. Therefore the patient characteristics play a dominant role in

satisfaction.19

6.3 Statement of the problem:

“A STUDY TO DETERMINE THE LEVEL OF SATISFACTION TOWARDS NURSING

CARE AMONG HOSPITALIZED PATIENT’S IN SELECTED HOSPITAL OF

DHARWAD ”

6.4 Objectives of the study :

1. To determine the level of satisfaction towards nursing care among hospitalized

patients in a selected hospital.

2. To correlate the level of satisfaction and nursing care among hospitalized patients in

selected hospital.

3. To find the association between the level of patients satisfaction with selected socio

demographic variables.

6.5 Operational definitions:

1. Determine: In this study, determine refers to the measurement of patient

satisfaction influenced by nursing care.

2. Patient’s satisfaction: In this study, patient satisfaction refers to the degree of

congruence between a patient’s expectations of ideal nursing care and their

perception of the real nursing care.

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3. Hospitalized patient: In this study, hospitalized patient refers to a person who is

admitted in surgical ward for more than 5 days in selected hospital of dharwad.

4. Nursing care: In this study, nursing care refers to the services provided by the

licensed nurses which aim to satisfy the needs of the patients.

6.6 Hypotheses: at 0.05 level of significance :

Ho : There will be no significant difference between level of patient satisfaction and

nursing care.

6.7 Assumptions:

The satisfaction of patient is influenced by the nursing care.

6.8 Delimitations:

The study is delimited to the patients who are admitted in surgical ward for more

than 5 days in selected hospitals of Dharwad.

6.9 Projected Outcome

The findings of the study will help in evaluating the level of patient satisfaction and

also aids the health care organization to identify factors that enhance consumer satisfaction

and build loyalty.

MATERIALS AND METHODS

7.1 Source of data

The data will be collected from the patients who are admitted in surgical ward for

more than 5 days in the selected hospital of Dharwad.

7.2 METHODS OF DATA COLLECTION

7.2.1 Type of study approach : Descriptive approach

7.2.2 Research design : Non experimental research design.

7.2.3 Variables under study

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Independent variable : Nursing care provided.

Dependent Variables : Patient’s satisfaction.

Extraneous Variables : Personal characteristics which include age, gender,

religion, marital status, education, occupation,

monthly income and duration of hospitalization.

7.2.4 Setting : A selected hospital of Dharwad.

7.2.5 Population : The population consists of patients admitted in

surgical ward for more than 5 days in selected

hospital of Dharwad.[

7.2.6 Sampling technique : Non probability purposive sampling technique.

7.2.7 Sample size : Sample size consists of 80 patients, admitted in

surgical ward for more than 5 days in selected

hospital of Dharwad.

7.2.8 Duration of study : 1 Month (data collection).

7.2.9 Inclusion criteria for sampling

1. Patients who are admitted in surgical wards of a selected hospital.

2. Both male and female patients.

3. Patients who can read and write Kannada and English.

4. Patients who are willing to participate in the study.

7.2.10 Exclusion criteria for sampling

1. Critically ill patients who are admitted in Critical care units and step down ICU.

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7.2.11 Instruments intended to be used

SECTIONA: Socio-demographic profile consisting of items related to age, gender,

religion, marital status, education, occupation, monthly income and duration of

hospitalization.

SECTION B: A patient satisfaction scale will be used to determine the level of satisfaction

towards nursing care among hospitalized patient in selected hospital.

7.2.12 Data collection method

To conduct the research study the investigator will obtain permission from the

concerned Authority of the Hospital.

The investigator will obtain informed consent from the patient.

The data will be collected individually from the patient who falls into the inclusion

criteria.

A patient satisfaction scale will be used to determine the level of

satisfaction towards nursing care among patients in selected hospital.

7.2.13 Data analysis plan

Descriptive statistics

Mean median and standard deviation will be used to determine the level of patient

satisfaction towards nursing care.

Frequencies and percentages will be used for analysing the selected socio

demographic data by using tables, graphs and diagrams.

Inferential statistics

Karl Pearson correlation coefficient will be used to find out the relationship between

level of satisfaction and nursing care.

Chi square test and will be used to determine the association between level of

satisfaction and selected socio demographic variables.

Paired‘t’ test will be used to find the significant difference between level of

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satisfaction and nursing care.

7.3 Does the study require any investigations or interventions to be conducted on

patients, humans or other animals? If so please describe briefly.

No

7.4 Has ethical clearance been obtained?

Yes, Ethical clearance has been obtained from Institutions’ ethical committee.

LIST OF REFERENCES

1. Available at http:// www. aiims. Edu /aims /nursingservices /NURSING % 20

SERVICES.htm

2. Poramaphorn Chunlaka. International Patients’ Satisfaction towards Nurses Service

Quality at Samitivej Srinakarin Hospital. April 2010. Available at: URL: http:

//thesis .swu.ac.th/swuthesis/Bus_Eng_Int_Com/Poramaphorn_C.pdf

3. Partasarathy, S. Analysis of factors affecting patient satisfaction; International Journal

for quality in health care.2005; 6(2): 12-18.

4. B.Janarthan. Patients satisfaction from hospital services. Nightingale Nursing times.

2011; 7(4):12-14&40.

5. Ehiemere Ijeoma, Nwaneri Ada, Iheanacho Peace and Akpati. Helpless patients’

satisfaction with quality of nursing care in Federal tertiary hospitals, International

Journal of Nursing and Midwifery. January 2011; 3(1): 6-13. Available at: URL:

http://www.academicjournals.org/ijnm

6. Zuthans, F. A patient satisfaction in public hospitals. Journal of hospital

administration.1989; 13(2): 7-12.

7. Taylor, C. & Benger, J.R. Patient satisfaction in emergency medicine; Journal of

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Emergency Medicine.2004; 21(5): 8-11.

8. Lee MA, Yom YH. A comparative study of patients' and nurses' perceptions of the

quality of nursing services, satisfaction and intent to revisit the hospital: a questionnaire

survey. Int J Nurs Stud. 2007 May; 44(4):545-55.Available at:http

://www.ncbi.nlm .nih.gov/pubmed/16687147

9. Raja, P. & Muthulakshmi, S. Role of patient satisfaction surveys at a rural hospital;

Prism Nursing practice.2008; 4(4): 114-117.

10. Maria Vanessa C. Villarruz-Sulit, Antonio. Dans, and Mark Anthony U. Javelosa.

Measuring Satisfaction with Nursing Care of Patients Admitted in the Medical Wards

of the Philippine General Hospital. Available online: URL: http :// www.actamedica

philippina.com.

11. Linda H Aiken. Patient safety, satisfaction, and quality of hospital care: cross sectional

surveys of nurses and patients in 12 countries in Europe and the United States.

Available at: URL: http:// www. bmj. Com /content /344/bmj.e1717.

12. Mufti Samina, Qadri GJ, SA Tabish, Mufti Samiya, and R Riyaz. Patient’s Perception

of Nursing Care at a Large Teaching Hospital in India. Int J Health Sci (Qassim). 2008

July; 2(2): 92–100. Available at: URL:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068745/

13. Kamsol, Mohamed Kassim. Patient satisfaction with nursing care in Hospital Kangar

2001 Masters thesis, University Utara Malaysia. Available at URL: http: //

eprints .uum.edu.my/1390.

14. Al Momani M, Al Korashy H. Patient experience of nursing quality in a teaching

hospital in Saudi Arabia. Iran J Public Health. 2012; 41(8):42-9. Available at URL:

http://www.traveldoctoronline.net/patient-experience-of-nursing-quality-in-a-teaching-

hospital-in-saudi-arabia-MjMxMTMyMjM=.htm

15. Alhusban MA, Abualrub RF. Patient satisfaction with nursing care in Jordan. J Nurs

Manag. 2009 Sep; 17(6):749-58. Available at URL: http:// www.ncbi.nlm.nih.gov

/pubmed /19694918

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16. Al-Doghaither AH. Inpatients satisfaction with nursing services at king Khalid

university hospital, Riyadh, Saudi Arabia. J Family Community Med. 2000 Sep;

7(3):37-45. Available at URL ; http://www.ncbi.nlm.nih.gov/pubmed/23008629

17. Peter Johansson, Magnus Oléni, Bengt Fridlund RN, RNT, PhD. Patient satisfaction

with nursing care in the context of health care: a literature study. Scandinavian Journal

of Caring Sciences. December 2002;16(4): 337–344.Available at URL:

http://www.ncbi.nlm.nih.gov/pubmed/12445102

18. Findik UY, Unsar S, Sut N. Patient satisfaction with nursing care and its relationship

with patient characteristics. Nurs Health Sci. 2010 Jun; 12(2):162-9. Available at

URL:http://www.ncbi.nlm.nih.gov/pubmed/20602687

19. Wu ML, Courtney M, Berger G. Models of nursing care: a comparative study of patient

satisfaction on two orthopaedic wards in Brisbane. Aust J Adv Nurs. 2000 Jun-Aug;

17(4):29-34. Available at URL: http://www.ncbi.nlm.nih.gov/pubmed/11249397

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9 SIGNATURE OF THE CANDIDATE

10. REMARKS OF THE GUIDE The study is relevant, appropriate and feasible to conduct.

11. 11.1 NAME AND DESIGNATION

OF GUIDE

(IN BLOCK LETTERS)

Mrs. HELENA. R. JOSEPH, M.Sc(N),

ASSOCIATE PROFESSOR,

DEPT OF MEDICAL-SURGICAL NURSING,

SDM INSTITUTE OF NURSING SCIENCES, SATTUR, DHARWAD.

11.2 SIGNATURE

11.3 CO-GUIDE(IF ANY) MR. PRASHANT. M.Sc(N)

LECTURER, SDMIONS,

DHARWAD.

11.4 SIGNATURE

11.5 HEAD OF THE

DEPARTMENT

Mrs. HELENA.R. JOSEPH

SDM INSTITUTE OF NURSING SCIENCES, SATTUR,

DHARWAD.

11.6 SIGNATURE

12. 12.1 REMARKS OF THE

CHAIRMAN/ PRINCIPAL

This study is relevant and findings of the study will help to add to the body of Nursing knowledge.

12.2 SIGNATURE

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