26-Research Presentation (27.02.2024).pptx

Lecture on research

1. Assessment of Nurse-Patient communication and patient satisfaction from nursing care at Kharadar General Hospital Karachi, Pakistan Group-1 Mr. Izhar Uddin, Mr. Salman Khan, Mr. Yaseen Khan, Ms. Arafat Akber , Mr. Islam Uddin, Mr. Arshad Javid , Mr. Sadiq Ur Rehman , Ms. Fariya Naaz and Ms. Shariqa Gu l Students of Generic-BSN, Session 2019-23, Batch-01 School of Nursing Kharadar General Hospital SYNOPSIS PRESENTATION NURSING SEMINAR (NU-228) SUPERVISOR & COSUPERVISOR : Mr. Muhammad Shahid Mr. Mehmood Ahma Mr. Ali Abbas March 5 th , 2024

2. Introduction and Background The nurse-patient communication and the patient's satisfaction have a significant impact on the quality of healthcare services provided by nurses worldwide. Effective communication between nurses and patients is essential to providing quality care and making sure that patients' needs and concerns are understood and addressed. On the other hand, the patient's satisfaction—a critical measure of the overall healthcare experience—reflects the effectiveness of the communication and treatment provided. ( Newell, 2015, P.76 ) Rationale of the Study: The review of the literature and the health care system in Pakistan indicate that low nurse-patient ratio, inadequate training, and poor communication contribute to low patient satisfaction with nursing care. By conducting this research, valuable insights can be gained to address communication gaps, enhance patient experiences, and ultimately improve the quality of nursing care at Kharadar General Hospital .

3. Introduction and Background Research Problem: Inappropriate Nurse-Patient communication can result unsatisfactory care or substandard nursing care. Research Question What is the level of patient satisfaction with quality of Nurse-Patient Communication and Nursing care? Study objective: To assess nurse-patient communication and patient satisfaction with nursing care.

4. Significance of the Study Investigation into nurse-patient communication dynamics in Private Tertiary care Teaching Hospitals Examination of the direct influence on patient satisfaction Identification of strengths and areas for improvement within hospital healthcare delivery Provision of valuable insights for enhancing patient care standards Establishment of a foundation for healthcare providers to refine practices Emphasis on prioritizing patient-centered care in healthcare delivery systems

5. Operational Definitions Registered Nurse: A person who studied General Nursing/BS Nursing/Community Midwifery and registered with the Pakistan Nursing and Midwifery Council (PNMC ). Patient: A patient is an individual who is ill and admitted to the hospital for treatment. Communication: The give and take of information between nurse and patient, including both verbal and non-verbal interactions in the hospital . Therapeutic Communication: The exchange of information between nurses and patients regarding their treatment is known as therapeutic communication . Satisfaction: The extent to which patients perceive and evaluate the healthcare services they receive .

6. Literature Review

7. Literature Review

8. Research Methodology Study Design Cross-Sectional study design. Study Setting Medical, Surgical and Gynea Wards of Kharadar General Hospital Karachi Pakistan Study Duration August-2023 to January-2024 Study Population A dmitted adult patients both Geneder Sampling Technique Non-probability, convenient sampling technique Sample Size n = 240 (Calculated through Open.epi.com)

9. Research Methodology Inclusion Criteria Patient admitted to the hospital both Gender A ge > 18 years Stay in Hospital minimally 24 Hours. Exclusion Criteria   OPD , Emergency, and Nursery patients Critically ill patients Not willing to participate in research

10. Research Methodology Data Collection Tool The data was collected through adopted structured questionnaires. Which includes; Part-A Demographic ( Gender , Age, Marital Status, Education, Known Nurse Name, Known Doctors Name, Hospitalization, And Hospital Stay) Part-B Patients Satisfaction with Quality of Nursing Care (LOPSS) Part-C Patient satisfaction with Nurse-Patient Communication (NQCPQ )

11. La Monica- Oberst Patient Satisfaction Scale (LOPSS) This scale was developed by La Monika and Abreast in 1986. It measures patient satisfaction with nursing care. this scale with extensive reliability and validity data has 25 items. Each item has five responses with a Likert form from “Poor” to “Excellent” The minimum score is 25, and the maximum score is 125. A higher score reflects more satisfaction with nursing services. LOPSS has three domains that include dissatisfaction (17 items), interpersonal support (13 items) and good impression (11 items)

12. Nurse Quality of Communication with Patient Questionnaire (NQCPQ) This questionnaire was designed by Vekovich et al. in 2012 ( Vukovic et al., 2010). The questionnaire includes 25 items that examine verbal , non-verbal communication and general communication between nurses and patients. The answer to each item is fluctuates in a Likert spectrum 5 options of “Poor” to “Excellent”. The minimum score is 25, and the maximum score is 125. A higher score reflects is better nurse Communication with the patient

13. Ethical Consideration Ethical approval from Ethical Review Committee Kharadar General Hospital Data collection Permission was taken from CEO Kharadar General Hospital Written consent was taken from participants

14. Data Collection flow chart Assess for eligibility N=1364 Enrollment Excluded ( n=1124) Not meeting inclusion Criteria ( n=452) Decline to participate ( n=672) Convenient Sampling (n = 240) Patients (n= 240) LOPSS & NQCPQ Given ( n=240) C ompleted Analyzed (n=240) Allocation Questionnaire Analysis

15. 1) Screened the participant file 2) Based on inclusion and exclusion criteria 4 ) Patient recruited 3 ) Informed consent 5) Give Questionnaire 6) Data Recorded 7) Data analyzed on SPSS V. 20.0 DATA COLLECTION PROCEDURE

16. Data Analysis Data was entered and analysed by using IBM-SPSS version 20.0 Frequencies and percentages were recorded for categorical variables such as gender Mean and standard deviation were measured for numerical variables such as age The Pearson correlation coefficient was used to determine the relationship between patient satisfaction and nurse patient communication. Independent sample T-test was applied on Gender variable and ANOVA was used to compare test score of patient satisfaction and communication with other Demographic variables such as Age group, Hospitalization, Education etc All test were two sided and statistical significance level was set at p < 0.05.

17. 70.33 % Results

18. Table-1 Frequency Information of Participants at various department of Kharadar General Hospital Sr. No Department Name No. of Participants Gender Male Female 01 Male General Ward (ADW) 30 30 00 02 Private Ward 30 30 00 03 Semi-Private Ward 30 30 00 04 Female General Ward 30 00 30 05 Private Wings (Gynae) 30 00 30 06 Antennal Ward (Gynae) 30 00 30 07 Post-Natal (Gynae) 30 00 30 08 Post-Operative (Gynae) 30 00 30 Total Participants (n) 240 Male= 90 Female = 150

19. Frequency Information of Participants at various department of Kharadar General Hospital

20. Table-2 Demographic Information of Participants at Kharadar General Hospital Sr. No Variable Group n % 01 Gender Male 90 37.5 Female 150 62.5 02 Age ( X̄ = 36.72 + 12.68) 18-40 154 64.2 41-60 85 35.4 >60 1 .4 03 Marital Status Single 53 22.1 Married 187 77.9 04 Education Illiterate 37 15.4 Primary 75 31.3 Middle 43 17.9 Matric 65 27.1 Intermediate 8 3.3 Bachelor 9 3.8 Master 3 1.3

21. Table-2 Demographic Information of Participants at Kharadar General Hospital Sr. No Variable Group n % 05 Participant Known Nurse Name Yes 68 28.3 No 172 71.7 06 Participant Known Doctor Name Yes 188 78.3 No 52 21.7 07 No. of Hospitalization during last 2 years Once 53 22.1 Twice 30 12.5 More than 3 time 157 65.4 09 Recent Hospital Stay 1 Day 35 14.6 2 Days 44 18.3 More than 3 Days 161 67.1

22. Table-3 Department wise Patient Satisfaction with Quality of Nursing Care and Nurse-Patient Communication Sr. No Department Name No. of Participants Satisfaction with Nursing care (LOPSS) Nurse-Patient Communication (NQCPQ) Mean SD Satisfaction Level Mean SD Satisfaction Level 01 Male General Ward (ADW) 30 76.2 . 28 60.96% 78.9 .24 63.12% 02 Private Ward 30 89.6 . 47 71.68% 82.4 . 60 65.92% 03 Semi-Private Ward 30 85.3 . 35 68.24% 87.8 . 40 70.24% 04 Female General Ward 30 93.8 .30 75.04% 89.9 .36 71.92% 05 Private Wings (Gynae) 30 94.2 .32 75.36% 90.5 .34 72.4% 06 Antennal Ward (Gynae) 30 92.8 . 37 74.24% 93.4 .36 74.72% 07 Post-Natal (Gynae) 30 86.5 . 56 69.2% 86.7 .52 69.36% 08 Post-Operative (Gynae) 30 84.7 . 40 67.76% 87.9 . 33 70.32%

23. Table-4 Frequencies, Mean and Standard Deviation of Patient Satisfaction with Nursing Care Sr. No# Item (n=240) LOPSS (Min = 25, Cut off= 62.5 and Max = 125) Mean + SD Poor Fair Good V-Good Excellent 1 How clear and complete the nurses’ explanations were about tests, treatments, and what to expect. 6 5 56 144 29 3.77 + .783 2 How well nurses explained how to prepare for tests and operations. 20 4 93 102 21 3.42 + .98 3 Willingness of nurses to answer your questions. 5 19 92 101 23 3.49 + .85 4 How well nurses communicated with patients, families, and doctors. 5 20 85 104 26 3.53 + .87 5 How well the nurses kept them informed about your condition and needs. 6 27 113 78 16 3.30 + .84 6 How much they were allowed to help in your care. 8 31 108 75 18 3.27 + .89 7 Courtesy and respect you were given; friendliness and kindness. 1 14 110 86 29 3.50 + .79 8 How often nurses checked on you and how well they kept track of how you were doing. 1 11 99 85 44 3.67 + .84 9 How much nurses ask you what you think is important and give you choices 7 27 103 80 23 3.35 + . 90

24. Table-4 Frequencies, Mean and Standard Deviation of Patient Satisfaction with Nursing Care Sr. No# Item n=240 LOPSS (Min = 25, Cut off= 62.5 and Max = 125) Mean + SD Poor Fair Good V-Good Excellent 10 Willingness of the nurses to be flexible in meeting your needs. 23 99 98 20 3.48 + .781 11 How well they adjusted their schedules to your needs. 21 102 92 25 3.50 + .797 12 Ability of the nurses to make you comfortable and reassure you. 5 107 103 25 3.62 + .699 13 How quick they were to help. 6 22 79 81 52 3.63 + 1.002 14 How well things were done, like giving medicine and handling IVs 2 8 86 115 29 3.67 + .763 15 The teamwork between nurses and other hospital staff who took care of you. 2 14 126 86 12 3.38 + .711 16 Amount of peace and quiet. 2 12 99 72 55 3.69 + .908 17 Provisions for your privacy by nurses. 1 11 107 99 22 3.54 + .742

25. Table-4 Frequencies, Mean and Standard Deviation of Patient Satisfaction with Nursing Care Sr. No# Item n=240 LOPSS (Min = 25, Cutt off= 62.5 and Max = 125) Mean + SD Poor Fair Good V-Good Excellent 18 How clearly and completely the nurses told you what to do and what to expect when you left the hospital. 2 13 115 95 15 3.45 + .730 19 Nurses ’ efforts to provide for your needs after you left the hospital. 2 16 127 83 12 3.36 + .719 20 Overall quality of Nursing care and services you received during your hospital stay 18 127 78 17 3.39 + .729 21 How do you rate the quantity of nurses on duty to care for you in the hospital? 1 11 104 99 25 3.57 + .757 22 How much do you have confidence and trust in the nurses treating you? 1 11 111 90 27 3.55 + .769 23 Based on the nursing care I received, I would recommend this hospital to my family and friends. Or How you will rate this organization in terms of recommendations for your family and friends' treatment? 1 18 105 95 21 3.49 + .776 24 Overall, how would you rate your (the patient’s) health before this most recent hospital stay? 1 9 117 92 21 3.51 + .726 25 How much do you have confidence and trust in the doctors treating you? 2 7 81 107 43 3.76 + .808

26. Over all Satisfaction with nursing care 70.33% Mean Score 87.91

27. Table-5 Frequencies, Mean and Standard Deviation of patients Satisfaction with Nurse-patient Communication Sr. No# Item (n=240) LOPSS (Min = 25, Cut off= 62.5 and Max = 125) Mean + SD Poor Fair Good V-Good Excellent 1 How was the assessment of the patient's current condition based on the quality of communication with the patient 1 10 84 114 31 3.68 + .76 2 What was the level of interest in the hospital regimen and the lifestyle during the conversation with me 1 9 101 112 17 3.56 + .700 3 How was the nurse cooperation with the patient on mobility, diet, and change of bedclothes 12 105 93 30 3.59 + .77 4 What is your rating for nurse communication With the Patient While Carrying out or Monitor Medication 2 9 98 100 31 3.62 + .78 5 What was the level of resolving needs without questioning due to the severity of the patient’s condition? 1 28 105 89 17 3.39 + .80 6 How was the Communication with the Patient during Care Procedures 3 15 105 91 26 3.51 + .81 7 How effective was the Communication at the Time of the Severity of the Patient's Illness 3 15 99 103 20 3.51 + .78 8 Nurses sensitivity level to the severity of the reaction 1 18 112 90 19 3.45 + .76

28. Table-5 Frequencies, Mean and Standard Deviation of patients Satisfaction with Nurse-patient Communication Sr. No# Item n=240 LOPSS (Min = 25, Cut off= 62.5 and Max = 125) Mean + SD Poor Fair Good V-Good Excellent 9 How was the Understanding level of symptoms of the disease by the nurse in examining the mental and physical condition 3 27 112 76 22 3.36 + .84 10 How was the Understanding level of presence and role of nurses in the course of illness 1 14 114 87 24 3.50 + .77 11 Response level when I Asked a nurse for appropriate help during meals 4 11 104 96 25 3.53 + .80 12 What is your rating for nurses for their teamwork 1 10 115 86 28 3.54 + .77 13 What was the activeness level in maintaining individual health? 6 12 99 102 21 3.50 + .82 14 Response level when asking about the details of the Medicine 2 16 90 95 37 3.62 + .85 15 How was the effectiveness of the treatment based on the patient’s reactions 3 10 88 116 23 3.61 + .76 16 How was the Hospital Regimen 3 9 109 85 34 3.58 + .82 17 Understanding the Level of the Patient by the Nurse 3 7 111 97 22 3.53 + .75

29. Table-5 Frequencies, Mean and Standard Deviation of patients Satisfaction with Nurse-patient Communication Sr. No# Item n=240 LOPSS (Min = 25, Cutt off= 62.5 and Max = 125) Mean + SD Poor Fair Good V-Good Excellent 18 How was the appropriateness of prescribed pharmacotherapy 4 17 84 93 42 3.63 + .91 19 What was the level of Conversation with the nurse about the medication? 3 9 102 99 27 3.58 + .79 20 What is the rating of Talking to the nurse about health issues? 3 12 103 104 18 3.51 + .76 21 What was the level of knowledge to answer nursing questions about the disease? 2 16 105 105 12 3.45 + .73 22 What is the rating of Talking to nurses about the severity of the disease? 2 15 132 75 16 3.37 + .74 23 How I accept and understand the presence of nurses related to illness 5 16 127 80 12 3.33 + .76 24 Level of willingness to treat at home by nurse 15 63 97 56 9 2.92 + .95 25 How was the acceptance of medication through the conversation with the nurse? 8 18 103 101 10 3.36 + .82

30. Over all Satisfaction with nurse-patient communication 30.2 % Mean Score 87.22

31. Table:6-The relationship between demographic information with Patient Satisfaction (LOPSS Scale) and Nurse Quality of Communication with Patients (NQCPQ Scale) Variable Education Level P-Value Primary Middle Matric Intermediate Mean Satisfaction Score 3.41 3.54 3.61 3.47 0.225 Mean Communication Score 3.36 3.53 3.45 3.48 0.272 Variable Marital Status P-Value widowed separted/ divorced married/ cohabiting single Satisfaction_Mean 3.30 3.96 3.49 3.58 .180 Communication_Mean 3.26 3.88 3.47 3.54 . 263

32. Table:6-The relationship between demographic information with Patient Satisfaction (LOPSS Scale) and Nurse Quality of Communication with Patients (NQCPQ Scale) Variable Hospital Stay P-Value 1 day 2 days > 3 days Satisfaction Mean 3.49 3.57 3.58 .376 Communication Mean 3.49 3.44 3.53 .707 Variable Age Group P-Value 18-40 21-60 > 60 Mean Satisfaction Score 3.54 3.5 3.32 0.149 Mean Communication Score 3.52 3.46 3.34 0.209 Variable Hospitalization P-Value Over 4 times 4 times 3 times Mean Satisfaction Score 3.52 3.37 3.58 0.121 Mean Communication Score 3.51 3.29 3.51 0.034*

33. Table:6-The relationship between demographic Variable Gender with Patient Satisfaction (LOPSS Scale) and Nurse Quality of Communication with Patients (NQCPQ Scale) Variable Gender P-Value 95% CI Male Female Mean Satisfaction Score 3.348 3.61 <.001 (-0.38,-.15) Mean Communication Score 3.321 3.58 <.001 (-0.38,-.15) Gender Variable P-Value 95% CI Mean Satisfaction Score Mean Communication Score Male 3.348 3.321 <.001 (-0.38,-.15) Female 3.61 3.58 <.001 (-0.38,-.15)

34. Table:6-The relationship between Patient Satisfaction (LOPSS) and Nurse Quality of Communication with Patients (NQCPQ) Satisfaction with nursing care ( LOPSS) Satisfaction with Nurse -Patient Communication (NQCPQ) Pearson Correlation P-Value Pearson Correlation P-Value .661** .000 .661** .000

35. DISCUSSION Patient

36. CONCLUSION Strengths and opportunities for development in healthcare delivery are identified in the study "Assessment of Nurse-Patient Communication and Patient Satisfaction with Nursing Care at Kharadar General Hospital." Significant satisfaction with nursing treatment was found in a sample of 240 participants from different departments, particularly in the male and female wards. But there's still room for improvement, especially when it comes to encouraging better nurse-patient communication across all departments. The study highlights the significance of thorough and lucid communication, with nurses' explanations of tests, treatments, and expectations receiving the highest mean score for clarity. Better patient involvement in care is yet required. The study also emphasizes the strong correlation between hospitalization, gender disparities in satisfaction levels, and nurse-patient communication. The results point to the necessity of customized interventions to meet certain.

37. Strength & Limitation Strength Limitation 1- Adequate sample size. 1 - The study was carried out only in one tertiary care hospital of Karachi. 2- Study conducted in different disciplinary units of KGH. 2- Patient feel pressure to provide positive feedback about their experience with nursing care. 3- Fulfilled epidemiological criteria (Study Design) 3- Time limitation 4- Data analyzed by out side professional Bio-Statistician 4- Data collected by the SON-KGH nursing students.

38. Recommendation Practice: Conduct a detailed examination of the current nurse-patient communication practices at Kharadar General Hospital, focusing on communication techniques, listening skills, empathy, and responsiveness. Identify areas for improvement and develop targeted interventions, such as communication skills training programs or workshops, to enhance nurse-patient interactions and improve patient satisfaction. Nursing Education: Evaluate the existing nursing education curriculum at Kharadar General Hospital to assess the extent to which it addresses effective communication skills and patient-centered care principles. Consider incorporating specific modules or courses dedicated to enhancing communication competencies among nursing students, ensuring they are adequately prepared to engage with patients in a compassionate and empathetic manner. Policy: Review the hospital's policies and protocols related to nurse-patient communication and patient satisfaction, identifying any gaps or inconsistencies that may hinder effective communication or impede patient-centered care delivery. Propose revisions or updates to existing policies to prioritize communication excellence and patient satisfaction as integral components of nursing practice within the hospital setting. Research: Conduct empirical research to explore the factors influencing nurse-patient communication and patient satisfaction at Kharadar General Hospital in greater depth. Utilize qualitative and quantitative research methodologies to gather insights from both nurses and patients, examining their perspectives, experiences, and preferences regarding communication practices and care delivery. Generate evidence-based recommendations for enhancing nurse-patient communication and improving patient satisfaction, contributing to the broader body of knowledge in healthcare communication and patient-centered care. By addressing these recommendations comprehensively, Kharadar General Hospital can cultivate a culture of effective communication, patient-centered care, and continuous quality improvement, ultimately leading to improved patient outcomes and experiences.

39. Acknowledgment Acknowledgment

40. REFERENCES Aiken, L. H., Sloane, D. M., Ball, J., Bruyneel , L., Rafferty, A. M., & Griffiths, P. (2021). Patient satisfaction with hospital care and nurses in England: an observational study. BMJ open , 8 (1), e019189. Alharbi , H. F., Alzahrani , N. S., Almarwani , A. M., Asiri , S. A., & Alhowaymel , F. M. (2023). Patients' satisfaction with nursing care quality and associated factors: A cross‐section study. Nursing Open , 10 (5), 3253-3262. Guo , S., Chang, Y., Chang, H., He, X., Zhang, Q., Song, B., & Liu, Y. (2023). Patient satisfaction with nurses' care is positively related to the nurse–patient relationship in Chinese hospitals: A multicentre study. Frontiers in Public Health , 10 , 1109313. Imam, S. Z., Syed, K. S., Ali, S. A., Ali, S. U., Fatima, K., Gill, M., ... & Jameel , O. F. (2007). Patients' satisfaction and opinions of their experiences during admission in a tertiary care hospital in Pakistan–a cross sectional study. BMC health services research , 7 (1), 1-8. Karaca , A., & Durna , Z. (2019). Patient satisfaction with the quality of nursing care. Nursing open , 6 (2), 535-545 . Khan, M. H., Hassan, R., Anwar, S., Babar, T. S., Babar, K. S., & Khan, D. I. (2007). Patient satisfaction with nursing care. Rawal Medical Journal , 32 (1), 28-30. Kousar , F., Inayat , S., & Ahmad, S. ASSESSMENT OF PATIENTS’SATISFACTION WITH THE QUALITY OF CARE OF NURSING AT ALLIED HOSPITAL PUNJAB MEDICAL COLLEGE, FAISALABAD . Lotfi , M., Zamanzadeh , V., Valizadeh , L., & Khajehgoodari , M. (2019). Assessment of nurse–patient communication and patient satisfaction from nursing care. Nursing open , 6 (3), 1189-1196. Mobolaji-Olajide , O. M., Adereti , S. C., Odutayo , P. O., & Adejumo , P. O. (2020). In-patient satisfaction with nursing care: outcome measurement in a tertiary health facility in Lagos, Nigeria. International Journal of Africa Nursing Sciences , 13 , 100264 .

41. REFERENCES Molina- Mula , J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making . International journal of environmental research and public health , 17 (3), 835. Muhammad, D., Ahmad, I. W., & Naz , S. (2020). LEVEL OF PATIENT SATISFACTION WITH NURSING CARE IN PUBLIC SECTOR TERTIARY CARE HOSPITALS OF PESHAWAR, PAKISTAN; A CROSS-SECTIONAL DESCRIPTIVE STUDY. Asian Journal of Allied Health Sciences (AJAHS) , 46-52. Newell, S., & Jordan, Z. (2015). The patient experience of patient-centered communication with nurses in the hospital setting : a qualitative systematic review protocol. JBI evidence synthesis, 13(1), 76-87. Putra, W. S., Nasution , S. L. R., Nasution , S. W., & Girsang , E. (2021). The effect of nurse therapeutic communication on patient satisfaction at medan advent hospital. Int J Sci Eng Sci , 5 , 98-102. Rehman , O. U., Rehman , M. U., Rahim, N. U. H., Zubair , M., Bibi, P., Sulaman , S., & Ali, S. (2023). Assessment of patient satisfaction in inpatient department of Ayub Teaching Hospital Abbottabad, Pakistan. The Professional Medical Journal , 30 (07 ), 929-935. Tsai, T. C., Orav , E. J., & Jha , A. K. (2015). Patient satisfaction and quality of surgical care in US hospitals. Annals of surgery , 261 (1 ), 2. ur Rashad, S., Bibi, A., Ahmad, A., Ahmed, T., Arshad, Z., Ali, Y., ... & Ali, F. M. (2023). Exploring Patient Satisfaction with Nursing Care and its Association with Gender at Tertiary Care Hospital Karachi: Patient Satisfaction with Nursing Care. Pakistan Journal of Health Sciences , 150-154. Zhang, J., Yang, L., Wang, X., Dai, J., Shan, W., & Wang, J. (2020). Inpatient satisfaction with nursing care in a backward region : a cross-sectional study from northwestern China. BMJ open , 10 (9), e034196.

42. REFERENCES