INTRODUCTION

1.1Background to the study

A good Nurse-patient relationship is the core of any nursing practice. It is geared

towards enhancing patients wellbeing since it is the nurses primary responsibility to

set the structure and purpose of the nurse-patient relationship, he/she is obliged to

establish and maintain this key relationship by using necessary nursing knowledge

and skills, applying caring attitude and behavior in a patient-centered care approach,

to develop the relationship that will meet the needs of the patient (Haoliang et al.,

2019).

Delivering patient education and promoting understanding, motivating and

persuading patients to adhere to treatment plans expressing empathy, care, and

comfort communication forms the bedrock of the nurse-patient relationship, directly

influencing patient satisfaction, trust, and health outcomes (Barbosa et al., 2020).

While pinpointing globally consistent data on patient satisfaction specifically linked to

nurse-patient relationships can be challenging, According to a study done in Port-

Harcourt by hassan et al., 2019, it revealed that out of 122 patients' who agreed to

participate in a study, 45% of patients were satisfied with the care provided, while

55% were dissatisfied. 94% liked nursing practice of keeping privacy of patients, 84%

had negative experiences as they observed nurses were not attentive to their needs,

particularly at night.

A recent study conducted in Benue state on patients' perception of Nurse-patient

relationship revealed that Nurse-patient relationship still remain a problem world-

1
wide as patients' complain emphasized more on lack of communication with the

patients' by nurses, and that nurses were unfriendly and were always wearing serious

faces (Nwosu et al.,2021). Patients'

draw conclusions about nurses based on their observation

The nurse-patient relationship itself can be defined as a collaborative and supportive

partnership built upon mutual trust and respect nurturing hope and fostering

optimism actively listening and demonstrating empathy helping patients meet their

physical, emotional, and spiritual needs through the combined knowledge and

expertise of both nurse and patient (Ahn et al., 2023).

Relationship between nurses and patients remains a cornerstone of high-quality

healthcare,it fosters trust, empowers patients, facilitates shared decision-making,

and ultimately leads to improved health outcomes (Zhang et al., 2022).

As the largest healthcare workforce, nurses grapple with the significant challenge of

evaluating and demonstrating the quality of their care. Nurse-patient relationship

plays a crucial role in this endeavor, as it fosters patient engagement, shared

decision-making, and ultimately, better health outcomes (Maben et al., 2019).

This therapeutic relationship blossoms when nurses and patients connect

authentically, leading to improved health, healing, and ultimately, a more rewarding

experience for both (Barbosa et al., 2020).

2
1.2 Statement of problem

In a perfect healthcare setting, nurses would develop strong, trusting relationships

with their patients. This would involve open communication, where patients feel

comfortable expressing their needs and concerns. Nurses would actively listen,

providing emotional support and clear explanations of procedures and care plans.

This ideal relationship would lead to high patient satisfaction, with patients feeling

confident in their care and empowered to participate in their own healing process.

Unfortunately, the reality often falls short of this ideal. Factors like nurse workload,

staffing shortages, and time constraints can limit the amount of time nurses can

spend with each patient. This can lead to rushed interactions, limited

communication, and a sense of detachment between nurses and patients.

When patients are dissatisfied with their nursing care, it can have a negative impact

on their overall health experience. They may feel anxious, uninformed, and less likely

to adhere to treatment plans. This can lead to poorer health outcomes, increased

readmission rates, and a strain on the healthcare system.

To improve patient satisfaction and create a more positive healthcare experience, it's

crucial to bridge the gap between the ideal and reality. This may involve exploring

solutions like:Increased staffing levels to allow for more personalized care.Improved

communication strategies for nurses to effectively share information and address

patient concerns.Enhancing patient education so patients feel empowered to

participate in their care decisions.Implementing strategies to reduce nurse burnout

and promote a patient-centered care environment.

3
By addressing these issues, we can create a healthcare system where strong nurse-

patient relationships are the norm, leading to higher patient satisfaction and

improved health outcomes.

1.3 Research objectives

1. To assess level of nurse-patient relationship .

2. To assess factors affecting nurse-patient relationship.

3. To assess patient satisfaction from nursing care.

1.4 Research questions

1. what is the level of nurse-patient relationship?

2. What are the factors affecting nurse-patient relationship?

3. what is the level patient satisfaction from nursing care?

1.5 Significance of the study

The findings of this study will provide information on the assessment of the patient

nurse-patient relationship and patient satisfaction from nursing care to the

researcher. The study would add to the body of knowledge of Nursing discipline in

area of Nurse-patient relationship. It would also allow nurses to understand what

patients 'expect from them and also clarify any mis-perception patients may have

regarding Nurse-patient relationship. This would enhance the image of nursing and

would also assist Nurses to develop nursing care plans that are patients centered

because patients' experiences and expectations would be considered. It would help

patients have a better knowledge of the nurse-patient relationship, and improve

poor communication that both nurses and patients have as regards it, hence help in

4
enhancing culturally acceptable nurse-patient relationship in Nigeria.

1.6 Scope of the study

The scope of the study is all in patients in State Hospital ota, ado-odo/ota Local

Government, Ogun state.

1.7 Operational definition of terms

1. Nurse: A person giving care and interacting patient nures at state hospital ota.

2. Patient:An individual receiving care from a nurse at state hospital ota.

3. Nurse-Patient Relationship: an interaction between a nurse and a patient built

on quality of communication, trust, respect at state hospital ota

CHAPTER TWO

2.0 Literature review

Professional Interpersonal Relationship: Is a collaborative partnership where

recurring difficulties of patient live can be identified and manage by nurses through

5
respect and understanding. (McHale et al.,2023). According to yildirim et al.,2021 It is

the nurse's professional responsibility to understand the dynamics of the therapcutic

rclationship, to establish the relationship and to maintain the relationship within

therapeutic boundaries. Nurses must understand the difference between a

therapeutic relationship and a social relationship.

Nurses must exercise professional judgment when establishing a therapeutic

relationship with the client, taking into consideration the client's cultural, spiritual,

mental and biophysical needs. The

nurse-client relationship is professional, and therapeutic relationship is defined as a

helping relationship that's based on mutual trust and respect, the nurturing of faith

and hope being sensitive to self and others and assisting with the gratification of your

patient's physical,emotional and spiritual needs through your knowledge and skill.

This caring relationship develops when you and your patient come together in the

moment, which result in harmony and healing through effective verbal and non

verbal communication and providing care in a manner that enables your patient to

be an equal partner in achieving wellness. (Malik et at.,2022).

The nurse-client relationship is also known as therapeutic relationship, it ensures the

client's need are first and foremost. It exists to meet the needs of the clients, not the

needs of the nurse. It

is always the nurse who is responsible for establishing and maintaining boundaries

with clients regardless of how the patient behaves. In the nurse-client relationship a

power imbalance exists.

6
2.1 Component of nurse-patient relationship

The component of the nurse-client relationship are power, trust, respect,

professional intimacy and empathy which are present whenever the nurse is

providing nursing services. The nurse-client relationship is therapeutic.

• TRUST

Trust is critical in the nurse-client relationship because the client is in a vulnerable

position.

Initially the trust in a relationship is fragile so it's especially important that nurse

keep promise to achieve, if trust is breached, it becomes different to re-establish and

beneficial to patient on how the relationship progresses.Nurse promote through

attentiveness, competence. comfort, measures. personal trail and provision of

information.

• RESPECT

Respect is the recognition of the inherent dignity worth and uniqueness of every

individual regardless of socio-economic status personal attributes and the nature of

the health problem. It can also be a positive feelings of esteem or deference for a

person or other entity, and also specific actions and conduct representative of that

esteem.

• INTIMACY

Professional intimacy is inherent in the type of care and service that nurses provide.

It may relate to the physical activities such as bathing. The nurses perform and with

the client that creates closeness. Professional intimacy can also involve psychological,

7
spirital and socio element that

are identified in the plan of care, access to the client personal information also

contribute to professional intimacy.

• EMPATHY

Empathy is the expression of understanding, violating and resonating with the

meaning the health care experience, holds for the client.

In nursing, empathy includes appropriate emotional distance from the client to

ensure objectivity

and an appropriate professional response.

• POWER

The nurse-client relationship is one the unequal power although the nurse may not

immediately

perceived it, the nurse has more power than the client and the nurse has more

authority and influence in the healthcare system, specialized knowledge, access to

privileged information and

the ability to advocate for the client and the client significant others.

2.2 Factors influencing interpersonal relationship

 CLOSE RELATIONSHIP: Close relationships with the people around us are

important 10 our social existence, the key factors in interpersonal relationship

hence shown that people are mostly attracted to those they found physically

attractive and are geographically close.

Another question is that why and how do we relate with certain individual? Firstly we

8
must understand how we first meet someone, even if it's for a short period, we

formulate an impression of them and we account for the positive and negative

characteristic of that individual.

Even if the person attitude changes to contradict the first impression, we tend to

accept the perception of that person

Most a times, people look for positive altitude in an individual, however if the

negative outlook is latter demonstrated, it will entirely over powers the positive

behavior of an individual, a times, the following can even be the factor which are

physical attraction, proximity, similarity,

complementary and effects of frustration.

 PROXIMITY: Proximity is another stronger factor in interpersonal relationship.

Physical closeness must be shared in other to meet; one is more likely to become

another

person's friend who can be easily accessed than the one who is not easily assessed.

Interpersonal relationship addresses the knowledge, skills, attitude and behavior to

participate in positive, caring and respectful relationship in the hospital.

Factors that impact relationships (i.e. power conflicting interests, pear pressures, life

event) include:

 Establishing and maintaining relationships

 Building sclf-esteem and for self image through healthy relationship

 Communications styles.

 Techniques for effective communication.

9
 Leadership and team work

 Individual and group goal setting and decision making

 Preventing managing and conflict

 Address violence and abuse.

2.3 Skills and strategies for developing interpersonal relationships

 Observing and acting on approachability cues.

 Identify and use conversation starters.

 Follow initiation norms.

 Don't expect too much from the initial interaction.

 Skills and strategies used in both initiating and escalating relationships.

 Communicate attraction

 Be open and self-disclose appropriately

 Gather information to reduce uncertainty

 Listen actively and respond conformingly

 Socially dissenter and adopt another oriented perspective.

 Skills and strategies specific to escalating and maintaining relationship:

 Express emotion.

 Engage in relationship talk.

 Be tolerated and show restraint.

 Manage conflict cooperatively.

 Seck compliance.

2.4 Roles of nurses in interpersonal relationships

1. Stranger: Receives the client in the same way one meets a stranger in other life

10
situation, provides an accepting climate that build trust.

2. Teacher: One who impacts knowledge in reference to a need or interest.

3. Resource Person: one who provides needed information that aid in the

understanding of a problem or new situation.

4. Counsellor: Help to understand and integrate the guardians and encouragement

to

make changes.

5. Serrogate: Help to clarify domains of dependence and indepence and act on

client behalf as advocate.

2.5 Tools for nurse patient relationship

Communication is the key helping the relationship between the nurse and patient

run very smoothly. It is in the communication that the nurse establishing rapport

with the patient where the nurse is able to obtain the trust of the patient. In gaining

the trust of the patient it will contribute to both parties to effective outcome in

improving the relationship.

Also, communication is any means of exchanging information or feelings between

two or more people. It is the basic component of human relationship.

Communication can be defined as an art of transmitting information from the

initiator (sender) to the decoder through a channel.

Purpose of communication

The two main purpose of communication are:-

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 To obtain information

 To influence other

Benefit of effective communication

1. To collect assessment data

2. To initiate interventions

3. To evaluate outcomes of intervention

4. To initiate changes that promote health

5. To prevent legal problems associated with practices

6. To establish Nurse-client relationship

7. To provide the nurse with professional satisfaction

8. Foundation of relationship between the nurse and other member of health

2.6 How to improve nurse-patient relationship

The nurse-patient relationship remains a cornerstone of quality healthcare. It fosters

trust, promotes positive patient outcomes, and enhances overall satisfaction with

care.

1. Communication is Key:

I．Active Listening:Give patients your full attention, make eye contact, and

acknowledge their concerns verbally and nonverbally (Frisch et al., 2019).

II．Clarity and Simplicity:Use clear, concise language tailored to the patient's

understanding. Avoid medical jargon and explain complex information in a way that

is easy to digest.

III．Open and Honest Communication:Encourage patients to ask questions and

12
express their feelings openly. Be truthful and transparent in your communication

(Ahuja et al., 2021).

2. Building Trust and Respect:

I．Patient-Centered Care:Involve patients in decision-making whenever possible.

Respect their autonomy and preferences.

II．Empathy and Compassion:Acknowledge patients' fears, anxieties, and

emotional responses. Demonstrate empathy and understanding to build trust and

connection.

III．Cultural Sensitivity:Be aware of cultural differences in communication styles

and beliefs. Tailor your communication and care approach to respect patients'

cultural backgrounds (Yildirim & Kabadayi, 2021).

3. Creating a Supportive Environment:

I．Time Management:While workload demands exist, strive to dedicate adequate

time for patient interaction. This allows for better communication, addressing

concerns, and building rapport (Kutcher et al., 2019).

II．Active Collaboration:Collaborate with other healthcare providers to ensure

continuity of care and a consistent message for patients (McHale et al., 2023).

III．Positive Body Language:Maintain a professional yet approachable demeanor.

Use positive body language that conveys respect and attentiveness (Frisch et al.,

2019).

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4. Emerging Strategies

I．Technology-Assisted Communication:Explore the use of secure communication

platforms to facilitate communication between patients and nurses outside of

appointments (Ahuja et al., 2021). This can empower patients to ask questions and

address concerns in real-time.

Mindfulness and Communication Skills Training:Studies suggest that mindfulness

training for nurses can enhance communication skills and empathy, leading to

stronger patient relationships (McHale et al., 2023).

By implementing these strategies, nurses can foster strong and positive relationships

with patients. This collaborative approach leads to improved communication, trust,

and ultimately, better patient outcomes and experiences. Furthermore,

incorporating emerging strategies like technology-assisted communication and

mindfulness training can further strengthen these relationships in the evolving

healthcare landscape.

2.7 Hildegard peplau theory of interpersonal relationship.

Therapeutic nurse-client relationship

A professional and planned relationship between client and nurse focuses on the

client’s needs, feelings, problems, and ideas. It involves interaction between two or

more individuals with a common goal. The attainment of this goal, or any goal, is

achieved through a series of steps following a sequential pattern.

14
Four Phases of the therapeutic nurse-patient relationship:

1. Orientation Phase

The nurse’s orientation phase involves engaging the client in treatment, providing

explanations and information, and answering questions.

 Problem defining phase

 It starts when the client meets the nurse as a stranger.

 Defining the problem and deciding the type of service needed

 Client seeks assistance, conveys needs, asks questions, shares preconceptions

and expectations of past experiences.

 Nurse responds, explains roles to the client, identifies problems, and uses

available resources and services.

2. Identification Phase

The identification phase begins when the client works interdependently with the

nurse, expresses feelings, and begins to feel stronger.

 Selection of appropriate professional assistance

 Patient begins to have a feeling of belonging and a capability of dealing with the

problem, which decreases the feeling of helplessness and hopelessness.

3. Exploitation Phase

In the exploitation phase, the client makes full use of the services offered.

 Use of professional assistance for problem-solving alternatives

 Advantages of services are used based on the needs and interests of the

15
 patients.

 The individual feels like an integral part of the helping environment.

 They may make minor requests or attention-getting techniques.

 The principles of interview techniques must be used to explore, understand and

adequately deal with the underlying problem.

 Patient may fluctuate on independence.

 Nurse must be aware of the various phases of communication.

 Nurse aids the patient in exploiting all avenues of help, and progress is made

towards the final step.

4. Resolution Phase

In the resolution phase, the client no longer needs professional services and gives up

dependent behavior. The relationship ends.

 Termination of professional relationship

 The patient’s needs have already been met by the collaborative effect of patient

and nurse.

 Now they need to terminate their therapeutic relationship and dissolve the links

between them.

 Sometimes may be difficult for both as psychological dependence persists.

 The patient drifts away and breaks the nurse’s bond, and a healthier emotional

balance is demonstrated, and both become mature individuals.

16
2.7.1Application of theory to the study

Peplau's theory of interpersonal relationships outlines the phases a nurse-patient

relationship progresses through, along with the roles a nurse might adopt in each

phase.

1. Orientation Phase:

Application: This initial phase involves getting acquainted. The nurse gathers

information about the patient's needs, concerns, and past experiences. The patient

seeks information and understanding about their condition and expectations for

care.

Nurse's Role:

Stranger: Initially, both nurse and patient are unfamiliar. The nurse focuses on

building trust and rapport through introductions, active listening, and open-ended

questions.

Resource Person: The nurse provides basic information about the healthcare setting,

routines, and what to expect during their stay.

2. Identification and exploitation phase:

Application: This collaborative phase focuses on developing and implementing a plan

of care. The nurse educates the patient about their condition, treatment options, and

self-management strategies.

Nurse's Role:

Teacher: The nurse provides clear explanations and uses various teaching methods

tailored to the patient's learning style.

17
Leader: The nurse guides the patient towards informed decision-making about their

care, while respecting their autonomy.

Collaborator: The nurse works together with the patient to set realistic goals, develop

a care plan, and identify necessary resources.

3. Resolution phase

Application: The focus here is preparing the patient for discharge or transition to a

different level of care. The nurse helps the patient adjust to their new situation and

provides ongoing support as needed.

Nurse's Role:

Counselor: The nurse helps the patient cope with emotional challenges associated

with discharge, such as anxiety about managing their condition at home.

Surrogate: The nurse may offer emotional support and act as a source of comfort

during this time of change.

2.8 Emperical review

A research carried out by olajide et al.,2020 on the “assessment of nurse-patient

relationship and patient satisfaction with care in outcome measurement in a tertiary

health facility in Lagos,Nigeria”.The results show Regarding the factors influencing in-

patient's satisfaction with care, it was deduced that majority of the participant's

opined that individualized care (74.8%), Patient acceptance by nurses (71.7%), nurses

reassurance (72.5%), Nurses kindness and consideration (74%), Early discharge plan

(60.3%), quick response to patient's needs (63.4%), Good knowledge of conditions

(68.7%), Good nurse/patient relationship (63.4%), Nurses setting realistic goals

18
(71.8%), Improved self-esteem (72.5%), Timely medications (73.3%), Relative

involvement in patient's care (64.9%) and nurses cheerful and gentle approach to

care were the factors influencing their satisfaction with nursing care.

A research conducted by Onianwa et al.,(2022) on the”assessment of patient’s

satisfaction with nursing care in a tertiary hospital south west,Nigeria”. The result

showed that approximately 62% of the patients were satisfied with the overall

nursing care they received at the Hospital. Most particularly, patients were satisfied

with overall nurse-patient interaction (76.9%); nurse’s admission and provision of

information (61.3%) and nurse’s attitude and performance of duty (61.6%). An overall

48% level of dissatisfaction with the services was observed. There was a statistically

significant positive association between educational status with level of patients

satisfaction.

Mojgan et al.,(2019), conducted a study on “assessment of nurse patient relationship

and patient satisfaction from nursing care among the patient in sina hospital

northwest burn center of Iran”. The results show that most patients were dissatisfied

with nursing care. More than 80% were not satisfied with the care, communication

and relationship with their nurses. Improving the satisfaction of patients in the

hospital should be the priorities of the hospital managers. Which can be achieved by

educating staff, especially nurses, identifying motivating factors as well as identifying

dissatisfaction factors. improved patient satisfaction.

Similarly,In 2022, Shuije et al carried out a study on “Patient satisfaction with nurses'

care is positively related to the nurse-patient relationship in Chinese hospitals: A

19
multicentre study”.The results showed that the nurse–patient care relationship was

positively correlated with nursing care satisfaction. The interaction between the

patient and nursing staff, eye contact, and respect for the patient's choice can

cultivate trust between the nurse and patient, as patients prefer the nurse to treat

them as a person rather than a disease. This kind of good care relationship will

inevitably affect patients' satisfaction with nurses' care. However, because nursing

care satisfaction is a part of patient satisfaction and affected by many factors, the

relevant factors explained only 37% of the patients were satisfied and suggested that

the humanistic care ability of nurses can be increased by improving the nursing

humanistic care education and evaluation system, creating a harmonious working

atmosphere, improving work–family support for nurses, optimizing the allocation of

human resources, and accelerating the construction of intelligent nursing. A good

working atmosphere is conducive to improving the satisfaction of nursing staff and

making them happier and more patient when treating patients. Managers should

consider the work quality, nursing service, professional assessment, and other

conditions of nursing staff in terms of performance pay and implement humanistic

management methods. This will enhance collaboration and trust between care

leadership and immediate bedside staff to create a culture of care that improves the

support, communication, and opportunities for shared decision-making. Establishing

a good humanistic care atmosphere will trigger a positive professional identity and

improve nurses' enthusiasm for work.

According to a study carried out by Ariyanti et al .,(2022). On Nurse's Therapeutic

20
Communication Affects Patient Satisfaction and Motivation Level, the result showed

that showed that most respondents were given therapeutic communication as many

as 43 respondents (61.4%) were satisfied with as many as 46 respondents (65.7%)

and had high motivation among as many as 41 respondents (58.6%). Obtained p-

value = 0.001 < 0.05.

21
 Chapter Three

3.0 Research methodology

This chapter is based on the method used to carry out the research on the

assessment of nurse-patient communication and patient satisfaction in nursing care

among the patient.It discusses the method that is used in the research study, It

focuses on design, setting, and target population, sampling technique, instrument of

data collection, analysis

and ethical consideration.

3.1 Research Design

A descriptive research design will be used to carry out this study to assess nurse-

patient communication and patient satisfaction in nursing care among the patient in

state hospital Ilaro.

3.2 Research Setting

The research study will be carried out at State Hospital, Ota. State Hospital, Ota was

established on 1st of January, 1990 and operate 24 hour basis. The Hospital was

licensed by the Nigeria Ministry of Health, with facility code 27/03/1/2/2/0001 and it

is registered as Secondary Health Care. The aim of the health institution is to

promote, alleviate and restore health of individuals and families in the society.

Services rendered are majorly restorative measures. The hospital has Antenatal

Clinic, Immunization Clinic, Family Planning Clinic, Eye Clinic, Male and Female Ward,

Post Natal Ward, Orthopedic ward, Surgical Ward, Children Ward, Accident and

22
Emergency Unit. It is headed by the Chief Medical Director (CMD) who controls the

affairs of the health care facility.

3.3. Target Population

The target population will be the total in patient on the ward during the day i will

administer the questionnaires at state hospital, Ilaro ogun state.

3.4 Sampling technique

A convenience sampling technique will be used to collect the sample. It involves

using respondents who are “convenient” to the researcher. There is no pattern

whatsoever in acquiring these respondents. The questionnaire will be taken to each

ward and those willing to participate will be included in the study.

3.5 Sample size

Total enumeration of in-patient will be used by the researcher to carry out the

research.

3.6 Instrument of data collection

The research instrument that will be used is a self- constructed questionnaire and

questions that elicits information to assess Nurse-patient communication and patient

satisfaction. The respondent's identity and responses will be made confidential.

The questionnaire is divided into four sections;

Section A: this is a socio- demographic section and will include questions such as

respondents' age, religion, , marital status, past admission history.

23
Section B: this includes questions to assess the level of nurse-patient relationship.the

question will be in likert scale which contains 3 responses i.e yes, no and not sure.

Section C:this includes questions on the factors affecting nurse-patient

relationship.The questions will be in yes/no format.

Section D: this includes questions to assess the level of patient satisfaction from

nursing care.the question will be in likert scale which contains 3 responses i.e yes, no

and not sure.

3.7 Validity of the instrument

In order to ensure valid research instrument, a face and content validity will be used,

a self-structured questionnaire will be constructed and given to my supervisor for

corrections and comments.

3.8 Reliability of Instrument

In order to improve the tool, a test-retest will be done to establish reliability.10

percent of questionnaires will be administered to nurses in similar setting. This will

also help to measure the degree to which the questionnaire could reflect a true

change. It will be done at the state hospital ilaro.

3.9 Method of data collection

A self-structured, well developed questionnaire was used to collect information from

the participants (patients).

24
3.10 Method of Data Analysis

Data collected will be analysed using the statistical package for social science,

version 28.

3.11. Ethical Consideration

Permission to conduct the study will also be gotten from the school i.e College of

nursing sciences, Ilaro. Ethical approval will be obtained from Ogun State Research

Committe and submitted to the Health Research Ethics Committe of state hospital

ota ogun state.

Eligible participants will be briefed on the study objectives and methodology which

will help them to comprehend the intention of the study and what will be expected

of them prior to collection of data. Written informed consent will be obtained from

eligible participants. Confidentiality of participants will be maintained throughout the

study.

25
 CHAPTER 4

RESULT & DISCUSSION

DATA ANALYSIS AND RESULTS

4.1 DATA ANALYSIS

This chapter deals with analysis assessment of nurse-patient relationship and patient satisfaction

with nursing care among in-patient at State Hospital, Ota, Ogun State.

This study was designed to assess nurse-patient relationship and patient satisfaction from

nursing care among in-patient at State Hospital, Ota, Ogun State.

Data were collected from the in-patients at State Hospital, Ota, Ogun state, using adapted

questionnaire to assess socio- demographic characteristics, nurse-patient relationship, factors

affecting nurse-patient relationship and patient satisfaction with nursing care.

Three research questions answered, the data were analyzed descriptive statistics using frequency

counts, percentage, mean and standard deviation and data were presented in tables and figures

and findings were discussed at the end of the analysis.

26
Table 4.1: SOCIO-DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENTS

VARRIABLE FREQUENCY PERCENTAGE (%)

AGE
18-35 25 50.0
36-50 18 36.0
ABOVE 50 7 14.0
TOTAL 50 100.0
SEX
MALE 17 34.0
FEMALE 33 66.0
TOTAL 50 100.0
ETHNICITY
YORUBA 27 54.0
HAUSA 16 32.0
IGBO 5 10.0
OTHERS 2 4.0
TOTAL 50 100.0
MARITAL STATUS
SINGLE 19 38.0
MARRIED 24 48.0
DIVORCED 5 10.0
WIDOWED/WIDOWER 2 4.0
TOTAL 50 100.0
RELIGION
CHRISTANITY 31 62.0
MUSLIM 17 34.0
TRADITIONAL 2 4.0
TOTAL 50 100.0
EDUCATIONAL LEVEL
NO FORMAL EDUCATION 3 6.0
PRIMARY EDUCATION 4 8.0
SECONDARY EDUCATION 6 12.0
ND/NCE 13 26.0
HND/BSC 22 44.0
POSTGRADUATE 2 4.0
TOTA;L 50 100.0

27
The table showed the socio-demographic characteristics of the respondents. The table revealed
that a significant proportion of the respondents (50%) were between the ages of 18-35 years,
followed by 36-50 years amounting to (36%). The table also revealed that majority of the
respondents (66%) was female, while majority of the respondents (48%) were married.
Regarding educational status, it was reflected that majority of the respondents (44.0%) had
HND/BSC, followed by ND/NCE amounting to (26%) while very few (6%) had no formal education;
furthermore, the table revealed that majority of the respondents (54%) was Yoruba while very
few (4%) were others.

FIGURE 1: THE BARCHART REPRESENTATION OF THE SUMMARY OF NURSE-PATIENT

RELATIONSHIP.

TABLE 4.2: NURSE-PATIENT RELATIONSHIP

VARRIABLE FREQUENCY PERCENTAGE (%)

THE NURSE WAS WELCOMING
AND APRECCIABLE

28
YES 42 84.0
NO 8 16.0
TOTAL 50 100.0
THE NURSE SEEMED GENUINELY
INTRESTED IN MY WELL-BEING
AND HOW I WAS FEELING
YES 37 74.0
NO 13 26.0
TOTAL 50 100.0
THE NURSE LISTENED
ATTENTIVELY TO MY CONCERNS
AND QUESTIONS
YES 42 84.0
NO 8 16.0
TOTAL 50 100.0
THE NURSE TREATED ME WITH
RESPECT AND DIGNITY
YES 44 88.0
NO 6 12.0
TOTAL 50 100.0
THE NURSES VALUED MY INPUTS
IN DECISION ABOUT MY CARE
YES 42 84.0
NO 8 16.0
TOTAL 50 100.0
I FELT CONFIDENT IN THE NURSE
KNOWLEDGE AND SKILLS
YES 38 76.0
NO 12 24.0
TOTAL 50 100.0
I FELT COMFORTABLE TRUSTING
THE NURSES WITH MY CARE
YES 40 80.0
NO 10 20.0
TOTAL 50 100.0
THE NURSES ARE FRIENDLY AND
EASY TO TALK TO
YES 33 66.0
NO 17 34.0
TOTAL 50 100.0
The table provides an insight into the nurse-patient relationship, where it was revealed that
majority of the respondents (84%) indicated that nurses were welcoming and appreciable, it was

29
shown from the table that majority of the respondents (74%) expressed that nurse seemed
genuinely interested in their well-being and how they were feeling. Interestingly, majority of the
respondents (76%) believed that nurses valued their input in decision about their care, while it
was also shown that appreciable percentage of them (84%) reported that nurses listened
attentively to their concerns and question. Additionally, impressive proportion of the
respondents (80%) affirmed that they felt comfortable trusting nurses with their care.

FIGURE 2: THE PIE CHART REPRESESNTATION OF THE SUMMARY OF PATIENT SATISFACTION

WITH NURSING CARE.

TABLE4.3: FACTORS AFFECTING NURSE-PATIENT RELATIONSHIPS

VARRIABLE FREQUENCY PERCENTAGE (%)
THE NURSES EXPLAINED
INFORMATION ABOUT MY
CONDITION AND TREATMENT

30
PLAN IN A WAY THAT WAS EASY
TO UNDERSTAND
YES 38 76.0
NO 12 24.0
TOTAL 50 100.0
THE NURSES USED CLEAR AND
CONCISE LANGUAGE WHEN
COMMUNICATING WITH ME
YES 40 80.0
NO 10 20.0
TOTAL 50 100.0
THE NURSE WAS AVAILABLE TO
ATTEND TO ME ON DEMAND
YES 31 62.0
NO 19 38.0
TOTAL 50 100.0
THE NURSES ACTIVELY LISTENED
TO MY QUESTIONS AND
CONCERNS WITHOUT
INTERRUPTING
YES 39 78.0
NO 11 22.0
TOTAL 50 100.0
THE NURSES TREATED ME WITH
DIGNITY AND RESPECT,
REGARDLESS OF MY CULTURAL
BACKGROUND AND SITUATION
YES 40 80.0
NO 10 20.0
TOTAL 50 100.0
THE NURSES WERE AVAILABLE TO
ANSWER MY QUESTIONS AND
ADRESS MY NEEDS WHEN I
NEEDED THEM
YES 26 52.0
NO 24 48.0
TOTAL 50 100.0
I FELT RUSHED DURING
INTERACTIONS WITH THE
NURSES, EVEN WHEN I HAD
QUESTIONS AND CONCERNS
YES 28 56.0
NO 22 44.0

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TOTAL 50 100.0
THE NURSES SPENT ENOUGH
TIME WITH ME TO ENSURE I
UNDERSTOOD MY CARE PLAN
AND FELT COMFORTABLE
YES 32 64.0
NO 18 36.0
TOTAL 50 100.0
THERE WERE ENOUGH NURSES
OR STAFF TO PROVIDE TIMELY
AND ATTENTIVE CARE
YES 23 46.0
NO 27 54.0
TOTAL 50 100.0
The table revealed key findings regarding factors affecting nurse-patient relationship, it is
noteworthy that majority of the respondents (76%) expressed that the nurses explained
information about their condition and treatment plan in a way that was easy to understand,
while it was shown from the above table that majority of the respondents (78%) admitted that
the nurses actively listened to their question and concerns without interrupting. Regarding,
availability of nurses and address to the needs as militating factor, more than half of the
respondents (52%)

TABLE 4.3: SUMMARY OF THE NURSE-PATIENT RELATIONSHIP

GRADE FREQUENCY PERCENTAGE (%)
GOOD 39 78.0
POOR 11 22.0
TOTAL 50 100.0
The table showed the summary of the nurse-patient relationship, where tangible proportion of
the respondent (78%) expressed they have a very good nurse-patient relationship, while very few
of them (22%) admitted a poor nurse-patient relationship

TABLE 4.5: PATIENT SATISFACTION WITH NURSING CARE

VARRIABLE FREQUENCY PERCENTAGE (%)
THE NURSES RESPONDED
PROMPTLY TO MY NEEDS
(E.G,PAIN MEDICATION,
ASSISTANCE WITH TOILETING)
YES 38 76.0
NO 12 24.0
TOTAL 50 100.0
THE NURSES WERE AVAILABLE
WHEN I NEEDED THEM
YES 32 64.0

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NO 18 36.0
TOTAL 50 100.0
THE NURSES PROVIDED MY CARE
IN A SKILLED AND COMPETENT
MANNERS
YES 42 84.0
NO 8 16.0
TOTAL 50 100.0
I FELT CONFIDENT IN THE NURSES
ABILITY TO MANAGE MY
CONDITION
YES 37 74.0
NO 13 36.0
TOTAL 50 100.0
THE NURSES PROVIDED CLEAR
AND UNDERSTANDABLE
INFORMATION ABOUT MY
CONDITION AND TREATMENT
PLAN
YES 43 86.0
NO 7 14.0
TOTAL 50 100.0
THE NURSE TREATED ME WITH
KINDNESS AND UNDERSTANDING
YES 40 80.0
NO 10 20.0
TOTAL 50 100.0
THE NURSES PREPARED ME FOR
WHAT TO EXPECT AFTER
DISCHARGE FROM THE
HOSPITAL/CARE FACILITY
SYES 37 74.0
NO 13 26.0
TOTAL 50 100.0
The table provided above highlighted patient satisfaction with the nursing care. The table
revealed a substantial proportion (76%) affirmed that nurse responded promptly to their needs
(e.g. pain medication, assistance with toileting), it was also reflected from the table that majority
of the respondents (84%) expressed that nurses provided their care in a skilled and competent
manners, with very few (16%) showed dissatisfaction. Also, overwhelming percentage (86%)
attested that nurses provided clear and understandable information about their condition and
treatment plan.
Furthermore, appreciable proportion (80%) of the respondents affirmed that nurses treated
them with kindness and understanding while impressive figure of the respondents (74%) of them

33
concurred that nurses prepared them for what to expect after discharge from the hospital facility.

TABLE 4.6: SUMMARY OF THE LEVEL OF PATIENT SATISFACTION WITH NURSING CARE
GREADE FREQUENCY PERCENTAGE (%)
EXCELLENT 39 78.0
AVERAGE 6 12.0
POOR 5 10.0
TOTAL 50 100.0
The table showed the overall summary of the patient satisfaction with nursing care, where it was
obviously shown that majority of the respondent (78%) were excellently satisfied with nursing
care, followed by very few (12%) with average satisfaction and 10% reported poor satisfaction.

RELIABILITY
Reliability is the measure of internal consistency of the constructs in the study. A construct’s

reliable of the Alpha(x) value is greater than .70(Hair et al, 2013). Construct reliability was

assessed using the crounbach’s alpha. The result revealed that the nurse-patient relationship

scale with 8 items was (x=.949) and the factors affecting nurse-patient relationship scale with 9

items was (x=.905), and the patient satisfaction with nursing care scale with 7 items (x=.863)

were found to be reliable. Reliability results are summarized below

CONSTRUCT NO OF ITEMS ALPHA (X)

NURSE-PATIENT RELATIONSHIP 8 .949
FACTORS AFFECTING NURSE – 9 .905
PATIENT RELATIONSHIP
PATIENT SATISFACTION WITH 7 .863
NURSING CARE

RESEARCH QUESTIONS

RESEARCH QUESTION1
WHAT IS THE NURSE PATIENT RELATIONSHIP?
REESEARCH 2
WHAT ARE THE FACTORS AFFECTING NURSE PATIENT RELATIONSHIP?
RESEARCH 3
WHAT IS THE PATIENT SATISFACTION FROM NURSING CARE?

RESEARCH ANSWERS
1. The result derived from the finding of this study has distinctly indicated that majority of
the inpatient have good-commendable level (78%) of nurse-patient relationship, while

34
 very few (22%) claimed a poor nurse-patient relationship.
2. The findings from this study unveiled three prominent factors significantly affecting and
influencing nurse patient relationship. Specifically, using clear and concise language
when communicating with patient (80%), treating patient with dignity and respect
regardless of the cultural background and situation (80%) and actively listened to the
questions and concerns of the patient without interruption (78%) emerged as foremost
consideration in this regard.
3. The findings from this study indicated that majority of the patient (78%) expressed they
have excellent patient satisfaction with nursing care, followed by (12%) fair and few
(10%) of them held belief that they have poor patient satisfaction with nursing care.

Chapter 5

DISCUSSION
Nurse-patient relationship is a significant parameter any in the world to measure the
effectiveness of health care delivery while the satisfaction of patient is seen as extent the
patients feel that their expectation and needs are being taken care of by the health care provider.
This is viewed as a measure of quality of care and also give gives the health care provider an eye
opener to the various aspect of service delivery.
The results of this study showed that most of the respondents (50%) fall between the age of 18-
35 years, this is similar to findings conducted in Port Harcourt by Levesque et, al, (2022) in which
the majority of the respondent fell within the same age range, the finding is also in contrast to
another study conducted by Okeye and Ilo at Nnamidi Azikwe Teaching Hospital (2023), where
majority of the respondents fell within the age range of 31-46 years. Also, majority of the
respondents (66%) were female, this finding is in consonance with study conducted by Akindele
et, al (2022) at a private tertiary clinic in Ogun State, where majority of the respondent (52.8%)
female against (44.4%) male. This could be because female were said to access health care
services more predominantly than male either for medical advice or the treatment of their
children.
The results from the findings also revealed that majority of the respondents (44%) had tertiary
education-HND/BSC, this is consistent with a study conducted by Onianwa et, al (2022), where
majority of the respondents (41.8%) had tertiary education, the figure is also congruent with
another study conducted in Abuja, Nigeria, by Lawal et, al (2018) where majority of the
respondents were graduates (47.9%)
Also, findings showed that majority of the respondents (84%) reported that nurses was
welcoming and appreciable, this finding is similar to study conducted by Agbonjimi et, al (2022)
at Babcock University Teaching Hospital, where majority of the respondents (50.6%) expressed
satisfaction with nursing ways and manner of attending to their treatment. In another vein,
majority of the respondents (84%) expressed that nurses valued their input in decision to take;
this is consistent with same study conducted by Agbojimi et, al. (2022) at Babcock University
Teaching Hospital, where more than half of the respondents (31.8%) expressed that nurses
valued their inputs and involving them in decision making, this will actually help the patients to
express their mind and actively involved in whatever treatment plan advised.
Interestingly, the study indicated that the overall nurse-patient relationship was good (78%), this

35
finding is similar to a study conducted by Oniamwa et, al. (2022), where good nurse-patient
relationship was recorded (76.9%), this is attributed to the level of professionalism by the nurses.
The nurse-patient relationship has been regarded as an inevitable precursor of quality nursing
care at all levels of health care delivery system (Ojo, 2010). The finding, however is contrast to
another study conducted in Northern Nigeria, where majority of the respondents express poor
interpersonal relationship and unfriendliness of the nurse (Ajayi and Olumodeji, 2016)
Additionally, the findings of this study revealed that majority of the patients (78%) expressed
excellent level of satisfaction with nursing care, a report similar to another study conducted by
Onianwa et, al (2022) where majority of the patients (62%) were satisfied with overall nursing
care, but in contrast to another study conducted by Mojgan et, al. (2019) where majority of the
respondents (80%) expressed poor satisfaction with nursing cares, but also better than another
study conducted in Ethiopia in which 52.5% of the respondents were satisfied with overall
nursing care (Eyasu et,al 2018)
It is very important that patient satisfaction should be prioritized in any hospital, and this can
only be actualized by educating staff, especially nurses, identifying both motivating factors and
dissatisfaction factor.

CONCLUSION
The study revealed that more than half of the respondents expressed that there is a good nurse-
patient relationship which also brings about excellent patient satisfaction with nursing care, the
study highlighted the importance of interpersonal relationship in our health facility most
especially between nurse and patients, as nurses anywhere in health sectors are closer to the
patients than other health professionals. There is a strong link between the nurse-patient
relationship and patient satisfaction with nursing care, the failure of one will definitely have
negative impact on the other.

RECOMMENDATION
Sequel to an impressive nurse-patient relationship together with majority of respondents
affirmed excellent satisfaction from with care; this can be better maintained and improved upon
by:
1. Provision of enabling environment and see to the welfare of nurses
2. Adequate equipment that will facilitate and ease stress at work should be provided at
every ward.
3. Implementation of policies by the government for nurses’ remuneration and other
benefits should be made.

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