CHAPTER ONE

INTRODUCTION

1.1. Background study

One of the most crucial forms of care in the medical field is nursing care, which is provided by nurses to keep patients healthy and comfortable, as well as to prevent the onset of new or worsening illnesses (1, 2). Its goal is to deliver high-quality treatment to patients, which is essential in achieving organizational objectives (3). Patients spend most of their time with nurses, who make up the majority of the medical personnel. Consequently, the manner in which nursing care is provided greatly affects patients’ overall hospitalization experience (4, 5). Patients’ perception of nursing care refers to the feelings or opinions they have regarding the care received from nurses during their hospital stay. It is recognized as a good indicator of the standard of nursing care (6). In addition to providing crucial and comprehensive information on the overall quality of nursing care, it assesses the level of patient outcomes and patient satisfaction (7–11). It also provides feedback to establish standards and evaluate nursing care (12). favorable patient perception has been correlated with intended clinical outcomes, such as lower readmission and mortality rates (13).

Various factors influence how patients view nursing care, such as the length of time nurses spend with patients, respect, the amount of information provided about their condition and treatment, compassion, and cheerfulness (14, 15). Understanding patients’ perception of nursing care is crucial for healthcare organizations to identify the strengths and weaknesses of care from the patients’ perspective (16). Additionally, assessing patients’ needs for nursing care is essential to enhance the delivery of care (17, 18). Nurses play a significant role in patients’ care and interact with them more frequently than any other medical personnel, thus impacting how patients perceive nursing care (19, 20).

While patients in some continents have positive perceptions of nursing care, in Africa, particularly in the sub-Saharan region, negative perceptions have been reported, with percentages ranging from 18.5–50.3% (6, 21–23).Patients’ perception of nursing care is influenced by various factors, such as cultural background, socioeconomic status, nurse’s communication skills, provision of information, kindness, cheerfulness, patient-centered care, compassion, and competence in diagnosing and treating health problems (15, 24, 25).Poor perception of nursing care leads to patient dissatisfaction, decreased trust in the service provided, delayed health-seeking behavior, missed appointments, decreased treatment adherence, discomfort, disengagement, perception of care plans as unimportant, negative word-of-mouth, and a negative attitude towards the healthcare system. This, in turn, affects the hospital’s image, patients’ intentions to return, and overall health outcomes, resulting in financial losses for hospitals and wastage of government resources (21, 26–30). The Ethiopian Federal Ministry of Health, through the Health Sector Transformation Plan and the National Healthcare Quality Strategy-II, envisions all citizens enjoying quality and equitable access to healthcare services (31). Strategies and initiatives such as EHRIG (Electronic Health Record Integration Gateway) been launched to enhance patients’ health-seeking behavior and improve nursing care provision (32). Despite a few studies conducted regarding patients’ perceptions of nursing care and the initiatives launched to enhance these perceptions in inpatient departments, this remains a problem in Cameroon (6, 21, 23).The aim of this study was to assess patients perception of nursing care attitudes.

1.2. Statement of problem:

Despite the recognized importance of positive nursing care attitudes in enhancing patient outcomes and satisfaction, a gap exists in understanding patient perceptions of these attitudes within the outpatient department (OPD) of many healthcare facilities, including the Bambili Medicalized Health Center. While anecdotal evidence may suggest variations in patient experiences, there is a lack of systematic investigation into how patients perceive the empathy, communication, respect, and responsiveness demonstrated by nurses during their OPD visits. This lack of understanding poses a significant problem because without accurate and reliable data on patient perceptions, it becomes challenging to identify specific areas where nursing care can be improved to better meet patient needs and expectations. Consequently, potential issues such as perceived lack of attention, poor communication, or inadequate emotional support may persist, leading to decreased patient satisfaction, reduced adherence to treatment plans, and ultimately, compromised health outcomes. Therefore, a comprehensive assessment of patient perception of nursing care attitudes in the OPD is crucial to inform targeted interventions and ensure the delivery of high-quality, patient-centered care at the Bambili Medicalized Health Center. This study aims at highlighting critical areas of nursing care that requires attention  and ultimately enhance the quality of healthcare provided at the Bambili sub-divisional Hospital.

1.3. Research questions

1. What are the positive perceptions of patients regarding nursing care attitudes in the outpatient department (OPD) of the Bambili sub-divisional hospital
2. What are prevalence of perceived negative nursing care attitudes among patients attending the OPD?

3.What are the challenges faced by nurses in providing quality patient care to patients at the outpatient department of the Bambili subdivisional Hospital

1.4. Hypothesis

• (H0): There are no negative perceptions of nursing care attitudes among patients in the OPD in the Bambili sub-divisional Hospital
• Alternative Hypothesis (H1): There are negative perceptions of nursing care attitudes among patients in the OPD in the Bambili sub-divisional Hospital

1.5. Objectives of the study.

1.5.1. Main objective

To assess patient perception of nursing care attitudes at the outpatient department of the Bambili sub-divisional Hospital.

1.5.2. Specific objectives

1. To identify the perceived positive nursing care attitudes among patients at the Bambili sub-divisional Hospital.
2. To determine the perceived negative nursing care attitudes among patients in the outpatient department at the Bambili sub-divisional Hospital

ii.To identify challenges faced by nurses in providing quality patient care to patients at the outpatient patient department at the Bambili Sub-Divisional Hospital