ABSTRACT
This study seeks to examine the effect of doctor-nurse relationship on patient care in Federal Medical Centre Owerri, Imo State. The null hypotheses were formulated to guide the study. They are: Medical teamwork; hospital administrative structure; and doctor-nurse value orientation. In order to generate data for testing these hypotheses, a 42 item questionnaire was developed by the researcher and validated by the supervisor. Survey research design was adopted while data collected from 200 randomly selected respondents (male & female). Purposive, stratified and simple random sampling procedures were variously applied at appropriate stages of the study. The generated data was statistically tested using chi-square analysis procedure. The analysis revealed that: there is a significant relationship between medical team work and patient care, hospital administrative structure, doctor-nurse value orientation and patient care. It was however recommended that collaborative work relationship between doctors and nurses should be encouraged for effective health care delivery system.
TABLE OF CONTENTS
ABSTRACT
CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
1.2 PROBLEM STATEMENT
1.3 STUDY OBJECTIVES
1.4 SIGNIFICANCE OF THE STUDY
1.5 STUDY QUESTIONS/HYPOTHESES
1.6 SCOPE AND LIMITATION OF THE STUDY
1.7 DEFINITION OF TERMS
CHAPTER TWO
REVIEW OF RELATED AND RELEVANT LITERATURE
INTRODUCTION
CONCEPT OF DOCTOR-NURSE RELATIONSHIP
COMPONENTS OF THERAPEUTIC DOCTOR-NURSE RELATIONSHIP
TYPES OF RELATIONSHIP
EFFECT OF DOCTOR-NURSE RELATIONSHIP ON PATIENTS
PATIENT’S PERCEPTION OF DOCTOR-NURSE RELATIONSHIP
DISCUSSION
THEORETICAL PERSPECTIVE
CHAPTER THREE
RESEARCH METHODLOGY
3.1 RESEARCH DESIGN
3.2 STUDY AREA
3.3 SOURCES OF DATA
3.4 POPULATION OF THE STUDY
3.5 SAMPLE SIZE DETERMINATION
3.6 INSTRUMENTATION
3.7 RELIABILITY AND VALIDITY OF INSTRUMENT
3.8 METHOD OF DATA ANALYSIS
CHAPTER FOUR
DATA PRESENATATION, ANALYSIS AND INTERPRETATION
4.1 DATA PRESENTATION
4.2 DATA ANALYSIS
4.3 DATA INTERPRETATION
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
5.1 SUMMARY
5.2 CONCLUSION
5.3 RECOMMENDATION
REFERENCES
APPENDIX
CHAPTER ONE INTRODUCTION
BACKGROUND OF THE STUDY
Effective doctor-nurse relationship is imperative in nursing care since this makes the patient feels at home and ease in and out of the hospital setting. It symbolizes agreement between the nurse and the patient to work together for the good of the patient. For a nurse patient relationship to be therapeutic there must be good communication between nurses and patients. Good communication skills make the difference between average and excellent nursing care.
Patients are described to have less power in the nurse patient relationship which can add to their vulnerability if they are not treated with respect by nurses. Emotional, physical and mental problem of patients can make them difficult to handle by nurses in the relationship. In view of this nurses need to strengthen their interpersonal relationship and their professional standard by exhibiting to the maximum level the principles of therapeutic relationship.
The underlying principles of the therapeutic relationship are the same regardless of the length of contact: respect, genuineness, empathy, active listening, trust and confidentiality. The purpose of the therapeutic relationship is to support the patient, to promote healing and to support or enhance functioning. A therapeutic relationship differs from social relationship in that it is health focused and patient centered with defined boundaries. Peplau (1991) described the nurse focus interest in the patient as “professional closeness”
Irrespective of the qualification, facilitation of a therapeutic doctor-nurse relationship has always been the cornerstone of nursing and includes self-knowledge and knowledge about the
essential components of therapeutic communication. These components include unconditional acceptance of the patient, the ability to listen and to hear, constructive non- verbal skills and verbal communication techniques. The use of rapport and alliance enables this process to happen by providing support, consistency and reliability in patient care (Gilbert 2009).
However, the bureaucratic environment in hospitals is driven by technology and a mainly medical model of care, making a therapeutic relationship between nurses and their patients difficult. The focus of communication in the doctor-nurse relationship is to satisfy patients‟ needs that are patient-centered care.
STATEMENT OF THE PROBLEM
According to literature of nursing care, nurses are obliged to treat patients with maximum respect and empathy. Attending behaviour is a patient-centered process and the basic conditions required on the part of the nurse for attending to occur are genuineness, warmth and empathy (Burnard, 1990; Stein-Parbury, 1993). It is the responsibility of the nurse to be aware of the power imbalance, to recognize the potential for clients to feel intimidated and to create a therapeutic relationship. This awareness therefore helps to establish and maintain appropriate boundaries.
However, articles, news, and experiences of some patients reveal that patients are not treated well in the doctor-nurse relationship. Patients are often without defenses and might depend on nurses to meet basic needs. Patients might not have a network of supportive family and friends and may want to depend on the nurse beyond the practice setting. Some patients, such as those with mental health problems or those in need of ongoing care, could be particularly vulnerable.
It was because of this discrepancy that the study was conducted at Federal Medical centre owerri to find out the kind of relationship between nurses and patients. This will help to improve upon the doctor-nurse relationship in the hospital.
OBJECTIVES OF THE STUDY
This study addressed the following objectives:
- To determine whether the socio-demographic characteristics of the nurse and the patients influence the type of relationship between the
- To examine the effects of doctor-nurse relationship on the health of the
- To find out the various types of doctor-nurse
RESEARCH QUESTIONS
Prior to the statement of problem discussed above, the study sought to answer the following research questions:
- How do the socio-demographic characteristics of the nurse and the patient influence the type of relationship between the two?
- What are the effects of doctor-nurse relationship on the health of the patient?
- What are the various types of doctor-nurse relationship?
SIGNIFICANCE OF THE STUDY
The study was aimed at providing relevant reasons why patients should be treated with maximum respect, confidentiality, empathy and warm in the hospital settings. Complete health does not mean only absence of disease or infirmity but also mental and social wellbeing. The stud addressed the importance of incorporating bio-psychosocial model into healthcare. The findings of the study will improve the understanding of doctor-nurse relationship by both nurses and patients.
Findings of the study will reveal the importance of using patient centered approach rather than task centered approach in the nursing care by nurses. The research will also add to the existing body of knowledge in the subject field.
Patients hope to be treated with respect, warm and genuineness. However, nurses, overlook the implications of their relationship with patients. The study was important because it will make it explicit the effects of doctor-nurse relationship on the health of patient. When nurses become aware that their negative attitudes and behaviour negatively affect the relationship with patients and ultimately deteriorate their adjustment to illness, there is a possibility that they will improve their interpersonal relationship with patient.
SCOPE OF THE STUDY
The study was conducted at Federal Medical centre owerri. People of Owerri and its environs receive treatment from this hospital. The study intended to cover effects of doctor-nurse relationship on the health of patients.
DEFINITIONS OF CONCEPTS
Effect: Effect in this study refers to the end result of the doctor-nurse relationship on the health of the patient in and out of the hospital setting. Effect can mean negative or positive depending on the kind of doctor-nurse relationship.
Doctor-nurse relationship: Doctor-nurse relationship refers to how nurses communicate and interact with patients during provision of healthcare services.
LIMITATION OF THE STUDY
The researcher foresaw that this study will involve some limitations. These limitations included finance, language barrier, time constraints and co-operations from nurses and patients that were asked to fill questionnaires. Some respondents requested for money before filling questionnaires. Some respondent, moreover, were not be able to read and probably fill the form. This therefore called for translation of the English to respondent‟s language. These limitations hindered the smooth running of this research. Despite all these constraints and problems, the researcher believes that the study covered enough respondent for generalization.
ORGANISATION OF THE STUDY
The research was divided into four chapters. Chapter one began with the background of the study constituting the introduction to the topic. It included statement of the problem, research objectives, research questions, and hypothesis, methodology used in undertaking the research, significance of the study, the study‟s limitations, the scope of coverage and then the study‟s organization. Chapter two dealt with the review of relevant literature to the subject discussed as well as related texts. It looks at the theories, concept and various views by authors relating to the area of study. Chapter three involved the presentation and analysis of collected data. Chapter four contained the summary, conclusion and recommendations as well as the appendices.
