ArticlePDF Available

Attitude of Health Workers (Nurses) towards Patients and the Perception Patients have about Them: A Case Study at Kropa Health Centre in Ghana

Authors:

Abstract and Figures

The purpose of this study is known as a specific hospital operating issue on employee attitude, service quality, customer satisfaction, and customer loyalty in health-care organizations. The proposed research model was done using the mixed methods approach. The results indicate that hospitals can improve customer satisfaction and loyalty through efficient public relations with patients and their families, frequent in-service training for employees in terms of public relations and customer care and service quality. One of the key findings of our study was that health workers especially nurses had bad public relations with patients and their families in health-care organization's influence employee reaction and service quality. The researchers concluded that public relations and customer care should be included in the curricula of nursing training schools to help students appreciate the need and approach to patients when they start their practice.
Content may be subject to copyright.
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
203
Attitude of Health Workers (Nurses) towards Patients and the Perception Patients have
about Them: A Case Study at Kropa Health Centre in Ghana
by
Richard Owusu Nyarko
1
Department of Health management, School of Graduate studies, Ghana Technology University
College 100, Tesano, Accra, Ghana
Email: richardnyarko91@yahoo.com
Ph: +233266884732
Ivan Kahwa
Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology,
P.O BOX 1410, Mbarara, Uganda.
Abstract
The purpose of this study is known as a specific hospital operating issue on
employee attitude, service quality, customer satisfaction, and customer loyalty in
health - care organizations. The proposed research model was done using the mixed
methods approach. The results indicate that hospitals can improve customer
satisfaction and loyalty through efficient public relations with patients and their
families, frequent in-service training for employees in terms of public relations and
customer care and service quality. One of the key findings of our study was that
health workers especially nurses had bad public relations with patients and their
families in health care organization’s influence employee reaction and service
quality. The researchers concluded that public relations and customer care should
be included in the curricula of nursing training schools to help students appreciate
the need and approach to patients when they start their practice.
Keywords: customer care, employee reaction, service quality, customer satisfaction and loyalty,
health care.
Introduction:
Health care is unique from any other type of industry in that health care professionals are
highly dependent on each other to provide and coordinate services of high value for human beings.
This is especially challenging for health care managers who are responsible for managing health
care organizations [1]. Since one of the main goals of any health care organization is not only to
meet, but also to exceed the expectations of patients, improving levels of patient satisfaction is
very critical to their long-term success.
Gathering the views of service users is a key feature of recent developments in society and
the health care sector has identified methods for assessing the views of patients, especially in the
last decade [2]. If health care organizations are in the business to provide service for their
customers, then they must strongly consider the needs and expectations of their most important
customers.
1
Corresponding author
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
204
Efforts at quality improvement in health care organizations present their own unique set of
challenges. As with all types of services, health care is an intangible product [3]. The services that
patients receive cannot physically be viewed or touched like manufactured products such as
televisions and cars. It is easier for managers dealing with manufactured products to develop and
implement quality improvement measures than it is for health care organizations [3].
Therefore, the aim of this research was to bring on board and bridge the gap of uncertainty
between health workers especially nurses and their relationship with patients hence improving
health quality within staffs and patients and manner in which health care organizations have
traditionally been operated.
Materials and Methods:
This chapter spells out in detail the research method and design that were used in the study.
This involves the research design that was used, sources of data, population sample and sample
procedures, data collection instruments, data processing and analysis as well as ethical issues
involved and how these were addressed
Research Design:
The research was a descriptive cross sectional and non-experimental study and both
quantitative and qualitative variables was used. The qualitative variable comprised of the
respondent’s age, sex, ethnicity, religion, knowledge, attitude and perception of health workers
especially nurses towards patients and the attitude of patients towards nurses. The quantitative
variables also captured the number of respondents as well as the numerical value of respondent’s
perception.
Study Setting:
The study was conducted at the Kropa Health Centre in the Ashanti region of Ghana. This
setting was chosen because of a news bulleting six months ago and live interviews on how patients
were complaining of disrespect by nurses at the facility and their lazy attitude to work. Kropa has
a population of about 500 people with only one health centre mined by a physician assistant and
one supervising medical officer who only visited once a week to see to pregnant woman and
seriously sick patients or those who need to undergo surgery.
The research was solely based on nurses and patients visiting the facility. The health center has a
daily attendance of 70 to 85 patients per day and has 12 regular nurses of all ranks with the senior
most been at the rank of a principal nursing officer and the junior most been a health assistant.
Population and Sampling:
The target population for the study consisted of two groups of people with age in general
above 18 years. The groups comprised of health workers emphatically nurses and patients
receiving care from them.
Sample and Sampling Technique:
Sampling is the process of selecting a portion of the population in quantitative studies, the
representation of the sample enhances generalization of the findings [4]. The sampling methods
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
205
are classified into probability and non-probability sampling method. A convenient sampling
technique which is non-probable was used to sample the population of the study.
Instrumentation:
The researcher used interviews as the main instrument based on the research objectives and
was used to collect the data. Straight forward questions were asked so as to suit the educational
level of respondents.
Data Collection Procedure:
The instrument that was used for the collection of data was a research interviews, individual
interviewing technique was used for patients all of above 18 years and points noted and written
down. The health workers that are mainly nurses, the researcher used the focus group interview
approached, the leader of the nurses steered the interviews and all participants worked according
to time allotted. The researcher made some recordings with his phone on some of the key points
raised by the nurses on their attitude towards patients and the perception they think patients have
on them.
Data Analysis:
Data was analyzed using descriptive and analytical statistical test to simplify the
information that was collected. Both closed ended and open-ended questions were used to obtain
response. Frequency tables were used to analyze the data to enable them to be viewed easily and
clearly. Open ended questions were analyzed and discussed based on the respondents’ answers.
Ethical Consideration:
The researcher used his original student’s identification card to seek permission from the
district health director but the director could only give the researcher the opportunity if only
findings were not going to be published. The researcher could not agree with the district director
since it was an academic exercise to solve a problem and may be published. The researcher relied
on the supervising medical officer for the Kropa Health Centre who gave him the permission to
access the facility for information but not the administration for any document and with this the
district director of health service accepted and paved the way for the research to be carried out.
The respondents were assured of confidentiality of information given and its anonymity.
Respondents were assured of the right to withdraw from the interviews at any point in time and
consent was seek from all respondents before they participated in the study.
Validation and Reliability:
Validity is the state of being legally or officially accepted while reliability can be trusted to do
something well or more efficient. The interviewing tool was discussed with the supervisor of the
project and other experts in the subject area which helped improve on modification. This also
ensured that the context was valid and reliable.
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
206
Limitations of the Study:
i. The sample was too small due to the limited time and resources that was allocated.
ii. There was the possibility of provided information being shallow and biased because
participants provided information that was influenced by my presence.
Results:
Out of the numbers interviewed, specifically for nurses and patients, the total number of
respondents was 45 respondents with response rate of 96%. The attitude of nurses towards patients
and perception of patients toward nurses were assessed and analyzed as shown below.
Table 1 Sex of Respondents (Health Workers Nurses)
Respondents
Frequency
Percentage (%)
Male
4
30.7
Female
9
69.2
Total
13
99.9
The majority of the respondents with the NURSES were (69.2%) were females (Table 1).
Table 2 Sex of Respondents (PATIENTS)
Respondents
Percentage (%)
Male
29.6
Female
70.3
Total
99.9
The majority of the respondents with the PATIENTS were (70.3%) were females (Table
2). Table 3 Marital Status of Respondents NURSES
Marital Status
Frequency
Percentage (%)
Married
9
69.2
Single
2
15.3
Divorced
1
7.6
Widowed
1
7.6
Total
13
99.7
The majority of respondents (69.2%) were married NURSES (Table 3).
Table 4 Marital Status of Respondents PATIENTS
Marital Status
Frequency
Percentage (%)
Married
45
70.3
Single
15
23.4
Divorced
1
1.5
Widowed
3
4.6
Total
64
99.8
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
207
The majority of respondents (70.3%) were married PATIENTS (Table 4).
Table 5 Religion of Respondents NURSES
Religion
Frequency
Percentage (%)
Christian
9
69.2
Muslim
3
23.0
Traditionalist
1
1.5
Others
1
1.5
Total
13
95.2
The majority of the respondents (69.2%) were Christians for NURSES. (Table 5)
Table 6 Religion of Respondents PATIENTS
Religion
Frequency
Percentage (%)
Christian
35
54.6
Muslim
20
31.2
Traditionalist
8
12.5
Others
1
1.5
Total
64
99.8
The majority of the respondents (54.6%) were Christians for PATIENTS. (Table 6)
Table 7 Educational Status of Respondents NURSES
Educational status
Frequency
Percentage (%)
Nursing College Diploma
3
23.0
Nursing College Certificate
5
7.8
University Degree
0
0
Ward Assistants
5
38.4
Total
13
69.2
The majority of the respondents (38.4%) had 1-year training to become ward assistants
Table 8 Educational Status of Respondents PATIENTS
Educational status
Frequency
Percentage (%)
Tertiary
5
7.8
Senior High School
8
12.5
Junior High School
22
34.3
Middle School Leaving Certificate
29
45.3
Total
64
99.9
The majority of the respondents PATIENTS (45.3%) had attended and completed middle
school.
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
208
Table 9 Attitude of NURSES to PATIENTS
Are the nurses in this facility disrespectful?
Respondents
Frequency
Percentage (%)
Yes
55
85.9
No
3
4.6
Not sure
4
6.2
No idea
2
3.1
Total
64
99.8
The majority of respondents (85.9%) believe the nurses are disrespectful.
Table 10 Hard Working and Conscious Nurses
Are the nurses in this facility hard working and time conscious?
Respondents
Frequency
Percentage (%)
Yes
15
23.4
No
48
75.0
Not sure
1
1.5
No idea
0
0.0
Total
64
99.9
The majority of respondents (75%) believe nurse at the facility are not hard working and
do not respect time (Table 10).
Table 11 Perception Nurses Have for Patients
Are patients pretentious when it comes to them showing they are sick?
Respondents
Frequency
Percentage (%)
Yes
7
53.8
No
5
38.4
Not sure
1
7.6
No idea
0
0.0
Total
13
99.8
The majority of respondents (38.4%) been nurses believe patients are pretentious when it
comes to them showing sickness (Table 11).
Table 12 Patients Behaviour
Are patients disrespectful when it comes to them showing they are sick?
Respondents
Percentage (%)
Yes
53.8
No
38.4
Not sure
7.6
No idea
0.0
Total
99.8
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
209
The majority of respondents (38.4%) been nurses believe patients are disrespectful when
they visit the health facility (Table 12).
Discussion:
The majority of the respondents with the nurses were (69.2%) were females while as the
majority of the respondents with the patients were (70.3%) were females. The majority of
respondents (69.2%) were married nurses where the majority of respondents (70.3%) were married
patients. The majority of the respondents (69.2%) were Christians for nurses whereas the majority
of the respondents (54.6%) were Christians for patients. The majority of the respondents (38.4%)
had 1-year training to become ward assistants whereas the majority of the respondents’ patients
(45.3%) had attended and completed middle school. The majority of respondents (85.9%) believe
the nurses are disrespectful whereas the majority of respondents (75%) believe nurse at the facility
are not hard working and do not respect time. The majority of respondents (38.4%) been nurses
believe patients are pretentious when it comes to them showing sickness whereas the majority of
respondents (38.4%) been nurses believe patients are disrespectful when they visit the health
facility. It was also noted that majority of the nurses that work at the health center were Christians
and same as the majority of patients that patronize the facility.
Summary and Conclusion:
The purpose of the study was to assess the attitude of health workers particularly nurses
towards patients and the perception patients have about them in the improvement of quality health
care delivery. Both quantitative and qualitative variables were used for this research.
Achieving high levels of patient satisfaction through quality improvement should be one
of the top priorities of any health care organization. After all, without patients, these organizations
would cease to exist. There are several approaches that can be utilized to meet and exceed the
expectations of the patients. Of these, measuring the views of the patients, improving patient
outcomes with a community-wide effort, and using a Six Sigma program were discussed. Each of
these programs can be an effective mechanism for quality improvement if used properly. One of
the key components of quality improvement techniques involves collaborative efforts by all health
care professionals and managers as they seek to increase patient satisfaction. Implementing quality
improvement initiatives to improve patient satisfaction can enable health care organizations to
position themselves for success in today’s global and increasingly competitive environment.
Recommendations:
A third approach involves using devices such as surveys, written complaints and
questionnaires to obtain patient feedback. This way, the views of the patients can be analyzed and
appropriate actions can be taken to improve on weak areas. Here, health care organizations can
implement processes to meet their patients’ needs more reliably and efficiently.
Furthermore, this approach can provide indication of the direction and intensity of staff
training and education to improve specific areas such customer care and relations.
The ministry of health and agencies under it should introduce public relations and customer
care as a course in all nursing training schools to equip trainees with this skill to be able to serve
patients well.
Health facilities, hospitals and clinic should set up public relations or customer service desk
with trained personnel to assist and support patients with their complains.
Electronic Research Journal of Social Sciences and Humanities Vol 2: Issue II
ISSN: 2706 8242 www.eresearchjournal.com Apr - Jun 2020
210
Conflict of Interest:
The authors declare no conflict of interest, financial or otherwise.
Availability of Data and Materials:
Due to confidentiality issues, it is not permitted to share the data.
References
[1]. Shortell, S.M. and Kaluzny, A.O. ,2000, "Organization theory and health services
management", in Shortell, S.M. and Kaluzny, A.D. (Eds), Essentials of Health Care
Management, Delmar Publishers, New York, NY, pp. 4-33.
[2]. Wensing, M. and Elwyn, G., 2002. Research on patients' views in the evaluation and
improvement of quality of care. BMJ Quality & Safety, 11(2), pp.153-157.
[3]. Ford, J.K. and Weissbein, D.A., 1997. Transfer of training: An updated review and
analysis. Performance improvement quarterly, 10(2), pp.22-41.
[4]. Polit, D.F. and Beck, C.T., 2004. Nursing research: Principles and methods. Lippincott
Williams & Wilkins.
ResearchGate has not been able to resolve any citations for this publication.
Article
Full-text available
The identification of methods for assessing the views of patients on health care has only developed over the last decade or so. The use of patients' views to improve healthcare delivery requires valid and reliable measurement methods. Four approaches are recognised: inclusion of patients' views in the information to those seeking health care, identification of patient preferences in episodes of care, patient feedback on delivery of health care, and patients' views in decision making on healthcare systems. Outcome measures for the evaluation of the use of patients' views should reflect the aims in terms of processes or outcomes of care, including possible negative consequences. Rigorous methodologies for the evaluation of methods have yet to be implemented.
Transfer of training: An updated review and analysis. Performance improvement quarterly
  • J K Ford
  • D A Weissbein
Ford, J.K. and Weissbein, D.A., 1997. Transfer of training: An updated review and analysis. Performance improvement quarterly, 10(2), pp.22-41.
Nursing research: Principles and methods
  • D F Polit
  • C T Beck
Polit, D.F. and Beck, C.T., 2004. Nursing research: Principles and methods. Lippincott Williams & Wilkins.