AN INVESTIGATION INTO THE PERCEPTION OF CARE QUALITY AND SATISFACTION WITH NURSING SERVICES AMONG ELDERLY PATIENTS IN THE MEDICAL WARDS OF UNTH ITUKU

CHAPTER ONE INTRODUCTION 1.1Background of the study According to the World Health Organization (WHO,2019) and the International Council of Nurses (ICN) (2006), the overarching objective is for all people to be in the best possible health, and delivering high-quality care is one way to achieve this goal. The Norwegian Ministry of Health and Care Services' national action plan on health and social care (Ministry of Health and Care Services, 2011) emphasizes the importance of providing high-quality care through patient-centered care and developing systems that allow patients to participate in regular quality-of-care evaluations. 'Quality of care' is a concept that can have various meanings depending on different cultures, whether on an individual or social level, which aspect we are looking at; process, structure, or outcome, whether it is the patients, relatives, healthcare personnel, administrators, or politicians who define the term and the time at which it is defined (Donabedian, 2013). Researchers believe it to be a multifaceted term (Crow, et al., 2012). In the mid-nineteenth century, Florence Nightingale was the first to organize and arrange nursing care. Her notes must be interpreted in the context of her period, yet much of what she wrote is still applicable today in hospitals all around the globe. Her thoughts on excellent nursing are detailed in her book Notes on Nursing (2011). Nursing's goal was to put the person in the best possible position for nature to intervene. She was worried about the level of attention each patient received. She was a skilled bedside nurse who cared deeply for the troops during the Crimean War, and she kept meticulous records of the treatment she provided and the patients' reactions to it in order to enhance nursing care (Nightingale, 2011). She didn't use the word 'quality' overtly, but excellent treatment is what she implicitly aspires for in her nursing notes. However, she saw the quality of treatment from the viewpoint of the nurses. Patient satisfaction, which dates back to the 1960s consumer movement, has practical and political implications in today's healthcare system. It is often used to drive research on people' healthcare experiences (Danielsen, Garratt, Bjertnes, & Pettersen, 2017). There hasn't been a consensus on a conceptual definition (Merkouris, Ifantopoulos, Lanara, & Lemonidou, 2014). There are, however, several perspectives on the idea of contentment. Alternative approaches to the idea of satisfaction include the discrepancy theory, fulfillment theory, equity theory (Lawler, 2014), and the value-expectancy model (Linder-Pelz, 2015). An alternate approach to the notion is presented by Larsson, Wilde, and Starrin (2011), who established a preliminary model that views patient satisfaction as an emotion, which was further expanded by Larsson and Wilde-Larsson (2011). Because of the manner satisfaction was assessed, Lawler (2014) classified satisfaction research according to their inherently theoretical orientation. Patient satisfaction during hospitalization is a balance between the patient's viewpoint and the exceptions to their nursing treatment. Patient satisfaction is an essential patient-centered outcome to evaluate, it is widely acknowledged as a standard measure of treatment quality, and it is growing in popularity. Care provider, advocate, critical thinker, teacher, communicator, manager, researcher, and rehabilitative are just a few of the tasks played by today's nurse [Harkreader and Hogan2004]. Patient satisfaction with nursing care has been found to be consistently correlated with overall satisfaction with care, and has been defined as the patient's subjective evaluation of the cognitive and emotional response that results from the interaction between the patient's expectation of nursing care and their perception of actual nurse behavior and characteristics [Erickson.,2014]. 1.2Statement of the problem When a person becomes older, he or she is unable to do most of his or her self-care duties, such as bathing, eating, exercising, leisure, and grooming, due to health-related issues. As a result of disease or injury, this individual need support with self-care tasks. When self-care organization is insufficient to satisfy the recognized self-care demand, a self-care deficit occurs. According to Johansson (2012), it is at this moment of deficiency that the nursing profession steps in to aid. An aged patient is frequently unmotivated to modify his or her conduct. Helplessness is usually the consequence of people realizing through time that they have little control over the outcomes of events in their life, and that even if they put out the effort, their objectives may not be met. When older individuals become immobile due to a severe sickness or/and accident, this kind of circumstance arises. Because an old patient may have little choice or contribution to make toward his or her care, it becomes relatively straightforward for the nurse to guarantee that the services supplied satisfy needed standards in this case (Laschinger,2015). Nurses, as the professionals who have the most interaction with patients, have a greater duty than other members of the health care team to offer high-quality, safe, and fulfilling care to all patients, particularly the elderly. Hence the need to look into the perceived quality of care and satisfaction with nursing care among elderly patients in medical wards of UNTH Ituku. 1.3 Objective of the study The general objective of the study is the perception of care quality and satisfaction with nursing services among elderly patients in the medical wards of unth Ituku. The specific objective are as follows: 1. To access the quality of care given to the elderly patients by the nurses in UNTH 2, To ascertain the level of satisfaction with nursing care among elderly patients in the medical wards. 3, To determine the hindrances experienced by nurses in rendering quality care to elderly patients. 4, To determine the response of the elderly patients about the care given to them. 1.4 Research hypotheses The following hypothesis have been formulated for the study. HO: There are no hindrances experienced by nurses in rendering quality care to elderly patients. HA: There are hindrances experienced by nurses in rendering quality care to elderly patients. HO: The quality of care given to the elderly patients by the nurses in UNTH is not satisfactory. HA: The quality of care given to the elderly patients by the nurses in UNTH is satisfactory. H0: The response of the elderly patients about the care given to them is negative HA: The response of the elderly patients about the care given to them is positive H0: The level of satisfaction with nursing care among elderly patients in the medical wards is low. HA: The level of satisfaction with nursing care among elderly patients in the medical wards is high. 1.5 Significance of the study This study will examine perceived quality of care and satisfaction with nursing care among elderly patients in medical wards of UNTH Ituku. Hence the study will be significant in the following ways. Health care management board: this study will be significant to the health care management board as it will expose them to the need of improving quality of nursing care, nurses need to know what factors influence patient satisfaction. Nursing care plays the key role in providing satisfaction in this arena. Academia: this study will be significant to the academic community as it will contribute to the existing literature on quality of care and satisfaction with nursing care among elderly patients in medical wards. 1.6 Scope of the study This study will access the quality of care given to the elderly patients by the nurses in UNTH. The study will also ascertain the level of satisfaction with nursing care among elderly patients in the medical wards. The study will further determine the hindrances experienced by nurses in rendering quality care to elderly patients. Lastly, the study will determine the response of the elderly patients about the care given to them. Hence this study will be delimited to UNTH Ituku, 30 elderly patients in UNTH will be the respondent for the study in Enugu state. 1.7 Limitations of the study As with many other research endeavors, this study encountered several challenges. One of the primary difficulties was the lack of readily available and accurate materials relevant to the topic under investigation, as well as the inability to obtain sufficient data. The researcher also faced financial limitations, which created obstacles in sourcing appropriate materials and in carrying out the printing and compilation of questionnaires. In addition, time constraints posed another significant challenge. The need to balance the demands of writing the research with other academic responsibilities made the research process particularly strenuous and demanding for the researcher. 1.8 Definition of terms Quality: the standard of something as measured against other things of a similar kind; the degree of excellence of something Care: the provision of what is necessary for the health, welfare, maintenance, and protection of someone or something. Nursing care; assistance provided for the health care needs of sick or disabled individuals, by or under the direction of licensed nursing personnel Medical wards: a hospital ward in which patients are being treated by drugs rather than surgery.