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British Journal of Healthcare and Medical Research - Vol. 10, No. 6
Publication Date: December 25, 2023
DOI:10.14738/bjhmr.106.16014.
Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar;
Within 2022. British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
Services for Science and Education – United Kingdom
Relative/Patients’ Satisfaction of Nurses Services in Federal
Neuro-Psychiatric Hospital, Calabar; Within 2022
Umoh, Edet O.
Federal Neuro-Psychiatric HospitL, Calabar
Endra, Michael E.
Federal Neuro-Psychiatric HospitL, Calabar
ABSTRACT
The study was conducted to investigate relative/patients’ satisfaction to nursing
services in Federal Neuro-Psychiatric Hospital, Calabar from January to December,
2022. Three (3) research questions were raised and one hypothesis was formulated
to guide the study. A cross sectional research design was used to study 204 relatives
who came to retrieve their recovering member home. Instrument for data
collection called Relative/Patient Satisfaction of Nursing Services (RSNS) was
constructed in line with research questions; it was also validated with face
validation and its reliability ascertained with split-half reliability test and a
reliability coefficient of 0.885 was obtained. Collected data were analyzed with
descriptive statistics using frequency counts, simple percentage, mean and
standard deviation, while hypothesis was tested with use of One-Way Analysis of
Variance (ANOVA). Obtained results were presented in charts, tables and graphs.
Finding revealed that majority of the respondents waited within 0-30 minutes
before attention and administration of care, that a significant proportion of the
patients remarkably improved before allowed for trial leave, and that there is a high
level of relatives’ satisfaction with nursing care services. Hypothetical finding
shows that there is statistically significant difference in relatives’ satisfaction with
nursing services based on the Wards/Units (p<0.05). It was recommended among
other things that nurses should avoid beating patients when they are wrong and
should upgrade from manual to online payment transaction with use of Point of Sale
(POS).
Keywords: Relatives, Patients, Satisfaction, Nursing Services
INTRODUCTION
Satisfaction is a state of gratification of desired want from expected source. Every patient and
relative requires best attention and care in the healthcare facility. In psychiatric setting,
relatives are family members, philanthropic or Non-Governmental Organizations who bring or
refer their sick associates for treatment of abnormal behaviors. They suffer the impact, risk and
poor functionality of their members than the sufferers. In most instances they expect prompt
and effective care from Caregivers like the nurses, doctors, laboratorists, pharmacists and
others. List of their satisfaction ranges from courtesy, respect, reduction in waiting time,
attention to complaints, provision of emerging health needs and patients’ safety. These patients
being humans has expectations even with poor mental state, to be regarded and considered in
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available services. Healthcare services might be far from reach due to relatives’ constraint to
resource, high expectations and organizational dysfunction. Despite any or all above
constraints, it involves nursing skill to be available, attentive, friendly, communicative and
reassuring to the anxious and desperate members that Nursing care Services is readily available
for their mentally ill patients.
Commencement of nursing care began at arrival of a patient and/or relative at reception toward
reduction of waiting time, assessment and history taking, attention to presenting complaints
and other arising needs, prevention of escape, custodian of patients’ property, and other clinical
cares.
Waiting Time
This is the length of time a patient and relative wait outside expecting caregivers’ attention
either for observation, data or specimen collection, supply and administration. According to
Jing, et. el. (2017), every organized health facility should offer timely and appropriate service
to all their patients and relatives as their need arises.
Patient’s Health Status
Health status is relative and never static. It takes a proactive and skillful nurse to maintain it
within comfortable range for a peaceful working environment. This could be attained with
patient-centered care from scientific community and practicing caregivers (Rumsfeld, 2002).
In psychiatric nursing unlike general practice, patient’s health status ranges from disease or
mental trauma, mental illness, deviation from function and severance from reality; health
related quality of life as illustrated in Spertus model (1995).
A patient is said to be normal when reasoning is within reality testing with attendance to daily
life activities. This is confirmed by clinicians with use of mental state assessment at various
levels of care (Forrest, 2020). Deviation from this is what warrants the relative to bring their
member for treatment.
Nurses Activities
Nurses being core care providers in every health facility has wide range of activities to justify
patients/relatives’ satisfaction even during trial leave. At inception, relatives and patients has
to be accepted, listened to, cared for, prevention from harming self and/or others,
accommodated, protected from injury and infection, and advocated for till insight is regained.
According to Townsend (2015), above activities could be attained through value clarification
which involved self-awareness, respect to culture and beliefs of patients, proof of genuineness
to patients in interpersonal relationship, show of sympathy and empathy toward patient’s
condition.
A psychiatric patient, irrespective of behavior and appearance needs reception and acceptance.
Ryan (2020) comment that accepting a psychiatric patient help him make a change, accept
peace with difficult situations which was hard for him to bear and amount a loss to him. This
shows a level of compassion and assistance to assume reality by a Care provider.
Most psychiatric patient has no sense of safety and who may be affected by his activities.
Prevention from harm is one priority of psychiatric nursing as negligence can lead to adverse
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Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar; Within 2022.
British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
URL: http://dx.doi.org/10.14738/bjhmr.106.16014.
consequence. Murphy, Keogh and Doyle (2019) reported incidence of over 220,000 cases seen
at accident and emergency unit Australia, arising from self harm. This results in challenging
situations with common admission in healthcare facilities. According to Taylor and Zborowsky
(2019), harm to self and others could best be guided against with use of Safety Risk Assessment
(SRA). The same vigilance skill used to prevent harm self and others extends to prevention from
elopement. Taylor and Zborowsky (2019) design an SRA tool to monitor and easily arrest
patients’ escape at first point of emergence.
Doncaster and Bassetlaw Hospital issue a check list for Custodian of a psychiatric patients’
property in Healthcare Institution (Clegg & Carville, 2015). In accordance with Mental Capacity
Act (2005), items found with admitted patients who are unconscious, confused, incapacitated
or dead are required to be custodies or safe kept in a psychiatric facility by a nurse. Care Quality
Commission provides that this is done to avoid misuse, theft, misappropriation of valuable
properties especially monies and possession (CQC, 2010).
In the same vein, accountability to patients’ property is born by nursing staff that receives and
care for them. The patient has right to demand or seek for explanation of the property, and has
to be attended to. In line with CQC (2010) rules, any damage of misplaced property is explained
to patient on regain of insight or communicated with relatives. Moreover, forgotten and
rejected items are only destroyed following the patient or relatives’ consent.
Irrespective of source of collecting patients’ data, it is nurses’ role to preserve and guide it from
public access mindless of level of relationship with the patients. This demonstrates patient’s
safety, ethical practice and effective nursing practice. Anand (2014) asserts that nurses’ ability
to preserve and guide information is one of her tools that enhances practice and upgrades
patient’s care. Patients’ documented data are reliable and are meant to be kept permanent as
base for communication between inter-health professionals. It demonstrates nurses’
accountability, useful in nursing audit and legal involvements. This further provides framework
for research, resourceful evidence and rationale for funding further studies.
Transparency of nursing services requires explanation of treatment options, costs and risks to
relatives. This information is relevance to gain their cooperation and trust, which further
enhances staff relationship and patient’s outcome (Duquesne University, 2020).
Nurses justify their activities by retaining a rationale for each of their action to fellow
caregivers, relatives, society and even the patient. Hence, confinement is meant for absconding,
aggressive and violent patients likely to escape from healthcare facility to harm the public or
family members. Similarly, shifting duty allocation made for nursing staff help to share
responsibility of upholding safety within patients in the Ward and lesson stress and anxiety on
a set of staff for another set (Slemon, Jenkins & Bungay, 2017).
Another basic care a nurse owes her psychiatric patient is maintenance of environmental and
personal hygiene. A nurse must maintain balance between excess and poor grooming
(Goldenhart & Nagy, 2022). It is also mandatory to prevent spread of contamination by patient
to care providers and other patients, or from care workers to patients. To ensure cleanliness
disinfectant is useful to wash and mob the floor and instruments, disinfect caregivers’ hand
before touching and attending to patients. This mitigates chances of hospital acquired on in-
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mates in the wards. According to Groven, Zwakhalen, Odekerken-Schröder, Joosten and Hamers
(2017), encouraging and assisting patient into self bath, bathroom or bed bath is a fundamental
step to proper hygiene; as this clears dirt, death skin, bacteria, perspiration, and promotes
blood circulation. It may be necessary to recommend bathing toiletries to combat and prevent
skin infection between patients in the Wards.
Collaboration with other medical disciplines is an adjunctive treatment approaches which
requires nutraceuticals, lifestyle and behaviour change interventions with treatment of mental
health problems (Ee, Lake, Firth, Hargraves, De Manincor, Meade, Maryx and Sarris, 2020). It
involves more than one single professional giving health care; and proving their services
systematically, working in synergy and in team for any patient based on their emerging needs.
Furthermore, collaborative care is necessary for high quality care in patients requiring physical
and mental health intervention. This enhances close working relationship among partaking
team members and integration of primary, secondary and tertiary healthcare providers
towards patients’ presenting complaints. Ee, et. al. (2020) opined that better outcome of co- morbid presentations in psychiatric conditions is with collaborative care.
Moreover, there is need of collaboration with same colleagues like in Nursing, Medical,
Laboratorists, Pharmacy and Records geared at patients’ wellbeing. For instance, management
of a schizophrenia, depression and most serious chronic mental disorders demands different
professional disciplines contributing their services toward patients improved mental state
(Unutzer, Katon, Fan, Schoenbaum, Lin, Della Penna & Powers, 2008). There is also
coordination in care within collaboration when caregivers ensure patient’s needs are provided
alongside utilization of health services. This concept equally permits sharing of medical record
and inter-professional communication. This further foster early identification of adverse drug
effect and interactions as observed in a particular patient. Importance of collaboration also
enables holistic care to a particular patient, and where symptom persists, referral is
recommended to other physical or mental health facility for continuation of care. There is
opportunity for shared learning and exchange of knowledge among colleagues giving room for
effective use of conventional and integrative modalities (Hannigan, Simpson, Coffey, Barlow &
Jones, 2018). Professionalism of nursing care involves delivery of services to meet standard.
Though psychiatric care may be termed as a hurried or carless care, professionalism in safety
practice, infection control, moral ethics and human rights are regarded (Ee, et. al., 2020).
Advantage of this permits creation and use of professional care plan with involvement of the
patient and family members to deliver care. There are peculiar nursing diagnoses based on
patients’ symptoms professionally designed by nurses to describe and direct management. This
is done after assessment and thorough review of patients’ background literature with a defined
goal (Herdman, et. al., 2021).
Theoretical Framework
Donabedian evaluation model is a useful framework to guide in assessment of patient or
relative’s satisfaction of psychiatric nursing care in FNPH Calabar.
Donabedian Evaluation Model
McDonald, Sundaram and Bravata (2014) posited that these three elements: structure, process
and outcome are involved in Donabedian model. These were first discussed by Donabedian in
1966 in his article titled “Evaluating the Quality of Medical Care” (Donabedian, 2007; McDonald
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Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar; Within 2022.
British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
URL: http://dx.doi.org/10.14738/bjhmr.106.16014.
et al., 2014). The three elements provide a framework for examining health care services and
quality of care provided to patients for effective outcome of care. Based on this model, structure
refers to all physical structure, equipment and personnel needed to deliver physical, social and
spiritual care to the patients. These factors control the behaviour of health care workers and
may influence the nature on how care is delivered which may consequently influence how
patients receive their care and may also affect their judgment of satisfaction. It could also be
regarded as a means of measuring “average quality of care provided in the health system and
factors within the structure component that could predispose to challenges occurring within
the healthcare facility.
Process involves actions that are used to provide this care. It is the sum total of activities carried
out to render services to the clients by health care workers. These activities include diagnostic
procedures, treatment procedures and preventive measures involving health promotion
activities, health education, psychomotor activities including technicality of carrying out the
procedures and the interpersonal relations between the health care workers and the clients.
The process information as to how care is being rendered could be obtained through assessing
the clients’ records and also from survey, focus group discussion and interview with the clients
who actually are the recipients or consumers of health services and with the practitioners or
health professionals. In addition, observation could also be employed in obtaining data which
will actually reveal the quality of services provided. It is reported that from measuring this
element of process, quality of care provided could be ascertained.
Outcome is the effects of healthcare systems on the clients or health consumers. It is said to be
the best indicators used to measure quality of care rendered. This is because, it deals with
ensuring whether the goals of health care have been accomplished or not, which will be seen in
clients’ general health status and patient’s expression of satisfaction regarding care. This model
is commonly used in the health system to assess quality of care, though it does not contain
implicit definition of care; however, the three domains identified are useful tools to identify
quality of care provided to clients in a health care setting (Andersen, Rice & Kominski, 2016).
Donabedian Model of evaluation (2014)
Application of Donabedian Model to the Study
Donabebian model does not only apply to assessment of healthcare system, it could also be used
to assess the relatives and patients’ satisfaction of mental healthcare services among patients
of receiving care in Federal Neuro-psychiatric Hospital, Calabar. In applying this model to the
study, appropriate use of the three domains which are structure, process and outcome can
STRUCTURE PROCESS OUTCOME
Physical and
organizational
characteristics
where
healthcare
occurs
Focus on the care
delivered to
patients e.g.
services, diagnostics
or treatments
Effect of
healthcare
on the status of
patients and
populations
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produce positive impressions, perceptions and feelings with regards to patient/relative’s
judgment of satisfaction about mental healthcare services. The structure in the study is
considered as all the physical objects like building, instruments, apparatus, machineries,
appliances and personnel grouped together to make up physical facilities in all wards and units
in the Hospital. In clear terms, these include spacious arena, comfortable bed and beddings,
indoor games, recreational gadgets, orientation cues, chemical agents to modify behaviors and
the staff like nurses, physicians, psychologists, social workers and health assistants who
provide care and services patients require in the psychiatric ward/unit.
The process in this study is the series of activities employed in managing the patient from
psychotic to stable phase. In this study, they include prompt attention to reduce waiting time
and considerate service charge that in-cooperating feeding and accommodation. Outcome in
this study has to do with measurement of overall satisfaction of relatives/patients’ health needs
while in the facility. There is also interconnectedness of the elements or variables, this means
that one element can influence the other which may in turn affect the outcome of care. For
example, physical facilities such as equipment and human resources may influence the
satisfaction of patients of all the variables within the large three circles. Below is an illustration
of the relationship between the variables. The three circles are connected to one outstanding
circle at the right extreme through interlinked arrows showing that the variables are related to
one another and directing at outcomes. The four internal arrows show the connectivity of the
three circles, meaning that, the variables when effectively employed could lead to positive
impressions in terms of satisfaction of relatives and patients with psychiatric mental
healthcare.
Donabedian’s Structure, Process, Outcome Model (1982)
Statement of Problem
Objective:
The aim of the study is to investigate relative/patients’ satisfaction to nursing services in
Federal Neuro-Psychiatric Hospital, Calabar from January to December, 2022 using FNPHRSNS.
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Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar; Within 2022.
British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
URL: http://dx.doi.org/10.14738/bjhmr.106.16014.
Specific objectives are:
1. To ascertain the waiting time before admission
2. To determine the level of patient’s wellness before taken home
3. To illicit relatives’ satisfaction to nursing services
Research Questions:
1. What is the waiting time before patients’ admission?
2. What is the level of patients’ wellness before taken home?
3. What is relatives’ satisfaction to nursing services?
Hypothesis:
1. There is no significant difference on relatives’ satisfaction based on Ward/Unit
METHODS
The researcher used a cross sectional survey design to conduct the study. As a form of
observational survey, relatives offer response to the instrument once as data for decision
making. That gives no room for manipulation of variables; their response had consideration for
other characteristics at the same time, and also provides required analytical data for the subject
of study (Kerry, 2022). Moreover, Levin (2006) describe the design as useful in studying any
prevailing situation of interest in a given population.
The study progressed by perusal of patients’ admission through discharge as recorded in
Hospital documents, Registers and forms like patients’ Nursing Processes, Ward and Compound
reports, Incident books, patients’ folders and Nursing Audit Register from January till
December, 2022.
The area of study was Federal Neuro-Psychiatric Hospital, Calabar in Calabar South Local
Government of Nigeria. Being the oldest psychiatric hospital in Nigeria established in 1903, she
offers quality and effective mental health services to her clients/patients across South-South
geo-political Zone of Nigeria up to Southern Cameroun.
Out of three hundred and ninety-two (392) patients given trial leave within the period, relatives
of two hundred and four (204) relatives accepted to pick and respond to the instrument. The
scale was introduced to relatives at nursing station when retrieving their member home in any
part of nursing shift (morning, evening and night).
The Researcher constructed an institution-based instrument—Relative/Patient Satisfaction of
Nursing Services (RSNS) to illicit opinion of the relatives on retrieving their member’s home. It
contains eight (8) items measured with five (5) point scale of close and open-ended
questionnaire to seek relatives’ opinion towards improvement of nursing care. Validation was
done by Research Fellows of University of Calabar.
S/Nos Variables N Test positions X̅ SD r-cal
1 Nursing activities on patients’ care 46 Part 1
Part 2
40.6537
35.8244
5.17081
4.77723
.885
.894
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RESULTS
This study is an assessment of relatives’ satisfaction with nursing care activities in Federal
Psychiatric Hospital, Calabar. A total of 204 patients’ relatives responded to the questionnaire.
The filled questionnaires were coded, scored and analyzed using frequency counts, simple
percentages, weighted scores, mean and standard deviation. One way analysis of variance
(ANOVA) was used to ascertain the differences in the respondents’ satisfaction with nursing
care activities based on the respective Wards/Units. Organized data were presented using
frequency table and charts.
Answering Research Questions
➢ What is the waiting time before patients’ admission?
Table 1: Patients’ waiting time before admission (n = 204)
Waiting time Frequency Percentage (%)
0 – 30 minutes 117 57.4
31 – 60 minutes 39 19.1
More than 1 hour 27 13.2
More than 2 hours 21 10.3
Total 204 100
Source: Fieldwork, 2023
The respondents’ waiting time before admission is presented in Table 1 above. According to the
result, more than half 117 (57.4%) of the 204 respondents indicated that they were given
prompt attention and as such they did not wait for more than 30 minutes before their patients
were admitted into the Hospital. The remaining proportion responded that they waited for 31-
60 minutes (39 [19.1%)]), more than 1 hour (27 [13.2%]), and more than 2 hours (21 [10.3%]).
Based on these results, it is concluded that majority of the respondents waited for about 0-30
minutes before admission demonstrating high level of quick attention to patient and relatives
0 - 30 mins
58%
31 - 60 mins
19%
More than 1 hour
13%
More than 2 hours
10%
Waiting time
0 - 30 mins 31 - 60 mins More than 1 hour More than 2 hours
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Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar; Within 2022.
British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
URL: http://dx.doi.org/10.14738/bjhmr.106.16014.
with general and psychiatric health complaints. These results are also presented in figure 1
above for more clarity.
➢ What is the level of patients’ wellness before taken home?
Table 2: Level of patient’s wellness before taken home (n = 204)
Patient’s wellness Frequency Percentage (%)
Mild improvement 3 1.5
Moderate improvement 69 33.8
Remarkable improvement 132 64.7
Total 204 100
Source: Fieldwork, 2023
Table 2 and figure 2 present the level of wellness of the patients before given trial leave. As
indicated, majority 132 (64.7%) of the 204 respondents responded that their patients showed
remarkable improvement before they were picked home on trial leave, while 69 (33.8%) said
their patients showed moderate improvement, and only 3 (1.5%) responded that their patients
showed mild improvement, when he/she was sent home for a trial leave. With these results, it
can be inferred that a significant proportion of the patients remarkably improved before taken
home for a trial leave.
➢ What is relatives’ satisfaction to nursing services?
Table 3 presents the relatives’ satisfaction with nursing care activities performed on their
respective patients. The Table shows that majority 126 (61.8%) of the 204 respondents were
very satisfied with nurses’ acceptance of patients; a slightly more than half 108 (52.9%) were
very satisfied with nurses’ reception of patients’ relatives in the Hospital, the attention they
accord to patients’ problems, and nurses’ provision of patients’ care/need respectively.
0 20 40 60 80 100 120 140
Mild Improvement
Moderate Improvement
Remarkable Improvement
Patient's wellness prior to trial leave
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Table 3: Relatives satisfaction with nursing care activities on patients
SN
Nursing care activities
Very
Satisfied Satisfied Neutral Unsatisfied
Very
unsatisfied
n (%) n (%) n (%) n (%) n (%)
1. Acceptance of patients 126 (61.8) 72 (35.3) 3 (1.5) - 3 (1.5)
2. Reception of relatives 108 (52.9) 90 (44.1) 6 (2.9) - -
3. Attention to patients’ problem 108 (52.9) 87 (42.6) 9 (4.4) - -
4. Provision of patients’ care/ needs 108 (52.9) 78 (38.2) 18 (8.8) - -
5. Prevention of patients’ from
escape
123 (60.3) 60 (29.4) 15 (7.4) 3 (1.5) 3 (1.5)
6. Custodian of patients’ property 120 (58.8) 63 (30.9) 18 (8.8) - 3 (1.5)
7. Accountability to patients’
property
108 (52.9) 78 (38.2) 18 (8.8) - -
8. Preservation of patients’
information
102 (50.0) 90 (44.1) 9 (4.4) 3 (1.5) -
9. Transparency of nursing
transactions
111 (54.4) 78 (38.2) 15 (7.4) - -
10. Justification of nursing activities 114 (55.9) 75 (36.8) 15 (7.4) - -
11. Professionalism of nursing
services
138 (67.6) 54 (26.5) 12 (5.9) - -
12. Maintenance of patients’ hygiene 105 (51.5) 84 (41.2) 15 (7.4) - -
13. Hygiene of the Ward/Unit 99 (48.5) 96 (47.1) 9 (4.4) - -
14. Attention by medical doctors 114 (55.9) 78 (38.2) 9 (4.4) 3 (1.5) -
15. General care of the patients 102 (50.0) 93 (45.6) 9 (4.4) - -
16. Attention to patients’ complaints 96 (47.1) 96 (47.1) 12 (5.9) - -
17. Cooperation among nursing staff 117 (57.4) 78 (38.2) 9 (4.4) - -
Source: Fieldwork, 2022
On prevention of patients from escape, slightly less than 2-third 123 (60.3%) of the relatives
were very satisfied with this nursing services rendered to their respective patients. Similarly, a
greater proportion 120 (58.8%) of the respondents were very satisfied with the custody of
patients’ property accorded by the nurses; a little above half 108 (52.9%) of the relatives
studied were very satisfied with nurses’ accountability to patients’ property; exactly half of the
participants were very satisfied with preservation of patients information – that is
confidentiality of patients’ information by the nurses; many 111 (54.4%) relatives were very
satisfied with the transparency of nursing transactions in the Hospital; while a greater
proportion 114 (55.9%) of the relatives were very satisfied with justification of nursing
activities; slightly more than 2-third 138 (67.6%) of the relatives were very satisfied with
nursing professional services rendered to the patients; most 105 (51.5%) relatives were very
satisfied nurses’ maintenance of patients’ hygiene; slightly less than half 99 (48.5%) of the
relatives were very satisfied with maintenance of the Wards/Units hygiene; a greater
proportion 114 (55.9%) were very satisfied with the attention accorded to patients by medical
doctors; a higher percentage 96 (47.1%) were very satisfied and satisfied respectively with the
nurses’ attention to patients’ complaints; and majority 117 (57.4%) were very satisfied with
the cooperation among nursing staff in the Hospital. A summary of these results is presented in
Table 4 and figure 4 below.
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Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar; Within 2022.
British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
URL: http://dx.doi.org/10.14738/bjhmr.106.16014.
Table 4: Level of relatives’ satisfaction with nursing care activities
Level of
satisfaction
No. of
respondents
Percentage
(%)
Score
Range
Mean (x̅) Standard
Deviation (SD)
High 196 96.1 57 – 85 77.02 6.97
Moderate 8 3.9 28 – 56 53.75 1.91
Low - - 1 – 27 - -
Total 204 100 1 – 85 76.10 8.21
Source: Table 3
Table 4 presents a summary of the level of satisfaction of relatives with nursing care activities
in the Hospital. The Table shows that among the 204 respondents, majority nearly all 196
(96.1%) of them had a high level of satisfaction with a mean satisfaction score of 77.02 (6.97),
while 8 (3.9%) had moderate level of satisfaction with a mean satisfaction score of 53.75 (1.91),
and none of them had low level of satisfaction with nursing care activities in the Hospital. The
aggregate mean score of 76.10 (8.21) obtained for all the 204 participants falls within the score
range of high level of satisfaction (57-85), therefore, it is inferred that there is a high level of
satisfaction with nursing care activities among patients’ relatives in Federal Psychiatric
Hospital, Calabar.
As indicated in Figure 5, the relatives were mostly satisfied with the professionalism of nursing
services, and least satisfied with the attention accorded to patients’ complaints.
High, 196
Moderate , 8
Low, 0
0
50
100
150
200
250
High Moderate Low
Level of satisfaction
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Mean plot of relatives’ satisfaction with the respective aspects of nursing care activities
Answering the Hypothesis
➢ There is no significant difference on relatives’ satisfaction based on Ward/Unit
Difference in Relatives’ Satisfaction with Nursing Care Activities Based on Wards/Units
Table 5a and 5b show the differences in the relatives’ satisfaction with nursing care activities
in the respective Wards/Units. Table 5a presents the differences in mean satisfaction scores
obtained for relatives in the respective Wards/Units. Accordingly, the Table shows that there
are differences in the mean satisfaction scores of the respondents in various Wards/Units with
relatives in Ward 6 having the highest mean satisfaction score 84.00 (1.50); followed by, Ward- 4 [80.45 (3.90)], Ward 1 [77.86 (7.00)], Ward 2 [74.08 (9.64)], and Ward 3 [73.62 (8.08)]; while
patients’ relatives in Ward 5 had the least satisfaction with nursing care activities with a mean
satisfaction score of 73.28 (9.56). Similarly, the variation in the respondents’ mean satisfaction
scores by Wards/Units is presented in Figure 6.
Table 5b is a summary of one-way ANOVA computed to test if the mean differences observed
in Table 5a are statistically significant. In this analysis, the null hypothesis states that: there is
no statistically significant difference in the mean satisfaction score of the relatives based on
Ward/Unit where the patients were cared for. The level of significant for this test was set at
p≤0.05. According to Table 5b, the p-value (0.000) associated with computed F-value (6.857) is
less than the significant level (p≤0.05). Therefore, the null hypothesis is rejected with a
conclusion that there is a statistically significant difference in relatives’ satisfaction with
nursing care based on the Wards/Units of care.
4.3
4.35
4.4
4.45
4.5
4.55
4.6
4.65
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Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar; Within 2022.
British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
URL: http://dx.doi.org/10.14738/bjhmr.106.16014.
Table 5a: Descriptive Statistics
N Mean Std.
Deviation
Std.
Error
95% Confidence
Interval for Mean
Minimum Maximum
Lower
Bound
Upper
Bound
Ward 1 42 77.8571 7.00025 1.08016 75.6757 80.0386 63.00 85.00
Ward 2 36 74.0833 9.64328 1.60721 70.8205 77.3462 52.00 85.00
Ward 3 63 73.6190 8.08509 1.01863 71.5828 75.6553 56.00 85.00
Ward 4 33 80.4545 3.90585 .67992 79.0696 81.8395 73.00 85.00
Ward 5 21 73.2857 9.56108 2.08640 68.9336 77.6379 53.00 85.00
Ward 6 9 84.0000 1.50000 .50000 82.8470 85.1530 82.00 85.00
Total 204 76.1029 8.20574 .57452 74.9702 77.2357 52.00 85.00
Table 5b: ANOVA
Sum of Squares df Mean Square F Sig.
Between Groups 2017.621 5 403.524 6.857 .000
Within Groups 11651.218 198 58.845
Total 13668.838 203
RECOMMENDATIONS
Many respondents recommend as below:
1. They will ensure to refer more psychiatric patients to the facility
2. Patients are nursed in a very neat and serene environment
3. Nursing care to patients are effective and impressive
4. Nurse are very honest and sincere
Recommendation on Area of Improvement
1. The Ward toilets and water system should be improved
77.86
74.08 73.62
80.45
73.28
84
Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 Ward 6
Mean satisfaction score
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2. Nurses should incorporate variety of foods, snacks and fruits in their menu
3. The quality and quantity of patients’ feeding should improve
4. Staff should desist from being arrogant towards relatives and patients
5. Staff of Social Works should be taught on information management and release
6. Nurses should improve on manner of approach with the patients’ relatives
7. Nursing staff should refrain beating patients when they are wrong
8. Nurses should upgrade from manual to online payment transaction within the facility
by providing POS
9. Nurse should devise measure to abate their sexual weakness following their due drugs
Implication of Study to Nursing
➢ Appraisal of nursing care by relatives inversely improves service delivery and quality
health care.
➢ The study also illicit from relative and patients’ area of care to be improved to guide
image of the profession and facility.
➢ It discloses patient’s nursing needs requiring advocacy to the family or Hospital
Management for patients’ benefit
References
Parker, C. (2019). Patient Satisfaction in Healthcare: What it is, why it Matters & How to
improve it. Guidewaycare. https://guidewaycare.com/patient-satisfaction-what-why-how/
Umoke, M.; Umoke, C.I.& Olaoluwa, A.S., (2022). Patients’ satisfaction with quality of care in
general hospitals in Ebonyi State, Nigeria. PDF/ePub open access. https://doi.org/10.1177/2050312120945129
Jing Sun, Qian Lin, Pengyu Zhao, Qiongyao Zhang, Kai Xu, Huiying Chen, Cecile Jia Hu, Mark Stuntz, Hong Li & Yuanli
Liu (2017). Reducing waiting time and raising outpatient satisfaction in a Chaises public tertiary General Hospital:
An Interrupted time series study. BMC Public Healthvolume 17, Article number: 668 (2017)
Rumsfeld, J.S. (2002). Health Status and Clinical Practice, When Will They Meet? Originally published2 Jul
2002https://doi.org/10.1161/01.CIR.0000020805.31531.48Circulation. 2002; 106:5–7
Spertus JA, Winder JA, Dewhurst TA, et al. (1995). Development and evaluation of the Seattle Angina
Questionnaire: a new functional status measure for coronary artery disease. J Am Coll Cardiol. 1995;25: 333–
341.CrossrefMedlineGoogle Scholar
Forrest, J.S. (2020). History and Mental Status Examination. Medscape, Chief editor: Bienenfeld, D. Departments
of Psychiatry and Geriatric Medicine, Wright State University, Boonshoft School of Medicine.
Townsend (2015), Psychiatric Mental Health Nursing: Concepts of Care in Evidenced-Based Practice; 8th Edition;
F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103; www.fadavis.com; Printed in the United States of
America
Institute of Medicine, Committee on Quality Health Care in America (2001). Crossing the Quality Chasm: A New
Health System for the 21stCentury. Washington, DC: National Academy Press; 2001
Ryan, V. (2020). Why Acceptance is important for our Mental Health? MyMind is a registered trademark of
MyMind CLG. Copyright © 2022 MyMind All rights reserved. https://mymind.org/why-is-acceptance-important- for-our-mental-health
Page 15 of 16
297
Umoh, E. O., & Endra, M. E. (2023). Relative/Patients’ Satisfaction of Nurses Services in Federal Neuro-Psychiatric Hospital, Calabar; Within 2022.
British Journal of Healthcare and Medical Research, Vol - 10(6). 283-298.
URL: http://dx.doi.org/10.14738/bjhmr.106.16014.
Murphy, C., Keogh, B. & Doyle, L. (2019). 'There is no progression in prevention' The experiences of mental
health nurses working with repeated self-harm. Int J Ment Health Nurs; 2019 Oct;28(5): 1142-1151.doi:
10.1111/inm.12626. Epub 2019 Jun 26.
Taylor, E. & Zborowsky, T. (2019). Reducing injury and harm: Safety for behavior and Mental Health.
https://www.healthdesign.org/insights-solutions/reducing-injury-and-harm-safety-behavioral-mental-health
Clegg, A. & Carville, K., (2015). Policy on the Safe Keeping of Patients Property and Valuables. Doncaster and
Bassetlaw Hospital (NHS) Foundation Trust; PAT/ PA 12 v.3, Page 1 of 22
Anand, S. (2014). Documentation in Psychiatric Nursing. International Journal of Health Sciences. December
2014, Vol. 2, No. 4, pp. 99-101; ISSN: 2372-5060 (Print), 2372-5079 (Online). Copyright © The Author(s). 2014.
All Rights Reserved. Published by American Research Institute for Policy Development; DOI: 10.15640/ijhs.
v2n4a8; URL: http://dx.doi.org/10.15640/ijhs.v2n4a8
Duquesne University (2020). Transparency in Nursing Leadership and Healthcare, Duquesne University,
School of Nursing. https://onlinenursing.duq.edu/blog/transparency-in-nursing-leadership-and-healthcare/
Slemon, A., Jenkins, E. & Bungay, V., (2017). Safety in Psychiatric inpatient care: The impact of risk
management culture on mental health nursing practice. Wiley-Blackwell Online Open; Nurs Inq. 2017 Oct;
24(4): e12199. Published online 2017 Apr 18. doi: 10.1111/nin.12199
Goldenhart, A.L. & Nagy, H., (2022). Assisting Patient with Personal Hygiene. NIH National Library of Medicine.
https://www.ncbi.nlm.nih.gov/books/NBK563155/
Groven FM, Zwakhalen SM, Odekerken-Schröder G, Joosten EJ, Hamers JP. (2017). How does washing without
water perform compared to the traditional bed bath: a systematic review. BMC Geriatr. 2017 Jan 25;17(1):31.
[PMC free article] [PubMed] [Reference list]
Ee, C., Lake, J., Firth, J., Hargraves, F., De Manincor, M., Meade, T., maryx, W. & Sarris, J., (2020). An Integrative
Collaborative Care Model for People with Mental Illness and Physical Comorbidities. International Journal of
Mental Health Systems. volume 14, Article number: 83 (2020).
Unutzer J, Katon WJ, Fan M-Y, Schoenbaum MC, Lin EHB, Della Penna RD, Powers D., (2008). Long-term cost
effects of collaborative care for late-life depression. Am J Manag Care. 2008;14(2):95–100
Hannigan B, Simpson A, Coffey M, Barlow S, Jones A. (2018). Care coordination as imagined; care coordination as
done: findings from a cross-national mental health systems study. Int J Integr Care. 2018; 18:3
Herdman et al.: NANDA International, Inc. Nursing Diagnoses: Definitions and Classification 2021-2023. 12th
Ed.© 2021 Thieme. All rights reserved.
Kerry, C. (2022). How do Cross Sectional Study Work? “Everything Psychology Book 2nd Edition”.
www.verywellmind.com
Levin, KA (2006). Study design III: Cross-sectional studies. Evid Based Dent. 2006; 7(1):24-5. Doi:
10.1038/sj.ebd.6400375
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Scale Statistics
Mean Variance Std. Deviation N of Items
Part 1 40.6537 26.737 5.17081 9
a
Part 2 35.8244 22.822 4.77723 8
b
Both Parts 76.4780 95.849 9.79024 17
Case Processing Summary
N %
Cases Valid 46 100.0
Excludeda 0 .0
Total 46 100.0
a. Listwise deletion based on all variables in the procedure.
Reliability Statistics
Cronbach's Alpha Part 1 Value .885
N of Items 9
a
Part 2 Value .894
N of Items 8
b
Total N of Items 17
Correlation Between Forms .937
Spearman-Brown Coefficient Equal Length .967
Unequal Length .968
Guttman Split-Half Coefficient .966