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Patient Education in Rural Community Hospitals: Registered Nurses’ Attitudes and Degrees of Comfort

Jul 9, 2017 | 0 comments

Jul 9, 2017 | Essays | 0 comments

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Introduction. 3

Justification. 4

Variables: 5

Independent variables. 5

Dependent variable. 6

Research Design. 6

Strengths of the Research. 7

Highlights the importance of role orientation. 7

Emphasize the need for experience: 7

Data is an adequate representation of the present situations. 8

Weakness. 8

Sampling. 8

Attitudes of other health care professionals. 8

Self diagnosis. 9

Conclusion. 9

References. 10

Patient Education in Rural Community Hospitals: Registered Nurses’ Attitudes and Degrees of Comfort


The study focused on understanding aspects of the nurse’s attitude towards education of their patients. Normally, nurses are often charged with the role of educating patients regarding various aspects of their treatment and general health. Surprisingly, not all nurses understand the importance of this education towards the general wellbeing of the patient. A review of the literature shows that the attitude of the nurse towards patient education is primary in ensuring the success of the initiative. Without a positive attitude and confidence in the program, failure is imminent. Much concern has been raised on the skills as well as attitude of the nurses.

It is important to note that the nurse attitude may not be as opposed to the program itself but may rather stem from the lack of knowledge and skills to handle patient education. The criterion given for patient education is in many cases something acquired practically rather than taught and examined under the professional instruction. In rural communities, there is need to employ time as well as energy in basic patient instruction, something that the nurses may not have mastered while training. Further there is the belief that the patients will not follow the instructions given even after careful education and instruction.

According to Krau and Prevost (2011), Patient education can be categorized into four major categories and these are:

  • Education aimed at understanding the patient’s condition and behavior that could improve the chances of recovery
  • Education directed at assessing the needs and requirements of the patient in managing their own health
  • Discharge instructions that are vital towards the recovery of the patient.

From the above categories, it is obvious that patient education is a vital step towards full recovery of the patient.


Research has shown that patient education is a major rather than minor process of intervention that falls categorically under the nursing roles, (Mutagh 2000).  Professionally nurses are socialized to develop and mature skills that are directly involved in the success of patient education. In the rural communities, hospitals are few and the hospital workers are getting fewer each year. Surveys have indicated that the number of patients versus the bed space in rural communities is decreasing each year. The result is that discharge often happens earlier.  This means that patient education will be vital to ensure full recovery of the patients.  Nurses ultimately spend more time caring for patients and interact more with them than other health care professionals. This means that the duty of patient care intentionally falls squarely upon their shoulders. As the rural hospitals work more towards cost containment and management of the increasing number of patients, greater emphasis will be on the nurses and their role in patient education. Caring for the patient is no longer adequate, nurses need to ensure that the patients understand their diseases, their own needs and can manage their own care with little or no assistance.  However, this will not be possible if the nurse themselves poses negative attitudes and are uncomfortable with engaging patients. From an early stage it is important to engage the skills of the nurse in proper training to ensure confidence while interacting with patients. This study also identified several barriers towards the attitude of nurses in patient education. This will allow proper assessment and management of such barriers towards the growth and success of nurses in rural patient education.


Independent variables

The main independent variable in the study is the patient education programs. Recent focus on the health care and the cost of the same have forced majority of the patients to become proactive in their own health care. These emerging patterns mean that nurses are now being called upon to actively participate and engage in patient education. It is important to note that there is nothing new or unique about patient education. Patient education in itself is as old as the nursing profession. Patients have often been forced to receive care from home especially in cases of terminally ill patients.  Professional organizations have taken the responsibility of encouraging nurses to engage patients in their own care. Some studies have shown that patient education not only leads to more affordable health care but also ensures faster and more sustainable processes of recovery for the patients.

Dependent variable

Nurse’s attitudes are the main dependent variable for this study. The role of the nurse is vital in ensuring that patient education is effective. Various researchers have identified nurse attitudes as the main reason why the patient education is failing or succeeding.  Attitudes come from socialization and skill development. Institutions training nurses are now charged with the responsibility of ensuring that they socialize students towards accepting their role and appreciating the importance of patient education.

A second dependent variable is the comfort of nurses while dealing with patient education. Comfort is defined as the confidence and security in theory own skills. Nurses who are comfortable with patient education are more willing to engage their patients.


The research employed a descriptive survey. This design includes gathering data without manipulating or changing any of the variables. This design is important in developing and ensuring that the data presented is accurate. The descriptive research design gives strength to the data, and allows the researcher to document events as they happen.

In this research, the data instruments employed involved questionnaire administration. The instruments used were developed by Stanton (1986). This instrument has proved adequate and indeed every effective in measuring the attitude of individuals as well as their comfort within various subjects. Because the data gathered was already measured using the lickert scale, entry and analysis was a simple step.

This study employed qualitative data analysis methods to present the results of the data collection. The data collected on the various variables being tested was entered into the SPSS version 15 package. Once entered, analysis that is thematic and content analysis were carried out to determine the interpretation of the results.  Various statistical tests were applied where necessary to interpret the collected information. Responses to the open and closed-ended questions of the indicators to the main variables contained in the model were numerically coded for entry into the computer. The coded qualitative data was rated using scale top score the responses to numerically express the magnitude of the variables for summary and analysis.


Highlights the importance of role orientation: there has been speculation on the importance of socializing nurses into patient education. This study shows that while job orientation may not be as important, the importance of the role socialization cannot be ignored. This means that from the first day of training in nursing institutions, individuals need to be exposed to patient education. This way they develop the right skills and experience that is vital towards being comfortable and confident with the patients. Redman (2001) states that Institutions have often focused on giving nurses other skills and left socialization into patient education for the institutions. As can be seen from this study, this is however far from being effective.

Emphasize the need for experience: like any other profession nursing requires excellent skill development to improve the confidence of the nurses. Though one maybe professionally trained, the theoretical knowledge often does not match the practical requirement. To ensure that more nurses are confident and comfortable with patient education, it is vital for the nurses to continually be engaged in the process of patient education.

Experienced nurses can also be used to orient the younger and newer professionals. Experience allows nurses to navigate through the challenges that often cause discomfort with patient education. They can anticipate the challenges and therefore prepare adequately for the same, (Bastable 2006).

Data is an adequate representation of the present situations: the data was gathered through a survey. This means that the attitudes measured and the level of comfort indicated was as it is on the ground. No changes were made to the data and therefore it can be considered as proper, present and adequate representation of the nurse attitudes in the hospitals. Further, during the process of data collection, nurses were able to learn more about themselves, their skills and studies and therefore ways in which they can improve on both thus benefiting the patients as well as themselves.


Sampling: the study employed a non-random sample of the nurses. While a random sample provides a more representative sample, a non-random sample does not. In this case, it is impossible to calculate the chances that a particular nurse would be in the sample and therefore it is also impossible to calculate the bias level. The results of the study are important and can be used to improve on the care of the patients; however, they cannot be generalized to all nurses in the nursing profession. A different study with a different sample could yield completely different results. The reliability and validity of the study cannot be assured.

Attitudes of other health care professionals: while the study focused on education, skill attainment and even socialization into patient care; a gap was identified with regard to the attitudes of other health care professionals. Often the attitude of clinicians and doctors can rub off on the nurses. Where they do not appreciate or recognize the importance of patient education, it is likely that it will be ignored and takes a back seat, (Rankin and Stallings 2001). This aspect of measuring attitudes was not included in the measuring instruments.

Self diagnosis: instruments of data collection were anonymously distributed, gathered and analyzed. This provides a weakness in the process of research. With such a data collection method, the data in itself cannot be proved and is not rich. Whereas individuals maybe prone to be honest because of the anonymity, there is the concern of social biasness and concern. They may elect answers that seem more preferable to them socially rather than the exact truth. Further, the researcher has no advantage of non-verbal cues to rely upon.


It is important to note that the majority of the nurses in themselves recognize the importance of patient education. However, they have no time or resources to devote towards proper teaching and training of the patients. This in turn means that patient education is no longer a priority to them. Such attitudes are most likely to deteriorate the quality of education that they give the patients.

Further, patient education is not a haphazard training technique. It needs to be structured and well centered to the needs of the patient. The nurse needs to develop the right skills in order to confidently ensure that they are able to handle the challenges that come with patient education. Patient education should not take a back seat during training on the job and in school. In both settings, institutions are charged with the responsibility of ingraining the importance of patient education and the role of the educator to the nurses.


Bastable, S. B. (2006). Essentials of patient education. Sudbury, MA: Jones and Bartlett Publishers.

Krau, S. D., & Prevost, S. S. (2011). Patient education. Philadelphia, Pa: Saunders.

Murtagh, J. (2000). Patient education. Sydney: McGraw-Hill.

Rankin, S. H., & Stallings, K. D. (2001). Patient education: Principles & practices. Philadelphia, PA: Lippincott.

Redman, B. K. (2001). The practice of patient education. St. Louis, Mo: Mosby.

Stanton, M. P. (January 01, 1986). Nurses’ attitude toward nurse-patient interaction in the patient-teaching situation. Nursing Success Today, 3, 4, 12-9.

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