Quality of nursing care through patient participation: an integration of Orem’s theory to the nursing process in Kiambu and Thika hospitals - Kenya.

Abstract

Introduction Patient participation in health care is regarded as a primary condition for quality care. However the traditional paternalistic perception among the health care workers is a major barrier to patient participation. Study Objective The study aimed at establishing whether training of nurses on the nursing process and its integration with Orem’s theoretical model would have an impact on the quality of nursing care provided to patients in Kiambu and Thika hospitals. Research Methodology This was a quasi-experimental study Questionnaires and checklists were used to collect data from the nurses and patients and analysis was performed by use of computer software SPSS version 22, and descriptive statistics was used for data presentation. Chi square test of significance (p<0.05) was used to in hypothesis testing while logistic regression analysis was used to predict the determinants of satisfaction at post –test. Findings The study findings revealed that the training of nurses on the nursing process showed significant difference (p<0.05) between pretest and post-test on knowledge of the steps of the nursing process. There was no significant difference (p>0.05) on attitude towards the nursing process. Logistic regression findings revealed nurses aged below forty (40) years were more likely to be satisfied with the support from management (OR 5.809, 95% CI 1.049- 32.187). On the patient participation, the findings revealed significant change (p<0.05) in Kiambu on nurses’ perspective about patient involvement in the care. On the role of leadership, the nurses were in common agreement that the management supports the use of the nursing process Conclusion The findings rejected the null hypotheses that the training of nurses on the nursing process does not have an influence on the nurses’ knowledge, attitude and practice towards the nursing process and that there is no relationship between implementation of the nursing process based on Orem’s theory and the quality of care provided to patients Therefore the integration of Orem’s theoretical model to the nursing process improved the level of patient participation in their own care Recommendations The nursing management should establish policies to incorporate nursing theory to the nursing process to improve patient involvement provision of quality nursing care.