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RESEARCH ARTICLE

PATIENTS' EXPERIENCES AND LEVEL

OF SATISFACTION ON THE CARE
RENDERED BY STUDENT NURSES
Melanie Reboldera-Adolfo, DNS, MSN, RN1,2*, Alyssa Justine E. Valdez, RN1,
Kathleen Gail C. Tomas, RN1, Keneth T. Anguluan, RN1, Josephine D. Lorica, DPA, RN1
1 St. Paul University Philippines, PH
2 Lecturer, King Faisal University, KSA

Abstract
Understanding the patients' views on the care they receive is essential for the development of quality health care services. The study
aimed to determine the patients' experiences and level of satisfaction on the care rendered by student nurses in the medical and
surgical wards of a private hospital . Furthermore, it determined any significant difference in the patients' experiences and level of
satisfaction when grouped according to demographic variables.

A descriptive research design was utilized in the study. The participants were recruited from the medical and surgical wards of the
hospital from September 5 to October 15, 2016. A total of 100 patients who received care from the student nurses for a minimum of 2
days were included in the study.

The Newcastle Satisfaction with Nursing Scale (NSNS) was used to determine the patients' experiences and level of satisfaction on the
care rendered by student nurses. Frequency, percentage, mean score, T-test, and ANOVA were utilized for the data analysis.

Results showed that patients' experiences were above good (category mean of 4.97) and were completely satisfied (category mean of
3.53) with the care rendered by the student nurses. A significant difference was also found between the highest educational attainment
and patients' experiences (P< 0.05). These findings are important in improving the quality of care rendered to the patients by student
nurses. Furthermore, it helps the nursing education in determining and enhancing the competencies of the students in some focused
areas.

Keywords: Patients' experiences, patients' satisfaction, care, student nurses

Introduction

U derstanding the patients' views on the care they receive is

essential for the development of quality health care
services. Taking notice of the patients' perceptions and
involves a series of patient-centered attitudes based on
interactions that are carefully strategized to show respect,
gentleness, sensitiveness, and patience (Loke, et. al., 2015). The
satisfaction is the first step towards bringing patient-centered care provided is dependent on the needs of the patients. Nursing
care in practice. Hence, student nurses, as part of the health care actions are expected to meet patients' needs to conclude that the
team, must determine the needs of the patients and provide care patient has received quality care (Adereti, et. al., 2014).
that meets the patients' expectations.
Patients' experiences refer to the feelings, thoughts, and
Caring involves two co-existing dimensions: instrumental and knowledge shared by patients that influence the way they react,
expressive caring. Instrumental caring, which is the 'doing of think, or behave (Makumbang & Adejumo, 2014). Patients can
care', is goal-oriented to achieve efficiency and good evidenced- either have a positive or negative experience from the care
based treatment. On the other hand, the expressive caring rendered to them. Commendable nursing care results in positive
* Corresponding author email: melanierebolderaadolfo@gmail.com
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experiences, while poorly executed nursing acts or interventions Thus, the study sought to assess the patients' experiences and
produce unpleasant and negative experiences from the level of satisfaction on the care rendered by student nurses in the
therapeutic encounter with student nurses. medical and surgical wards of the hospital. Moreover, it aimed to
determine any significant difference in the patients' experiences
On the other hand, patient satisfaction is the perception of and level of satisfaction when grouped according to their
patients' needs and expectations being met (Ndambuki, 2013). It demographic variables.
is a result of each patient's perception of the care individualized
for them to eliminate his or her problems (Oskay, et. al., 2015). METHODOLOGY
Based on the literature, patients were highly satisfied with the A descriptive design was utilized in evaluating the patients'
nursing care of student nurses. Results showed that patients experiences and level of satisfaction on the care rendered by
were more satisfied with nursing care given by the student student nurses in the medical and surgical wards of the hospital.
nurses, especially those who were able to spend more time with
them and provided individualized patient care (Topcu and After permission was granted, data were gathered between
Cakmak, 2014). They were able to meet patients' needs in a September 5 and October 15, 2016. Using a convenience
caring and attentive manner (responsiveness), provided care sampling, a total of 100 patients who received care from BSN
according to the patients' feelings (individualization), promoted 3/BSN 4 student nurses for a minimum of 2 days within the two
communication among nurses and patients (coordination), and weeks of data collection were included in the study. For patients
provided knowledgeable, skillful nursing care (proficiency) who were unable to complete the questionnaire themselves (e.g.
(Oskay, et. al., 2015). because of difficulties in reading or writing), the researcher who
distributed the questionnaires assisted by reading out and
Though some findings were found by the researchers during the explaining the questions along with the possible responses to the
literature review on the patient experiences and satisfaction on patients and noted their answers on the questionnaire. The
the care rendered by the student nurses (Oskay et al., 2015), patients were given option to answer the Filipino or English
patient experience on the care rendered by first-year student version of the tool. The researchers also encouraged the patients
nurses (Mossop & Wiliinson, 2006; Camilla et, al., 2015) and to ask questions if they can't understand the questionnaire.
patient satisfaction on the care rendered by student nurses
(Topcu & Cakmak, 2014), these were found to be insufficient. The Newcastle Satisfaction with Nursing Scale (NSNS) with a
Some studies were done in perinatology ward (Oskay et al., Cronbach's alpha of 0.91 for experience and 0.96 for
2015), gerontology ward (Mossop & Wiliinson, 2006, dedicated satisfaction was utilized in the study (Thomas, et.al., 1996) after
education unit (Camilla et, al., 2015), and general surgery clinic asking permission from the author. The NSNS tool was
(Topcu & Cakmak, 2014), but none was done in the medical ward translated into Filipino by a Filipino teacher and back-translated
and surgical wards in the hospital. The researchers chose the by an English teacher. It was pre-tested on September 2 to 5,
medical and surgical wards since the third/fourth-year students with 10 participants.
have their clinical placements in these areas and are expected to
render more direct care to the patients as compared to first-year The mean scores computed for patients' experiences scale were
students in the reviewed studies (Mossop & Wiliinson, 2006). categorized from not so good to very good, while the patients'
Moreover, in the studies reviewed, there are two studies which satisfaction scale computed was categorized from not at all
used qualitative research designs (Camilla et, al., 2015; Mossop satisfied to completely satisfied. Frequency and percentage
& Wiliinson, 2006) and another two studies which used were used to determine the demographic profile of the
quantitative research designs (Topcu & Cakmak, 2014; Oskay et respondents while the weighted mean was used to determine the
al., 2015), which are very minimal considering the importance of patients' experience of nursing care and satisfaction level.
the topic. Analysis of Variance (ANOVA) was used to determine if there is a
significant difference in the patient's experience in nursing care
Student nurses' rendered care is part of the overall care given to and satisfaction level.
patients in training hospitals; that is why it should be given the
same attention as to how staff nurses rendered care. Regularly Ethical Consideration
assessing patients' experiences and satisfaction with valid and
reliable assessment tools is useful in increasing the quality of The St. Paul University Philippines Ethics Board approved the
healthcare through the implementation of necessary regulations study. As there is no Research Ethics Committee in the hospital,
aligned with patients' expectations. With a better understanding a letter asking permission from the nursing management of the
of patients' expectations for care, student nurses will be able to hospital to conduct the study was asked and approved. The
improve individualized care rendered to the patient leading to researchers secured the informed consent, did the interview, and
more positive patient outcomes. collected the data from the participants of the study. Data

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Table 1. 7-point Likert scale (Patient Experience) Table 3. Distribution of Participants when grouped
according to Demographic Data

Table 2. 5-point Likert scale (Patient's Satisfaction)

collection was done without the student nurses who are in charge
of the patients to mitigate bias. Anonymity and confidentiality of
information were also observed.

FINDINGS
The majority of the respondents (80%) were admitted at Mere
Mary Ann de Tilly/MMA, with ages 40 to 50 (29%), male (53%),
married (86%), were educated up to college-level (27%), and
stayed in the ward on an average of at least three nights (36%).

The patients' experiences on the care rendered by student

nurses were “Above Good”, with a category mean of 4.97. The
highest mean scores were: "Student nurses explained what they
were going to do to me before they did it " (5.69), and "Student
nurses told the next shift what was happening with my care"
(5.69). The lowest mean score is: "Student nurses let things get
on top of them" (0.60).

Table 4. Patients' Experiences with the care Rendered by Student Nurses

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Table 5. Patients' Satisfaction with the Care Rendered by Student Nurses

The respondents were completely satisfied with the care found to be more satisfied with the care rendered to them than
rendered by student nurses, with a category mean of 3.53. The those with other relationship statuses like being single, widowed,
items with the highest satisfaction scores were: “Student nurses' and divorced (Abdulla, 2000).
helpfulness”, (3.68), and “Student nurses' treatment of you as an
individual” (3.65). On the other hand, the item with the lowest People who have college level as highest educational attainment
satisfaction scores is: “The amount of time student nurses spent visits the hospital frequently maybe because they have enough
with you” (2.41). knowledge and exposure to health services. Some studies found
that patients with higher education were associated with a higher
There is no significant difference between patients' experiences level of satisfaction (Oskay, et. al., 2015; Abdulla, 2000). On the
and levels of patients' satisfaction when grouped according to other hand, another study established that patients with lower
the unit of admission, age, marital status, and length of education levels have higher satisfaction levels than those with
hospitalization. There is however a significant difference higher educational attainment (Topcu & Cakmak, 2014).
between patients' experiences when grouped according to
highest educational attainment. This is supported by a The present study tells us that the experience of the patients with
probability value of 0.001, which is less than .05. the students is positive. This is similar in the experience of the
older population with first-year students (Mossop & Wilkinson,
DISCUSSIONS 2006). It is noted that positive patient experience can be
achieved by explaining procedures to be done and maintaining
Based on the findings, there are more medical than surgical the continuity of care. This means that knowledge about their
cases in the hospital. This could be because diseases are care and autonomy that comes with the explanation of care are
treated using medications first before surgery. Surgery is important aspects of quality care for the participants of the
observed to be less preferred by patients due to some present study. On the other hand, it was found that patients feel
complications and changes in activities of daily living associated both stability and less stability on care rendered by students.
with it. Accordingly, this could be solved by including the patients in both
the learning process of the students and their health care
Males, as compared with females, are also more likely to engage (Eskilsson, et. al., 2006).
in risky behaviors such as drinking or fast driving, which can
affect their health (Korn & Bonny-Noach, 2018), causing more Based on the findings, students should improve care
hospitalizations. This reflects the findings of the present study as management. Making time for the patients conveys a sense of
there are more males than females. However, it was found that commitment to the patient and plays a major role in meeting
females tend to be more satisfied with the nursing care rendered patients' expectations (Kieft et al., 2014). Moreover, the extra
by nurses as compared to males (Abdulla, 2000). care, attention, and social opportunities are valued by the
patients (Mossop & Wilkinson, 2006). In terms of satisfaction,
Ages within 40 to 50 are in middle adulthood and have the present findings are similar to the study conducted by Oskay,
generativity vs. stagnation as a developmental task –(Erikson, et al., (2015) and Topcu and Cakamak (2014), where patients'
2013). At this stage, physical development is essentially satisfaction with nursing care was determined to be high.
complete and a very gradual decline in functioning occurs
(Berman, et. al., 2008). Also, this age group is more likely Again, the time element scored low in the satisfaction level. This
married as social norm dictates. However, the present findings implies the need to emphasize the importance of presence to the
showed that there were more patients in middle adulthood and patients and to revisit the activities of the student nurses.
married who are admitted in the wards. Married people were Patients were found to be more satisfied with the nursing care

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given by student nurses when they spend more time with them Adereti, S.Olaogun, A.Olagunju, E.&Afolabi, K. (2014) Paediatric
and provide individualized patient care (Topcu and Cakmak, Patient and Primary CareGivers’ Perception on Nurse-
2014). Caring Behaviour in South-Western Nigeria.
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healthcare information may seek more healthcare services and Fundamentals of Nursing, 8th Edition. https://doi.org/10.1016/
has higher expectations than a patient who knew lesser. j.nepr.2015.04.001
Erikson, E. (2013). Theory of psychosocial development has eight
According to Oskay, et. al., (2015) as the patients' educational distinct stages. In Simply Psychology.
Eskilsson, C., Carlsson, G., Ekebergh, M., & Horberg, U. (2015) The
level increases, expectations toward the nursing service and
experiences of patients receiving care from nursing students at
nursing care increases. If these expectations are not met, a Dedicated Education Unit: A phenomenological study.
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negative. Furthermore, patients with higher levels of education Kieft, R. A., de Brouwer, B. B. J. M., Francke, A. L., & Delnoij, D. M. J.
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Ndambuki, J. (2013) The Level of Patients' Satisfaction and
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quality care even though they are still studying under their BSN being nursed by Student Nurses at a Teaching Hospital.
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____________________ the Care provided by the Student Nurses.
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Doghaither

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ABOUT THE AUTHORS

Melanie Reboldera-Adolfo, DNS, RN, is a Alyssa Justine E. Valdez, RN, is currently

lecturer at the King Faisal University, working in St. Paul Hospital Tuguegarao as
Kingdom of Saudi Arabia. She has been a staff nurse in the emergency department.
working in the academe since November She completed her bachelor's degree in
2007. She is also a Quality Assurance Nursing (2018) from St. Paul University
Officer and course coordinator in her Philippines, Tuguegarao City. Her research
college and department. She received her BSN, MSN, and interests include the quality of nursing care and patient safety.
DNS degrees from the St. Paul University Philippines,
Tuguegarao City in 2006, 2009, and 2017 respectively. Her
research interests include culture, qualitative research and Josephine D. Daquioag-Lorica, DrPAd,
methodology, mental health, and psychological issues RN, is currently a faculty of the School of
affecting health care workers. Nursing and Allied Health Sciences of the
St. Paul University Philippines since 1992.
Kathleen Gail C. Tomas, RN, is a staff She has taught research for the past 10
nurse at Isabela Doctors General Hospital years and has assisted nurses and other
in Ilagan, Isabela, She received her BSN allied health professionals in coming up with their research
degree (2018) from St. Paul University papers. She received her Bachelor of Science in Nursing
Philippines, Tuguegarao City. Her research (1991), Master of Science in Nursing (1995), and Doctor in
interests are mental health, communication, Public Administration (2003) degrees from the same university
and environmental studies. where she is employed. Her research interests are nursing
research and the provision of nursing care across populations.
Keneth T. Aguluan, RN, is a Hemodialysis
nurse under Medical White Hands Pioneer
Group, Al Redwan Company in Riyadh, Acknowledgment
KSA. She received her BSN degree (2018)
from St. Paul University Philippines, The authors wish to acknowledge the assistance of
Tuguegarao City. Her research interests Mr. Rufo Tuddao for checking the statistical processes.
are mental health, diseases, and health diversity.

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