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Patient"s Sociocultural Differences and the Delivery of Nursing Care Needs among patients in Tagum Doctors Hospital, Tagum City Davao Del Norte

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Patient’s Sociocultural Differences and the Delivery of Nursing
Care Needs among patients in Tagum Doctor’s Hospital,
Tagum City, Davao Del Norte
A Thesis Presented to the Faculty and Panel
of Tagum Doctor’s College, Inc.
Tagum City, Philippines
In Partial fulfilment of the Requirements for the
Bachelor’s Degree
in NURSING
by:
Cliff Mark S. Babalcon
Mark Janrel G. Genito
Eddie King B. Manguilimotan
Sheguila V. Milan
Sahar Ayesha Maong Zumbaga
January 2020
ACKNOWLEDGEMENT
The completion of this research study would not be possible without the help and
assistance of many people, whose may not be enumerated. Their contribution are
sincerely appreciated and gratefully acknowledged. Moreover, we would like to express
our deepest appreciation to the following:
The researchers would like to extend our warmest gratitude to the panelist,
particularly Mrs. Anabelle Franada, RN, MN, our chairman for research study for her
patience, dedication and support during the process of finalizing our research study. As
well as to Manuel Dennis Molina our school vice president, and to Hon. Joel A.
Padoran, MD our school president;
To our dean, Mrs. Willyn B. Adrias, RN, MN, for her valued time shared,
patience, understanding, and brilliant ideas to improve our study;
To our clinical instructor and research adviser, Myka Allene Catoto, RN, USRN,
our for her valuable time shared, patience, understanding, guiding and sharing her
brilliant ideas and suggestions to improve our research study. We would like to express
our warmest gratitude and thank you for this endeavor;
Our sincere thanks to Hon. Joel A. Padoran the president of Tagum Doctors
Hospital inc., for giving us the permission to conduct our study. Our utmost appreciation
to the respondent who helped in the completion of this research; and
To our parents, who gave us the never ending and unconditional love and
support, and above all, to our Almighty God and Allah, who is always the source of
inspiration, strength and wisdom to the researcher in the completion of this work.
Sincerely yours,
The Researchers
TABLE OF CONTENTS
APPROVAL SHEET
ABSTRACT
ACKNOWLEDGEMENT
INTRODUCTION
Background of the Study
01
Review of Related Literature
02
Theoretical and Conceptual Framework
18
Statement of the Problem
20
Significance of the Study
22
Definition of Terms
22
METHODS
Research Design
24
Research Instruments
26
Data Collection Procedures
28
Treatment of the data
29
RESULTS AND DISCUSSION
Presentation and Analysis of Findings
30
Summary of Findings
42
Conclusion, Recommendations
42
REFFERENCES
44
APPENDIX
Appendix A
49
Appendix B
55
LIST OF FIGURES
Figure 1: Paradigm of the Study
20
Figure 2: Map and picture of Tagum Doctors Hospital, Tagum City,
25
Province of Davao del Norte where the study will be conducted.
LIST OF TABLES
a.) Table 1: Extent of Patient’s Socio-Cultural Differences
30
in term of cultural beliefs.
b.) Table 2: Extent of Patient’s Socio-Cultural Differences
in terms of Attitude.
31
c.) Table 3: Extent of Patient’s Socio-Cultural Differences
32
in terms of Educational attainment.
d.) Table 4: Extent of Patient’s Socio-Cultural Differences
33
in terms of Religion.
e.) Table 5: Extent of Patient’s Socio-Cultural Differences
34
in terms of Economic Status.
f.) Table 6: Summary on the Extent of Patient’s Socio-Cultural
35
Differences.
g.) Table 7: Extent of delivery of Health care needs
36
in terms of Assessment.
h.) Table 8: Extent of delivery of Health care needs
37
in terms of Diagnosis.
i.) Table 9: Extent of delivery of Health care needs
38
in terms of Intervention.
j.) Table 10: Extent of delivery of Health care needs
39
in terms of Evaluation.
k.) Table 11: Summary on the Extent of delivery of
40
Health care needs.
l.) Table 12: Relationship between the Extent of the patients’
sociocultural differences and to the delivery of
nursing care needs among patients in Tagum doctor’s
hospital, Tagum City Davao del Norte.
41
INTRODUCTION
Background of the study
The make-up of the world population is changing as a result of people’s
movement across borders. This movement is giving rise to ethnically, culturally,
and linguistically diverse populations residing in many parts of the world. The
impact of this diversity presents unique challenges to the practice of medicine.
When individual providers and health care organizations fail to address possible
differences in the perceptions, occurrence, management, and outcomes of health
problems among different cultural groups, the result may be miscommunication
and reciprocal frustration ultimately leading to misdiagnosis and mistreatment
(Ahmed, 2017).
The growing ethnic minority population groups will bring unique needs to
health care interactions that may result from cultural differences between care
provider and receiver (Betancourt, 2014, 2003; Berger, 1998). Differences in
cultural values and beliefs between the health care provider and the receiver
account for many misunderstandings in health interactions (Cline & McKenzie,
2018). When such differences are not accommodated, poor health outcomes
arise. Fadiman (2017) described that the culture clash between the Merced
Community Medical Center in California and a refugee family from Laos over the
care of Lia Lee, among child diagnosed with epilepsy. Fadiman explained how
the fundamentally different notions of disease that divided among sense of health
and disease from the views of American scientific medicine eventually cost the
life of Lia Lee. Although Lia’s health was in the best interest of both her parents
and her doctors, miscommunication between the two cultures led to a tragedy
and brings to attention the issues of medical ethics and cultural differences.
The Department of Health of the Philippines (2017) fines that Filipinos are
considered fatalistic in that they tend to accept fate easily, especially when they
feel they cannot change a situation. Moreover, the acceptance of fate or destiny
comes from their close relationship and health respect to nature. The acceptance
2
of fate or destiny comes from their close relationship and health respect to
nature. The acceptance of events they cannot change is tied to their cultural
religious faith. A common expression uttered by Filipinos is “bahala na”,
originating from “bathala na” it is up to God (Enriquez, 2014).
Malaybalay City, the Department of Health, Department of the Interior and
Local Government and the National Commission on Indigenous Peoples (NCIP)
signed a Joint Memorandum Circular 2015-01, which was introduced to the
provincial government. The circular seeks to address inequity in the delivery of
health care services, discrimination and insensitivity to culture, beliefs and
traditions. The implementation will involve the Federation of Manobo Matigsalug
Tribal Councils, Inc. in Bukidnon, Subanen tribe in Zamboanga del Sur,
Dibabawon Mangguangan tribe in Compostella Valley, Arumanen-Manobo tribe
in North Cotabato and the Banwaon and Talaandig tribes in Agusan del Sur,
T’boli of South Cotabato in Southern Mindanao, Higawnun of misamis oriental
and subanon tribe in misamis occidental.
According to the circular, the physical segregation and socio-cultural
exclusion of IPs contribute to the barriers in their access to health services. The
order noted that health care providers should not see traditional and cultural
beliefs and practices as obstacle or barrier to health care service delivery.
Culture sensitivity in health is among the guiding principles pushed for the
delivery of basic services to indigenous cultural communities and indigenous
peoples in the country, according to the guidelines. It stressed that indigenous
peoples are considerably vulnerable to inequities in health services (Walter I.
Balane, 2015, Mindanao News). Ideally, health care needs provider seeks to
address all necessary preparations in order to provide good expectations of their
clients. The above mentioned problems of socio-cultural differences of patients
serves as the basis of the researchers to conduct the study about the impact of
patients’ sociocultural differences in the delivery of health care needs. This seeks
to find if there is a significant relationship between patients’ sociocultural
differences and the delivery of health care needs.
3
Review of Related Literature
This section contains related materials from books, journals and internet
articles that would give strength and support to the findings of this research.
The following are the Review of Related Literature of Independent Variable.
Socio-cultural Differences
Cline and McKenzie (2018) states that socio-cultural attributes that place
health care providers and receivers on two different ends of the health care
spectrum. Giving rise to cultural beliefs, attitudes, education, religion and
economic status. The impact of this diversity presents unique challenges to the
practice of medicine.
Cultural Beliefs. As stated on the journal of Immigrant Minority Health
(2014) cultural views are also emerging as a highly charged health care issue.
Ethnic and its counterpart’s xenophobia, prejudice and discrimination are being
increasingly implicated in racial and ethnic disparities in health and health care
and in disparities in the safety and quality of health care of ethnic minority
groups.
Another concept of (Equity, 2015) states that Irrespective of whether it is
direct or indirect, intended or unintended, cultural opinion harms people in
enduring ways. In order to better understand the harms of Ethnical differences,
an examination of the notion of ‘harm’ itself is required.
Cultural analysis cannot be done in the abstract because moral meanings
of health care goods are rooted in history and culture, and they can be
transformed or rendered obsolete by scientific and technological advances as
well as changes in economic and other social and institutional circumstances.
Hence, we need to understand some of this history.
Accessing culturally appropriate and acceptable health services is vital for
engendering the trust of clients who are Indigenous peoples, and extends
beyond the establishment of relationships to respecting their worldviews and
cultural preferences. Failure to identify key cultural beliefs and practices, or the
4
worldview of health, well-being, and illness risks providing health care that lacks
relevance and compromises its efficacy. When interventions 'go wrong' or
outcomes are not achieved, it is not unusual for clients to be blamed and labelled
'non-compliant'. This is a phenomena experienced by many Maori women
(Indigenous to Aotearoa New Zealand) who are often subjected to victim
blaming,
negative
labels
and
racism,
mistakenly
reinforced
by
their
underutilization of, and late presentation to, health services when they are
unwell. This situation is similar to other Indigenous women in countries where
they have been subject to colonization (Baker & Daigle 2000; Browne & Fiske
2001; Dodgson & Struthers 2005), and is an approach that denies who they are
and their unique health needs.
The provision of safe, high quality health care relies on health services
responding appropriately to this cultural and linguistic diversity. Barriers and
competing priorities exist at the organizational (leadership/workforce), structural
(processes of care) and clinical (provider-patient encounter) levels (Betancourt,
Green, Carrillo, & Ananeh-Firempong, 2003). Although discussion of culture and
its impact on health beliefs and health seeking behaviors runs the risk of
oversimplification
and stereotyping,
this
article
seeks
to
enhance our
understanding of the clinical barriers faced by migrant populations in accessing
health care and to present tools and strategies for addressing these challenges.
The concepts presented are exploration of the impact of culture on perceptions of
health and illness and how this can affect access to care, communication,
adherence to treatment, and perceptions of racism and discrimination in the
health context, all of which directly impact on child and youth health outcomes
(Kirmayer et al., 2010; Priest et al., 2013). These concepts can be applied across
cultural groups and understanding them is of benefit in any setting where
clinicians are treating children and families from culturally and linguistically
diverse backgrounds.
Health care delivery to families from migrant and refugee backgrounds
can be improved by addressing the "cultural competence" of the health system,
including understanding the importance of cultural influences on patients' health
5
beliefs and behaviors, considering how these factors interact at multiple levels of
the health care delivery system, and developing models of care that assure
quality for diverse populations. The evidence suggests that cultural competency
training of staff, use of multidisciplinary teams and interpreters, low cost services,
longer clinic opening times, outreach, free transport, home visiting, patient
advocacy for housing and welfare, gender-sensitive providers especially for
women, case management and integration across health and non-health
providers are effective in increasing access and quality (Joshi et al., 2013).
Patients may hold multiple beliefs blending Biomedical, Spiritual and
Traditional concepts and, at times of stress and illness, or in the face of complex
medical problems, traditional health beliefs and cultural practices may become
more dominant (Kalowski, 2014a; Kalowski, 2014b). Individuals within families
can vary enormously in their belief systems, often creating tensions between
generation’s in the extent to which they integrate the Biomedical model into their
Spiritual or Traditional health practice (Raman, Nicholls, Ritchie, Razee, &
Shafiee, 2016). Cultural practices play an important role in shaping people's
health behaviors and choices, for example delaying antenatal care due to
concealment of pregnancy for fear of malevolent spirits, making culturally
responsive care essential in optimizing health and wellbeing (Raman et al.,
2016).
Effective cross-cultural communication is a marriage of the expertise and
knowledge of the clinician and the patient, their family and community. Rather
than assuming the expert role, seeking to "educate" the patient, the health care
team that comes to understand the patient's health belief systems has a greater
chance of creating a therapeutic relationship. Clinicians may need to alter the
setting and their communication style so that the patient and family feel the levels
of comfort necessary for them to communicate (Kalowski, 2014a; Kalowski,
2014b; Mezzich et al., 2009). At all times, even if agreement is not possible, the
role of the clinician is to maintain the patient's sense of dignity and to facilitate
their understanding of what is happening (Kalowski, 2014; Kalowski, 2014b).
6
Attitudes. Patient satisfaction is a set of attitudes and perceptions of
patients towards health services. It is the degree to which an individual regards
health-care as useful, effective and beneficial. In other words it is the judgment of
the patients about their needs and expectations met by the care provided, or an
evaluation based on the fulfillment of expectations of the user. It is actually
determined by the interplay of two factors i.e. patient expectations and
experience of the real services. If the performance falls short of expectations, he
is dissatisfied and if it matches the expectations, then vice versa. Patient
satisfaction is therefore a match of expectations with experiences of the patient
during a treatment process (Journal of Medical Sciences July-December 2017,
Vol. 9, No. 2 183).
Predictors of patient satisfaction Patient perceptions are influenced by
sociocultural background of patients, their beliefs, attitudes and level of
understanding. Successful outcome depends on how far the doctor understands
these expectations and social context of his or her illness.22 Research findings
from developed world simply do not apply in the set-up of developing countries
including Pakistan (Journal of Medical Sciences July-December 2011, Vol. 9,
No).
Educational attainment. The relationship between education and health
is never a simple one. Poor health not only results from lower educational
attainment, it can also cause educational setbacks and interfere with schooling
(Chimere 2018).
In today’s knowledge economy, an applicant with more education is more
likely to be employed and land a job that provides health-promoting benefits such
as health insurance, paid leave, and retirement. Conversely, people with less
education are more likely to work in high-risk occupations with few benefits
(Brenda 2018).
Completing more years of education confers health benefits after leaving
school, such as better health insurance, access to medical care, and the
resources to live a healthier lifestyle and to reside in healthier homes and
7
neighborhoods (Virginia Commonwealth University Center on Society and
Health, 2014)
Religion. The influence of religion on health disparities remains obscure.
To date, religion and health research has tended to focus on the impact of
generalized religiosity (e.g., religious importance and attendance at religious
services), and in a limited way, specific religious practices on health outcomes
without much attention to the way religion shapes health behaviors of individuals
from a minority community (Levin et al. 2015). Health disparities research, on the
other hand, typically groups individuals by race, ethnicity, and socio- economic
status, assuming that relevant health-related beliefs, social experiences, and
cultures aggregate by these categories. As many have noted, this assumption
can be only partially true (Aspinall and Chinouya 2018; Karlsen and Nazroo
2010.
A shared minority religion is one health-related factor that often cuts
across and often unites individuals from disparate racial, ethnic, and
socioeconomic categories. Empirical research provides ample evidence that
religions shape their adherents’ understanding of disease and illness, their
health-related behaviors, their interactions with and expectations of the
healthcare system, and their adherence to medical recommendations (Ahmed et
al. 2016; Carroll et al. 2007; Suwaidi et al. 2004).
Despite both theory and data to support the influence of religion on health,
little research has systematically examined the extent to which religious factors
contribute to health disparities. The few studies that have tried to tease out the
relationship between religion and health in minority communities suggest that
religion exerts an independent influence upon health indicators when people from
the same ethnic but different religious groups are compared (Karlsen and Nazroo
2014).
Social-Economic Status. (Van Manen, 2016) states that barriers have
been identified among those in the lower social economic status (SES). These
barriers impede health care utilization and negatively fret health status. However,
8
studies show that among some African Americans when health care is affordable
and available, the utilization of health care systems is not maximized. This
suggests there are noneconomic barriers impeding access to and the utilization
of health care systems for some African Americans.
Supported by (Powell, 2017, Gomick et al., 1996) Barriers have been
identified which impede the utilization of health care systems. These barriers are
both economic and noneconomic. Economic barriers are caused by lack of
financial resources. Less is known about noneconomic barriers which exist at
income levels where insurance or other means of financing health care are
available.
Comprehensive and accessible primary health care is known to improve
health outcomes and help reduce health inequities. While the introduction of
universal health care in Canada has gone a long way towards reducing inequities
in health care accessibility, significant gaps remain in the quality of care received
by individuals of high versus low socio-economic status. For example, individuals
with low income or low education are less likely to have undergone cancer
screening than wealthier and better-educated individual. This is disconcerting, as
socio-economically disadvantaged individuals have poorer self-rated health,
higher rates of obesity and alcohol consumption, ischemic heart disease. Type
two diabetes, and other chronic conditions, and greater chances of premature
mortality. (Reducing Gaps in Health: A Focus on Socio-Economic Status in
Urban Canada (https://secure.cihi.ca/free_products/Reducing_Gaps_in_Health_
Report_EN_081009.pd, Retrieved; May 2019)
There is an evidence that socioeconomic status (SES) affects individual’s
health outcomes and the health care they receive. People of lower SES are more
likely to have worse self-reported health, lower life expectancy, and suffer from
more chronic conditions when compared with those of higher SES. They also
receive fewer diagnostic tests and medications for many chronic diseases and
have limited access to health care due to cost and coverage. (Adler, NE,
9
Newman, K. Socioeconomic disparities in health: pathways and policies. Health
Aff (Millwood). 2002;21:60-76.)
Compared with other patients, physicians are less likely to perceive low
SES patients as intelligent, independent, responsible, or rational and believe that
they are less likely to comply with medical advice and return for follow-up visits.
These physician perceptions have been shown to impact physicians’ clinical
decisions.
Physicians
delay diagnostic testing,
prescribe more generic
medications, and avoid referral to specialty care for their patients of low SES
versus other patients. Some physicians believe that tailoring care options to a
patient’s socioeconomic circumstances can improve patient compliance and
thereby improve health outcomes. However, other studies have shown that
physicians believe that the financial and coverage restrictions faced by low SES
patients limit access to care and results in worse health outcomes for these
patients. There are also some physicians who do not care for patients of lower
SES with publicly financed insurance due to low reimbursement rates. (Woo, JK,
Ghorayeb, SH, Lee, CK, Sangha, H, Richter, S. Effect of patient socioeconomic
status on perceptions of first- and second-year medical students. CMAJ.
2004;170:1915-1919).
Nursing Care Needs
Nursing Care encompasses autonomous and collaborative care of
individuals of all ages, families, groups and communities, sick or well and in all
settings. It includes the promotion of health, the prevention of illness, and the
care of ill, disabled and dying people. (Abdallah AK and Nussairat A, 2016)
Assessment. The purpose of assessment is to establish a database
about a client’s physical and emotional well-being, intellectual functioning, social
relationships, and spiritual condition. This information is used to identify healthpromoting behaviors as well as actual and or potential health problems. The
American Nurses Associations (ANA) in its classic publication, Nursing: Scope
and standards of practice (2004), supports the use of the nursing process as a
standard of practice for the registered nurse and outlines the essential
10
components of assessment within the nursing process. The data must be
relevant to client’s needs, collected from variety of valid sources, obtained using
appropriate techniques and in a systematic manner, and documented in a usable
format. Through assessment, the nurse determines the client’s functional abilities
and the absence or presence of dysfunctions. The client’s normal routine for
activities of daily living and lifestyle patterns are also assessed. Identification of
the client’s strengths provides the nurse and other members of the treatment
team information about the skills, abilities, and behaviors the client has available
to promote the treatment and family support, intelligence, spiritual beliefs, and
coping skills. The assessment phase also offers an opportunity for the nurse to
form a therapeutic interpersonal relationship with the client. (Fundamentals of
Nursing, Volume 1, Rick Daniels RN, COL, PhD, Ruth N. Grendel RN, DNSc,
Fredrick R. Wilkins RN, BSN, MSN, CNOR)
The initial nursing assessment, the first step in the five steps of the
nursing process, involves the systematic and continuous collection of data;
sorting, analyzing, and organizing that data; and the documentation and
communication of the data collected. Critical thinking skills applied during the
nursing process provide a decision-making framework to develop and guide a
plan of care for the patient incorporating evidence-based practice concepts
(Papathanasiou, Kleisiaris, Fradelos, Kakou, & Kourkouta, 2014). This concept of
precision education to tailor care based on an individual's unique cultural,
spiritual, and physical needs, rather than a trial by error, one size fits all approach
results in a more favorable outcome (Cook, Kilgus, & Burns, 2018). Part of the
assessment includes data collection by obtaining vital signs such as temperature,
respiratory rate, heart rate, blood pressure, and pain level using an age or
condition appropriate pain scale. The assessment identifies current and future
care needs of the patient by allowing the formation of a nursing diagnosis. The
nurse recognizes normal and abnormal patient physiology and helps prioritize
interventions and care.
A health assessment is a plan of care that identifies the specific needs of
a person and how those needs will be addressed by the healthcare system or
11
skilled nursing facility. Health assessment is the evaluation of the health status
by performing a physical exam after taking a health history. It is done to detect
diseases early in people that may look and feel well. It is the evaluation of the
health status of an individual along the health continuum. The purpose of the
assessment is to establish where on the health continuum the individual is
because this guides how to approach and treat the individual. The health
continuum approaches range from preventative, to treatment, to palliative care in
relation to the individual's status on the health continuum. It is not the treatment
or treatment plan. The plan related to findings is a care plan which is preceded
by the specialty such as medical, physical therapy, nursing, etc. (Moss, JR;
Sullivan, TR; Newton, SS; Stocks, NP (Jan 2014). "Effectiveness of general
practice-based health checks: a systematic review and meta-analysis". The
British Journal of General Practice. 64 (618): e47–53.)
In the 21st century, the nurse’s role in assessment continues to expand,
becoming more crucial than ever. The role of the nurse in assessment and
diagnosis is more prevalent today than ever before in the history of nursing.
Current focus on managed care and internal case management has had a
dramatic impact on the assessment role of the nurse. Assessment is the first and
most critical phase of the nursing process. If data collection is inadequate or
inaccurate, incorrect nursing judgements may be made that adversely affect the
remaining phases of the process: diagnosis, planning, implementation and
evaluation. Although the assessment phase of the nursing process precedes the
other phases in the formal nursing process, be aware that assessment is ongoing
and continuous throughout all phases of the nursing process. (Health
Assessment in Nursing, 5th edition, Janet R. Webber RN, EdD, Jane H. Kelly,
RN, PhD)
During emergency procedures, a nurse is focused on rapidly identifying
the root causes of concern for the patient and assessing the airway, breathing
and circulation (ABCs) of the patient. Once the ABCs are stabilized, the
emergency assessment may turn into an initial or focused assessment,
depending on the situation. If the nurse is not in a health care setting, emergency
12
assessments must also include an assessment for scene safety so that no other
individuals, including the nurse himself, are hurt during the rescue and
emergency response process. (David McGuffin, December 2018)
Nursing Diagnosis. A nursing diagnosis may be part of the nursing
process and is a clinical judgment about individual, family, or community
experiences or responses to actual or potential health problems or life processes.
Nursing diagnoses foster the nurse's independent practice (e.g., patient comfort
or relief) compared to dependent interventions driven by physician's orders (e.g.,
medication administration). Nursing diagnoses are developed based on data
obtained during the nursing assessment. A problem-based nursing diagnosis
presents a problem response present at time of assessment. Risk diagnoses
represent vulnerabilities to potential problems, and health promotion diagnoses
identify areas which can be enhanced to improve health. Whereas a medical
diagnosis identifies a disorder, a nursing diagnosis identifies the unique ways in
which individuals respond to health and/or life processes and/or crises. The
nursing diagnostic process is unique among others. A nursing diagnosis
integrates patient involvement, when possible, throughout the process. NANDA
International (NANDA-I) is body of professionals that develops, researches and
refines an official taxonomy of nursing diagnosis.
The diagnosing phase involves a nurse making an educated judgement
about a potential or actual health problem with a patient. Multiple diagnoses are
sometimes made for a single patient. These assessments not only include a
description of the problem or illness (e.g. sleep deprivation) but also whether or
not a patient is at risk of developing further problems. These diagnoses are also
used to determine a patient's readiness for health improvement and whether or
not they may have developed a syndrome. The diagnoses phase is a critical step
as it is used to determine the course of treatment. (Potter, Patricia A.; Perry,
Anne Griffin; Stockert, Patricia A.; Hall, Amy M. (2013). Fundamentals of Nursing
8th edition)
13
The nursing diagnosis is both pivotal step in the nursing process and a
diagnostic reasoning process. As a second step in the nursing process, it is
professional
clinical
judgement
about
individual,
family,
or
community
(aggregate) responses to actual or at-risk health problems, to wellness states, or
to life process events. As a diagnostic reasoning process, nursing diagnosis
includes the nurse’s critical thinking and interpretation of the meaning and
significance of evidence, or cues, derived from assessment data. The purpose of
diagnosis is to effectively communicate the health care needs of individuals and
aggregates among members of the health care team and within the health care
delivery system. When nursing diagnosis is a part of the client’s plan of care, the
nurse is able to communicate the client’s needs to other professionals involved in
that care. These needs encompass physiological, role function, self-concept,
interdependence, and spiritual dimensions. In order to determine individualized
therapeutic nursing interventions, the nurse must first collect and organize
assessment
data
before
developing
appropriate
nursing
diagnoses.
(Fundamentals of Nursing, Volume 1, Rick Daniels RN, et. al..)
Plan of Care. The third step of the nursing process encompasses
outcome identification and planning. After a nurse thoroughly assesses a client
and determines the client’s unique nursing diagnoses, or health problems, a plan
of action is developed. Client-specific outcomes are established to resolve the
diagnoses that are measureable within a time frame for attainment. A priority
outcome statement describes the expected client status (behavior or function)
when a problem-focused nursing diagnosis has been resolved, the modification
of condition that places the client at risk for a diagnosis, or a client’s positive
adaptation that has been enhanced, as with a wellness diagnosis. Expected
outcomes encompass biological, psychological, sociocultural, and spiritual
aspects of health, or related knowledge and skills. The purposes of setting
expected outcomes are to provide guidelines for individualized nursing
interventions and to establish evaluation criteria to measure the effectiveness of
the nursing care plan. (Fundamentals of Nursing, Volume 1, Rick Daniels RN, et.
al..)
14
Nursing care plan provides direction on the type of nursing care the
individual, family, and or community may need. The main focus of a nursing care
plan is to facilitate standardized, evidence-based and holistic care. Nursing care
plans have been used for quite a number of years for human purposes and are
now also getting used in the veterinary profession. A care plan includes the
following
components:
assessment,
diagnosis,
expected
outcomes,
interventions, rationale and evaluation.
According to UK nurse Helen Ballantyne, care plans are a critical aspect
of nursing and they are meant to allow standardized, evidence-based holistic
care. It is important to draw attention to the difference between care plan and
care planning. Care planning is related to identifying problems and coming up
with solutions to reduce or remove the problems. The care plan is essentially the
documentation of this process. It includes within it a set of actions the nurse will
apply to resolve/support nursing diagnoses identified by nursing assessment.
Care plans make it possible for interventions to be recorded and their
effectiveness assessed. Nursing care plans provide continuity of care, safety,
quality care and compliance. (Hooks, Robin (2016). "Developing nursing care
plans". Nursing Standard.)
Provide direction for individualized care of the client. A care plan flows
from each patient’s unique list of diagnoses and should be organized by the
individual’s specific needs. The means of communicating and organizing the
actions of a constantly changing nursing staff. As the patient’s needs are
attended to, the updated plan is passed on to the nursing staff at shift change
and during nursing rounds. The care plan should specifically outline which
observations to make, what nursing actions to carry out, and what instructions
the client or family members require. They serve as a guide for assigning staff to
care for the client. There may be aspects of the patient’s care that need to be
assigned to team members with specific skills. Care plans serve as a guide for
reimbursement. Medicare and Medicaid originally set the plan in action, and
other third-party insurers followed suit. The medical record is used by the
insurance companies to determine what they will pay in relation to the hospital
15
care received by the client. If nursing care is not documented precisely in the
care plan, there is no proof the care was provided. Insurers will not pay for what
is not documented.
The exact format for a nursing care plan varies slightly from place to
place. They are generally organized by four categories: nursing diagnoses or
problem list; goals and outcome criteria; nursing orders; and evaluation. As
defined by the North American Nursing Diagnosis Organization-International
(NANDA-I), nursing diagnoses are clinical judgments about actual or potential
individual, family or community experiences or responses to health problems or
life processes. A nursing diagnosis is used to define the right plan of care for the
client and drives interventions and patient outcomes.
Nursing care plan (NCP) is a formal process that includes correctly
identifying existing needs, as well as recognizing potential needs or risks. Care
plans also provide a means of communication among nurses, their patients, and
other healthcare providers to achieve health care outcomes. Without the nursing
care planning process, quality and consistency in patient care would be lost.
Nursing care planning begins when the client is admitted to the agency and is
continuously updated throughout in response to client’s changes in condition and
evaluation of goal achievement. Planning and delivering individualized or patientcentered care is the basis for excellence in nursing practice.
Interventions. Implementation is the fourth step in the nursing process
and involves the execution of the nursing plan of care formulated during the
planning phase of nursing process. In the implementation phase, the nurse and
other members of the health care team put the care plan into action. Nursing is a
dynamic process, and every nurse must continually incorporate new assessment
and diagnostic information into the implementation of the care plan (Estes, 2006).
Nurses, therefor draw from a broad base of clinical knowledge, careful planning,
critical thinking and analysis, and judgement.
In implementing the plan of care, the skilled nurse considers all aspects of
the presenting illness as well as the environmental, personal, and cultural
16
elements that make each client a unique individual. In addition, the nurse is
responsible for delegating appropriate task to staff members and ancillary
personnel, and documenting the entire process, including what the nurse does
and how the client responds. (Fundamentals of Nursing, Volume 1, Rick Daniels
RN, et. al..)
Nursing Interventions Classification (NIC) system is designed to
categorize and describe every possible intervention a nurse might perform. This
system is constantly used, evaluated and updated. Nursing Interventions
Classification (NIC) 6th Edition describes a number of uses for the system. They
include: Clinical documentation, Standardized communication regarding care,
Research on intervention effectiveness, Productivity measurement, Evaluations
of competency, Curriculum design.
There are different classifications of nursing interventions that can involve
care of the entire patient. This can be anything from promoting bowel functioning,
educating the patient on new medication side-effects or just keeping the patient
safe. Interventions can be focused on basic physiological needs, complex
physiological needs, behavioral functioning, promoting safety, caring for the
family, using the health system and/or the overall health of the community. As
nurses, we are caring for the total patient, so there are can be interventions
concerning every area of the patient's design.
Some of the nursing interventions will require a doctor's order and some
will not. There are different types of interventions: independent, dependent and
interdependent. Independent, these are actions that the nurse is able to initiate
independently. The following would be an example of a health promotion nursing
intervention, which is an independent nursing action. Dependent, these
interventions will require an order from another health care provider such as a
physician. Interdependent, these are going to require the participation of multiple
members of the health care team. (Health Assessment 2016)
Once outcomes have been developed and agreed, nursing interventions
that facilitate their achievement are planned and implemented. Planning and
17
using nursing interventions based on good quality evidence of effectiveness is of
importance to ensure that the desired outcomes of care are achieved. Identifying,
appraising, and incorporating the best currently available research into evidencebased nursing practice promotes clinically effective quality care.
A nursing Intervention is defined as “A single nursing action, treatment,
procedure, activity, or service designed to achieve an outcome of a nursing or
medical diagnosis for which the nurse is accountable’ (Saba, 2007). A physician
usually initiates the medical orders for patient services which are reviewed by the
hospital admitting nurse. As part of the admission process the primary nurse
interprets the medical orders and prepares nursing orders based not only on the
medical orders, but also on the signs and symptoms, diagnoses, and other
presenting problems together form the nursing plan of care (POC) which also
includes the goals/expected outcomes that require the specific Nursing
Interventions and Action Types to resolve (Saba, 2007).
Evaluation. Evaluation is the fifth step in the nursing process and involves
determining whether the client goals have been met. Even though it is the final
phase of the nursing process, evaluation is an ongoing part of daily nursing
activities. Ongoing evaluation can determine if the client has achieved these
outcomes or if care needs to be modified to help achieve these outcomes.
Evaluation also modified also is an integral process in determining the quality of
health care delivered. (Fundamentals of Nursing, Volume 1, Rick Daniels RN, et.
al..)
Are the central measures used in learning about the effectiveness of costsensitive, quality health care. Additionally, outcomes have been used to provide
a quantitative basis for making clinical decisions, to measure the effect of care on
patients, to measure the efficacy of care and to determine areas for care
improvement. Despite the importance of the patient outcomes concept, there has
not been enough focus on all aspects of this complex concept in the nursing
discipline. Furthermore, different researchers have provided different definitions.
The purpose of our concept analysis is to clarify and describe the multifaceted
nature of patient outcomes within the field of nursing.
18
The World Health Organization defines an outcome measure as a “change
in the health of an individual, group of people, or population that is attributable to
an intervention or series of interventions.” Outcome measures (mortality,
readmission, patient experience, etc.) are the quality and cost targets healthcare
organizations are trying to improve.
Measuring outcomes is an important component of physical therapists
practice. They are important in direct management of individual patient care and
for the opportunity they provide the profession in collectively comparing care and
determining effectiveness. The use of standardized tests and measures early in
an episode of care establishes the baseline status of the patient/client, providing
a means to quantify change in the patient's/client's functioning. Outcome
measures, along with other standardized tests and measures used throughout
the episode of care, as part of periodic reexamination, provide information about
whether predicted outcomes are being realized. As the patient/client reaches the
termination of physical therapy services and the end of the episode of care, the
physical therapist measures the outcomes of the physical therapy services.
Theoretical and Conceptual Framework
This study is anchored on the theory of Lev Vygotsky on Sociocultural
Theory, which states that sociocultural differences are emerging principles in
psychology that looks at the important contributions that society makes to
individual development.
The theory stresses the interaction between developing people and the
culture in which they live. Sociocultural theory also suggests that human learning
and needs are largely a social process. In this development carried many factors
that influence towards human health. Furthermore, sociocultural theory focuses
not only how adults and peers influence individual learning, but also on how
cultural beliefs, attitudes, education, religion and economic status played an
impact on how health care needs take place.
19
This study is anchored on the theory of Jean Watson “Human Caring
Theory” on which the theory states that nursing care is the philosophy and
science
of
caring,
four
major
concepts:
human
being,
health,
environment/society, and nursing. Watson’s definition of environment/society
addresses the idea that nurses have existed in every society, and that a caring
attitude is transmitted from generation to generation by the culture of the nursing
profession as a unique way of coping with its environment.
The nursing model states that nursing is concerned with promoting health,
preventing illness caring for the sick, and restoring health. It focuses on health
promotion, as well as the treatment of diseases. Watson believed that holistic
health care is central to the practice of caring in nursing. She defines nursing as
“a human science of persons and human health illness experiences that are
mediated by professional, personal, scientific, esthetic and ethical human
transactions.”
The nursing process outlined in the model contains the same steps as the
scientific research process: assessment, diagnosis, plan, intervention, and
evaluation. The assessment includes observation, identification, and review of
the problem, as well as the formation of a hypothesis. Nursing diagnosis are
developed based on data obtained during the nursing assessment and enable
the nurse to develop the care plan. Creating a care plan helps the nurse
determine how variables would be examined or measured, and what data would
be collected. Intervention is the implementation of the care plan and data
collection. Finally, the evaluation analyzes the data, interprets the results, and
may lead to an additional hypothesis.
Figure 1 presents the schematic diagram of the variables of this study.
The independent variable is the patients’ sociocultural differences with its
indicators cultural beliefs, attitudes, education, religion and economic status. The
dependent variable is the providing health care needs with its indicators basic
healthcare, medically-necessary treatment, health enhancement, optimum health
and environmental health. The moderator variable of the study are age and sex.
20
Statement of the Problem
This study is conducted to determine the relationship between the
patients’ sociocultural differences and the delivery of nursing care needs among
patients in Tagum doctor’s hospital, Tagum City, Davao del Norte. The specific
sub-problems of the study are as follows:
Independent Variable
Dependent Variable
Nursing Care Needs
Sociocultural differences
ï‚·
ï‚·
ï‚·
ï‚·
ï‚·
cultural beliefs
attitudes
educational attainment
religion
economic status
ï‚·
ï‚·
ï‚·
ï‚·
ï‚·
Assessment
Diagnosis
Plan of care
Intervention
Evaluation
Figure I: Paradigm of the Study
A paradigm is a standard, perspective, or set of ideas. A paradigm is a way of
looking at something. The word paradigm comes up a lot in the academic,
scientific, and research.
The two main variables in an experimental are the independent and
dependent variable. An independent variable is the variable that is changed or
controlled in a scientific experiment to test the effects on the dependent variable.
In our study, the independent variable is sociocultural differences, it has five
21
indicators, namely; cultural beliefs, attitudes, educational attainment, religion, and
economic status. A dependent variable is the variable being tested and
measured in a scientific experiment. The dependent variable of our study is
nursing care needs, namely; assessment, diagnosis, plan of care, intervention,
and evaluation.
1.
2.
What is the extent of patients’ Socio-cultural differences in terms of:
1.1
cultural beliefs;
1.2
attitudes;
1.3
educational attainments;
1.4
religion; and
1.5
economic status?
What is the extent of the delivery of health care needs in terms of:
2.1
assessments;
2.2
diagnosis;
2.3
planning;
2.4
intervention; and
2.5
evalutaion?
3. Is there a significant relationship between the patients’ sociocultural
differences and to the delivery of nursing care needs among patients in Tagum
doctor’s hospital, Tagum City, Davao del Norte?
Null Hypothesis
1.
There is no significant relationship between patients’ sociocultural
differences and the delivery of nursing care needs among patients
in Tagum doctor’s hospital, Tagum City, Davao del Norte.
22
Significance of the Study
This study will be significant for the Department of Health Officials,
Hospital personnel, School administrators, Clinical Instructors and other
researchers of nursing profession as they will focus on addressing medical
assistance and complete nursing care delivery of patients.
Department of Health Officials. This is important in the Department of
Health as a whole since it provides sufficient bases of health care delivery of
health care provider towards socio-cultural diversity particularly patients in the
province of Davao del Norte.
Hospital personnel. This study will provide the awareness and aid of the
hospital personnel problem in promoting quality medication needs of patients.
School administrators. This study will provide the awareness and aid of
the administration to their clinical teachers as part of developmental education
and additional information.
Clinical Instructors. This will help them to determine Health Care Delivery
of Health Care provider has the positive implication to the Socio-cultural Diversity
among patients in Tagum doctor’s hospital, Tagum City, Province of Davao del
Norte.
Students. This study will benefit the students since they are the recipients
of the knowledge will be acquired. Thus, give them an avenue for an informative
factors.
Other researchers. This study will serve as a guide or reference in making
their own research which are beneficial to professionals, non-professionals and
institutions.
DEFINITION OF TERMS
The following terms are defined operationally.
Sociocultural differences. It refers to different factors in providing
nursing care needs to patients.
23
Cultural beliefs. It refers to patients’ perception on how to deal with
providing nursing care.
Attitude. It relates to the act of treatment to the health care needs, it could
be a positive or negative responses.
Educational attainment. It refers on how the patients’ knowledge relate
on the delivery of care needs.
Religion. It refers to the sacred norms in giving nursing care to the
patients.
Economic status. It refers to the availability of income that allotted to any
financial health problem of the patients.
Nursing Assessment. It refers to the gathering of information about a
patient's physiological, psychological, sociological, and spiritual status by a
licensed Registered Nurse. It is used to identify current and future patient care
needs.
Diagnosis. It relates to the identification and statement of the problem
present at the time of assessment. It focuses on the signs and symptoms of the
patient at the time of the assessment.
Plan of Care. It relates to the direction of what type of nursing care the
individual, family, and or community may need. It focuses to the plan of care to
facilitate standardized, evidence-based and holistic care.
Nursing Intervention. It focuses on promoting patient’s physiological
needs and relates to complex physiological needs, behavioral functioning,
promoting safety, caring for the family, using the health system and/or the overall
health of the community.
Evaluation. It focuses on the outcomes of the effectiveness of nursing
interventions to measure the efficacy of care and to determine areas for care
improvement.
METHODS
This chapter presents the research design, research subjects, research
instruments, data gathering procedure and statistical treatment.
Research Design
The researcher used the Descriptive Correlational design in conducting
this study. This method is a design which describes the nature of a situation as it
exists at the time of the study and to explore the course of a particular
phenomenon. This investigates possible relations with the use of questionnaire
or instrument to be prepared by the researcher. It will help determine the
relationship between the patients’ sociocultural differences and the delivery of
health care needs among patients in Tagum Doctors Hospital, Tagum City,
Province of Davao del Norte.
Research Subject
The respondents of this study are patients who are admited in Tagum
Doctor’s hospital, Tagum City, Davao del Norte. The researchers will be using
Convenience sampling method to determine the sample. Convenience sampling
method is defined as a non-probability sampling technique where subjects are
selected because of their convenient accessibility and proximity to the
researcher. Figure 2 shows the map and picture of Tagum Doctors Hospital,
Tagum City, Province of Davao del Norte where the study will be conducted.
25
Figure 2. Map and picture of Tagum Doctors Hospital, Tagum City, Province
of Davao del Norte where the study will be conducted.
26
Research Instrument
The instrument to be used in gathering the data for this study will be
distributed to the respondents are a researcher-made questionnaire. The
researchers make use of two sets of questionnaires which suit to evaluate the
extent of patients’ sociocultural differences and the delivery of nursing care
needs among patients in Tagum doctor’s hospital with the following indicators
that corresponds to the two significant variables.
The questionnaires contain checklist using the Likert scale which consist
of five categories in numerical values that corresponds to the descriptive
equivalents. The rating scale to be used and the following scale and parameter
limits will be applied. The scale of 4.50-5.00 for Very much extensive; 3.50-4.49
for very extensive; 2.50-3.49 for moderately extensive; 1.50-2.49 for some
extensive; and 1.50-2.49 for some extensive. Data will be interpreted and
analyzed using the scale limits with descriptive rating equivalent as provided
below:
Delivery of Health Care Needs
Parameter
Descriptive
Limits
Equivalent
4.50-5.00
Very much extensive
Description
This means that the
delivery of Health Care
needs is observed in all
occasions.
3.50-4.49
very extensive
This means that the
delivery of Health Care
needs is observed in most
occasions.
27
2.50-3.49
moderately extensive
This means that the
delivery of Health Care
needs is observed in some
occasions.
1.50-2.49
some extensive
This means that the
delivery of Health Care
needs is
rarely
1.00-1.49
Not at all
observed.
This means that
thedelivery of Health Care
needs is not
observed.
Patients’ Socio-cultural Differences
Parameter
Descriptive
Limits
Equivalent
4.50-5.00
very much extensive
Description
This means that the Sociocultural Differences among
patients is observed in all
occasions.
3.50-4.49
very extensive
This means that the Sociocultural Differences among
patients is observed in
most occasions.
2.50-3.49
moderately extensive
This means that the Sociocultural Differences among
28
patients is observed in
some occasions.
1.50-2.49
Some extensive
This means that the Sociocultural Differences among
patients is rarely observed.
1.00-1.49
not at all
This means that the
Sociocultural Differences
among patients is not
observed.
Data Gathering Procedure
The researcher have undertaken the following procedures in order to
gather the data needed for the study:
Seeking Permission to Conduct the Study. The researcher asked
permission and sought the approval from the office of the Administrator of Tagum
Doctor’s College and to the CEO of Tagum Doctor’s Hospital to ask permission
to conduct the study about the employment Health Care Delivery of Health Care
provider and Socio-cultural Diversity among patients in Tagum doctor’s hospital.
Administration and Retrieval of Questionnaires. Upon the approval of
the Administrator of Tagum Doctor’s College and the CEO of Tagum Doctor’s
Hospital, the researcher proceed to all the subject hospital to distribute the
questionnaires to the respondents. Retrieval of questionnaires will be done by
the researcher after the respondents thoroughly answered all the questionnaires.
Checking, Collating and Processing. Right after the retrieval of
questionnaires, the researcher checked, collated and tabulated all the responses
given by the respondents. Results of the tabulated data were submitted to the
statistician for analysis and interpretation in order to answer the problems raised
in the first chapter of this research.
29
Statistical Treatment
The following statistical tools were used in the computation of the result as
well as in the testing of the hypothesis at a 0.05 level of significance.
Mean. This was used to determine the extent of implementation of the delivery of
nursing Care needs among patients in Tagum Doctor’s Hospital. Thus answers
the first and second statement of the problem.
Pearson r. This was used to determine significant relationship between patients’
sociocultural differences and the delivery of nursing care needs among patients
in Tagum Doctor’s Hospital. This answers the third statement of the problem.
Linear Regression. Was used to determine the degree of influence of
sociocultural differences to the delivery of health care needs among patients in
Tagum Doctors’ Hospital. This will answer the fourth statement of the problem.
(note: needs statisticians opinion about linear regression)
RESULTS AND DISCUSSION
In this Chapter, the researcher discusses the findings and results from the
data gathered. The researcher also tested the null hypothesis formulated in the
study.
Extent of Patients' Socio-Cultural
differences in term of
cultural beliefs
Item
1
Mean
Interpretation
3.59
Very Extensive
4.00
Very Extensive
3.51
Very Extensive
Moderately
Extensive
Moderately
Extensive
Moderately
Extensive
Moderately
Extensive
2
3
4
3.00
5
3.43
6
3.05
Total Mean
3.43
Table 1
Extent of Patients' Socio-Cultural Differences in term of cultural beliefs
Table 1, presents the extent on Patients’ Socio-cultural differences in
terms of cultural beliefs. “The people around you understand easily your cultural
beliefs” got the highest weighted mean of 4.00 with descriptive equivalent of very
extensive. It is followed by “Cultural beliefs affects the way of people (who does
not share the same cultural beliefs) treat you” that obtained a weighted mean of
3.59 with a descriptive equivalent of very extensive. The lowest weighted mean
of 3.00 with descriptive equivalent of moderately extensive goes to “Someone
quarrel/disagree with people who are far from what you believe”.
The extent on Patients’ Socio-cultural differences in terms of cultural
beliefs has a mean of 3.43 with a descriptive equivalent of moderately extensive.
31
The result means that the delivery of Health Care needs is observed in some
occasions.
The result is supported by the finding of Kalowski (2014a & 2014b) that
patients may hold multiple beliefs blending Biomedical, Spiritual and Traditional
concepts and, at times of stress and illness, or in the face of complex medical
problems, traditional health beliefs and cultural practices may become more
dominant.
Extent of Patients' Socio-Cultural
Differences in term of
Attitude
Items
1
2
3
4
5
Total Mean
Mean
3.38
Interpretation
Moderately
Extensive
3.97
Very Extensive
3.65
Very Extensive
4.08
Very Extensive
3.51
Very Extensive
3.72
Very Extensive
Table 2
Extent of Patients' Socio-Cultural Differences in term of Attitude
In Table 2, the presentation of the extent on Patients’ Socio-cultural
differences in terms of attitudes. Based on what you have observe, “How
satisfied are you with the care you receive” got the highest weighted mean of
4.08 with descriptive equivalent of very extensive. It is followed by “Do you feel
secured when people around you share the same beliefs” that obtained a
weighted mean of 3.97 with a descriptive equivalent of very extensive. The
lowest weighted mean of 3.38 with descriptive equivalent of moderately
extensive goes to “Someone perceive in a situation where the people based on
your beliefs.”
32
The extent on Patients’ Socio-cultural differences in terms of attitude has a
mean of 3.72 with a descriptive equivalent of very extensive. The result means
that the delivery of Health Care needs is observed in most occasions.
According to the journal of medical science (December 2017, vol.9
no.183), the Patient satisfaction is a set of attitudes and perceptions of patients
towards health services. It is the degree to which an individual regards healthcare as useful, effective and beneficial.
Extent of Patients' Socio-Cultural differences
In term of Educational
Attainment
Items
1
2
3
4
5
Mean
Interpretation
3.97
Very Extensive
3.68
Very Extensive
3.70
Very Extensive
3.89
Very Extensive
3.68
Very Extensive
Total Mean
3.78
Very Extensive
Table 3
Extent of Patients' Socio-Cultural Differences in term of Educational
attainment
Table 3, presents the extent on Patients’ Socio-cultural differences in
terms of Educational attainment. “How likely do you keep yourself updated to
new trends on health care programs” got the highest weighted mean of 3.97 with
descriptive equivalent of very extensive. It is followed by “How likely do you
watch educational television program” which obtained a weighted mean of 3.89
with a descriptive equivalent of very extensive. The lowest weighted mean of
3.68 with descriptive equivalent of very extensive goes to “How likely does your
community conduct programs/seminars that promotes new information about
health” and “How likely do you participate in your community in events that will
educate you and your neighbors”.
33
The extent on Patients’ Socio-cultural differences in terms of Educational
attainment has a mean of 3.78 with a descriptive equivalent of very extensive.
The result means that the delivery of Health Care needs is observed in most
occasions.
According to (Virginia Commonwealth University Center on Society and
Health, 2014) completing more years of education confers health benefits after
leaving school, such as better health insurance, access to medical care, and the
resources to live a healthier lifestyle and to reside in healthier homes and
neighborhoods.
Extent of Patients' Socio-Cultural
Differences in term of
Religion
Items
1
2
3
4
5
6
Total Mean
Mean
Interpretation
3.00
Moderately Extensive
4.24
Very Extensive
3.76
Very Extensive
4.19
Very Extensive
3.89
Very Extensive
3.89
Very Extensive
3.82
Very Extensive
Table 4
Extent of Patients' Socio-Cultural Differences in term of Religion
Table 4, presents the extent on Patients’ Socio-cultural differences in
terms of religion. “How often do someone pray” got the highest weighted mean of
4.24 with descriptive equivalent of very extensive. It is followed by “Do you
reinforce your belief in God/Allah” that obtained a weighted mean of 4.19 with a
descriptive equivalent of very extensive. The lowest weighted mean of 3.00 with
descriptive equivalent of moderately extensive goes to “Does your religion affects
your decisions to take any health care services”.
34
The extent on Patients’ Socio-cultural differences in terms of religion has a
mean of 3.82 with a descriptive equivalent of very extensive. The result means
that the delivery of Health Care needs is observed in most occasions.
According to Levin (2015), religion on health disparities remains obscure,
religion and health research has tended to focus on the impact of generalized
religiosity. On the other hand, Aspinall and Chinouva (2018) states that health
disparities groups individuals by race, ethnicity, and socio-economic status,
assuming that relevant health related beliefs, social experiences, and cultures
aggregate by these categories. This assumptions can only be partially true.
However, a shared minority religion is one health-related factor that often cuts
across and often unites individuals from disparate racial, ethnic, and
socioeconomic categories, this provides ample evidence that religions share their
adherents’ understanding of disease and illness, their health-related behaviors,
interactions and expectations of the healthcare system.
Extent of Patients' Socio-Cultural
Differences in term of
Economic Status
Items
1
2
3
4
5
6
7
Total Mean
Mean
Interpretation
3.95
Very Extensive
3.81
Very Extensive
3.86
Very Extensive
3.78
Very Extensive
4.00
Very Extensive
3.70
Very Extensive
3.97
Very Extensive
3.88
Very Extensive
Table 5
Extent of Patients' Socio-Cultural Differences in term of Economic Status
Table 5, it presents the extent on Patients’ Socio-cultural differences in
terms of Economic status “Do you see your community leader/s participate in the
35
community” got the highest weighted mean of 4.00 with descriptive equivalent of
very extensive. It is followed by “Do you encourage your neighbor to help clean
the surroundings” that obtained a weighted mean of 3.97 with a descriptive
equivalent of very extensive. The lowest weighted mean of 3.78 with descriptive
equivalent of moderately extensive goes “How often do you follow your
community's”.
The extent on Patients’ Socio-cultural differences in terms of Economic
status has a mean of 3.88 with a descriptive equivalent of very extensive. The
result means that the delivery of Health Care needs is observed in most
occasions.
According to Powell (2017), non-economic barriers which exist at income
levels where insurance or other means of financing health care are available.
Summary on the Extent of Patients'
Socio-Cultural Differences
Indicator
Cultural Beliefs
Attitude
Educational attainment
Religion
Economic Status
Mean
Interpretation
3.43
Moderately Extensive
3.72
Very Extensive
3.78
Very Extensive
3.82
Very Extensive
3.88
Very Extensive
Total Mean
3.73
Very Extensive
Table 6
Summary on the Extent of Patients' Socio-Cultural Differences
Table 6, presents the Summary on the Extent of Patients' Socio-Cultural
differences in terms of cultural beliefs, attitude, educational attainment, religion
and economic status.
36
It is shown in the table, the indicators with their corresponding mean and
descriptive equivalent. Economic Status got the highest mean of 3.88 with a
descriptive equivalent of very extensive. It is followed by religion that obtained
mean of 3.82 with a descriptive equivalent of very extensive. The lowest mean of
3.43 with a descriptive equivalent of moderately extensive goes to indicator
cultural beliefs.
Based on the results, the Extent of Patients' Socio-Cultural Differences
has a grand mean of 3.73 with a descriptive equivalent of very extensive.
This
means that the Extent of Patients' Socio-Cultural Differences is observed in most
occasions.
According to Cline and McKenzie (2019), socio-cultural attributes that
place health care providers and receivers on two different end of the health care
spectrum. Giving rise to cultural beliefs, attitudes, education, religion and
economic status. The impact of this diversity presents unique challenges to the
practice of medicine.
Extent of Delivery of Health
Care Needs in term of
Assessment
Items
1
2
3
4
5
6
7
Total Mean
Mean
Interpretation
4.54
Very much Extensive
4.35
Very Extensive
4.30
Very Extensive
4.30
Very Extensive
4.24
Very Extensive
4.05
Very Extensive
4.30
Very Extensive
4.30
Very Extensive
Table 7
Extent of delivery of Health Care Needs in terms of Assessment
37
Table 7, presents the extent of Delivery of Health Care Needs in terms of
Assessment During your hospitalization, “How quick does the doctor and nurses
attend to your concern” got the highest weighted mean of 4.54 with descriptive
equivalent of very extensive. It is followed by “On the day of your admission, how
would you rate the care and attention they gave you” that obtained a weighted
mean of 4.35 with a descriptive equivalent of very extensive. The lowest
weighted mean of 4.05 with descriptive equivalent of moderately extensive goes
“How often does the staff nurses and doctors show courtesy before doing a test
or procedure”.
The extent of Delivery of Health Care Needs in terms of Assessment has
a mean of 4.30 with a descriptive equivalent of very extensive. The result means
that the delivery of Health Care needs is observed in most occasions.
According to David McGuffin (2018) assessment is the first and most
critical phase of the nursing process. The data must be relevant to client’s needs,
collected from variety of valid sources, obtained using appropriate techniques
and in a systematic manner, and documented in a usable format.
Extent of delivery of Health
Care Needs in terms
of Diagnosis
Items
1
2
3
4
5
6
7
Mean
Interpretation
4.32
Very Extensive
4.35
Very Extensive
4.54
Very Much Extensive
4.46
Very Extensive
4.41
Very Extensive
4.16
Very Extensive
4.43
Very Extensive
4.38
Very Extensive
Table 8
Extent of delivery of Health Care Needs in terms of Diagnosis
Total Mean
38
Table 8, presents the Extent of delivery of Health Care Needs in terms of
Diagnosis. “How often does the nurse validates your identity?” (How satisfied are
you with the approach of care given by the nurses with a rating of 4.54) with
descriptive equivalent of very extensive. It is followed by “How comfortable are
you when the nurses are taking your vital signs” which has 4.46 mean rating and
a descriptive equivalent of very extensive. The lowest weighted mean of 4.43
with descriptive equivalent of very extensive goes to “Does the nurse motivates
you for faster recovery and healing?” (Listens to what you have to say and
addresses the concerns).
Extent of delivery of Health Care Needs in terms of Diagnosis mean of
4.38
with a descriptive equivalent of very extensive. The result means that the
delivery of Health Care needs is observed in most occasions.
According to Potter (2013), the diagnoses phase is a critical step as it
used to determine the course of treatment. In addition, it is both pivotal stem in
the nursing process and a diagnostic reasoning process. The purpose of
diagnosis is to effectively communicate the health care needs of individuals and
aggregates among members of the health care needs to other professionals
involved in that care. (Rick Daniels, Fundamentals of Nursing Volume 1).
Extent of delivery of Health Care Needs
In terms of Intervention
Items
1
2
3
4
5
6
7
Total Mean
Mean
Interpretation
4.24
Very Extensive
4.16
Very Extensive
4.27
Very Extensive
4.38
Very Extensive
4.22
Very Extensive
4.22
Very Extensive
4.41
4.27
Very Extensive
Very Extensive
Table 10
Extent of delivery of Health Care Needs in terms of Intervention
39
Table 10, presents the Extent of delivery of Health Care Needs in terms of
Intervention. ”How often does the nurse validates your identity?” (Ask for the
name of the client and/or checks the wrist band) got the highest weighted mean
of 4.41 with descriptive equivalent of very extensive. It is followed by “How often
does the staff nurses show courtesy before doing a procedure” that obtained a
weighted mean of 4.38 with a descriptive equivalent of very extensive. The
lowest weighted mean of 4.16 with descriptive equivalent of very extensive goes
to “How satisfied are you with the care given to you during your stay in the
institution?”
The extent on delivery of health care needs in terms of intervention has a
mean of 4.27 with a descriptive equivalent of very extensive. The result means
that the delivery of Health Care needs is observed in most occasions.
According to Saba (2007), a nursing Intervention is defined as “A single
nursing action, treatment, procedure, activity, or service designed to achieve an
outcome of a nursing or medical diagnosis for which the nurse is accountable’.
Extent of delivery of Health Care Needs
in terms of Evaluation
Items
1
Mean
4.24
Interpretation
Very Extensive
2
4.32
Very Extensive
Total Mean
4.28
Very Extensive
Table 11
Extent of delivery of Health Care Needs in terms of Evaluation
Table 11, presents the Extent of delivery of Health Care Needs in terms of
Evaluation. “How likely does your concerns addressed immediately” got the
highest weighted mean of 4.32 with descriptive equivalent of very extensive. The
lowest weighted mean of 4.24 with descriptive equivalent of very extensive goes
to “How likely does your health care provider attend to your needs.”
40
The extent on delivery of health care needs in terms of evaluation has a
mean of 4.28 with a descriptive equivalent of very extensive. The result means
that the delivery of Health Care needs is observed in most occasions.
According to Rick Daniels, RN (Fundamentals of Nursing, Vol. 1), it is an
ongoing evaluation that determines if the client has achieved these outcomes or
if care needs to be modified to help achieve these outcomes.
Summary on the Extent of
Delivery of Health
Care Needs
Indicators
Assessment
Mean
4.30
Interpretation
Very Extensive
Diagnosis
4.38
Very Extensive
Plan of Care
4.18
Very Extensive
Intervention
4.27
Very Extensive
Evaluation
4.28
Very Extensive
Total Mean
4.28
Very Extensive
Table 12
Summary on the Extent of delivery of Health Care Needs
Table 12, presents the Summary on the Extent of delivery of Health Care
Needs in terms of assessment, diagnosis, plan of care, intervention, and
evaluation.
It is shown in the table, the indicators with their corresponding mean and
descriptive equivalent. Diagnosis got the highest mean of 4.38 with a descriptive
equivalent of very extensive. It is followed by assessment that obtained a mean
of 3.30 with a descriptive equivalent of very extensive. The lowest mean of 4.18
with a descriptive equivalent of very extensive goes to indicator plan of care.
41
Based on the results, the Extent of delivery of Health Care Needs has a
grand mean of 4.28 with a descriptive equivalent of very extensive. This means
that the delivery of Health Care needs is observed in most occasions.
According to Abdallah AK and Nussairat A (2016), nursing care
encompasses autonomous and collaborative care of individuals of all ages,
families, groups and communities, sick or well and in all settings. It includes the
promotion of health, the prevention of illness, and the care of ill, disabled and
dying people.
Relationship between the Extent of the patients’
sociocultural differences and to the delivery
of nursing care needs among patients in
Tagum doctor’s hospital
Variable
Mean
Patients’ SocioCultural Differences
Delivery of Nursing
Care Needs
r
Interpretation
3.73
Negatively
-0.039
4.28
p-value
low
0.849
correlation
Decision
Fail to
Reject Ho
Table 12
Relationship between the Extent of the patients’ sociocultural differences
and to the delivery of nursing care needs among patients in Tagum
doctor’s hospital, Tagum City, Davao del Norte.
Table 12 shows the significant relationship between the Extent of the
patients’ sociocultural differences and to the delivery of nursing care needs
among patients in Tagum doctor’s hospital, Tagum City, Davao Del Norte.
The coefficient of correlation between the Extent of the patients’
sociocultural differences and to the delivery of nursing care needs among
patients in Tagum doctor’s hospital, Tagum City is -0.039. This indicates a
negatively low correlation. Since the computed p - value is greater than 0.5,
42
therefore, the null hypothesis is accepted. It means that there is no significant
relationship between the Extent of the patients’ sociocultural differences and to
the delivery of nursing care needs among patients in Tagum doctor’s hospital,
Tagum City.
Summary of Findings.
The summary of finding in this study is as follows:
1. The extent of patients' socio-cultural differences had a grand mean of 3.73
with descriptive equivalent of Very Extensive.
2. The extent of delivery of health care needs had a grand mean of 4.28 with
descriptive equivalent of Very Extensive.
3. Computed revealed that there is no significant relationship between the
extent of the patients’ sociocultural differences and to the delivery of
nursing care needs among patients in Tagum doctor’s hospital, Tagum
City.. Thus, the null hypothesis is accepted.
Conclusions
On the light of the aforementioned finding of the study, the following
conclusions are drawn.
1. The Extent of Patients' Socio-Cultural Differences is observed in most
occasions.
2. The Extent of the delivery of Health Care needs is observed in most
occasions.
3. There is no significant relationship between the extent of the patients’
sociocultural differences and to the delivery of nursing care needs among
patients in Tagum doctor’s hospital, Tagum City
43
4. There is no racial, cultural, and religious discrimination, which means, the
nurses in Tagum Doctors Hospital provide equal quantity care regardless
to the patient’s sociocultural differences.
5. There is no prioritization of patients base on their sociocultural beliefs and
the delivery of nursing care needs remains unbiased and top priority of the
health care team in the Tagum Doctors Hospital.
Recommendations
Since the result shows that there is no significant relation between the delivery of
nursing care needs to sociocultural differences; we recommend that the health
care team:
1. may focus on the other aspects like the compensation of patient to nurse
ratio to augment the health care delivery;
2. may incorporate the use of new technology to lessen the work load of the
nurses; and
3. make use of time rendering patient care rather than doing paper works.
44
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49
APPENDIX A
TAGUM DOCTOR’S COLLEGE, INC.
National Highway, Tagum City
NURSING DEPARTMENT
________________________________________________________________________
Dear MA’AM/SIR,
We would like you to answer the given questionnaire for the
research work entitled: “Patients’ Sociocultural Differences and the
Delivery of Nursing Care Needs among patients in Tagum doctor’s
hospital, Tagum City, Davao del Norte.”. In partial fulfillment of the
requirements for the Bachelors’ Degree in Nursing.
Your answers to the questions regarding Patients’ Sociocultural
Differences (SET A) and the Delivery of Nursing Care Needs (SET B) will
be great help for the success of the study.
We assure you that all your given answer shall be held confidential.
Thank you very much.
Very truly yours,
THE RESEARCHERS
50
Questionnaire on Patients’ Sociocultural Differences
Name: (Optional) ______________________________________
Hereunder are items concerning the Patients’ Sociocultural
Differences and the Delivery of Nursing Care Needs among patients in
Tagum doctor’s hospital. Put a check (
) on the blank provided on the
right column that correspond to your answer according to the scaling
presented below.
4.50-5.00
3.50-4.49
2.50-3.49
1.50-2.49
1.00-1.49
-
Very much extensive
Very extensive
Moderately extensive
Some extensive
Not at all
5
Cultural Beliefs
1. Cultural beliefs affects the way of people (who doesn't
share the same cultural beliefs) treat you.
2. The people around you understand easily your
cultural beliefs.
3. Cultural belief affects on how you get a proper medical
attention.
4. You quarrel/disagree with people who are far from
what you believe.
5. How often do people with different cultural belief ask
you about your cultural belief?
6. How often people label you as a stereotype of your
cultural belief?
Attitudes
1. Do you perceive in a situation where the people based
on your beliefs?
2. Do you feel secured when people around you share
the same beliefs?
3. How likely do you feel uncomfortable when the health
Rating
4
3 2
1
51
care providers assess your family background
specifically in your traditional practices?
4. Based on what you have observe, how satisfied are
you with the care you receive?
5. How likely do you count yourself as one of the
stereotype people often described your beliefs?
Educational attainment
1. How likely do you keep yourself updated to new
trends on health care programs?
2. How likely does your community conduct
programs/seminars that promotes new information
about health?
3. How often does your community leaders organize
events/activities to improve the community information
about diseases?
4. How likely do you watch educational television
program?
5. How likely do you participate in your community in
events that will educate you and your neighbors?
Religion
1. Does your religion affects your decisions to take any
health care services?
2. How often do you pray?
3. Did you participate in religious activity in your
community?
4. Do you reinforce your belief in God/Allah?
5. Do you read a Bible or religious artifacts?
6. Do you spend your time with your family and pray?
Economic status
1. How likely do you give budget for your health
insurance?
2. How likely does your income affects the health care
service you received?
3. Do you participate in your community?
52
4. How often do you follow your community's
5. Do you see your community leader/s participate in the
community?
6. Do you participate in your community's livelihood
program?
7. Do you encourage your neighbor to help clean the
surroundings?
Thank you and God bless.
Questionnaire on the Delivery of Nursing Care Needs
Name: (Optional) ______________________________________
Hereunder are items concerning the Delivery of Nursing Care
Needs. Put a check (
) on the blank provided on the right column that
correspond to your answer according to the scaling presented below.
4.50-5.00
3.50-4.49
2.50-3.49
1.50-2.49
1.00-1.49
-
Very much extensive
Very extensive
Moderately extensive
Some extensive
Not at all
5
ASSESSMENT
1. During your hospitalization, how quick does the
doctor and nurses attend to your concern?
2. On the day of your admission, how would you rate
the care and attention they gave you?
3. Are you with the process of admission?
4. Are you satisfied with the approach of the nurses
and doctors in the institution during your admission?
Rating
4
3
2
1
53
5. Are you comfortable are you with the assessment
given to you by the doctors and nurses?
6. How often does the staff nurses and doctors show
courtesy before doing a test or procedure?
7. Are you satisfied are you in the service of the staff in
Emergency Room?
DIAGNOSIS
1. How satisfied are you with the procedures of
diagnosing your conditions?
2. How quick does the doctors diagnosed your
condition?
3. How comfortable are you when the doctor explains
personally the findings of your tests?
4. How comfortable are you when the doctor explains
your condition?
5. How often does the doctors show courtesy before
doing a additional test?
6. Does the doctor explain what and why the
procedure is needed to further validate their
diagnosis?
7. Does the doctor explains what the diagnostic test is
for?
PLAN OF CARE
1. How satisfied are you with the care of nurses gave
to aid you in your healing process?
2. How satisfied are you with the care given by the
doctors in the institution?
3. How satisfied are you with the approach of care
given by the nurses?
4. How comfortable are you when the nurses are
taking your vital signs?
5. How comfortable are you when the nurses explains
the procedures?
54
6. Does the nurses explains the procedures?
7. Does the nurse motivates you for faster recovery
and healing? (Listens to what you have to say and
addresses the concerns)
INTERVENTION
1. From the day of your admission, how satisfy are you
on how the nurses and doctors address your concerns?
2. How satisfied are you with the care given to you
during your stay in the institution?
3. How quick does the staff address your concerns?
Thank you and God bless.
55
APPENDIX B
Items
1. Cultural beliefs affects the way of
people (who doesn't share the
same cultural beliefs) treat you.
2. The people around you
understand easily your cultural
beliefs.
3. Cultural belief affects on how you
get a proper medical attention.
4. You quarrel/disagree with people
who are far from what you believe.
5. How often do people with
different cultural belief ask you
about your cultural belief?
Mean
Interpretation
3.59
Very Extensive
4.00
Very Extensive
3.51
Very Extensive
Moderately
Extensive
3.00
3.43
6. How often people label you as a
stereotype of your cultural belief?
3.05
Total Mean
3.43
Moderately
Extensive
Moderately
Extensive
Moderately
Extensive
Table 1
Extent of Patients' Socio-Cultural Differences in term of cultural beliefs
Items
1. Do you perceive in a situation where
the people based on your beliefs?
2. Do you feel secured when people
around you share the same beliefs?
3. How likely do you feel uncomfortable
when the health care providers assess
your family background specifically in
your traditional practices?
4. Based on what you have observe, how
satisfied are you with the care you
receive?
5. How likely do you count yourself as
one of the stereotype people often
described your beliefs?
Total Mean
Mean
Interpretation
3.38
Moderately
Extensive
3.97
Very Extensive
3.65
Very Extensive
4.08
Very Extensive
3.51
Very Extensive
3.72
Very Extensive
Table 2
Extent of Patients' Socio-Cultural Differences in term of Attitude
56
Items
1. Does your religion affects your
decisions to take any health care
services?
2. How often do you pray?
3. Did you participate in religious activity
in your community?
4. Do you reinforce your belief in
God/Allah?
5. Do you read a Bible or religious
artifacts?
6. Do you spend your time with your
family and pray?
Mean
Interpretation
3.00
4.24
Moderately Extensive
Very Extensive
3.76
Very Extensive
4.19
Very Extensive
3.89
Very Extensive
3.89
Very Extensive
Total Mean
3.82
Very Extensive
Table 3
Extent of Patients’ Socio-cultural Differences in terms of Religion
Items
1. How likely do you give budget for
your health insurance.
2. How likely does your income affects
the health care service you received.
3. Do you participate in your community.
4. How often do you follow your
community's
5. Do you see your community leader/s
participate in the community.
6. Do you participate in your
community's livelihood program.
7. Do you encourage your neighbor to
help clean the surroundings.
Total Mean
Mean
Interpretation
3.95
Very Extensive
3.81
3.86
Very Extensive
Very Extensive
3.78
Very Extensive
4.00
Very Extensive
3.70
Very Extensive
3.97
Very Extensive
3.88
Very Extensive
Table 4
Extent of Patients’ Socio-Cultural Differences in terms of Economic Status
57
Indicator
Cultural Beliefs
Attitude
Education
Religion
Economic Status
Mean
Interpretation
3.43
Moderately Extensive
3.72
Very Extensive
3.78
Very Extensive
3.82
Very Extensive
3.88
Very Extensive
Total Mean
3.73
Very Extensive
Table 5
Summary in the Extent of Patients’ Sociocultural Differences
Items
1. During your hospitalization, how
quick does the doctor and nurses
attend to your concern.
2. On the day of your admission, how
would you rate the care and attention
they gave you.
3. Are you with the process of
admission.
4. Are you satisfied with the approach
of the nurses and doctors in the
institution during your admission.
5. Are you comfortable are you with
the assessment given to you by the
doctors and nurses.
6. How often does the staff nurses and
doctors show courtesy before doing a
test or procedure.
7. Are you satisfied are you in the
service of the staff in Emergency
Room.
Mean
Interpretation
4.54
Very much
Extensive
4.35
Very Extensive
4.30
Very Extensive
4.30
Very Extensive
4.24
Very Extensive
4.05
Very Extensive
4.30
Very Extensive
Total Mean
4.30
Very Extensive
Table 6
Extent of delivery of Health Care Needs in Terms of Assessment
58
Items
1. How satisfied are you with the care
of nurses gave to aid you in your
healing process.
2. How satisfied are you with the care
given by the doctors in the institution.
3. How satisfied are you with the
approach of care given by the nurses.
4. How comfortable are you when the
nurses are taking your vital signs.
5. How comfortable are you when the
nurses explains the procedures.
6. Does the nurses explains the
procedures
7. Does the nurse motivates you for
faster recovery and healing (Listens to
what you have to say and addresses
the concerns)
Mean
Interpretation
4.32
Very Extensive
4.35
Very Extensive
4.54
Very Much Extensive
4.46
Very Extensive
4.41
Very Extensive
4.16
Very Extensive
4.43
Very Extensive
Total Mean
4.38
Very Extensive
Table 7
Extent of delivery of Health Care Needs in terms of Diagnosis
Items
1. How satisfied are you with the care of nurses
gave to aid you in your healing process?
2. How satisfied are you with the care given to
you during your stay in the institution.
3. How quick does the staff address your
concerns.
4. How often does the staff nurses show
courtesy before doing a procedure.
5. How often does the nurses explains what the
medication is for.
6. How often does the nurses come fully
prepared for the procedure to be done?
7. How often does the nurse validates your
identity. (Ask for the name of the client and/or
checks the wrist band)
Mean
Interpretation
4.41
Very Extensive
4.24
Very Extensive
4.35
Very Extensive
4.11
Very Extensive
4.27
Very Extensive
4.08
Very Extensive
3.81
Very Extensive
Total Mean
4.18
Very Extensive
Table 8
Extent of delivery of Health Care Needs in terms of Plan of Care
59
Items
1. From the day of your admission, how
satisfy are you on how the nurses and
doctors address your concerns?
2. How satisfied are you with the care
given to you during your stay in the
institution?
3. How quick does the staff address your
concerns?
4. How often does the staff nurses show
courtesy before doing a procedure?
5. How often does the nurses explains
what the medication is for?
6. How often does the nurses come fully
prepared for the procedure to be done?
7. How often does the nurse validates
your identity? (Ask for the name of the
client and/or checks the wrist band)
Mean
Interpretation
4.24
Very Extensive
4.16
Very Extensive
4.27
Very Extensive
4.38
Very Extensive
4.22
Very Extensive
4.22
Very Extensive
4.41
Very Extensive
Total Mean
4.27
Very Extensive
Table 9
Extent of delivery of Health Care Needs in terms of Intervention
Items
How likely does your health care provider
attend to your needs?
How
likely does
your
concerns
addressed immediately?
Total Mean
Mean
Interpretation
4.24
Very Extensive
4.32
Very Extensive
4.28
Very Extensive
Table 10
Extent of delivery of Health Care Needs in terms of Evaluation
60
Assessment
Indicators
Mean
4.30
Interpretation
Very Extensive
Diagnosis
4.38
Very Extensive
Plan of Care
4.18
Very Extensive
Intervention
4.27
Very Extensive
Evaluation
4.28
Very Extensive
Total Mean
4.28
Very Extensive
Table 11
Summary on the Extent of delivery of Health Care Needs
Variable
Mean
r
Interpretation
p-value
Decision
Patients’
SocioCultural
3.73
Negatively
Differences
-0.039
Delivery of
Nursing
Care
low
correlation
0.849
Fail to
Reject Ho
4.28
Needs
Table 12
Relationship between the Extent of the patients’ sociocultural differences
and to the delivery of nursing care needs among patients in Tagum
doctor’s hospital, Tagum City, Davao del Norte.
ABSTRACT
Title of the Research:
PATIENTS’ SOCIOCULTURAL DIFFERENCES AND
THE DELIVERY OF NURSING CARE NEEDS
AMONG PATIENTS IN TAGUM DOCTORS
HOSPITAL, TAGUM CITY, DAVAO DEL NORTE
Authors:
BABALCON, CLIFF MARK S.
GENITO, MARK JANREL G.
MANGUILIMOTAN, EDDIE KING B.
MILAN, SHEGUILA V.
ZUMBAGA, SAHAR AYESHA MAONG
Degree:
BACHELOR OF SCIENCE IN NURSING
Date of Completion:
JANUARY 2020
OBJECTIVE: This study was conducted to give clarifications and verify the
hypothesis on the delivery of nursing care needs in patient’s sociocultural
differences in Tagum Doctors Hospital, Tagum City, Davao Del Norte.
METHODS: The researcher used the Descriptive Correlational design in
conducting this study. This method is a design which describes the nature of a
situation as it exists at the time of the study and to explore the course of a
particular phenomenon.
RESPONDENTS: The respondents of this study are patients who are admited in
Tagum Doctor’s hospital, Tagum City, Davao del Norte. The researchers will be
using Convenience sampling method to determine the sample.
CONCLUSION AND RECOMMENDATION: Result shows that there is no
significant relation between the delivery of nursing care needs to sociocultural
differences; we recommend that the health care team:
1. may focus on the other aspects like the compensation of patient to nurse
ratio to augment the health care delivery;
2. may incorporate the use of new technology to lessen the work load of the
nurses; and
3. make use of time rendering patient care rather than doing paper works.
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