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Nursing Theses and Dissertations

Theses/dissertations from 2023 2023.

Psychological Distress, Resilience, and the Impact on Quality of Life in Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy , Lauren Schwab

Theses/Dissertations from 2022 2022

Medication-Assisted Treatment Versus 12-Step Group Therapy: A Comparative Analysis of Adherence and Abstinence In Patients With Opioid Use Disorder , Derrick C. Glymph

Theses/Dissertations from 2021 2021

Quality of Life of Older Adults with Complicated Grief Receiving Accelerated Resolution Therapy: A Mixed Methods Study , Tina M. Mason

Theses/Dissertations from 2020 2020

In Post-Extubated Patients What are the Preferred Methods of Communication During Their Experience of Endotracheal Intubation with Mechanical Ventilation , Lanette Dumas

The Effect of Hope on the Relationship between Personal and Disease Characteristics and Anxiety and Depression in Adolescents and Young Adults with Cancer , Sharon B. McNeil

Predictors of Nonadherence to Radiation Therapy Schedules Among Head and Neck Cancer Patients , Jennifer Lynn Miller

Theses/Dissertations from 2019 2019

Perceived Discrimination and Cardiovascular Outcomes in Blacks: A Secondary Data Analysis of the Heart SCORE Study , Marilyn Aluoch

Exploration of Gratitude in Cardiovascular Health: Mediators, Medication Adherence and Psychometrics , Lakeshia A. Cousin

Theses/Dissertations from 2018 2018

Fatigue-related Symptom Clusters and their Relationship with Depression, and Functional Status in Older Adults Hospice Patients with Cancer. , Suzan Fouad Abduljawad

Genetic Moderation of Pain and Fatigue Symptoms Resulting from the Mindfulness-Based Stress Reduction for Breast Cancer Program , Carissa Bea Alinat

The Moderating Effect of Religion on Death Distress and Quality of Life between Christian Cancer patients in the United States with Muslim cancer patients in Saudi Arabia , Doaa Almostadi

Prevention of Post Intensive Care Syndrome-Family with Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study , Paula L. Cairns

Assessing Abstinence in Infants Greater Than 28 Days Old , Genieveve J. Cline

The Relationship Between Sleep Quality and Motor Function in Hospitalized Older Adult Survivors of Critical Illness , Maya N. Elías

The Role of Migration-Related Stress in Depression Among Haitian Immigrants in Florida: A Mixed Method Sequential Explanatory Approach , Dany Amanda C. Fanfan

The Effect of Depression, Inflammation and Sleep Quality on Risk for Cardiovascular Disease , Catherine L. O'Neil

Adapting SafeMedicate (Medication Dosage Calculation Skills software) For Use In Brazil , Samia Valeria Ozorio Dutra

Theses/Dissertations from 2017 2017

The Relationship Between Total Neuropathy Score-reduced, Neuropathy Symptoms and Function. , Ashraf Abulhaija

Validation of the Electronic Kids Dietary Index (E-KINDEX) Screening Tool for Early Identification of Risk for Overweight/Obesity (OW/OB) in a Pediatric Population: Associations with Quality of Life Perceptions , Patricia A. Hall

Theses/Dissertations from 2016 2016

The Effectiveness of an Intervention Designed to Improve Chlorhexidine (CHG) Bathing Technique in Adults Hospitalized in Medical Surgical Units , Janette Echemendia Denny

Levels of Distress Among Women Veterans Attending a Women’s Health Specialty Clinic in the VA Healthcare System , Debbie T. Devine

Examination of the Use of Accelerated Resolution Therapy (ART) in the Treatment of Symptoms of PTSD and Sleep Dysfunction in Veterans and Civilians , Marian Jevone Hardwick

Investigating the Mutual Effects of Depression and Spiritual Well-being on Quality of Life in Hospice Patients with Cancer and Family Caregivers Using the Actor-Partner Interdependence Model , Li-Ting Huang

The Change in Nutritional Status in Traumatic Brain Injury Patients: A Retrospective Descriptive A Retrospective Descriptive Study , Dina A. Masha'al

Exploring the Relationship Between Severity of Illness and Human Milk Volume in Very Low Birth Weight and Extremely Low Birth Weight Infants Over Six Weeks , Shannon Leigh Morse

Cardiovascular Disease Risk Scores and Novel Risk Factors in Relation to Race and Gender , Johanna Wilson

Theses/Dissertations from 2015 2015

A Comparative Evaluation of the Learner Centered Grading Debriefing Method in Nursing Education , Marisa J. Belote

Sleep, Depressive Symptoms and Cognition in Older Adults and Caregivers of Persons with Dementia , Glenna Shemida Brewster

The Relationship between Hearing Status and Cognitive Performance and the Influence of Depressive Symptoms in the Older Adult , Julie A. Daugherty

Basal Salivary Oxytocin and Skin to Skin Contact among Lactating Mothers of Premature Infants , Jessica Marie Gordon

The Relationship Between Nurses' Emotional Intelligence and Patient Outcomes , Mary Kutash

Sexual Functioning and Body Image in Younger Breast Cancer Survivors , Carly Lynn Paterson

Cognitive Load of Registered Nurses During Medication Administration , Sarah Faith Perron

A Comparison of Quality of Life between Intense and Non-Intense Treatment for Patients with Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome , Sara Marie Tinsley

Theses/Dissertations from 2014 2014

Acculturation, Self-Efficacy and Breastfeeding Behavior in a Sample of Hispanic Women , Ivonne F. Hernandez

Knowledge and Acceptance of HPV and the HPV Vaccine in Young Men and Their Intention to be Vaccinated , Brenda Renee Jasper

The Relationships Between Sleep Disturbances, Depression, Inflammatory Markers, and Sexual Trauma in Female Veterans , Ellen Marcolongo

Examination of Possible Protective Effect of Rhesus D Positive Blood Factor on Toxoplasma-related Depressive Symptoms in Pregnancy , Lisa Lynn Parnell

Knowledge, Attitudes, and Practice of Primary Care Nurse Practitioners Regarding Skin Cancer Assessmnets: Validity and Reliability of a New Instrument , Debra Michelle Shelby

Theses/Dissertations from 2013 2013

Knowledge and Practice of Reproductive Health among Mothers and their Impact on Fetal Birth Outcomes: A Case of Eritrea , Winta Negusse Araya

Race/Ethnicity, Subjective and Objective Sleep Quality, Physical and Psychological Symptoms in Breast Cancer Survivors , Pinky H. Budhrani

Factors Predicting Pap Smear Adherence in HIV-infected Women: Using the Health Belief Model , Crystal L. Chapman Lambert

The Relationship Between Socioeconomic Status and Body Mass Index on Vitamin D Levels in African American Women with and without Diabetes Living in Areas with Abundant Sunshine , Shani Vann Davis

Predictors of Quality of Life in Patients with Cutaneous T cell Lymphoma , Darcie Marie Deaver

Relationship between dysphoric moods, risk-taking behaviors, and Toxoplasma gondii antibody titers in female veterans , Allyson Radford Duffy

Prenatal Stress, Depression, and Herpes Viral Titers , Pao-Chu Hsu

Factors Associated with Fear of Breast Cancer Recurrence Among Survivors , Jean Marie Lucas

Sickle Cell Disease: The Role of Self-Care Management , Nadine Matthie

Factors Influencing Vaccination Decisions in African American Mothers of Preschool Age Children , Chauntel Mckenzie Mcnair

The Strong Black Woman, Depression, and Emotional Eating , Michelle Renee Offutt

Development of an Investigator-designed Questionnaire Concerning Childbirth Delivery Options based on the Theory of Planned Behavior , Chun-Yi Tai

Theses/Dissertations from 2012 2012

The Mediating Effect of Distress Caused by Constipation on Predictors of Quality of Life of Hospice Patients with Cancer. , Abdel Alkhalouf

Testing a Model of Bacterial Vaginosis among Black Women , Jessica Brumley

The Effect of Tight Glycemic Control on Surgical Site Infection Rates in Patients Undergoing Open Heart Surgery , Sierra Gower

Development of a Tool for Pressure Ulcer Risk Assessment and Preventive Interventions in Ancillary Services Patients , Monica Shutts Messer

Hospice Nurses- Attitudes and Knowledge about Pain Management , Amie Jacqueline Miller

Theses/Dissertations from 2011 2011

Literacy and Hazard Communication Comprehension of Employees Presenting to an Occupational Health Clinic , Christine Bouchard

A Meta-Analysis of Cultural Competence Education in Professional Nurses and Nursing Students , Ruth Wilmer Gallagher

Relationship Between Cancer-Related Fatigue and Depression: A Pilot Study , Gloria Michelle Guess

A Comparison of Oncology and Non-Oncology Nurses in Their Knowledge of Cancer Pain Management , Nicole Houle

Evaluating Knowledge and Attitudes of Graduate Nursing Students Regarding Pain , Eric Bartholomew Jackson

Bone Marrow Transplant Nurses' Attitudes about Caring for Patients Who are Near the End of Life: A Quality Improvement Project , Leslie Lauersdorf

Translation and Adaptation of the Center for Epidemiologic Studies-Depression (CES-D) Scale Into Tigrigna Language for Tigrigna Speaking Eritrean Immigrants in the United States , Mulubrhan Fisseha Mogos

Nurse Manager Emotional Intelligence as a Predictor to Registered Nurse Job Satisfaction and RN Perceptions of the Practice Environment and the Relationship to Patient, Nursing and Hospital Outcomes , Jacqueline Cecilia Munro

The Relationship of Mid-Pregnancy Levels of Cytokines, Stress, and Depression with Gestational Age at Delivery , Melissa Molinari Shelton

Prophylactic, Risk-Reducing Surgery in Unaffected BRCA-Positive Women: Quality Of Life, Sexual Functioning and Psychological Well-Being , Sharon Tollin

Theses/Dissertations from 2010 2010

The Relationship Between FAM5C SNP (rs10920501) Variability, Metabolic Syndrome, and Inflammation, in Women with Coronary Heart Disease , Jennifer L. Cline

Women’s Perceptions of Postpartum Stress: A Narrative Analysis , Nancy Gilbert Crist

Lived Experience: Near-Fatal Adolescent Suicide Attempt , Phyllis Ann Dougherty

Exploring the Relationships among Work-Related Stress, Quality of Life, Job Satisfaction, and Anticipated Turnover on Nursing Units with Clinical Nurse Leaders , Mary Kohler

A Comparative Study of Knowledge of Pain Management in Certified and Non-Certified Oncology Nurses , Sherrie A. LaLande

Evaluating Knowledge and Attitudes of Undergraduate Nursing Students Regarding Pain Management , Jessica Latchman

Evaluation of Oncology Nurses' Knowledge, Practice Behaviors, and Confidence Specific to Chemotherapy Induced Peripheral Neuropathy , Rebecca Denise McAllister

Moderating the Effectiveness of Messages to Promote Physical Activity in Type 2 Diabetes , Rachel E. Myers

Factors Affecting the Process of Clinical Decision-Making in Pediatric Pain Management by Emergency Department Nurses , Teresa A. Russo

The Correlation Between Neuropathy Limitations and Depression in Chemotherapy Patients , Melissa Thebeau

Theses/Dissertations from 2009 2009

Fatigue Symptom Distress and Its Relationship with Quality Of Life in Adult Stem Cell Transplant Survivors , Suzan Fouad Abduljawad R.N., B.S.N.

Nursing Advocacy and the Accuracy of Intravenous to Oral Opioid Conversion at Discharge in the Cancer Patient , Maria L. Gallo R.N., O.C.N.

Transitional Care for Adolescents with HIV: Characteristics and Current Practices of the Adolescent Trials Network Systems of Care , Patricia Gilliam

The Effect of Ethical Ideology and Professional Values on Registered Nurses’ Intentions to Act Accountably , Susan R. Hartranft

Falls in Bone Marrow Transplant Patients: A Retrospective Study , Lura Henderson R.N., B.S.N.

Predictors of cancer caregiver depression symptomatology , Henry R. Rivera

Psychosocial outcomes of weight stigma among college students , Sabrina Joann Robinson

The Experience of Fatigue and Quality of Life in Patients with Advanced Lung Cancer , Andrea Shaffer

The Relationship Between Uncertainty in Illness and Anxiety in Patients With Cancer , Naima Vera

Shifting Paradigms: The Development of Nursing Identity in Foreign-Educated Physicians Retrained as Nurses Practicing in the United States , Liwliwa Reyes Villagomeza

Theses/Dissertations from 2008 2008

Prostate Cancer Screening Intention Among African American Men: An Instrument Development Study , Susan Anita Baker

The Geriatric Cancer Experience in End of Life: Model Adaptation and Testing , Harleah G. Buck

Communication Systems and HIV/AIDS Sexual Decision Making in Older Adolescent and Young Adult Females , Rasheeta D. Chandler MS, ARNP, FNP-BC

Relationship of Anger Trait and Anger Expression to C-Reactive Protein in Post-Menopausal Women , Rosalyn Gross

Identifying Patients with Cancer at Risk of Experiencing a Fall While Hospitalized , Joann M. Heaton

Modulation of Monocyte-Derived Dendritic Cell Maturation and Function by Cigarette Smoke Condensate in a Bronchial Epithelial Cell Co-Culture Model , Alison J. Montpetit

Cancer Patients with Pain: Examination of the Role of the Spouse/Partner Relationship In Mediating Quality of Life Outcomes for the Couple , Mary Ann Morgan

Development of an Ecological Model to Predict Risk for Acquisition of Clostridium difficile -Associated Diarrhea During Acute Care Hospitalization , Susan Elaine Steele

Development and Psychometric Evaluation of the Chemotherapy Induced Peripheral Neuropathy Assessment Tool , Cindy S. Tofthagen

Health Decision Behaviors: Appropriateness of Dietary Choice , Daryle Hermelin Wane

Theses/Dissertations from 2007 2007

The Relationship Between Sleep-Wake Disturbance and Pain in Cancer Patients Admitted to Hospice Home Care , Marjorie Acierno

Wheelchair Positioning and Pulmonary Function in Children with Cerebral Palsy , Lee Barks

Structural Equation Model of Exercise in Women Utilizing the Theory of Unpleasant Symptoms and Social Cognitive Variables , Sarah Elizabeth Cobb

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Home > USC Columbia > Nursing, College of > Nursing Theses and Dissertations

Nursing Theses and Dissertations

Theses/dissertations from 2023 2023.

Is There a Relationship Between Direct Patient Care Registered Nurses Emotional Intelligence and Patient Satisfaction? , James J. Leach

The Impact of Shift Work on Women’s Neurological Health , Kathy Nelson

Nurse Perceptions of Caring and Professional Governance , Lan Angela Nguyen

Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease (UPSTREAM CVD): African American Emerging Adults , Shannon Bright Smith

Substance Use Disorder Treatment Among African American Men Living in the Rural South of the United States , Serge Raoul Wandji

Theses/Dissertations from 2022 2022

Unintended Consequences of the Electronic Health Record And Cognitive Load in Emergency Department Nurses , Carolyn S. Harmon

Physical Activity and Breast Cancer Prevention Among Asian American Women , Jingxi Sheng

Theses/Dissertations from 2021 2021

Early Premature Infant Physiologic and Behavioral Indicators of ANS Instability , Karen Popp Becker

Nurses’ and Patients’ Perceptions of the Availability of Post-hospital Instrumental Support as a Predictor of 30- And 60-Day Acute Care Utilization , Beth E. Schultz

Race Is Not a Risk Factor: Examining the Influence of Models Of Care, Race, and Discrimination on Racial Disparities in Maternal Outcomes , Curisa Mae Tucker

Advancing Knowledge of Exercise as a Therapeutic Management Strategy for Women with Polycystic Ovary Syndrome , Pamela J. Wright

Theses/Dissertations from 2019 2019

Examining Caregiver Vigilance for Child Sexual Abuse , Kate K. Chappell

Exploring Turnover Among Nurse Managers, Directors, and Executives in Acute Care Hospitals , Deborah Hughes Warden

Psychometric Evaluation of Lung Cancer Stigma Among Lung Cancer Survivors in South Carolina , Lisa A. Webb

Theses/Dissertations from 2018 2018

Utilization Of The USDA Supertracker System In High Schools: A Quality Improvement Project , Twanda D. Addison

Online Risks, Sexual Behaviors, And Mobile Technology Use In Early Adolescent Children: Parental Awareness, Protective Practices, And Mediation , Kendra Allison

Implementation of a Depression Screening Tool for Cardiovascular Patients in the Primary Care Setting , Amber Nicole Ballentine

Forensic Patient Flow: An Imbalance Between Capacity And Demand , Versie J. Bellamy

An Evidence-Based Evaluation Tool To Assist Healthcare Providers In Their Assessment Of Effective mhealth Applications For The Management Of Chronic Health Conditions , Sara Belle Donevant

The Effect of a Compassion Fatigue Awareness and Self-Care Skills Educational Program on Retention Among Certified Nursing Assistants Working in a Veterans Nursing Home , Michele M. Dreher

Efficiency Of Ambulatory Blood Pressure Monitoring Vs. 5-Day Serial Monitoring In A Military Treatment Facility , Kadijatu Kakay

Initiating the Loeb Criteria in Long-term Care , Janice Khauslender

High Fidelity Simulation Experience and Development of Clinical Judgment: Recent Graduate Nurses’ Reflections , Martha Kay Lawrence

Implementing a Surgical Pathway to Reduce Operating Room Cancellation Rates , Demerise Ott Minor

Home Exercise Therapy For The Treatment Of Knee Osteoarthritis , Kezia Nixon

Assessment Of An Educational Intervention To Increase Knowledge And Intention To Take HPV Vaccine And Cervical Cancer Screening In Nigeria , Chigozie Anastacia Nkwonta

Chemotherapy Knowledge And Health Literacy Among Women With Breast Cancer , Pearman deTreville Parker

Using Ultrasound Guided Peripheral Intravenous Catheters In Difficult Access Patients , Courtney Prince

Initiating a Peer Support Program for Parents of Children With Autism Spectrum Disorder in Richland and Lexington Counties , Danielle P. Simmons

Implementation Of Provider And Workflow Strategies To Increase Adherence To Tqip Guidelines In Traumatic Brain Injury , Regina Thompson

Theses/Dissertations from 2017 2017

Best Practice for Screening Adult Patients with Psoriasis for Polyautoimmunity: Celiac Disease, Rheumatoid Arthritis and Crohn’s Disease , Susan Danielle Ashbaugh

Adherence of Nurse Practitioners to JNC 8 Guidelines , Stephanie E. Averette

Losing Weight with Five A’s (5 A’s): Assess, Advise, Agree, Assist, Arrange framework and Motivational Interviewing (MI) for health behavior change counseling , Jacqueline Baer

A Quality Improvement Project to Reduce the Incidence of Clostridium difficile Infection through Implementation of Evidence-Based Terminal Clean Procedures , Tamara Cook

Tuberculosis Screening in New Healthcare Employees: A Comparison of QuantiFERON®-TB Gold In-Tube Test and Tuberculin Skin Test , Mary C. Giovannetti

Utility of the Modified Early Warning System Score in Early Sepsis Identification , Lisa E. Hart

Picturing Rest: A Photovoice Study Of African American Women’s Perceptions And Practices Of Rest , Eboni T. Herbert Harris

Developing And Implementing A Quality Assurance Strategy For Electroconvulsive Therapy , Jessa Hollingsworth

Improving Leadership Communication In Nurse-Physician Dyad Teams , Lisa James

Assessment of Providers’ Perception and Knowledge of Overactive Bladder in Women: A Quality Improvement Project , Helen Wambui Ngigi

Simulation-Based Interprofessional Education in a Rural Setting , Ann D. Scott

An Evidence-Based Process Change to Improve Mammography Adherence , Tara E. Smalls

Evaluation, Treatment, and Education In The Hospice Setting By Initiating a Formalized Pain Card , Alyssa M. Soprano

Scribes Impact On Patient And Provider Experience In The Outpatient Setting , Kimberly A. Taylor

Barriers to the Use of Guardrails On IV Smart Pumps , Ivory Williams

Theses/Dissertations from 2016 2016

Nursing Attitudes towards Suicidal Patients in the Emergency Department: Assessment Interview Training , Belinda Beaver

MySleep101©: An Educational Mobile Medical Application for Sleep Health in Primary Care , Sonya Cook

Effects Of Sepsis Protocols On Health Outcomes Of Adult Patients With Sepsis , Monika U. Mróz

Multi-Symptom Management in Hospice Patients during End-of-Life Transition , Ashley N. B. Sirianni

Theses/Dissertations from 2015 2015

Best Practice for a Standardized and Safe Registered Nurse Shift Handoff , Nancy Rankin Ewing

An Evidence-Based Approach to Prepare Interdisciplinary Team Members for Implementation of the ABCDE Bundle , Jessica Murner Hamilton

Nurses Utilizing the V.O.I.C.E.S. HIV Prevention Intervention in the Black Church Community , Jason Richard

Unexpected and Interrupted Transitions Among Newly Licensed Registered Nurses: Perspectives of Nurse Managers and Preceptors , Sheri S. Webster

Theses/Dissertations from 2014 2014

Best Practice for Antipsychotic Medication Management in Community Dwelling Older Adults with Schizophrenia , Estelle Marie Brown

The Effects of Multiple Gratitude Interventions Among Informal Caregivers of Persons with Dementia and Alzheimer's Disease , Cristy DeGregory

An Analysis of Interpreter-Mediated Healthcare Interactions , Robin Dawson Estrada

Quality Improvement Project: A Comparison of Daily Routine Chest Radiography Versus Clinically-Indicated Chest Radiography in Preventing Ventilator-Associated Pneumonia in Adult ICU Patients on Ventilators: An Evidenced Based Practice Project , Kimberly McKenney

Best Practices in High Fidelity Patient Simulation to Enhance Higher Order Thinking Skills , Kathryn S. Mock

Best Practices in the Management of Pediatric Obesity in Primary Care Clinics , Lori Moseley

Early Screening and Identification of Preschool Children Affected by Serious Emotional Disorders , Cathy Renee Robey-Williams

Theses/Dissertations from 2013 2013

Improving the Diagnostic Accuracy of Failure-to-Rescue , Amelia Marie Joseph

Best Practice Guideline For Managing Interstitial Cystitis In Adult Women , Amanda Thomas Langford

The Use of Ultrasound as an Adjunct to X-Ray For the Localization and Removal of Soft Tissue Foreign Bodies in an Urgent Care Setting , Stacy Lane Merritt

Prevention of Skin Breakdown In the Pediatric Intensive Care Unit , Lydia H. Palmer

A Pilot Intervention To Engage Nurses To Lead Transformation of The Workplace , Molly Patton

Foot Assessment In the Dialysis Unit , Karen Robertson

Emergency Department Triage Acuity Ratings: Embedding Esi Into the Electronic Medical Record , Candace Whitfield

Theses/Dissertations from 2012 2012

Best Practice to Promote Bone Health in Post-menopausal Women through Adequate Intake of Calcium and Vitamin D , Ellen Soley Adkins

Developing A Facilitated Pathway For Associate Degree Nursing Graduates to Enroll In An Rn-Bsn Program , Christy Vansant Cimineri

Pursuing Improved Quality of Life In the Atrial Fibrillation Population: Evidence-Based Practice , Jamie Hayes Cunningham

Continuous Subcutaneous Insulin Infusion in Comparison to Subcutaneous Insulin Injections in the Preschooler with Type 1 Diabetes Mellitus , Meredith D'Agostino

Transition to Motherhood-A Qualitative Study of Low Income Women's First Term Pregnancy Experiences , Lisa Bennett Duggan

Vitamin D and Calcium Supplementation For Prevention of Falls and Fractures In Older Adults , Cynthia Hartman

The Best Practice Guideline for Early Detection and Treatment of Heart Disease In Asymptomatic Adults with a Family History of Premature Coronary Artery Disease , Stephanie Brooke Huston

Best Practice Protocol for Patients with Schizophrenia and Co-Occurring Substance Use Disorders , Shauna Rae Jones

Transcultural Nursing Clinical Education: A Systematic Review of the Literature Since 2005 With Recommendations for International Immersion Clinical Courses , Deborah J. McQuilkin

Using a Consensus Process to Develop an Evidence-Based Practice Guideline for School Exclusion For Head Lice (Pediculosis Capitis) , Michelle Lorraine Myer

Using Therapeutic Writing to Deconstruct Recovery from Posttraumatic Stress Disorder (PTSD) , Pamela Phillips

Improving Outcomes by Improving Practice: Evidence-Based Assessment, Prevention and Documentation of Pressure Ulcers In the ICU. , Kristy Fry Speronis

Increasing Awareness of Fertility Preservation Options in Cancer Patients & Survivors , Norma Sweet

Identification, Prevention and Treatment of Children with Decreased Bone Density , Laura Lee Szadek

Assessment and Strategic Planning to Determine the Growth Feasibility of a Distance-Based Rural Baccalaureate Nursing Program , Amber Proctor Williams

Theses/Dissertations from 2011 2011

A Research Utilization Project: Implementation of an Evidence-Based Behavioral Treatment for Students At-Risk of Dropout at Richland Northeast High School , Kathrene Carter Berger

The Impact of the Patient Protection and Affordable Care Act of 2010 On the Evidence Based Practice of Distributive Justice Via Comfort Care In Elderly Burn Trauma Victims , Christina Pacileo Blottner

Parenting Interventions For Children Exposed to Intimate Partner Violence , Christie Michelle Furr-Roeske

Nurse State Legislators: The Journey to State Capitols , Debbie Whitman Herman

Autonomous Nurse Practitioner Practice: A Position Paper and Action Plan for Change , Patricia Susan Noser

Best Practices in The Use of Vena Cava Filters oo Prevent Pulmonary Emboli in Trauma Patients , Dennis Absher Taylor

Theses/Dissertations from 2010 2010

Assessment and Identification of Deliberate Self-Harm in the Adolescent and Young Adult Patient in the Primary Care Population , Courtney Brooks Catledge

A Best Practice Guideline for Screening and Treating Vitamin D Deficiency in a Primary Care Setting: Moving Beyond the Bones , Amy Jeanette Clark

Best Faculty Practice Plan Model for a Small College of Nursing , Sharyn Neiman Conrad

Impact of A Primary Care-Based Organ Donation Practice Initiative On Individual Willingness to Donate , Cyndi B. Faudree

Substance Abuse Treatment Avoidance, Length of Stay, and Criminal Justice Referral For Women of Reproductive Age In South Carolina Prior to and After theWhitner Decision (1993 to 2007) , Sarah J. Gareau

Childhood Obesity and School-Based Interventions: An Evidence-Based Best Practice Guideline , Jessica Guyton

The Best Practice Guideline For theTreatment of Pediatric Diaper Dermatitis , Kate Hansson Mack

A Church-Based Health Promotion Program for Older Adults: Impacts on Participants' Religiosity, Spirituality, and Social Support , Katherine Holland Pope

Dedicated Education Units: Dothey Improve Student Satisfaction? , Eileene Elizabeth Shake

Recommendation For A Best Practice Model of Hiv Management by Advanced Practice Registered Nurses In Primary Care Settings , Sabra Smith

Exploration of the Evidence to Support Clinical Practice to Decrease Hospital Readmission Rates For Patients With Chronic Pancreatitis , Shannon Bright Smith

Best Practices: Retaining Registered Nurses , Jessica Epps Wilkes

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Writing a Thesis for Nursing School

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Writing a thesis presents an opportunity for graduate students to conduct scholarly inquiry, with the potential of publishing their finished paper. A thesis requires nursing students to identify a problem in nursing, and review academic literature while developing advanced research skills. Thesis advisors and committees guide students from the proposal phase to the final oral defense, a process that spans about two semesters.

Not every nursing student is required to complete a thesis. Some nursing programs offer a non-thesis option, in which candidates complete a final capstone project or oral examination on topics such as nursing theories and clinical practices.

The thesis process and requirements vary by school. Ohio State University’s master of science in nursing program’s final examination includes oral and written portions.

Want to know what to expect during the thesis process? Read on to learn how you can choose a thesis topic and orally defend your paper.

Choosing Your Nursing Thesis Topic

Nursing students must choose a thesis topic before they begin the research and writing process, typically within the first two terms of nursing school. A solid thesis must present an original argument, manageable research scope, and worthy academic pursuit. A thesis advisor or research professor will help to guide each student through the process of choosing a topic.

In the conceptual phase, candidates research potential thesis topics based on their interests within their nursing specialty. Students may start with a broad topic such as obesity and weight management, depression, or cardiovascular disease. To narrow their thesis argument, graduate students might focus on racial or ethnic groups, socio-economic issues, or current events.

After settling on a topic, students draft and submit a thesis proposal to an advisor or committee chair. Once this proposal has been approved, students can begin the formal work on his or her approved thesis topic.

While graduate students must complete a thesis to fulfill the requirements of a master’s degree in nursing, the thesis process also offers a chance for future nurses to immerse themselves in current academic literature and collaborate with fellow graduate students, faculty, and professors. A thesis can also serve as the foundation for doctoral studies. A thesis at the doctoral (PhD) level is called a dissertation.

Completing Your Nursing Thesis

Brainstorming a thesis topic begins as early as the first semester of a master’s in nursing program. The formal thesis process, which typically spans multiple terms, does not take place until the student’s final year, usually during the last term.

Thesis requirements vary by school, and students must meet specific deadlines and take prerequisite courses beforehand. At the University of Texas-Houston’s School of Nursing , candidates take a public health class before they submit a thesis proposal.

Future nurses work under the guidance of a thesis committee and advisor. The experience of writing a thesis trains students in original investigation, data collection, implementing research design, and public speaking. Candidates also learn to flex their analytical thinking skills and master a specific area of nursing as they develop the ability to analyze and draw conclusions through data.

At a program’s conclusion, students submit their thesis as a bound manuscript or electronic file. In addition to submitting a written report, students orally defend their final thesis in front of the committee. Many graduates also submit their manuscripts for publication.

Presenting Your Nursing Thesis

Graduate students generally orally defend their proposal and present their completed thesis in front of their committee. This committee also includes the thesis mentor, a faculty member specializing in the nursing discipline of their scholarly inquiry. There are generally 3 total committee members on a thesis committee.

Fellow graduate students or consultants outside of the college may attend presentations, if the process is open to the public. Otherwise, the thesis defense remains a private session, with students presenting their findings. The oral examination of the thesis takes up to one hour, but can last longer depending on how many questions the committee has for the student.

During that time, the committee evaluates the thesis based on how the research experience has shaped the student’s graduate education and the findings’ significance to the nursing field. When the exam concludes, the committee either accepts or rejects the thesis defense.

How is a Nursing Thesis Graded?

Nursing schools rely on each committee to formally grade each product in the thesis process. Some graduate nursing students may receive a letter grade, while other nursing schools adhere to a “pass” or “fail” policy.

To determine a grade, the committee assesses the thesis based on set criteria. Committee members look at the project’s key components, including the statement of purpose, literature review, research methodology, analysis, findings, and implications. The process and grading criteria for the thesis process can be found in the school’s graduate handbook. Most of these handbooks are published online for student review.

The thesis must identify significant issues or service gaps in nursing and present them in a concise and coherent fashion. Candidates must support all findings and analysis by research and explain the implications for healthcare.

The oral defense also factors into the grade. The committee grades the defense based on the quality of the student’s presentation, taking into consideration if the student spoke clearly and presented a logical and well-organized argument.

What is the Difference Between a Nursing Thesis and a Capstone?

A nursing thesis and a capstone demonstrate the student’s comprehensive knowledge and educational journey. Graduate students in a non-research track may have the choice of completing a clinical project. Doctoral of Nursing ( DNP ) students complete a capstone project.

Graduate-level nursing students work on an original scholarly inquiry during their thesis, while undergraduates recap their cumulative learning experience. The thesis process, which includes completing nursing courses and writing a proposal, takes place over the entire program.

Learn more about the difference between a thesis and capstone project on this page .

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College of Nursing Dissertations and Theses

The College of Nursing Dissertations and Theses Series is comprised of dissertations theses authored by Marquette University's College of Nursing doctoral and master's students.

Theses/Dissertations from 2023 2023

Why We Work: Exploring the Relationships Between Work Rewards, Burnout, and Intention to Leave for Professional Nurses , Jacqueline Christianson

Examining Relationships Among Nursing Students' Views of Suffering, Positive Thinking, and Professional Quality of Life , Ruth Anne Engbers

THE IMPACT OF PEDAGOGY AND PROGRAM ON PSYCHIATRIC-MENTAL HEALTH EDUCATION FOR PRE-LICENSURE NURSING STUDENTS , Virginia F. Riggs

APPLICATION OF THE SOCIAL DETERMINANTS OF HEALTH TO GERIATRIC PATIENTS BY NURSE PRACTITIONER STUDENTS , Theresa Marie Gruenke Schnable

Theses/Dissertations from 2022 2022

Mediating Effects of Positive Thinking on Compassion Fatigue, Compassion Satisfaction, and Resilience in Nurse Leaders , Jay Randall Gottschalk

Exploring Relationships Between Depression Self-stigma and Trust in Primary Care Provider on Willingness to Seek Help , Tana Karenke

The Impact of Nutrition Literacy and Neighborhood on Diet Quality in the Mexican Origin Population , Sylvia Pena

Theses/Dissertations from 2021 2021

Experiences of Exclusively Expressing Breast Milk for Term Infants: A Qualitative Analysis , Lisa Anders

Examining the Relationship of Physical Activity, Inflammation & Adiposity on Physical Function with Gender Differences , Jeanne Hlebichuk

Securing Nasogastric Tubes in Children , Julie Ann Lavoie

Exploring Culture of Safety and Failure to Rescue , Holly Lynn Losurdo

Processes Used by Mothers in Opioid Recovery to Manage the Needs of the Maternal-Infant Dyad: A Grounded Theory Study , Nicole M. Mattson

Pregnant Women's Experiences with Gastrointestinal Discomforts and Strategies They Use to Cope , Heidi Jo Paquette

Examining Social Factors in Self-Management for Older Adults Living Alone , Margaret Salinas

Effectiveness of a Postpartum Breastfeeding Protocol for Avoiding Pregnancy and Descriptive Analysis of the Physiology of the Postpartum Transition , Mary Schneider

Theses/Dissertations from 2020 2020

Modeling Heart Failure Predictive Mortality in Skilled Nursing Facilities , Stephen Charles Biondi

Understanding the Requisite Content for Interprofessional Education on Sentinel Injuries, A Qualitative Study , Elizabeth A. Cleek

Leading Rural Nurse Academic Progression , Cynthia Jean Larsen

Theses/Dissertations from 2019 2019

The Influence of Continuity of Nursing Care in the Acute Care Setting on Readiness for Discharge and Post-Discharge Return to Hospital , Sarah J. Bahr

Understanding Baccalaureate Nursing Education Progression from the Student Perspective Using a Grounded Theory Approach , Jennifer Jean Dahlman

Identifying a History of Nonfatal Strangulation: What Impacts Screening by Healthcare, Law Enforcement and Advocates? , Jennifer Delwiche

Healthcare Provider Influence on Health Behavior Modification in Gestational Diabetics , Denise K. Fryzelka

Measuring Polyvictimization Among Vulnerable Children: A Confirmatory Factor Analysis , Kelli J. Jones

Toward Quality Preceptorship: A Dyad Sudy , Laurie Ann Kunkel-Jordan

Theses/Dissertations from 2018 2018

Qualitative Exploration of the Perceptions of Nursing Undergraduates Regarding Family Care at End-of-Life , Penny A. Alt-Gehrman

Evaluation of Clinical Growth and Nursing Student Motivation in the Traditional Clinical Learning Environment , Jessica Barkimer

United States Born Mexican Origin Women's Descriptions About Their Eating Patterns , Juanita Teresa Garcia

Comparing Interprofessional Socialization in Mixed Discipline and Nursing Student only Cohorts , Kara Groom

Chronic Stress and Reproductive Function in Female Childhood Cancer Survivors , Theresa Marie Hardy

Understanding Relationships Between Early Life Toxic Stress, Childhood Socioeconomic Disadvantage, and Allostatic Load in Adolescence , Amanda King

Pre-Death Grief, Resourcefulness and Perceived Stress Among Care Givers of Partners with Young Onset Dementia , Karie Kobiske

Home Health Care Effect in Post-Discharge Return to Hospital , Danielle M. Siclovan

The Impact of Advance Directives on the Intensity of Care Received in the Acute Care Setting in Older Adults , Marsha Helen Tyacke

Theses/Dissertations from 2017 2017

The Mediating Effects of Positive Thinking and Social Support on Suicide Resilience Among Undergraduate Students , Denise Marie Matel-Anderson

The Development and Psychometric Analysis of the MU- Fertility Knowledge Assessment Scale , Qiyan Mu

Pediatric Oncology Nurses' Experiences with Prognosis-Related Communication , Amy Rose Newman

Relationship of Exposure to Heart Failure Discharge Teaching to Readmission Within 30 Days , Becky Ann Pogacar

Theses/Dissertations from 2016 2016

Effect of Sequence of Simulated and Clinical Practicum Learning Experiences on Clinical Competency , Jamie Hansen

Experiences of Registered Nurses Who Were Not Initially Successful on the NCLEX-RN, Then Subsequently Passed , Tammy L. Kasprovich

Racially and Ethnically Underrepresented Students’ Completion of RN BSN Program: Factors Affecting Success , Patricia Ann Varga

Theses/Dissertations from 2015 2015

Role of Shared Care in the Relationship between Depressive Symptoms and Self-Care in Patients with Heart Failure , Susan Cole

Diffusion of Inclusion: Measuring Willingness , Janet A. Levey

Effects of Spiritual Care Education on Pediatric Nurses' Knowledge, Attitudes, and Competence , Cheryl Lynn Petersen

Theses/Dissertations from 2014 2014

Relationships among Uncertainty, Coping, and Psychological Distress in Older Adults with Mild Cognitive Impairment , Jennifer Sjostedt Avery

Spirituality And Religiosity In Adolescents With Sickle Cell Disease: A Descriptive Qualitative Study , Dora L. Clayton-Jones

A Feminist Perspective On Listening To Women: Birth Stories Of Vaginal Birth Following Previous Cesarean Delivery , Elizabeth Hill-Karbowski

The Influence Of Patient Activation And Social Facilitation On Engagement In Postpartum Weight Self-Management Behaviors , Jennifer Marie Ohlendorf

Hispanic Mothers' Normative Beliefs and Intentions about the Discussion of Sex-Related Topics with Their Adolescent Daughters , Dana M. Rodriguez

Antecedents of Regular Exercise among Women Who Do and Do Not Achieve Weight Loss Over Six Months , Heather Vartanian

Theses/Dissertations from 2013 2013

The Relationships Between Nurse Attributes, Site Characteristics, And Labor Support Attitudes And Behaviors Among Intrapartum Nurses , Ann Prenger Aschenbrenner

Patient Perceptions of Patient-Empowering Nurse Behaviors, Patient Activation, and Functional Health Status After Surgery , Teresa Arline Jerofke

Self-Care Behaviors of African Americans with Heart Failure: A Photovoice Project , Aimee A. Woda

Theses/Dissertations from 2012 2012

Academic Success Factors Influencing Linguistically Diverse and Native English Speaking Associate Degree Nursing Students , Josie Lynn Veal

Theses/Dissertations from 2010 2010

Associate Degree Nursing Students' Thoughts, Feelings, and Experiences of Short Study Abroad in a Low-Income Country , Cynthia Foronda

A Narrative Analysis of Perinatal Hospice Stories , Anthony Adams Lathrop

The Transition from Hospital to Home in Parents of Pediatric Solid Organ Transplant Recipients , Stacee M. Lerret

The Lived Experience of Hispanic new Graduate Nurses in the United States , Esther Morales

Pushing Techniques Used by Midwives When Providing Second Stage Labor Care , Kathryn Osborne

The Association of Spirituality, Religiosity, Depression, Anxiety, and Drug Use Among Persons Undergoing Methadone Maintenance Therapy , Linda B. Piacentine

Parenting Behaviors and Their Relationship with a Child's Weight Status , Michele L. Polfuss

African American Women's Infant Feeding Choices: Analyzing Self-Efficacy and Narratives from a Black Feminist Perspective , Karen Marie Robinson

More than S.K.I.N. Deep: Decreasing Pressure Ulcer Development in the Pediatric Intensive Care Unit , Christine A. Schindler

Theses/Dissertations from 2009 2009

Efficacy of a behavioral intervention to decrease medication transcription errors among professional nurses , Kathleen Ann Becker

Quality of Life: The Humanbecoming Perspective, A Descriptive Exploratory Study , Barbara J. Johnson Farmer

Factors Associated with Nurses' Perceptions of Patient Safety Culture in One University Hospital in China , Xianqiong Feng

The Meaning of Spirituality in Elders with Dementia , Lesley Boaz Gardiner

Understanding Relationships in Health Related Quality of Life for Parents of Children with Autism Spectrum Disorder , Norah Louise Johnson

Loneliness, Self-Esteem, Cognition, Physical Functioning, and Nursing Home Satisfaction As Predictors of Depression , Lynn Rose Maloney

The Impact of Health Literacy and Patient Trust Glycemic Control , Josephine M. Mancuso

Investigating Relationships Among Collaborative Behavior, RN Experience and Perceptions of Discharge Teaching Quality , Jane Morgan Nosbusch

Is a School Based Educational Program Effective in Changing Knowledge Regarding the Prevention of Shaken Baby Syndrome? , Margaret Kay Stelzel

Effects of Beta Blockade on Physiologic Regulation, Depressive Symptoms and Heart Failure Severity , Kimberly A. Udlis

Theses/Dissertations from 2008 2008

Self-Efficacy, Outcome Expectation, Self-Care Behavior and Glycosylated Hemoglobin Level in Persons with Type 2 Diabetes , Kathryn B. Kott

Oppression in 21st Century Nursing , Linda K. Matheson

Predictors of success and failure on the NCLEX-RN for Baccalaureate graduates , Christine L Vandenhouten

Predictors of Success and Failure on the NCLEX-RN for Baccalaureate Graduates , Christine L. Vandenhouten

Theses/Dissertations from 2007 2007

Being-With Dying: Tacit Wisdom Embedded in the Experiences of Nurses Who Attend to Dying , Virginia L. Burton

Theses/Dissertations from 1999 1999

An Organizational Case Study of Shared Leadership Development in Nursing , Vicki George

Submissions from 1971 1971

NURSES' PERCEPTIONS OF THEIR HOSPITAL'S ORGANIZATIONAL CHARACTERISTICS , AUDREY MABEL STENVALL DE BLOCK

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Nursing School Theses, Dissertations, and Doctoral Papers

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Home > College of Nursing > Nursing Student Scholarship and Creative Works > Nursing Graduate Theses and Dissertations

Nursing Graduate Theses and Dissertations

A collection of Nursing Masters Theses and Doctoral Dissertations.

Theses/Dissertations from 2023 2023

Racial Discrimination, Social Support and Psychological Distress among Black Pregnant Women , Camilla Carey

The Associations Among Racial Discrimination, Perceived Stress and Birth Satisfaction Among Black Women , Amanda de la Serna

A Digitally Enhanced Virtual Cognitive Behavior Skill Building Intervention to Reduce Parent Stress and Family Obesogenic Behaviors , Sharlene Smith

Mother-Father Relationship and Perceived Stress among Black Pregnant Women: A Mixed Methods Approach , Jenna Wheeler

Theses/Dissertations from 2022 2022

Nurse Managers' Patient Safety Communication , Christine Deatrick

Exploration of the Oral Microbiome in Non-Ventilated Hospitalized Patients , Kimberly Emery

Social Support and Empowerment Among Caregivers of Children with Asthma , Lauren Lebo

Theses/Dissertations from 2021 2021

Factors Associated with Resilience and Sense of Coherence in Adult Transgender Persons: Identifying Predictors to Reduce Health Disparities in a Vulnerable Population , Jake Bush

Cognitive Rehearsal, Self-efficacy, and Workplace Incivility Among Baccalaureate Nursing Students , Alina Diaz-Cruz

Survivors of Human Trafficking: Reintegration into the Community and Society , Charrita Ernewein

Remembering to Resume: Using Simulation-based Education to Teach Nursing Students to Manage Interruptions , Peggy Hill

First Impressions of the Bedside Nurse From the Patient Perspective , Sharon Imes

The Influences of Generational Membership and Practice Environment on Nurse Manager Job Satisfaction , Angela Keith

Knowledge and Attitudes of Nurse Practitioner's Assessment of Adults with Signs and Symptoms of Posttraumatic Stress Disorder , Kelli Lipscomb

Ethical Decision Making Among Nurses Participating in Social Media , Melissa Lynn

Hospital Readmission After Major Abdominal/Colorectal Surgeries: A Mixed-Methods Study , Ansu Sebastian

The Effect of the Medilepsy Mobile App on Medication Adherence and Transition Readiness in Adolescents and Young Adults with Epilepsy , Michelle Tall

Theses/Dissertations from 2020 2020

Access and Utilization of Prenatal Care in Florida and its Effects on Preterm Birth , Corinne Audette

Nurse-Physician Collaboration during Bedside Rounding: What is the Impact on the Nurse? , Martha Decesere

The Relationship of Cognitive Load and Different Participant Roles on Knowledge Retention in Simulation-based Learning Among Undergraduate Nursing Students , Amanda Houston

Undergraduate Nursing Students' Depth of Reflection and Perceptions of Self-Debriefing Following Virtual Simulation: A Multi-method Descriptive Study , Valorie MacKenna

Patients with a Left Ventricular Device and Factors Affecting Readmission , Diana Pitcher

Geographic Access to Community Mental Healthcare and Adherence to Treatment Among Patients with Schizophrenia Spectrum Disorders , Marie Smith-East

The Effect of Acuity-based Nurse Staffing on Nursing Medication Errors , Egidius Maria Eugene Waterval

Theses/Dissertations from 2019 2019

Persistence of Physical Activity Among Veterans , Jean Davis

Factors Influencing Nurse Practitioners' Weight Management Practices in Primary Care , Suzanne Hyer

Evaluation of Postoperative Air Leak and Chest Tube Drainage Systems after Pulmonary Resection , Kristina Jacobsen

Stress, Coping, and Quality of Life Among Parental Caregivers of Children with Autism Spectrum Disorder , Dawn Turnage

Theses/Dissertations from 2018 2018

Understanding the Perceived Experiences of Goal Setting of Mothers of Preschool Children: A Narrative Analysis , Dawn Eckhoff

Theses/Dissertations from 2017 2017

The Influences of Mindfulness and Neuromotor Exercise Mode on Balance in Healthy Older Adults , Maxine Hicks

Theses/Dissertations from 2016 2016

An Evaluation of Anxiety Following Substance Abuse Withdrawal and Assessment of Somatic Treatments presently Available with a Focus on Cranial Electrotherapy Stimulation , Janet Hutchison

Perceived readiness to transition to adult health care for youth with cystic fibrosis and congruence with their caregivers' views , Valerie Lapp

Evaluating Moral Distress, Moral Distress Residue and Moral Courage in Oncology Nurses , Lolita Melhado

Preschool Attendance: A Parental and Teacher Perspective of Barriers and Behaviors using Grounded Theory Research , Anne Meoli

Prehabilitation (Prehab): Prevention in Motion , Billie Russell

Theses/Dissertations from 2015 2015

Impact of Interruption Frequency on Nurses' Performance, Satisfaction, and Cognition During Patient-Controlled Analgesia Use in the Simulated Setting , Kristi Campoe

Perceived Social Support and Self-care in Patients Hospitalized with Heart Failure , Lyne Chamberlain

Rapid Response Teams versus Critical Care Outreach Teams: Unplanned Escalations in Care and Associated Outcomes , Valerie Danesh

The Impact of Relational Coordination and the Nurse on Patient Outcomes , Fanya DeJesus

Family Care Giver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults with Cancer , Patricia Geddie

Helping Mothers Defend their Decision to Breastfeed , Kandis Natoli

Nurse Managers, Work Environment Factors and Workplace Bullying , Joy Parchment

A Faith-Based Primary Diabetes Prevention Intervention for At-Risk Puerto Rican Adults: A Feasibility Study , Sylvia Torres-Thomas

Pre and Post Implementation Evaluation of an Emergency Department Severe Sepsis Alert and Practice Protocol , Darleen Williams

Theses/Dissertations from 2014 2014

Factors Associated With Information Literacy Competencies Of The Traditional Baccalaureate Nursing Student , Patricia Lafferty

Mobile Phone Short Message Service (SMS) to Improve Malaria Pharmacoadherence in Zambia , Elinda Steury

Theses/Dissertations from 2013 2013

Evaluation Of A Mind-body Website By Women With Breast Cancer , Laura Beck

Nutrition Literacy And Demographic Variables As Predictors Of Adolescent Weight Status In A Florida County , Leslee D'Amato-Kubiet

Ventilator-associated Complications In The Mechanically Ventilated Veteran , Joan Grano

The Early Postpartum Experience Of Previously Infertile Mothers , Sigrid Ladores

Early And Intermediate Hospital-to-home Transition Outcomes Of Older Adults Diagnosed With Diabetes , Jacqueline Lamanna

Improving Chronic Kidney Disease Care With Group Visits , Vicki Montoya

Theses/Dissertations from 2012 2012

An Exploratory Study Of Physiologic Responses To A Passive Exercise Intervention In Mechanically-ventilated Critically Ill Adults , Christina M. Amidei

The Self-described Experience Of Coping And Adaptation Associated With Workplace Stress Of Registered Nurses In The Acute Care Setting In Florida: An Ethnographic Study , Joyce Burr

Predictors Of Immunosuppressant Adherence In Long-term Renal Transplant Recipients , Sandra J. Galura

Stressors Experienced By Emergency Department Registered Nurses At The Bedside: A Phenomenological Study , Stephen D. Heglund

Noncardiac Chest Pain: The Use Of High Resolution Manometry As A Diagnostic Tool , Iman Hilal

Infection Control And Health Care Associated Infection (hcai) In The Nursing Home: A Study To Determine The Impact Of An Educational Video And Pamphlet About Infection Control On Knowledge And Perception Of Hand Hygiene In Certified Nurse Assistants , Kathe Hypes

Barriers To Timely Administration Of Thrombolytics In Acute Ischemic Stroke Patients , Elizabeth Joseph

Development And Evaluation Of An Instrument To Measure Mother-infant Togetherness After Childbirth , Carol Lawrence

Perceptions Influencing School Nurse Practices To Prevent Childhood Obesity , Susan Quelly

Front-line Registered Nurse Job Satisfaction And Predictors: A Meta-analysis From 1980 - 2009 , Deborah Anne Saber

Impact Of Cancer-specific Advance Care Planning On Anxiety, Decisional Conflict, And Surrogate Understanding Of Patient Treatment Preferences , Lynn Waser

Theses/Dissertations from 2011 2011

Duplicated Laboratory Tests : A Hospital Audit And Evaluation Of A Computerized Alert Intervention , Sharon Bridges

Exploring Women's Life Course Experiences With Weight Using Story Theory , Poff Allison Edmonds

Adherence Practices Of Caucasian Women With Hypertension Residing In Rural Florida An Exploratory Study , Jeanne M. Hopple

The Lived Experience Of Young-onset Dementia , Debra A. Hunt

Identifying Patients At Risk For Obstructive Sleep Apnea In Primary Health Care : Can Obesity In Combination With Other High-risk Diagnoses Be Used For Screening Purposes? , Clelia Lima

Clopidogrel Provision For Indigent Patients With St-elevation Myocardial Infarction , Sita S. Price

Comparative Retrospective Analysis Assessment Of Extracellular Volume Excess In Hypertensive Hemodialysis Patients , Amma Serwaah-Bonsu

Spirituality And Expectations Of Care Providers Of Older Patients With Chronic Illnes In North Central Florida , Myra Sherman

Factors Related To Birth Transition Success Of Late-preterm Infants , Karen L. Wright

Theses/Dissertations from 2010 2010

The Experiences Of Health Care Providers Providing Comfort For Nursing Home Patients At The End Of Life , Herma Baker

Comparison Of Arnp And Physician Malpractice In States With And Without Controlled Substance Prescribing Authority , Deborah Chandler

A New Measure Of Parental Self-efficacy For Enacting Healthy Lifestyles In Their Children , Jonathan W. Decker

Effectiveness Of Probiotics In Preventing Antibiotic Associated Diarrhea And Clostridium Difficile In Long Term Care , Marva Edwards-Marshall

The Effect Of Combat Exercises On Cardiovascular Response: An Exploratory Study , MeLisa Gantt

The Impact Of Pre-operative Mupirocin Prophylaxis On Surgical Site Infections In Same-day Admission Open Heart Patients , Joanna Gerry

Evaluation Of A Simulation-enhanced Obstetric Clinical Experience On Learning Outcomes For Knowledge, Self-efficacy, And Transfer , Mary Elizabeth Guimond

The Incidence And Epidemiologic Factors Of Community-acquired Methicillin-resistant Staphylococcus Aureus Skin And Soft Tissue I , Ivonne Johnson

The Impact Of An Interdependent Conferencing Activity In An Online Rn-bsn Practicum Clinical Conference On Psychologocial Sense Of Community , Barbara Lange

Advanced Practice Nursing In The Faith Community Setting: A Case Study , Chianta Lindsey

Prevalence Of And Risk Factors For Intraoperative Non-euglycemia Events In Premature Neonates >2500 Grams , Zulay Ritrosky

Retrospective Analysis Of Screening Patterns In Cirrhotic Patients With Heptocellular Carcinoma , Shelly-Ann Scott-Castell

A Phenomenological Description Of The Lived Experience Of Creating Art For Women With Breast Cancer , Laurie Stark

Assessing Adult Attitudes Toward End-of-life Issues And Advanced Directives After Implementing An Educational Intervention In A , Marchina Tolbert-Jones

Theses/Dissertations from 2009 2009

Cohort Study Of Pain Behaviors In The Elderly Residing In Skilled Nursing Care , Allison Burfield

Effects Of An Evidence-based Intervention On Stress And Coping Of Families Of Critically Ill Trauma Patients , Sandra Knapp

Awareness Of Increased Risk For Heart Disease And Cardiovascular Risk Factors In Women With Systemic Lupus Erythematosus , Patricia Weinstein

Consumer Perspectives Of Health During Prenatal Care In The Usa And Iceland: An Exploratory Study , Claudia Wiseman

Theses/Dissertations from 2008 2008

A Comparison Of Computer And Traditional Face-to-face Classroom Orientation For Beginning Critical Care Nurses , Patricia Anzalone

Health-care Seeking Behaviors Of Puerto Ricans With Diabetes Mellitus Who Live In South Florida: An Exploratory Study , Laura Gonzalez

Evaluation Of The Antecedents Of Cultural Competence , Mary Harper

The Impact Of A Nurse-driven Evidence-based Discharge Planning Protocol On Organizational Efficiency And Patient Satisfaction In , Tracey King

Theses/Dissertations from 2007 2007

Resiliency In Adolescent College Students , Nancy Ahern

The Impact Of Music On Postoperative Pain And Anxiety , Kelly Dixon Allred

Evaluation Of An Education Intervention For The Staff On The Head Of The Bed Elevation In The Pediatric Intensive Care Unit , Randall Johnson

Quality Of Life In Older Breast Cancer Survivors , Victoria Loerzel

Evaluating Neonatal Facial Pain Expression: Is There A Primal Face Of Pain? , Martin Schiavenato

Theses/Dissertations from 2003 2003

The Effect of Parent Education on Maternal Self-efficacy and Preference for Pain Control During Labor , Aubrey Willard

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Home > Nursing > Yale School of Nursing Digital Theses

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Theses/dissertations from 2023 2023.

Reduction Of Unnecessary Emergency Department Visits Through An Ed-Initiated Advanced Care Program For Vulnerable Patients , Dr. M. Dustin Bass

Implementing Prediabetes Screening During Hospitalization In An Internal Medicine Unit , Roxana Bustamante

Harnessing Family Empowerment To Promote Healthcare Transition For Youth With Special Healthcare Needs: The F.a.m.e. Project , Vanessa Coppola

Implementing A Workload Tool To Increase Float Nurses' Job Satisfaction And Reduce Intent To Leave The Workplace , Lisa Czaplinski

Shifting The Paradigm Toward Intent To Stay: Creating A Nurse Career Crafting Program To Increase Nurse Engagement In An Urban Teaching Hospital , Jaclyn Davis

Achieving Success[ion] In Healthcare Leadership: Building An Immersive Nurse Manager Residency Program , Natalie Marie Fucito

Enhancing Self-Efficacy Of Novice And Emerging Nurse Leaders Through A Virtual Emotional Intelligence Education Program , Josephine C. C. Garcesa-Duque

A Project To Improve Advanced Practice Provider Financial Metrics Through A Practice Management Program , Stefanie Anne Generao

Increasing Transplant Medication Knowledge Through Implementation Of A Medication Education Intervention Algorithm , Colleen Chime Karkhang

Multimodal Opioid-Sparing Analgesia: Increasing Regimen Adherence In Minimally Invasive Abdominal Surgery , Panicha F. Kittipha

Evaluating The Use Of Reflective Practice Principles To Support Nurse Manager Well-Being During A Period Of Chronic Distress , Amy A. Martone

Implementing A Prediabetes Screening Algorithm To Improve Identification And Referrals In Primary Care , Katherine Masoud

Addressing Social Needs And Creating Community Linkage Pathways For Vulnerable Populations In Primary Care Practice Settings , Mindy Marie Matthews

Improving Treatment Outcomes For American Indians With Posttraumatic Stress Disorder Through The Use Of Telepsychaitry , Shaylice Meserole

Obstructive Sleep Apnea Screening And Sleep Specialist Referral In Outpatient Psychiatric Populations , Jeremy Michael Mills

A Mixed Methods Exploration Of Stigma, Discrimination, And Sleep Among Those On Medication For Opioid Use Disorder , Uzoji Nwanaji-Enwerem

Reducing 30-Day Readmission Rates For Copd Patients: A Care Standardization & Quality Improvement Project , Oana Raluca Randolph

The Adaptation And Implementation Of A Comprehensive Retirement Transition Program For Members Of Law Enforcement , Renee White

Development Of An Educational Program To Elevate The Financial Cumen Of Nurse Managers , Quyen Wong

Theses/Dissertations from 2022 2022

Nurses, Politics And Policy: Moving A Critical Initiative Forward Through Education, Inspiration And Motivation For Political Activity , Elizabeth Clark

Assessing Risk For Right Heart Failure After Left Ventricular Assist Device Implantation , Mary-Ann Lombardi Cyr

A Nurse-Driven Protocol To Increase Metabolic Screening And Interventions For Inpatients On Antipsychotic Medications , James Thomas Demarco

Creating A Welcoming, Inclusive, And Affirming Primary Care Environment For Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex And Asexual Patients , Samantha Korbey

Retention Of The Newly Licensed Registered Nursing Workforce Post-Coronavirus (covid-19): Establishing A Trauma-Informed Wellness Program, The Registered Nurse Residency Script For The Future (rnrx) (© Maryellen Hope Kosturko, 2022) , Maryellen Hope Kosturko

Sepsis Discharge Program: An Interdisciplinary Approach To Reduce Sepsis Readmissions , Rex Daniel Demetria Lomboy

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• v.6(2); 2019 Apr

Patient satisfaction with the quality of nursing care †

Anita karaca.

1 Florence Nightingale Hospital School of Nursing, Istanbul Bilim University, Istanbul, Turkey

Zehra Durna

To evaluate patients’ satisfaction with the quality of nursing care and examine associated factors.

A cross‐sectional, descriptive survey study.

The sample was composed of 635 patients discharged from a private hospital. Data were collected using “Patient Satisfaction with Nursing Care Quality Questionnaire” with a total of 19 items, and a questionnaire designed to record socio‐demographic characteristics and medical histories between January 1–May 31, 2015.

Patients were more satisfied with the “Concern and Caring by Nurses” and less satisfied with the “Information You Were Given.” Patients (63.9%) described nursing care offered during hospitalization as excellent. Patients who were 18–35 years old, married, college or university graduates, treated at the surgery and obstetrics–gynaecology units, and patients who stated their health as excellent and hospitalized once or at least five times were more satisfied with the nursing care. According to this study, the nurses needed to show greater amount of interest to the information‐giving process.

1. INTRODUCTION

Increasing competition in every field today also affects the healthcare industry. The most important competitive advantage of health service providers is to provide quality health services (Alsaqri, 2016 ; Reck, 2013 ; Şişe, 2013 ). The need for increased quality of healthcare services has been identified via health‐related information and advances in technology, changes in expectations and opinions about health care, an increase in individuals’ involvement in their health care and increased cost and competitiveness in the health sector (Freitas, Silva, Minamisava, Bezerra, & Sousa, 2014 ).

The quality and adequacy of healthcare services can be measured based on views and satisfaction of patients and their relatives (Merkouris et al., 2013 ). Patient satisfaction is the most important indicator of quality of care and it considered an outcome of healthcare services (Abdel Maqsood, Oweis, & Hansa, 2012 ; Akhtari‐Zavare, Abdullah, Syed Hassan, Binti Said, & Kamali, 2010 ; Mohanan, Kaur, Das, & Bhalla, 2010 ). Patient satisfaction measurement provided crucial information on performance thus contributing to total quality management (Goh, Ang, Chan, He, & Vehvilainen Julkunen, 2016 ; Shinde & Kapurkar, 2014 ). Total quality management includes professional knowledge, competence and application of appropriate technology, the patients’ perception about the type and level of the care they have received (Özsoy et al., 2007 ; You et al., 2013 ). In today’s consumer‐oriented healthcare markets, a patient‐centred measure of satisfaction with the quality of nursing care received is a major component of hospital quality management systems (Laschinger, Hall, Pedersen, & Almost, 2005 ). Patients need their problems diagnosed and treated properly, their function restored and/or symptoms relieved. If the results are unsatisfactory, consumers will change the healthcare facility they applied for treatment and care (Ksykiewicz‐Dorota, Sierpińska, Gorczyca, & Rogala‐Pawelczyk, 2011 ; Shinde & Kapurkar, 2014 ). Patients who are more satisfied with their care are more likely to follow medically prescribed regimens and thus contributing to the positive influence on health (Buchanan, Dawkins, & Lindo, 2015 ; Dzomeku, Atinga, Tulukuu, & Mantey, 2013 ; Fröjd, Swenne, Rubertsson, Gunningberg, & Wadensten, 2011 ). More satisfied patients are more liable to recommend the hospital to family and friends (Buchanan et al., 2015 ; Mohanan et al., 2010 ). Patients’ opinions are the best source that can tell the providers of what is important, that is why this information can be used in healthcare planning and evaluation (Abdel Maqsood et al., 2012 ; Alsaqri, 2016 ; Merkouris et al., 2013 ; Villarruz‐Sulit, Dans, & Javelosa, 2009 ). All these changes and developments in the healthcare field require restructuring of all healthcare services, including nursing, through questioning the quality of treatment services (Şişe, 2013 ).

1.1. Background

Patient satisfaction is a concrete criterion for evaluation of health care and therefore quality of nursing care (Alhusban & Abualrub, 2009 ; Shinde & Kapurkar, 2014 ). It provides crucial information for healthcare managers by providing important resources for processes such as those involved in measuring patients’ expectations and satisfaction with nursing care quality, improving nursing service quality through identification of areas of failure and planning and implementing necessary training (Abdel Maqsood et al., 2012 ; Gadalean & Cheptea, 2011 ; Geçkil, Dündar, & Şahin, 2008 ). Evaluation of health care involves defining the objectives of care, monitoring healthcare inputs, measuring the extent to which the expected outcomes have been achieved and assessing the extent of any unintended or harmful consequences of the intervention (Alsaqri, 2016 ; Sitzia & Wood, 1997 ; Tang, Soong, & Lim, 2013 ).

Nursing care is one of the major components of healthcare services (Buchanan et al., 2015 ; Merkouris et al, 2013 ; Mohanan et al., 2010 ; Sitzia & Wood, 1997 ). Patients’ satisfaction with nursing care has become an established as the most important predictor of the overall satisfaction with hospital care and an important goal of any healthcare organization (Goh et al., 2016 ; Laschinger et al., 2005 ; Mohanan et al., 2010 ; Reck, 2013 ). Measuring patients’ satisfaction with nursing care could be effective in improving nursing service quality by facilitating the creation of standards for care while monitoring both results and patients’ perceptions of quality (Akın & Erdoğan, 2007 ; Senarath & Gunawardena, 2011 ; Tang et al., 2013 ). The nurses have a central role in offering emotional and psychological support to patients and their families in all settings, such as supporting the patient through diagnosis and ensuring optimum care given to them. Besides the provision of technical care, nurses must have the qualified professional knowledge, attitudes and skills, providing the informational, emotional and practical supports (Akhtari‐Zavare et al., 2010 ; Buchanan et al., 2015 ; Goh et al., 2016 ).

If healthcare organization managers are able to identify patient expectations, they could accordingly adjust the performance of services that they offer to meet these expectations (Freitas et al, 2014 ; Fröjd et al., 2011 ; Milutinovic, Simin, Brkic, & Brkic, 2012 ). The surveys in health services concerning health satisfaction are carried out to evaluate the patient satisfaction, to learn patient’s expectations, their suggestions and feedbacks, make the quality improvement constantly in all service periods, to search the effects of socio‐demographic and treatment periods on patient satisfaction (Buchanan et al., 2015 ; Özer & Çakıl, 2007 ; Sitzia & Wood, 1997 ). That is why patient satisfaction should be measured constantly using valid, reliable assessment instruments to assess care quality, identify variables that affect care and determine which items should be prioritized and which require alteration in the service based on patients’ responses (Buchanan et al., 2015 ; Merkouris et al., 2013 ). A good assessment instrument measuring the factors that determine patient satisfaction should be developed to improve nursing service quality (Freitas et al., 2014 ; Laschinger et al., 2005 ). Therefore, the findings of nursing management research should be used as an indicator of the contribution made by nursing to the patient care process and this could aid the advancement of the profession in terms of scientification (Alsaqri, 2016 ; Freitas et al., 2014 ; Goh et al., 2016 ).

1.2. Research questions

• What is the satisfaction level of patients about the quality of nursing care?
• Is there any relationship between patients’ satisfaction with the quality of nursing care according to their socio‐demographic characteristics and medical history?

2.1. Design

The study used a descriptive, cross‐sectional research design.

2.2. Setting and samples

Participants included 635 hospitalized patients receiving internal medicine, surgery and obstetrics and gynaecology services at a private hospital between January 1–May 1, 2015. The sampling criteria were as follows: patients aged 18 years or older, patients who were discharged, hospitalized for at least 2 nights at the time of data collection, able to speak and understand Turkish, not too confused or ill to complete the questionnaires and agreeing to participate in the study.

The response rate of this study is 92.8%. The survey was not administered to all patients who had not planned their discharge (those were decided or wished to be discharged suddenly) or were transferred to another hospital. Incompletely filled out surveys were not included in the study.

2.3. Ethical considerations

Prior to data collection, the research protocol was reviewed and approved by the relevant scientific ethics committee (IBU Clinical Research Ethical Committee, Ethical Approval Number: 01.11.2014/25‐168). Permission to conduct the research was also obtained from hospital administrators. Written approval to use the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) and translate it into Turkish was obtained from Laschinger, who developed the scale. All patients provided written informed consent.

2.4. Measurement

2.4.1. patient satisfaction with nursing care quality questionnaire.

The PSNCQQ was designed to measure the extent of anticipated need, assess patient satisfaction following short‐stay hospitalization and determine the influence of socio‐demographic, personal and other factors at a minimum level. The scale was developed using the Patient Judgements of Hospital Quality Questionnaire, which was developed by a multidisciplinary research team at the Hospital Corporation of America (Laschinger et al., 2005 ; Reck, 2013 ).

The scale consists of 19 items pertaining to features of a wide range of nursing activities including nurses’ attention, kindness, respect, courtesy, skills, competence and fulfilment of patient needs. As it is short and it can be completed easily, it has very good psychometric properties that can be used by managers in quality improvement activities (Fröjd et al., 2011 ; Laschinger et al., 2005 ). Each item consists of a “signpost,” which is a phrase designating its content and a “descriptor,” which is a detailed question. The scale also includes a general perceptions section consisting of four additional questions designed to measure satisfaction with the overall quality of care and treatment received during hospitalization, the overall quality of nursing care, thoughts on overall health and the likelihood that the patient would recommend the hospital to relatives and friends (Laschinger et al., 2005 ; Milutinovic et al., 2012 ).

The scale was designed for application by administrators in areas requiring improvement, to provide patient‐oriented outcomes and for the identification of strong and weak aspects of the nursing care process. Items were based on factors identified as important elements of patient satisfaction with nursing care. The PSNCQQ can be incorporated into existing hospital quality monitoring systems to monitor patient satisfaction. In addition, the PSNCQQ can be used as an evidence‐based indicator given its contribution to the patient care process as a result variable, to evaluate changes in departmental and institutional processes. This feedback provides useful information to nurse administrators (Abdel Maqsood et al., 2012 ; Laschinger et al., 2005 ).

Participants’ responses are provided using a 5‐point Likert‐type scale. Total possible scores range from 19–95. Lower total scores indicate greater satisfaction with nursing care. The scoring of the scale was: 1 = excellent, 2 = very good, 3 = good, 4 = fair, 5 = poor.

2.5. Data collection

Data were collected using the PSNCQQ, which measures health‐related properties considered to affect patient satisfaction and a questionnaire, designed in the light of related literature, to record socio‐demographic characteristics and medical history. A questionnaire consisting of 16 items pertaining to variables affecting patient satisfaction was developed according to these characteristics. Income levels were measured by the patients’ self‐perception of their economic status and lifestyle. It was presented in four options: low, moderate, high and very high. Perceived health was measured by a self‐reported question was graded by six variables prior to their admission as excellent, good, fair, poor, very poor and unsure.

The data were collected by the researcher. The patients completed the questionnaires prior to their discharge from the hospital. The patients who agreed to participate in the study were provided with an explanation about the purpose of the study and they signed informed consent forms. Those who refused to participate reported that they did not have the time or were just not interested in participating. Data were collected by face to face interviews from illiterate patients.

2.6. Data analysis

Data were analysed using SPSS software (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0; IBM Corp, Armonk, NY, USA). The analysis included descriptive statistics such as frequencies, means, standard deviations and percentages. The distribution of the data was assessed using the Single Sample Kolmogorov–Smirnov test and as the significance values exceeded 0.05, parametric tests were used in the advanced‐level analysis. About the parametric tests, t tests were performed to analyse independent variables with two categories, one‐way ANOVAs were performed to analyse independent variables with more than two categories and Pearson’s correlation coefficients were used to analyse relationships.

2.7. Validity and reliability analysis

The PSNCQQ was translated into Turkish and the linguistic, and conceptual equivalence of the items was established. Back translation was performed to ensure language equivalence between the English and Turkish versions of the scale. The original scale was translated into Turkish linguists who were highly competent in both languages. Five bilingual experts consisted of a doctor, two nursing faculty members, a nurse manager and a linguist. Expressions used in the scale were analysed individually and in combination and optimal expressions were selected by forming a pool of 19 items. Back translation from Turkish to English was performed by two trained linguists (English teachers) with knowledge and experience in both languages. The back‐translated and original versions of the PSNCQQ were compared and found to be highly similar in meaning and reorganized based on the characteristics of the country. After then, the expert met and reviewed to determine the scope of the validity of the scale. Eight experts (nursing academicians specialized in medical nursing, surgical nursing and nursing administration) provided opinions about meaning and content sufficiency. A pilot study was then conducted from 1–31 December 2014 to determine whether there were any unclear questions in the scale. The data from the pilot study were then excluded from the final data analysis. According to the results of the pilot study, small changes were then made to the expressions in some scale items to increase their understandability.

In this study, the coefficients for correlations between average PSNCQQ item scores ranged from 0.80–0.89, which demonstrated an appropriate level of reliability. Cronbach’s α for the PSNCQQ, calculated to determine internal consistency and uniformity, was 0.98, which was very high. In Laschinger et al.’s ( 2005 ) study, the coefficients for the correlations between PSNCQQ items ranged from 0.61–0.89 and were described as high and Cronbach α was 0.97, which was described as excellent. Therefore, the results obtained in the current study were similar to those reported by Laschinger et al. ( 2005 ). In view of this, the Turkish version of the PSNCQQ could be considered to possess excellent psychometric properties, which were similar to those reported for the original scale.

3.1. Socio‐demographic characteristics and medical history

The mean age of the sample age was 47.94 ( SD 19.66) years and 37.6% were aged between 18–35 years. The most of participants were women (77.3%), married (74.5%) and college or university graduates (33.2%), at moderate‐income level (52.1%) and housewives (31.3%). Of the patients, 2.2% were illiterate. More than half of the sample (61.6%) were admitted to the service directly from the patient admission department and had been hospitalized once in the preceding 2 years (66.6%). The average duration of the current hospitalization was (4.38 SD 5.75) days (Table ​ (Table1 1 ).

Patient characteristics ( N  = 635)

3.2. PSNCQQ scores

Analysis of PSNCQQ scores revealed that the item for which satisfaction levels were highest (1.38 SD 0.66) was the “Concern and Caring by Nurses: Courtesy and respect you were given; friendliness and kindness” item. The item for which satisfaction levels were lowest (1.74 SD 0.86) was the “Information You Were Given: How clear and complete the nurses’ explanations were about tests, treatments and what to expect” item. Overall, patients’ PSNCQQ scores ranged between 1–4.05, with an average score of 1.61 ( SD 0.65). This indicated that the level of satisfaction with nursing care was high (Table ​ (Table2 2 ).

Distribution of Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) Scores ( N  = 635)

Analysis of PSNCQQ scores for perception‐related items showed that 61.4% and 63.9% of participants’ responses for the “Quality of the care and service provided during your stay at the hospital” and “Quality of the nursing care provided during your stay at the hospital” items, respectively, were “excellent.” In addition, 87.9% of patients stated that they would recommend the hospital to their family and friends.

3.3. Comparison of PSNCQQ scores according to patients’ socio‐demographic characteristics

The mean PSNCQQ score of patients at the age of 56 years or older was significantly higher (1.75 SD 0.68) in relation to those observed for patients aged 18–35 years (1.50 SD 0.61) and aged 36–55 years (1.56 SD 0.62; p  < 0.001). No statistically significant differences were found in the PSNCQQ scores of patients by gender or occupation ( p  > 0.05).

The widowed patients’ mean PSNCQQ score was found to be statistically higher (1.81 SD 0.75) than that of the married patients’ (1.57 SD 0.62), and the difference was significant ( p  < 0.05). The patients’ PSNCQQ scores varied significantly by education level and income ( p  < 0.001). The literate patients and patients with moderate incomes scores were higher (2.02 SD 0.65, 1.71 SD 0.68, respectively) than those of the patients who had completed college or university and patients with high incomes (1.52 SD 0.60, 1.48 SD 0.56, respectively; Table ​ Table3 3 ).

Comparison of Patient Satisfaction with Nursing Care Quality Questionnaire scores based on patients’ socio‐demographic characteristics ( N  = 635)

F : one‐way ANOVA; t : t test.

* p  < 0.05 ** p  < 0.01 *** p  < 0.001

3.4. Comparison of PSNCQQ scores according to patients’ medical histories

The mean PSNCQQ score of the patients hospitalized in the internal medicine unit was higher (1.95 SD 0.75) than those of the patients in the surgery and the obstetrics and gynaecology units (1.51 SD 0.57, 1.46 SD 0.55, respectively), and the differences were significant ( p  < 0.001). Score for patients admitted to the service from the emergency department was significantly higher (1.90 SD 0.69) relation to those observed for patients admitted from the patient admission department and through other means (1.54 SD 0.62, 1.58 SD 0.66, respectively; p  < 0.001).

The mean score of the patients who had been hospitalized twice in the preceding 2 years was higher (1.70 SD 0.71) than those of the patients who had only been hospitalized once and more than five times (1.55 SD 0.61, 1.35 SD 0.57, respectively), and the differences were significant ( p  < 0.001). The mean scores of the patients who perceived their health status very poor, poor, fair and good were higher (1.99 SD 0.69, 1.67 SD 0.64, 1.65 SD 0.66 and 1.60 SD 0.64, respectively) than in excellent health (1.31 SD 0.55), and the differences were significant ( p  < 0.001). Also, the results showed that the duration of hospitalization was significantly associated with PSNCQQ scores; however, the correlation was weak ( r p : 0.195, p  < 0.01; Table ​ Table4 4 ).

Comparison of Patient Satisfaction with Nursing Care Quality Questionnaire scores according to patients’ medical histories ( N  = 635)

4. DISCUSSION

The results of this study revealed similarities and differences with the existing national and international literatures. This issue has been discussed as follow.

4.1. Discussion of finding about the PSNCQQ scores

Measures of patient satisfaction can assess communication in the consultation such as information transfer, patient involvement in decisions and reassurance (Goh et al., 2016 ; Shinde & Kapurkar, 2014 ). Effective and continuous interaction and communication are critical determinants in patients' satisfaction, hospital stay and recovery (Koç, Sağlam, & Şenol, 2011 ; Mohanan et al., 2010 ; Negarandeh, Bahabadi, & Mamaghani, 2014 ; Villarruz‐Sulit et al., 2009 ). Health professionals’ communication skills play a pivotal role in ensuring that patients feel valued and cared for. The allocation of sufficient time for talking and listening to patients and providing information is a prerequisite for patient satisfaction, as it ensures that patients are less stressed and more engaged and well adjusted (Koç et al., 2011 ). There is evidence that the health professionals are perceived as communicating well when the patient feels he/she shows individualized interest, understanding and reassurance (Sitzia & Wood, 1997 ). A study (Abdel Maqsood et al., 2012 ) indicated that patients were more satisfied with having respectful communication whereas they were less satisfied with the professional information provided by the nurses about their disease, health status, investigations and prognosis of their condition. In a meta‐analysis conducted by Özsoy et al. ( 2007 ), patients expected favour, attention, understanding, kindness and helpfulness from individuals providing care services. In our study, the highest level of satisfaction, represented by PSNCQQ scores, was reported for the “Concern and Caring by Nurses” item. The results indicate that the nurses’ communication style is to treat patients respectfully and be friendly towards them. However, the nurses were less interested in explanations about their interventions and communication with patients that did not meet their expectations.

Information provision and education are important factors affecting patient satisfaction (Abdel Maqsood et al., 2012 ; Koç et al., 2011 ; Villarruz‐Sulit et al., 2009 ). Nurses and other healthcare professionals play a key role in providing support and information. Nurses care for the patients on a 24‐hr basis and should be empowered to provide requisite information and instructions to the patients (Alhusban & Abualrub, 2009 ; Shinde & Kapurkar, 2014 ). Patient education has been linked with positive clinical outcomes such as improved adherence to a therapeutic regime, reduced anxiety and enhanced ability to cope with symptoms (Sitzia & Wood, 1997 ). It is known that receipt of adequate information affects patients’ confidence and satisfaction and this is the most important factor in encouraging patients to participate in their own health care. In addition, providing patients and their families with information about patients’ conditions is important in helping them overcome fear of the unknown (Dzomeku et al., 2013 ; Koç et al., 2011 ; Milutinovic et al., 2012 ). Several studies have reported inadequacies in information provision. For example, Dzomeku et al. ( 2013 ) found that the type and amount of information provided by nurses about patients’ conditions constituted one of the main causes of dissatisfaction. In a meta‐analysis conducted by Özsoy et al. ( 2007 ), the patients’ most important expectation concerning care quality was that they should be informed about medication and treatment. Patients reported that information played an important role in their satisfaction and they emphasized that information provided by nurses should be clear and concise. Therefore, it is crucial for nurses to realize that information provision and education are nursing responsibilities and that they should collaborate with other healthcare staff to provide complete and relevant information to patients. Abdel Maqsood et al. ( 2012 ) indicated that the patients had low levels of satisfaction with information and instructions given by nurses and nurses had the perception that “information giving” was the role of the physicians and the nurses may be fearful to provide information because of the power hierarchy between the nurses and the physicians. In this study, the lowest level of satisfaction, represented by PSNCQQ scores, was reported for the “Information You Were Given” explanations were about tests, treatments and what to expect” item. This result indicates that the explanations and information provided by nurses at the hospital were unsatisfactory in the nursing care.

4.2. Discussion of finding about to the PSNCQQ scores according to patients’ socio‐demographic characteristics

Different studies indicated that older patients are generally more satisfied (Dzomeku et al., 2013 ; Fröjd et al., 2011 ; Milutinovic et al., 2012 ). Sitzia and Wood ( 1997 ) stated in their review study that older people tend to be more satisfied with health care than younger people are. Similarly, according to Shinde and Kapurkar ( 2014 ) older respondents were more satisfied, probably because they were more social and accepting than younger or they had more respect and care for providers. On the contrary, we found that patients aged 56 years or older were less satisfied than other age groups. This can be related to the fact that the nurses did not pay more attention to elderly patients. Another possible reasons can be that levels of satisfaction could differ according to cultural values or the patients did not held positive attitudes towards events, based on age‐related increases in tolerance and maturity levels.

Similarly, in our study, Sitzia and Wood ( 1997 ) found that patient gender did not affect satisfaction values and a conclusion reached also in the reports that significantly more men than women. In other studies (Alsaqri, 2016 ; Arslan & Kelleci, 2011 ), no relationships were found between gender and patient satisfaction levels. However, while some of these studies (Akın & Erdoğan, 2007 ; Alhusban & Abualrub, 2009 ) reported that women’s levels of satisfaction with care were higher relative to those observed in men, others (Koç et al., 2011 ; Milutinovic et al., 2012 ; Shinde & Kapurkar, 2014 ) showed higher satisfaction levels in men relative to those observed in women. In addition, in a study conducted by Dzomeku et al. ( 2013 ), 38% and 30% of hospitalized men and women, respectively, were completely satisfied with their nursing care. While the reason for these differences can involve cultural characteristics, they can also occur because, relative to men, women pay more attention to hygiene and care and are more anxious.

In this study, college or university graduates were more satisfied relative to those who were literate patients. However, in some other studies (Dzomeku et al., 2013 ; Geçkil et al., 2008 ; Milutinovic et al., 2012 ; Özsoy et al., 2007 ), literate individuals and primary school graduates reported greater satisfaction with nursing services relative to that reported by college or university graduates. In addition, Sitzia and Wood ( 1997 ) indicated that greater satisfaction was associated with lower levels of education. Patients with lower levels of education being most satisfied, similarly, showed that higher educational attainment was strongly associated with dissatisfaction. Some studies (Akın & Erdoğan, 2007 ; Shinde & Kapurkar, 2014 ) revealed that the level of education was not associated with patient satisfaction. These study findings indicated that patients expect more from nursing and care as their education levels increase. This can occur because patients with high educational levels possess more information about treatment alternatives and expect higher care standards and therefore are more critical in this regard.

Patients with high incomes tend to anticipate an improvement in their symptoms and expect to receive care from highly qualified staff and they become dissatisfied if they receive care that does not meet their expectations. Patients with low incomes had low health, get lower health care, had less continuous relation with doctors and have difficulties in getting appointments (Shinde & Kapurkar, 2014 ). Some studies (Akhtari‐Zavare et al., 2010 ; Arslan & Kelleci, 2011 ; Özsoy et al., 2007 ) reported that satisfaction with nursing care did not differ significantly according to income. In our study, patients with high incomes were more satisfied relative to those with moderate incomes. We can say that these patients received care in the direction of their expectations.

4.3. Discussion of finding about to the PSNCQQ scores according to patients’ medical histories

Patients who were hospitalized in surgery and obstetrics and gynaecology units were more satisfied relative to those hospitalized in the internal medicine unit. Shinde and Kapurkar ( 2014 ) found that the gynaecological ward had a significantly higher percentage of patients’ satisfaction with nursing care than the surgical wards. In a study conducted by Alhusban and Abualrub ( 2009 ), the patients hospitalized in an obstetrics and gynaecology unit reported higher satisfaction levels relative to those hospitalized in internal medicine and surgical units, while in a study conducted by Geçkil et al. ( 2008 ), patients hospitalized in surgical units reported higher satisfaction levels relative to those hospitalized in obstetrics and internal medicine units. In the other studies (Akın & Erdoğan, 2007 ; Koç et al., 2011 ; Tang et al., 2013 ), satisfaction scores for patients treated in internal medicine units were higher relative to those treated in surgery units. The difference in dissatisfaction between the types of units occurred because of problems experienced during surgical procedures in conjunction with medical diagnoses and socio‐demographic characteristics. All of these differences can be the levels of physical and psychological dependency on the hospital.

The results of the present study revealed that the patients who hospitalized once or at least five times in the preceding 2 years were more satisfied relative to those hospitalized twice in the preceding 2 years. Alsaqri ( 2016 ) showed that there was a statistically significant difference between previous admissions and patient satisfaction levels. The same study demonstrated patients with a history of admission to hospital during the last 2 years found nurses more caring. It seems that more lengths of stay in hospital increase patients’ opportunities for receiving more nurses’ care and observing their caring behaviours. Similarly, in these studies (Koç et al., 2011 ; Milutinovic et al., 2012 ) satisfaction levels reported by patients who had been hospitalized previously were higher relative to those who had not. In contrast, in a study conducted by Arslan and Kelleci ( 2011 ) satisfaction levels reported by patients with previous hospital experience were lower relative to those without previous hospital experience. The result of another study (Akın & Erdoğan, 2007 ) found no statistical relationship between satisfaction with nursing care and the numbers of hospitalization. According to these results, we can say that patients’ expectations can vary according to previous experience in similar situations and as the number of admissions increase, they can compare their care with that received previously. Also, the positivity or negativity of patients’ previous experience can be reflected in their approach to current care.

A study (Alsaqri, 2016 ) indicated that people who perceived themselves as being healthy were more likely to be satisfied with access to care. According to Alsaqri ( 2016 ), patients who perceived themselves to be in excellent or good health are more likely to be satisfied with their health care. Also, it is indicated in the same study that, a person’s health prior to arrival at hospital, whether through accident, a chronic condition or a voluntary procedure may affect the patients’ expectations about the care. In addition, Laschinger et al. ( 2005 ) reported that patients with good health status postdischarge report greater satisfaction than those with poor health status. Similarly, in our study, patients with very poor, poor, fair or good health were less satisfied relative to those of patients with excellent health. This may be due to the fact that healthier people do not need as much medical care and they interact with healthcare providers less frequently. They have less opportunity to experience problems with access to health care and therefore may express more satisfaction with access.

4.4. Study limitations

The sample was restricted to patients from the general surgery, obstetrics and internal medical units. In addition, the study was conducted in a single private hospital in Turkey. Therefore, the results cannot be generalized to all hospitals. Future studies should include more than one hospital in both the private and public sectors and the nursing care provided in private and public hospitals should be compared.

Test–retest reliability analysis should have been performed to strengthen the results of the study. Therefore, patients should be surveyed for a second time in 2 weeks of discharge and the results should be tracked and addressed in future studies. Although methodological problems, such as poor return rates and an inability to collect tracking data for all participants occurred in the study, the results could be considered useful because of the stability criterion for patient satisfaction surveys.

5. CONCLUSION

The results revealed that nurses should inform patients about each application and procedure and provide necessary explanations about illness, diagnosis and treatment to ensure patient satisfaction and the provision of high‐quality nursing care. The results also showed that nurses should provide care in a framework of respect, favour and courtesy towards patients by emphasizing the importance of communication. Besides these, the patients were highly satisfied with overall quality of hospital care, nursing care and reported that they would recommend this hospital to their families and friends.

Nurse managers could contribute to the quality service provision by evaluating the patient satisfaction with nursing care for the development and improvement of nursing care based on patients’ expectations. Data obtained from this evaluation should be considered in determining training requirements for nurses and in‐service training programs should be organized to develop nurses’ knowledge and skills in care planning. The PSNCQQ is considered useful for nurse administrators in improving nursing care. The scale could allow managers to determine the attitudes of individuals with whom they work and those whom they manage and exert some degree of control over employees’ behaviour.

CONFLICT OF INTEREST

The authors declare that there was no conflict of interests.

AUTHOR CONTRIBUTIONS

AK, ZD: Study design. AK, ZD: Data collection and analysis. AK, ZD: Manuscript preparation.

ACKNOWLEDGEMENTS

The authors thank the patients who participated into the study.

Karaca A, Durna Z. Patient satisfaction with the quality of nursing care . Nursing Open . 2019; 6 :535–545. 10.1002/nop2.237 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

† Correction added on 22 January 2019, after first online publication: a typographical error in the article title has been corrected.

This article was originally written as a doctoral thesis at Istanbul Bilim University Institute of Health Sciences Nursing PhD Program

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• Milutinovic, D. , Simin, D. , Brkic, N. , & Brkic, S. (2012). The patient satisfaction with nursing care quality: The psychometric study of the Serbian version of PSNCQ questionnaire . Scandinavian Journal of Caring Sciences , 26 , 598–606. org/10.1111/j.1471-6712.2012.00969.x [ PubMed ] [ Google Scholar ]
• Mohanan, K. , Kaur, S. , Das, K. , & Bhalla, A. (2010). Patient satisfaction regarding nursing care at emergency outpatient department in a tertiary care hospital . Journal of Mental Health & Human Behavior , 15 ( 1 ), 54–58. [ Google Scholar ]
• Negarandeh, R. , Bahabadi, A. H. , & Mamaghani, J. A. (2014). Impact of regular nursing rounds on patient satisfaction with nursing care . Asian Nursing Research , 8 , 282–285. 10.1016/j.anr.2014.10.005 [ PubMed ] [ CrossRef ] [ Google Scholar ]
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Each student must write a dissertation that presents the results of a research project carried out by the student.

An appropriate research project involves a substantive piece of original and independent research grounded in an appropriate body of literature. It is relevant to an identifiable field as it is currently practiced. It presents a hypothesis tested by data and analysis and provides a significant contribution or advancement in that field. It is the responsibility of the student's doctoral committee to evaluate the dissertation in these terms and to recommend the awarding of the doctoral degree only if the dissertation is judged to demonstrate these qualities.

Characteristics that a dissertation should demonstrate are:

• Establishment of an historical context for the presentation of an innovative and creative approach to the problem analysis and solution
• Clear understanding of the problem area as revealed by analysis and synthesis of a broad literature base
• Well-defined research design
• Clarity in composition and careful documentation
• Results of sufficient merit to be published in refereed journals or to form the basis of a book or monograph
• Sufficient detail so that other scholars can build on it in subsequent work
• Preparation of the author to assume a position within the academic nursing profession

The date and title of the defense must be submitted to the PhD Program Director one month prior to the final defense so that this event can be announced to the University community; see Policy 227 for more information.

Dissertation Committee

The student selects a qualified nursing faculty member with expertise in the area of research focus to guide the research and chair the dissertation committee.

In consultation with the committee chair, the student selects a minimum of three faculty members in addition to the committee chair to serve as dissertation committee members.

• The majority of the committee, including the major advisor, must be full or adjunct members of the Graduate Faculty of the University of Pittsburgh.
• Three committee members, including the chair, must have a faculty appointment in the School of Nursing.
• One member must be from a school or department outside of the School of Nursing.

The dissertation committee must be approved by the PhD Program Director and the Dean

This dissertation committee has the responsibility to advise the student during the progress of the candidate's research and has the authority to require high-quality research and/or the rewriting of any portion or all of the dissertation. It conducts the final oral examination and determines whether the dissertation meets acceptable standards; see Policy 227 for more information.

Meetings of the doctoral candidate and his/her dissertation committee must occur at least annually from the time the student gains admission to doctoral candidacy. During these meetings, the committee should assess the student's progress toward the degree and discuss objectives for the following year and a timetable for completing degree requirements.

Membership of the doctoral committee may be changed whenever it is appropriate or necessary, subject to the approval of the PhD Program Director and the Dean.

Dissertation Topic Approval

The dissertation focus must be approved by the student's dissertation committee and reported to the PhD Council by the student's dissertation chair before the student can proceed with the selected research. This Dissertation Committee's approval will be based on the appropriateness of the abstract of the planned study to the science of nursing and the match between the School of Nursing faculty and the student's research topic.

See Policy 227 for more information.

Home > FACULTIES > Nursing > NURSING-ETD

Nursing Theses and Dissertations

This collection contains theses and dissertations from the Department of Nursing, collected from the Scholarship@Western Electronic Thesis and Dissertation Repository

Theses/Dissertations from 2024 2024

Sex Differences in Coping Strategies, Infertility-Related Stress, and Predictors of Infertility-Related Stress among Saudi Men and Women Attending Infertility Clinics , Hayat Abdullah Algamadi

Exploring Parental Vaccine Decision Making: A Mixed Methods Study , Sarah A. Ashfield

The Experience of Postpartum Care Practices among Parent and Healthcare Providers in Canada: A Qualitative Evidence Synthesis , Andrea Atkinson

Exploring Student Experiences of Interprofessional Simulation Education , Jonathan Barrios

Theses/Dissertations from 2023 2023

Nurse-Hero Discussion on Twitter: A Social Network Analysis and Qualitative Content Analysis , Amna Ali

The impact of Authentic Leadership, Structural Empowerment, Psychological Empowerment, Interpersonal Conflict, and Job Satisfaction on Turnover Intention among Early Career Nurses in Saudi Arabia. , Ohood Ali Alkaabi miss

The Process of Art Creation Among Mothers from Ontario Who Have Experienced Gender-Based Violence , Madison L. Broadbent

Exploring How Mothers With A History Of Intimate Partner Violence Experienced The COVID-19 Pandemic , Emma Jane Butler

Nurse-Assisted Injection: Perceptions of Dependent Injectors in Ontario, Canada , Emelia C. Cormack

Exploring the Role of the Nurse in Supporting Breastfeeding among Indigenous Women in Canada: A Scoping Review of the Literature , Lindsey Corrigan

The Experiences of Clinical Placement Belonging Among Nursing Students with Racially and Ethnically Minoritized Identities: An Interpretive Descriptive Study , Connor J. Gould

Nurses’ and Midwives’ Lived Experiences as Mentees in a Clinical Mentorship Program in Rwanda: An Interpretive Phenomenological Study , Yvonne Kasine 2399948

Uncovering the Experience of Determining Readiness to Increase Self-Management Responsibility in Canadian Adolescents Living with Type 1 Diabetes , Kelly A. Kennedy

Exploring Clinical Reasoning in Nursing Through A Serious Gaming-Enabled Digital Simulation , Stephanie Kennedy Miss

The Development, Refinement, Implementation, and Impact of a Nurse-Led Health Coaching Self-Care Management Intervention for Heart Failure , Maureen Leyser

Relational Variables Impacting the Healthcare Team , Linda J. MacDougall Ms

Exploring Family Members’ Beliefs and Experiences of Supporting Relatives with Substance Use and Misuse within Black Communities , Esther N. Monari

An Exploration of the Culturally-Rooted Meaning and Consequences of Unintended Adolescent Pregnancy in Rwanda: A Multi-Dimensional Perspective , Jean Pierre Ndayisenga

Exploring how the Perinatal Services of Primary Health Care Settings in Rwanda Support Adolescent Mothers to Inform the Delivery of Trauma- and Violence-Informed Care: An Interpretive Description , Aimable NKURUNZIZA

Bridging the Gap: Canadian Health Care Providers Perspectives' of Harm Reduction and Substance Use Education in Hospital , Leanne Scott

Intimate Partner Violence, Social Support, Mastery, and Mental Health , Alice Pearl Sedziafa

A Picture of Spirituality in Youth Living with Bipolar Disorder , Michelle S. Solomon

Decentering Whiteness in Nursing Education: The Pitfalls, Tensions, and Opportunities , Ivy Tran

Theses/Dissertations from 2022 2022

Exploring Health Inequities: Head Injuries in People Experiencing Homelessness , Emily M. Angus

Women’s Priorities and Actions Mothering in the Context of Intimate Partner Violence , Sharon Broughton

Toward Understanding Culturally Safe Health Care for Transgender People: A Scoping Review of Health Care Provider Knowledge , Terrie Butler-Foster

Forming Authentic and Purposeful Relationships with Racialized Communities from an Anti-Oppressive Lens: A Framework for African, Caribbean, and Black Communities , Jaimeson R. Canie

Clinical Virtual Simulation: A Qualitative Usability Study , Samantha Beatrice Cooke

Predictors and Outcomes of Patient Stigma Perception Appraisal: Developing and Testing of a Dynamic Stigma Model of Mental Illness , Sebastian Kwadwo Gyamfi

Women’s Experiences of Accessing Breastfeeding and Perinatal Health Support in the Context of Intimate Partner Violence: An Interpretive Description Study , Samantha Larose

"Pain is What the Patient Says it is": A Secondary Analysis of Nurses’ Reflections on the Term Pain Catastrophizing , Riana Longo

An Exploration of Non-Urgent Emergency Department Use from the Patient and Health Care Professional Perspective , Amanda McIntyre

Self-management Experience of Nurses Living with Migraine: A Qualitative Study , Marionette Ngole Dione

Host Organizations' Perspectives of Partnered Global Study-Abroad Programs , Jessica C. Pop

The Effect of Interprofessional Conflict Resolution on Interprofessional Collaborative Practice among Health Care Provider Teams in Hospitals , Sibylle Ugirase

Teaching Family Planning in Nursing and Midwifery Schools: A Constructivist Grounded Theory Study , Pauline Uwajeneza

Theses/Dissertations from 2021 2021

Syrian Refugee Women's Experiences with the Ontario Health Care System: A Critical Ethnography Study , Areej Al-Hamad

The Influence of Authentic Leadership on Nurses’ Turnover Intentions and Satisfaction with Quality of Care in Saudi Arabia: A Cross-Sectional Study , Bayan Alilyyani

Understanding the Current State of Health Information Exchange in Long-Term Care Homes , Kendra R. Cotton

Relationships among Interactional and Organizational Factors with Healthcare Provider Outcomes Post-Implementation of an Interprofessional Model of Patient Care , Wendy L. Ellis

Chronic Disease Management in a Nurse Practitioner Led Clinic: An Interpretive Description Study , Natalie Floriancic

Understanding the Lived Experience of Health Through the Exploration of Well-being of Women with Multiple Sclerosis in Southwestern Ontario , Jennifer Howard

"Healthcare Heroes" - The Change in Perceptions of Nurses' Roles During the COVID-19 Pandemic: A Critical Discourse Analysis , Stephanie Jones

The Discursive Construction of Substance Use and Harm Reduction in Canadian Health Policy , Sibel Kusdemir

Nurses' and Nurse Educators' Experiences of a Pediatric Nursing Continuing Professional Development program in Rwanda , Amy K. Olson

Health Providers Perspectives on the Access and Use of Formal Health and Social Services by Stroke Caregivers , Hannah Pollock

The Effect of Authentic Leadership and New Graduate Support on New Graduate Nurses' Job Satisfaction , Stephanie H. Prtenjaca

Reddit and Nursing During Covid-19: A Summative Content Analysis , Julia C. Savin

Being a Child Bride in Nigeria: A Feminist Narrative Inquiry , Olubukola Foluke Sonibare

New Graduate Nurses’ Experiences of Engaging in a Leadership Role in Hospital Settings During the COVID-19 Pandemic , Justine Jeanelle Ting

Theses/Dissertations from 2020 2020

Interprofessional Role Clarification Among Licensed Health Care Practitioners in Rural and Smaller Community Hospitals , Dianne E. Allen

Exploring Nursing Student Use of Instagram: Selfies and Soliloquies and #becominganurse with Evolving Digital Footprints , Kingsley KS Au

The Association Between Intimate Partner Violence and Functional Gastrointestinal Disorders and Symptoms Among Adult Women: Systematic Review , Ohud Shawqi Banjar

Exploring the Relationships Among New Graduate Nurses’ Structural Empowerment, Psychological Empowerment, Work Engagement, and Clinical Nurse Educator Leadership in Acute Care Settings , Carly Blair

Caring Revisited: A Foucauldian Discourse Analysis on the Association of Caring with the Profession of Nursing , Margot Boulton

Optimization of Simulated Electronic Medication Administration for Safe Management During Nursing Education , Laura Brennan

Leader Empowering Behaviour as a Predictor of Nurse and Patient Outcomes , Karen Cziraki

The Effect of Authentic Leadership on New Graduate Nurses’ Organizational Identification, Trust in the Manager, Patient Safety Climate, and Willingness to Report Errors , Fatmah Fallatah

Unit Managers’ Authentic Leadership, Staff Nurses’ Work Attitudes and Behaviours, and Outcomes of Care: A Structural Equation Model , Lisa M. Giallonardo

Developing and Evaluating the Integrated Addiction Recovery Model for the Persons' Engagement and Retention in the Recovery Process Among Clinical Populations from Rwanda , Boniface Harerimana

Developing Competencies for Public Policy Advocacy: A Comparative Case Analysis , Amy L. Lewis

Prematurity, Socioeconomic Status, And Childhood Asthma: A Canadian Cohort Study , Crystal P. McLeod

Patient Roles within Interprofessional Collaborative Patient-Centred Care Teams: The Patient and Health Care Provider Perspectives , Kateryna Metersky

Nurses' and Midwives' Experiences as Mentors in a Clinical Mentorship Program in Rwanda , Marie Chantal Murekatete

Examining the Impact of Social Media on Youth Self-Perceived Mental Health , Chantal Singh

Exploring Mental Health, Physical Health, and Affective Commitment in Acute Care Oncology Nurses in Ontario , Lesley M. Smith

Women’s Experience of Obtaining Health and Social Services following Intimate Partner Violence: Lesbian, Gay, Bisexual, Transgender, and Queer Relationships in Rural Communities , Emily E. Soares

Values, Assumptions, Behaviours, and Practices Influencing the Professional Development of Nursing Students Within Acute Care Practice Environments in Rwanda: A Focused Ethnographic Study , Benoite Umubyeyi

A study of job satisfaction and turnover intention among acute care nurses working in rural and urban settings , Yasin Yasin

Theses/Dissertations from 2019 2019

Understanding the Lived Experiences of Saudi Students Enrolled in Canadian Graduate Nursing Programs , Aisha Namshan Aldawsari

Pathways to Homelessness: Exploring the Mental Health Experiences of Refugees Experiencing Homelessness in Canada , Bridget Annor

Breastfeeding Experiences of African Migrant Women in Developed Countries: A Qualitative Systematic Review. , Odinaka Ogoegbunam Anunike

Sociocultural Factors Affecting Mental Health Service Utilization by African Newcomer Women Following Childbirth in Canada , Deborah Baiden

Registered Nurses’ Perceptions of the Electronic Canadian Triage and Acuity Scale in a Community Hospital , Andrea de Jong

New Graduate Nurses: Relationships among Sex, Empowerment, Workplace Bullying, and Job Turnover Intention , Aaron L. Favaro

Women’s Experiences Receiving Humanitarian Aid , Aden M. Hamza

Registered Nurses' Intention To Use Electronic Documentation Systems: A Mixed Methods Study , Sarah Ibrahim

Exploring the Mental Health Care Experiences of Youth Transitioning from Paediatric to Adult Psychiatric Services Using the Photovoice Method: A Participatory Analysis of the PhotoSTREAM Project , Brianna Jackson

An exploration of how persons requiring hemodialysis treatment explain the ways in which access to transportation for such treatment influences their overall health. , Navpreet Kamboj

Exploring the Characteristics and Behaviours of Nurses Who Have Attained Microcelebrity Status on Instagram , Hanna Kerr

Collaborative Self-Management and Chronic Obstructive Pulmonary Disease: Integrating Patient Needs into an Educational Program for Nurses , Loretta G. McCormick RN (EC)

Assessing the Impact of Mentorship on Rwandan Nurses’ and Midwives’ Knowledge and Self-Efficacy in Managing Postpartum Hemorrhage , Marie Grace Sandra Musabwasoni

Nurse and Midwife Educators' Experiences of Translating Teaching Methodology Knowledge into Practice in Rwanda , Jean Pierre Ndayisenga

Exploration of Knowledge and Skills Development among Community Health Workers in Rwanda , Schadrack Ngabonziza

Assessing Changes in Knowledge about and Self-efficacy for Neonatal Resuscitation Among Rwandan Nurses and Midwives after a Mentorship Process , Gerard Nyiringango

Theses/Dissertations from 2018 2018

Lived Experience of Gestational Diabetes Mellitus among Saudi Women: Interpretive Phenomenological Study , Hayat Abdullah Algamadi

Relationships Among Authentic Leadership, Manager Incivility and Trust in the Manager , Ohood Ali Alkaabi

Gender and Experiences of Family Homelessness , Fawziah Almalki

The Influence of Authentic Leadership on Fourth-Year Nursing Students' Experience of Workplace Bullying and Withdrawal Intentions , Lindsay Anderson

Exploring Social Cohesion Among Syrian Refugees in Canada: A Secondary Analysis , Sara Calvert

An Exploration of Medication Errors Generated by Baccalaureate Nursing Students Using Electronic Medication Administration Record (eMAR) Technology in Clinical Simulation , Ryan Chan

An Exploration of the Nursing Leaders’ Experiences Addressing Indigenous Health in University Undergraduate Nursing Programs in Ontario , Danae Coggins

It's About Time! GDM: A Transformative Postpartum Process. A Constructivist Grounded Theory Study , Natalie Giannotti

Women's Quality of Life After Leaving an Abusive Relationship: The Effects of Past and Ongoing Intimate Partner Violence, Mastery and Social Support , Diana Jaradat

Exploring unmet healthcare needs, healthcare access, and the use of complementary and alternative medicine by chronic pain sufferers- An analysis of the National Population Health Survey , Jessica LaChance

Exploring Harm Reduction Among Canadian Veterans Experiencing Homelessness , Olivia Marsella

Explaining Collaboration in Nursing Education Programs , Jason Powell

Social inclusion for women experiencing homelessness , Jenna Richards

Examining the Relationships among Authentic Leadership, Interprofessional Collaboration, and Nurse Assessed Adverse Events: A Mediation Model , Vanessa Safian

The Effects of Authentic Leadership and Organizational Commitment on Job Turnover Intentions of Experienced Nurses , Alexis E. Smith

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©1878 - 2016 Western University

Nursing, Midwifery and Health Systems Theses

Permanent uri for this collection.

This collection is made up of doctoral and master theses by research, which have been received in accordance with university regulations.

For more information, please visit the UCD Library Theses Information guide .

Recent Submissions

• Publication The Discursive Positioning of the Advanced Nurse Practitioner in the Irish Healthcare System ( University College Dublin. School of Nursing, Midwifery and Health Systems, 2022 ) Thompson, Wayne   ; 0000-0002-2734-436X Background: The Irish health service, in common with health services across the world, faces the challenge of operating within economic constraints while responding to changing demographics that increase demand for health and social care services. Within this dynamic environment, nurses, especially Advanced Nurse Practitioners (ANP), are experiencing new challenges. Whilst nursing and medicine have established systems of disciplinary practices that produce nurses and doctors within historically-contingent role boundaries, these boundaries are becoming more fluid and porous. ANPs constantly negotiate these boundaries, offering the possibility of a new and potentially more liberating identity for them within the healthcare system. Uncertainty about the ANP identity results in the full potential of the ANP role not being realised and, consequently, ANPs are underutilised. This study aims to understand how ANPs are positioned within current nursing and health systems by making explicit the discourses that construct the ANP role and how they both enable and constrain it. Methods: The study is based on a critical discourse analysis (CDA) of healthcare professionals’ language-in-use. To gain an analytic purchase on participants’ language-in-use, James Paul Gee’s Tools of Inquiry and Building Task Frameworks were employed. In addition, Barry Oshry’s Organic Systems Framework (OSF) was applied to deepen the analysis and to help identify how the patterns of relationships and processes inherent in human systems manifest in language. Data were elicited from a literature review and document analysis as well as seven in-depth interviews and four focus groups involving twenty-nine participants including twelve ANPs, two staff nurses, eight nurse managers, one director of nursing and one nursing project officer, three medical doctors and two allied healthcare professionals. Findings: Language-in-use established that ANPs add value to the healthcare system from both a monetary and non-monetary perspective and highlighted the centrality of nursing to the ANP role. Language-in-use constructs an identity for ANPs as a medical substitute, an inferior role, yet an innovative addition to the system and a threat to existing structures. Language-in-use constructs tensions between independence and autonomy, on the one hand, and collaboration and control, on the other. Findings show that when hierarchical structures and professional self-interest dominate, systemic processes and relationships are impacted, resulting in a healthcare system that is out of balance. Whilst nursing research and professional scholarship are seen as central to the ANP role, discourses related to these elements were not prevalent in this study. Instead, ANPs are busied by the demands of the clinical aspect of the role, and the ANP role itself is based around the performance of tasks that are mastered by experience rather than erudition. Conclusions: This study alerts healthcare professionals to the ways in which discourses influence opinion and frame the ANP role. To meet the demands of an ever-changing, dynamic healthcare system, it is vital that ANPs are supported and allowed to ‘advance’. When Conversations and Discourses disparage the ANP role, they should be challenged. We need to move away from positioning ANPs as a marginal and contested presence in the health system and instead see their role as making an important and necessary contribution to it. ANPs need to clearly articulate their role, the value that it adds to the healthcare system and demonstrate how it aligns with and complements other healthcare professionals’ roles. ANPs need to become more visible and vocal, and more engaged in policy formulation. They should recognise and harness the tremendous strength and rich diversity that they collectively represent. This is key to maximising the ANPs potential and strengthening their distinctive contribution to the healthcare system.   312
• Publication A Participatory Action Research Study to inform the Development and Implementation of Combined Type 2 Diabetes and Chronic Kidney Disease Care Provided in the Context of Advanced Practice Nursing ( University College Dublin. School of Nursing, Midwifery and Health Systems, 2020 ) Blanchfield, Denise   ; 0000-0002-8726-7538 The rise in the incidence of type 2 diabetes with chronic kidney disease across the age spectrum has been highlighted as a major public health concern and is correlated with increased economic burden, patient suffering and mortality. Preventative care and early chronic kidney disease management strategies informed by best practice recommendations are associated with improved clinical outcomes, patient survival and reduced economic burden. However, opportunities to implement preventative and early management strategies are missed when the care for type 2 diabetes and chronic kidney disease are provided separately. Patients report an uncoordinated impersonal approach when type 2 diabetes and chronic kidney disease care is provided separately. Furthermore, facilitating a combined care strategy enhances care coordination, communication and quality. As current healthcare delivery strategies are failing to implement best practice early management strategies or achieve best practice targets, an alternative approach is required to meet the needs of care providers and patients. One such strategy was the development and implementation of combined type 2 diabetes and chronic kidney disease care, informed by best practice early management recommendations provided in the context of advanced practice nursing. Contemporary literary discourse indicates care provided in the context of advanced practice nursing is safe and effective, albeit there is no national and limited international evidence pertaining to the direct care contribution for patients with type 2 diabetes and chronic kidney disease. The main aim of this national and international unique study was to utilise co-created knowledge between health care professionals and patients to inform development and implementation of combined care provided in the context of advanced practice nursing. The outcomes of this study will inform development and implementation of future services for patients with type 2 diabetes and chronic kidney disease led by advanced nurse practitioners. A Participatory Action Research approach was utilised, as this nonlinear iterative process facilitates flexibility and responsiveness to challenges presented within the current healthcare environment.   417
• Publication Evaluating the impact of context within implementation research ( University College Dublin. School of Nursing, Midwifery and Health Systems, 2021 ) Rogers, Lisa   ; 0000-0001-8286-2082 The uptake of evidence-based healthcare interventions is challenging with, on average, a 17-year time gap between the generation of evidence and the implementation of change in routine practice. One of the key challenges to successful implementation requiring consideration is context. However, despite its noted importance, context remains a poorly understood construct, with a lack of consensus regarding how it should be accounted for within research. Subsequently, this research addressed this gap by exploring the following research questions: How does context influence the implementation of a collective leadership team intervention? Does context contribute to variances in implementation success across settings? If so, how? A systematic review was conducted which highlighted that inconsistencies exist when defining, assessing, and analysing context. These findings supported the development of an operational definition of context and the creation of a practical approach for measuring the construct. Using a multiple case study design and a triangulation of qualitative research methods (involving observation and interview data), this practical method was applied to evaluate how context influences implementation within two multidisciplinary healthcare teams. Two overarching themes were generated from the data. The first revealed the bidirectional influence of context and implementation, highlighting how these concepts dynamically interact, respond, and mutually evolve. The second theme addressed the micropolitical concepts of power, authority, and influence as essential contextual determinants impacting implementation. This thesis contributes to the implementation science literature by 1) developing an operational definition of context to improve the coherency and consistency with which the term is used; 2) advancing a practical method that captures the dynamism of the concept and creates actionable, detailed findings; and 3) exposing the impact of team-level contextual factors on implementation success. This valuable knowledge will help researchers negotiate the everyday realities of healthcare, supporting the successful implementation of change in routine practice.   241

• Open access
• Published: 27 May 2022

Patients' perceptions of the quality of nursing services

• Ali Reza Yusefi 1 ,
• Shakiba Rohani Sarvestani 2 ,
• Zahra Kavosi 3 ,
• Jamshid Bahmaei 4 ,
• Morteza Mortazavi Mehrizi 5 &
• Gholamhossein Mehralian 6 , 7  

BMC Nursing volume  21 , Article number:  131 ( 2022 ) Cite this article

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Introduction

The quality of nursing services is one of the main factors accelerating patients' recovery. The present study aimed to examine patients' perceptions of the quality of nursing services in the teaching hospitals of Iran.

This cross-sectional research was a descriptive-analytical study conducted in 2021, in which 1067 patients were selected as the research sample. The Qualipak nursing quality questionnaire (QUALPAC) was used to collect the required data. Data were analyzed using t-test, ANOVA, and Pearson correlation coefficient using SPSS software version 23.

From the patients' perspective, the mean and standard deviation of the quality of nursing services was 191.47 ± 19.51. Among the quality dimensions, all services quality: psychosocial (91.34 ± 9.34), physical (65.72 ± 10.18), and communication (34.41 ± 6.21) were placed at the moderate level. A significant association was found between patients’ age and nursing service quality. The perceived nursing service quality was subject to sex ( P  = 0.01, t = 1.921) and place of residence ( P  = 0.02, t = 1.873).

According to the findings, the quality of nurses 'care was "moderate" from the patients' perspectives. Planning is recommended to reinforce and promote the quality of nursing services.

Peer Review reports

Quality refers to a complicated structure of values, beliefs, and attitudes in individuals interacting in the health care system. Care is also considered an essential component of health services [ 1 ]. In other words, the quality of services is the service’s potential to satisfy the expressed needs [ 2 ] and the extent to which the service recipient’s expectations are met [ 3 ]. The quality of health services is achieving the most desirable health outcomes [ 4 ] so that the services provided are effective, efficient, and economical [ 5 ]. One of the main missions of healthcare organizations like hospitals is to provide quality services to meet patient expectations. To this end, the quality philosophy should be first institutionalized within the hospital settings, particularly in the nursing services [ 6 , 7 ]. This can reduce the length of hospitalization and enhance patients’ satisfaction [ 8 ]. In addition, service quality leads to lowering healthcare costs [ 9 ]. Hence, given that a large portion of a society usually will be eligible to receive hospital services in different life milestones, it necessitates nurses deliver high-quality services [ 10 ]. Nurses form the largest group of staff providing health services [ 11 ], and they are the main foundation of the process promoting the quality of care services. Accordingly, their performance plays a crucial role in advancing organizational goals [ 12 ]. The professional competence of this occupational group is critical in fulfilling the health system’s mission as such, the level of their professional competence and care is one of the main concerns for health systems and health care providers in different countries [ 11 ]. Since patients are most frequently in contact with nurses, some experts exclusively attribute the acceptability of the provided services to nurses, and the prominent role of other treatment groups is often overlooked [ 13 ].

All patients have the right to receive high-quality services, and all caring nurses are in charge of facilitating this goal. In most countries, hospitals’ accreditation and rating are affected by nursing care and its quality [ 14 ]. Moreover, nurses must be legally and ethically accountable for the quality of the offered care [ 15 ]. The quality of nursing care is the nurse's response to patients’ physical, psychological, emotional, social, and spiritual needs so that they can return to their healthy and normal lives while patients and nurses’ have also been satisfied [ 16 ]. From another perspective, nursing care is of great importance in health care systems [ 17 ], and care is a basic and pivotal reality in nursing [ 18 ]. Schroyer et al. highlighted the necessity of quality measurement in a competitive healthcare environment [ 19 ]. On the other hand, due to the increase in health care costs, the persistent improvement of the quality of nursing services is necessary, and quality control of nursing services is also a must to promote patient satisfaction [ 20 ]. Nantsupawat et al. showed that from the patients' point of view, quality nursing care facilitates access to physical, psychological, and social care [ 21 ]. It is well addressed that nursing services can decrease patients’ recovery time and help them go back home [ 13 ]. In contrast, low-quality services cause patients to experience severe symptoms, hospital infections, and psychological dysfunction such as anxiety and depression [ 22 ].

Given that nurses provide the largest proportion of treatment care services to patients, they play a significant role in improving the quality of services [ 23 ]. Patients have the right to receive acceptable and high-quality nursing care [ 24 ]. In today’s health systems, the quality of nursing services is exposed to many challenges. Furthermore, some recent studies on nursing have indicated that the quality of nurses' care is relatively low [ 25 , 26 ]. The results of a study in 2012 in 12 European countries and the United States revealed the low quality of nursing care in countries such as Ireland and Greece [ 26 ].

However, most patients and clients demand high-quality services due to their increased awareness in the field of health and also the increased costs of health services [ 27 ].

According to some experts, promoting the quality of services enhances productivity, reduces costs, and thus increases patient satisfaction [ 28 ]. Evidence suggests that understanding the different perspectives of stakeholders, including patients, caregivers, cost payers, and the general public, on care delivery is of paramount importance to design appropriate programs to improve service quality [ 29 ]. On the other hand, evaluating the quality of nursing care make improvements in the way services are provided so that services are offered in accordance with standard health patterns [ 30 ]. Relevant studies show that the assessment of the care quality leads to fostering practical skills and promoting competencies, detecting shortcomings, providing more accurate services, eliminating problems and dissatisfaction in departments, thereby ultimately motivating the provision of higher quality care and meeting patients’ needs [ 31 ]. Previous studies suggest that continuous and periodic review of the quality of nursing care from different perspectives can facilitate the detection of strengths and weaknesses and contribute to developing optimal programs to improve the quality of services. Neishabory et al. found out that the quality of nursing care was acceptable from the perspective of 92.6% of nurses regarding the psychosocial dimension and 56.8% of nurses regarding the communication dimension. Moreover, the quality of nursing care was acceptable from the perspective of 31.6% of patients regarding the psychosocial dimension and 24.7% of patients regarding communication [ 32 ]. In their study, Shannon et al. revealed that the average quality of care was 81.69% for patients, 73.86% for nurses, and 83.55% for physicians [ 33 ].

Given that nursing care is one of the most fundamental issues in nursing and results in improving the level of services offered to the community and the more immediate recovery of patients, the present study aimed to assess the quality of nursing care from the perspective of patients in teaching hospitals affiliated with the Shiraz University of Medical Sciences in 2021. Compared to previous research, this study was performed at several centers with a relatively large sample. In addition, we assessed a wide range of patients' views who have been admitted to different wards, leading to a better understanding of the nursing service quality.

Design and setting

This is a descriptive, cross-sectional study conducted in 14 hospital settings where 3043 nurses are working.

Participants

The study population encompassed patients admitted to these hospitals. Using the Cochran formula and the confidence level as 95%, d (3%), and P 50%, a sample of 1067 was estimated.

These numbers were selected using the stratified sampling method from each hospital. In each hospital, patients were randomly selected using the aforementioned method proportionate to the size of each ward. Inclusion criteria were willingness to participate in the study, being aged above 18 years, staying in one of the hospitals for at least 48 h, and not suffering from a mental disorder as confirmed by the treating physician. Exclusion criteria were inability to respond, lack of awareness, and unwillingness to participate in the study.

Instruments

Patient Demographic Information Questionnaire and QUALPAC (Quality Patient Care Scale [ 34 ] were used as data collection tools. QUALPAC contains 72 items examining the quality of nursing services in psychosocial (33 items), physical dimension (26 items), and communication dimension (13 items) dimensions. Each item was scored using a Likert scale with the following options: very low (score 1), low (score 2), medium (score 3), high (score 4), very high (score 5). Regarding the score ranges, the scores of the psychosocial dimension were classified as low (33–77), moderate (78–122), high (123–165). The physical dimension was scored as low (26–60), moderate (61–95), and high (96–130). The communication scores were low (13–30), moderate (31–48), and high (49–65). The total scores of QUALPAC were low (72–168), moderate (169–265), and high (266–360). Haghighi Khoshkho et al. confirmed the validity of this tool and adapted it to Iranian culture [ 35 ]. The reliability of the questionnaire is also confirmed in previous studies [ 36 , 37 ].

Procedure and statistical analysis

Regarding the research procedures, two of the researchers (SRS and MMM) referred to the concerned hospitals on different weekdays in morning, evening, and night shifts and distributed questionnaires, and collected the required information. Individuals willingly took part in the study and filled out the questionnaire. After obtaining the necessary permits from the Shiraz University of Medical Sciences and explaining the objectives of the project to the participants, the confidentiality of information was emphasized, and their verbal satisfaction was obtained. Questionnaires were then distributed among the patients. Questionnaires were completed by the patients; however, some patients asked the research team (SRS and MMM) to help them fill out the survey.

Then the questionnaires were completed independently and returned. Afterward, the collected data were imported to SPSS software version 23. We performed Pearson’s correlation to test the relationship between the nurses’ services quality and patients' age. T-test has been used to investigate the mean difference between the nurses’ services quality based on patients' sex and place of residence. To analyze if there are any differences between the nurses’ quality services and participants' profiles such as marital status, education, and income level variables, the ANOVA test has been applied.

According to the descriptive findings, most of the patients were in the age group of 20–35 years (35.80%), male (56.98%), and urban residents (55.58%), married (47.71%), with a diploma and higher education (64.94%) and an income level of 10–20 million Rials (380.735–764.47 US $) (51.45%) (Table 1 ).

As presented in Table 2 , the total quality of nursing care from the patients' perspectives was 191.47 ± 19.51, indicating a moderate quality level: psychosocial (91.34 ± 9.34), physical (65.72 ± 10.18), and communication (34.41 ± 6.21).

In Table 3 , among the domains of the psychosocial dimension from the patients' perspectives, "paying attention to patients’ request to meet a clergyman" had the lowest score (2.43 ± 0.27).

According to Table 4 , among the physical domains, from the patients' perspectives, "using aromatic substances to deodorize the environment" had the lowest score (2.39 ± 0.29).

As shown in Table 5 , among the communication domains from the patients' perspectives, "providing the patient's family with enough time to ask their questions" had the lowest score (2.48 ± 0.26).

Findings indicated a positive relationship between age nurses’ services quality ( r  = 0.536, P  = 0.03), signifying that with increasing age, patients showed better views regarding nurses’ services quality. The perceived nurses service quality was subject to sex ( P  = 0.01, t = 1.921) and place of residence ( P  = 0.02, t = 1.873). The average quality of nursing care was higher from the perspectives of female patients (193.29 ± 19.87) than male patients (189.66 ± 18.65). Moreover, patients living in rural areas (197.76 ± 20.34) had a higher average nursing care quality than urban residents (185.19 ± 16.24).

There was no statistically significant difference in the quality of nursing care according to marital status, education level, and income level (Table 6 ).

The aim of this study was to investigate patients' perceptions of the quality of nursing services in teaching hospitals settings. According to the first part of the research results, the average quality of nursing care from patients' perspectives was assessed to be moderate. In line with the findings of this study, the results of several studies indicate the average level of quality of nursing services from the perspective of patients [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. However, the findings of some studies showed that the quality of nursing services from the patients' point of view was at a desirable and acceptable level [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. The results of some other studies also indicated an inappropriate and unfavorable level of quality of nursing services [ 56 , 57 ]. The difference between the results of this study and other similar ones could be due to the research environment, society and the sample size, and differences in the socio-cultural status of the participants. In the present study, the prevalence of the Covid19 pandemic could affect the quality of nursing services and subsequently patients' perception of this quality, leading to reducing the quality of care to a moderate level. Therefore, it is necessary for senior managers of hospitals to plan and take action to improve the quality of nursing services and positive perceptions of patients towards this quality.

The average quality of nursing care in the psychosocial dimension from the patients’ perspectives was assessed to be at a moderate level. In this regard, the results of various studies indicate different levels of quality of nursing care in the psychosocial dimension. In the study of Dabirian and colleagues, most of the patients assessed the quality of nursing care in the psychosocial dimension as poor [ 38 ]. However, according to Neishabory et al., the quality of nursing care in the psychosocial dimension was not desirable for patients [ 32 ]. Haghighi Khoshkho et al. also reported the unsatisfactory quality of care for most patients in psychosocial and communication dimensions [ 35 ]. In Zamanzadeh et al.’s study regarding the patients' attitudes towards the quality of care, the highest dissatisfaction was associated with meeting patients’ social needs [ 57 ]. Also, in the study of Jamsahar et al., less than half of the patients (37.4%) reported the quality of nursing services in the desired psychosocial dimension [ 58 ]. The results of another study showed that hospitalized patients expect psychosocial interventions from health professionals to reduce mental health risks [ 59 ]. The findings of the present study and the above studies indicate that the psychosocial dimension of service quality needs more attention from nurses. Nurses have a legal and ethical responsibility and commitment to the quality of care they provide and should know that their psychosocial skills and expertise and skills in providing care affect the patient's perception of the quality of care. Since the nurse's primary task is to meet patients’ basic needs by communicating, intervening, assisting, and supporting their treatment, if nurses can communicate properly with patients, the quality of nursing care will be promoted. Moreover, if the care provided is appropriate and accurate, patients will be more satisfied [ 60 ].

Regarding another part of the findings of the present study, the average quality of nursing care in the physical dimension was evaluated by patients to be at a moderate level. In Haghighi Khoshkho et al.'s study, 42% of patients rated the quality of nursing care in the physical dimension as acceptable [ 35 ]. Hosseinzadeh et al. also revealed that nurses' caring behaviors were acceptable and that they focused more on the physical dimension of care [ 61 ]. In the study of Jamsahar et al., Only 38.8% of patients reported a good quality of nursing care in the physical dimension [ 58 ]. Gishu et al. further reported that the quality of nursing care in the physical dimension was below average [ 44 ].

Studies in developing countries have highlighted the physical dimensions of care more than the psycho-emotional dimensions [ 62 , 63 ]. It is important to note that nurses should value physical and psychosocial care equally when working with patients [ 63 , 64 ]. According to patients, a good nurse is someone who, in addition to providing acceptable care, can provide appropriate general and physical support [ 64 ]. Since behaviors in the physical dimension are more tangible and measurable than those in the psychosocial dimension, nurses may prefer to focus on the caring behaviors that are most frequently questioned [ 65 ]. Therefore, pay attention to the physical aspect of the quality of nursing care, such as observing personal hygiene by nurses, helping patients to do personal chores in case of disability, recognizing the cause of pain quickly and trying to eliminate or reduce it, using aromatic substances to deodorize the environment, etc. by nurses and nursing managers seems necessary.

Another dimension was the quality of nursing care in communication. From the patients' perspectives in this study, the quality of nursing care in communication was between moderate levels. Neishabory et al. declared that the quality of nursing care in the communication dimension was acceptable from the perspective of 24.7% of patients [ 32 ]. Haghighi Khoshkho et al. revealed that most patients reported low quality of care in the communication dimension [ 35 ]. In addition, in the study of Jamsahar et al., 41.3% of nurses reported the quality of nursing care in the communication dimension as desirable [ 58 ]. In this regard, Fallowfield and Jenkins emphasize that the effective and useful relationship of the nurse with the patient leads to a level of recovery, pain control and adherence to treatment regimens and improve the patient's mental and psychological function [ 66 ]. The Joint Accreditation Commission of Health Care Institutions also found that poor communication could affect patient's safety and satisfaction with the quality of care [ 67 ].

Since nurses’ primary task is to meet the patient's basic needs by communicating, intervening, helping, and assisting in treatment, the quality of nursing care will increase if they can communicate properly with patients, and patients will be more satisfied if the provided care is appropriate and accurate [ 32 ]. Moreover, promoting communication skills increases the quality of services in communication dimensions. In general, not understanding patients’ needs and desires by the nursing staff can be considered as the most important factor affecting nurses’ non-response. By promoting nurses' communication skills, especially the art of listening and inducing a sense of human dignity, it is possible to increase nurses' understanding of patients' needs and wants [ 56 ].

Findings confirmed a positive relationship between age and nurses services quality, indicating that with increasing the age, patients showed better view of nurses services quality. The perceived quality of nursing services was subject to patients’ sex and place of residence. In this regard, the findings of a study by Lee et al. in Canada conducted on 1866 patients showed that the age variable was significantly associated with their views on the quality of services [ 68 ]. Akin and Erdogan's study in Turkey also found that there was a statistically significant relationship between patients’ satisfaction with nursing care and patients' age and sex, so that older patients and female patients were more satisfied with the quality of nursing services. [ 69 ]. Adam et al. Also reported a statistically significant difference in the quality of nursing services based on patients' age [ 70 ].

Regarding the sex variable, in the studies of Abbasi Farajzadeh et al. [ 49 ] and EI- Nagger et al., [ 71 ] the level of satisfaction with nursing care was higher in male patients than female patients. The results of Taghavi Larijani and Najafi's research showed that patients' satisfaction with nursing services was different according to sex [ 72 ]. The difference in views between female and male patients may be due to the female-male relationship or behavioral differences between the sexes. The high average score of quality of nursing services from the perspective of women compared to men may be related to their emotional personality and maternal role. Women generally pay more attention to intangible aspects of services provided by nurses and percept the nursing services mostly from the communication and psychological aspects.

According to the findings of the present study, the study of Woldeyohanes et al. showed a significant difference in the quality of nursing services from the patients' point of view according to their location [ 73 ], so that patients living in rural areas had higher satisfaction with the quality of nursing services. It seems that one of the reasons for this result could be cultural and social differences and lower expectations of patients living in rural areas. It also seems that due to the lack of access to health services in rural areas compared to urban residents in Iran, when rural residents receive medical services from nurses, they would manifest much more positive feedback as opposed to those who receive such services frequently in rural areas. In addition, urban residents commonly benefit more from health services and are more oriented about how to receive such services, leading to becoming more sensitive to the services they receive; all would place them in a situation with high expectations toward the quality of the nursing services that they may need.

Based on the findings of this study, the quality of nursing services from the perspective of patients with primary school education and income of 10–20 million Rials (380.735–764.47 US $), as well as single patients, was better compared to their peers, but this difference was not statistically significant. Consistent with the present study, in Akin and Erdogan's study in Turkey [ 69 ] and Alhusban and Abualrub's study in Jordan [ 74 ], there was no statistically significant relationship between nursing care satisfaction and patients' education level. However, in the study of Lee et al., the satisfaction of patients with higher education was lower than that of patients with lower education [ 68 ].

Various studies have considered the level of education of patients as an influential factor on their view of the quality of nursing services [ 40 , 75 , 76 , 77 ]. Regarding the income variable, the results of studies by Abbasi Farajzadeh et al. [ 49 ] and Tavasoli et al. [ 78 ] showed that there is an inverse relationship between patients’ income level and their satisfaction with nursing care; hence, that with increasing patients' monthly income, their level of satisfaction with nursing care decreased. People with higher education and income seem to have lower satisfaction and lower quality of nursing services for reasons such as higher expectations of the health care system, more social communication, better access to information resources, and greater ability to identify system deficiencies. Contrary to the findings of this study, Garroutte and Robert in their study reported a statistically significant relationship between patients' satisfaction with the quality of nursing services based on marital status [ 79 ] that one of the reasons for this difference could be different in the sample.

According to the findings, the quality of nurses 'care was evaluated from the patients' perspectives at a moderate level. Accordingly, nursing managers and hospital officials are recommended to pay attention to how nursing care is provided as well as the quality of the offered services. It is also necessary to hold courses and workshops with an emphasis on promoting nurses' communication skills to promote the quality of nursing care. Further attention should also be paid to the observance of accreditation standards to provide care services to patients by nurses. Due to their different backgrounds and different experiences, patients and nurses have different perceptions and perspectives on the quality of care services. Accordingly, it is necessary to re-evaluate the quality care standards using a client-centered approach to take measures to increase the appropriate relationship between patients and nurses and consider patients’ psychosocial needs. This shortens the length of the patient's hospital stay and reduces the costs imposed on the treatment system.

One of the limitations of this study was that only the patients’ views and opinions were examined and nurses’ perspectives were not assessed. In contrast, one of the strengths of this study was the large sample size of the study.

Availability of data and materials

All the data is presented as a part of tables or figures. Additional data can be requested from the corresponding author.

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Acknowledgements

The present study was extracted from a research project approved by the Vice-Chancellor for Research in the Shiraz University of Medical Sciences (No. 21341). The researchers would like to express their gratitude to the esteemed Vice Chancellor for Research for his material and spiritual support in this study. All the participants in the study are also appreciated.

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Ali Reza Yusefi

Dr. Mir Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

Shakiba Rohani Sarvestani

Health Human Resources Research Center, School of Health Management and Information Sciences , Shiraz University of Medical Sciences, Shiraz, Iran

Zahra Kavosi

Student Research Committee, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

Jamshid Bahmaei

Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Scince, Yazd, Iran

Morteza Mortazavi Mehrizi

Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Gholamhossein Mehralian

Nottingham Business School, Nottingham Trent University, Nottingham, UK

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ARY and GM have designed the study and prepared the initial draft, SRS, ZK, JB and MMM have participated in data collection and data analysis. ARY and GM have technically edited the manuscript and finalized the draft. GM has supervised the whole study. All authors have read and approved the manuscript.

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Yusefi, A.R., Sarvestani, S.R., Kavosi, Z. et al. Patients' perceptions of the quality of nursing services. BMC Nurs 21 , 131 (2022). https://doi.org/10.1186/s12912-022-00906-1

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From the Bedside to Research: Navigating Change in Nursing

As we celebrate National Nurses Week, the AcademyHealth Interdisciplinary Research Group on Nursing Issues shines a spotlight on the indispensable contributions of nurses to the health care sector. Amid evolving challenges, these frontline professionals continue to lead with resilience and innovation, driving significant changes across the industry.

National Nurses Week is a time to celebrate and reflect on the evolving role of nurses and their significant impact on the health care system. As frontline caregivers, nurses face a myriad of challenges, yet they continue to lead and innovate, shaping the future of health care with their resilience and pioneering spirit.

Addressing Nurse Compensation

The establishment of the  Commission for Nurse Reimbursement in 2023 marks a significant shift in the financial recognition of nurses within the health care system. Historically, nursing services have been bundled into the general costs of health care, much like hospital supplies, leading to undervaluation and lack of visibility in the billing process. This commission, led by co-chairs Rebecca Love, RN, BS, MSN, FIEL, and Sharon Pearce, DNP, CRNA, FAANA, FAAN, was formed in response to a critical staffing shortage and aims to transform nursing care into a billable service. By advocating for changes in how Medicare and other entities reimburse for nursing services, the commission seeks to elevate the financial stature of nursing, enhancing job satisfaction, and retention, and ultimately stabilizing health care services. This initiative not only acknowledges the indispensable role of nurses but also strives to create a sustainable work environment that attracts and retains skilled professionals

Combating Workplace Violence

Workplace safety is another critical issue in the nursing sector, particularly the rising incidents of violence that nurses face. On average,  two nurses per hour are assaulted in acute care settings, underscoring the urgent need for better protection. Strategies to combat this include training staff in de-escalation techniques, implementing stricter security protocols, and establishing support systems for those affected by violence. Ensuring the safety of nurses is crucial for allowing them to provide the best possible care to their patients.

Policy Engagement: Amplifying Nurses' Voices

Nurses play a vital role in health care policymaking, given their direct patient care experience and patient-centered perspectives. Their active participation in legislative discussions helps ensure that health policies are practical and effectively implemented. Nurses advocate for policies that reflect the realities of patient care, steering the health care system toward more effective and humane outcomes.

Nurse Researchers: Pioneers of Innovation

Nurse researchers are at the forefront of refining nursing practices and introducing innovations that improve patient outcomes. Their work in 2024 is particularly vital as they research staffing models, patient care techniques, and the integration of new technologies such as digital health records and predictive analytics tools. These innovations are transforming everyday nursing practices, making health care more effective and responsive.

Embracing Technological Innovations

The integration of Artificial Intelligence (AI) and Telehealth has been a game-changer in health care delivery,  spearheaded by nurses . AI enhances diagnostic accuracy and treatment protocols by analyzing vast amounts of patient data. Telehealth, on the other hand, expands access to medical services, especially in remote or underserved areas, ensuring timely and efficient care. These technologies provide nurses with tools that augment their clinical skills and allow for better care across various settings.

As we observe National Nurses Week, it is essential to acknowledge the adaptability and innovative spirit of nurses globally. Despite numerous challenges, they continue to lead in the health care sector. With initiatives like the Commission for Nurse Reimbursement and the adoption of new technologies like AI, nurses are setting new standards in health care delivery. This week, and every week, we reaffirm our commitment to supporting and empowering the nursing profession as it continues to navigate these transformative times. From bedside care to research labs, nurses play an indispensable role in enhancing our health care system.

Marx/Engels Internet Archive

Theses On Feuerbach Download PDF Written: by Marx in the Spring of 1845, but slightly edited by Engels; First Published: As an appendix to Ludwig Feuerbach and the End of Classical German Philosophy in 1888; Source: Marx/Engels Selected Works, Volume One, p. 13 – 15. Note that this version differs from the version of Engels’ edition published in MECW Volume 5, pp. 6-8; Publisher: Progress Publishers, Moscow, USSR, 1969; Translated: W. Lough from the German; Transcription/Markup: Zodiac/ Brian Baggins ; Copyleft: Marx/Engels Internet Archive (marxists.org) 1995, 1999, 2002. Permission is granted to copy and/or distribute this document under the terms of the Creative Commons ShareAlike License ; Proofread: by Andy Blunden February 2005. I The chief defect of all hitherto existing materialism – that of Feuerbach included – is that the thing, reality, sensuousness, is conceived only in the form of the object or of contemplation , but not as sensuous human activity, practice , not subjectively. Hence, in contradistinction to materialism, the active side was developed abstractly by idealism – which, of course, does not know real, sensuous activity as such. Feuerbach wants sensuous objects, really distinct from the thought objects, but he does not conceive human activity itself as objective activity. Hence, in The Essence of Christianity , he regards the theoretical attitude as the only genuinely human attitude, while practice is conceived and fixed only in its dirty-judaical manifestation. Hence he does not grasp the significance of “revolutionary”, of “practical-critical”, activity. II The question whether objective truth can be attributed to human thinking is not a question of theory but is a practical question. Man must prove the truth — i.e. the reality and power, the this-sidedness of his thinking in practice. The dispute over the reality or non-reality of thinking that is isolated from practice is a purely scholastic question. III The materialist doctrine concerning the changing of circumstances and upbringing forgets that circumstances are changed by men and that it is essential to educate the educator himself. This doctrine must, therefore, divide society into two parts, one of which is superior to society. The coincidence of the changing of circumstances and of human activity or self-changing can be conceived and rationally understood only as revolutionary practice . IV Feuerbach starts out from the fact of religious self-alienation, of the duplication of the world into a religious world and a secular one. His work consists in resolving the religious world into its secular basis. But that the secular basis detaches itself from itself and establishes itself as an independent realm in the clouds can only be explained by the cleavages and self-contradictions within this secular basis. The latter must, therefore, in itself be both understood in its contradiction and revolutionized in practice. Thus, for instance, after the earthly family is discovered to be the secret of the holy family, the former must then itself be destroyed in theory and in practice. V Feuerbach, not satisfied with abstract thinking, wants contemplation; but he does not conceive sensuousness as practical, human-sensuous activity. VI Feuerbach resolves the religious essence into the human essence. But the human essence is no abstraction inherent in each single individual. In its reality it is the ensemble of the social relations. Feuerbach, who does not enter upon a criticism of this real essence, is consequently compelled: To abstract from the historical process and to fix the religious sentiment as something by itself and to presuppose an abstract – isolated – human individual. Essence, therefore, can be comprehended only as “genus”, as an internal, dumb generality which naturally unites the many individuals. VII Feuerbach, consequently, does not see that the “religious sentiment” is itself a social product, and that the abstract individual whom he analyses belongs to a particular form of society. VIII All social life is essentially practical. All mysteries which lead theory to mysticism find their rational solution in human practice and in the comprehension of this practice. IX The highest point reached by contemplative materialism, that is, materialism which does not comprehend sensuousness as practical activity, is contemplation of single individuals and of civil society. X The standpoint of the old materialism is civil society; the standpoint of the new is human society, or social humanity. XI The philosophers have only interpreted the world, in various ways; the point is to change it.   Deutsch | 1938 translation of Marx’s original | 2002 translation of Marx’s original | MECW translation of Engels’ 1888 version Marx/Engels Works Archive | Study Guide | Engels on Feuerbach | Image of Thesis 11 | Works Index

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Putin’s New War Weapon: An Economist Managing the Military

In his first public appearance as the newly appointed defense minister, Andrei R. Belousov spoke about veterans’ benefits and overcrowded hospitals rather than a new offensive in Ukraine.

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By Anton Troianovski and Anatoly Kurmanaev

To President Vladimir V. Putin of Russia, appointing a new defense minister provides a new building block toward fighting a long war.

That was evident in Moscow on Monday when Andrei R. Belousov, the economist who was Mr. Putin’s surprise pick to lead Russia’s sprawling defense ministry, made his first public appearance in his new role and spoke about bureaucracy rather than the battlefield.

The pick reflects an acknowledgment that the military production that is supplying Russia’s war, and heating its economy, must be carefully managed to sustain a war of attrition with Ukraine. In addition to Mr. Belousov’s appointment, Mr. Putin also promoted Denis Manturov, the outgoing minister of trade and industry, to the post of first deputy prime minister — a sign that expanding industrial production would rise as a government priority.

At the same time, Russia is playing the long game on the battlefield. Along the front line, most recently in northeastern Ukraine, Russian forces are pushing forward slowly rather than attempting major breakthroughs to big cities, as they did at the beginning of the war — with disastrous results.

In televised remarks at Russia’s upper house of Parliament, which is expected to rubber-stamp his nomination, Mr. Belousov emphasized the bureaucratic details of the fast-growing military effort, and made no reference to the situation at the front. He described his priorities as improving standards of care and living for soldiers, veterans and their families.

The excessive paperwork that fighters faced in obtaining benefits, he said, ought to be addressed “in the framework of interagency electronic coordination.”

“It’s absolutely unacceptable” that soldiers are redirected to overcrowded hospitals when on leave, said Mr. Belousov, who was nominated to the post in a cabinet reshuffling Sunday night. “This issue needs to be resolved.”

Mr. Belousov’s focus on bureaucratic minutiae was particularly notable given that the comments came just days after the Russian forces opened a new front in the war, successfully moving across Ukraine’s northern border. His remarks offered a snapshot of how the sudden rise of a soft-spoken expert on economic policy to the helm of an enormous military apparatus waging its biggest conflict since World War II has emerged as a new component in Mr. Putin’s strategy of defeating Ukraine through a war of attrition.

Mr. Belousov’s appointment signals Mr. Putin’s focus on subordinating the country’s economy to his military needs, in the expectation that a war in Ukraine, or at least a militarized standoff with the West, could shape Russia’s future for years to come.

“Putin’s priority is war, and war of attrition is won by economics,” said Alexandra Prokopenko, a former Russian central bank official now at the Carnegie Russia Eurasia Center in Berlin.

In more than six years as Mr. Putin’s economic adviser, Mr. Belousov developed a reputation as a strong supporter of a dominant state role in the economy and of high public spending. The war has already led Mr. Putin to enact some of the proposals that Mr. Belousov had advocated for years, such as higher taxes on big business and greater use of the country’s oil savings.

In Moscow, Valentina Matviyenko, the chairwoman of the upper house of Parliament, said Mr. Belousov was the best choice to find ways to procure “new, modern weaponry, new technology and new innovations” for the military.

She added that Mr. Belousov would not be involved in command on the battlefield, which would continue to be directed by the military’s general staff.

Sergei Mironov, an ultranationalist lawmaker, welcomed Mr. Belousov’s appointment, adding that “the servicemen are not the only ones fighting today, but so are economies.”

Some Russian officials have expressed hopes that Mr. Belousov’s organizational savvy will improve Russia’s production of high precision weapons, an area where Russia continues to lag behind the West.

In particular, the officials have cited Mr. Belousov’s attempts to improve Russia’s drone production last year, by streamlining bureaucratic red tape .

“With these personnel decisions, Putin is preparing for a long-term confrontation of attrition with the West,” said Konstantin Remchukov, a Moscow newspaper editor close to the Kremlin. “The victor will be the one who has more resources — or is more effective in using them.”

A person close to the defense ministry, who discussed government policy on condition of anonymity, said that Mr. Belousov would nevertheless face challenges like Russia’s continued shortage of high-precision weapons, which has made it difficult for Russia to secure a decisive advantage on the battlefield.

Mr. Belousov is replacing Sergei K. Shoigu, a long-serving minister who was fiercely loyal to Mr. Putin. Many analysts said that, despite his close ties to the Russian leader, Mr. Shoigu’s days were numbered because of the spectacular failure of the initial invasion in February 2022.

But rather than fire Mr. Shoigu as Russia was struggling to stay in the fight, Mr. Putin chose only to replace him after his forces recovered their balance. Today, Russia appears to be in its strongest position in the war.

“Putin is seeing that a lot of things were not done right — there were very grave mistakes,” Sergei Markov, a Moscow political analyst and a former Kremlin adviser, said in a phone interview. But, he added, “you don’t make personnel decisions in a crisis.”

“Now the crisis has been resolved,” Mr. Markov said.

Mr. Shoigu’s position in the defense ministry was severely weakened last month, when prosecutors charged one of his deputies, Gen. Timur Ivanov, with “large scale” corruption. Russian commentators widely interpreted the move as evidence of Mr. Putin’s displeasure with the extravagant lifestyle of Mr. Shoigu’s inner circle.

In contrast, Mr. Belousov has not been implicated in any major corruption scandals after decades of working in the government.

“Putin needs a dependable person in the segment where the greatest amount of money is flowing,” Mr. Remchukov, the newspaper editor, said.

The person close to Russian defense ministry said that while Mr. Belousov is unlikely to root out the widespread graft in military procurement, he could hide its worst excesses, reducing the threat of outbursts of popular discontent.

The appointment of Mr. Belousov, however, does not represent a complete break from the military system that came up with the disastrous plan for the invasion.

Military analysts say that Mr. Belousov’s impact will depend on how he manages relationships with senior security officials like Gen. Valery Gerasimov, the head of the general staff.

But the appointment of a methodical bureaucrat to oversee Russia’s war effort also meshes with the consolidation of a slower-paced Russian strategy on the battlefield.

The failed attempts to stun the enemy into submission in the first month of the invasion with armored thrusts and paratrooper drops have since given way to systematic pummeling of Ukrainian defenses in various sections of the front line simultaneously.

This strategy has allowed Russia to exploit its manpower and firepower advantage to gradually inch forward against overstretched and exhausted defenders — evident in the way Russia made its recent incursions in Ukraine’s north.

Russia had initially tried to capture the northern city of Kharkiv in the early weeks of the war by sending armored columns streaming across the border along the highways. The attack quickly collapsed after encountering determined Ukrainian forces, who later forced Russia into a hasty retreat.

This time Russia has used small units of infantry supported by artillery to filter across the border and slowly push forward, one village at a time.

Military analysts said the offensive stands little chance of capturing the city of Kharkiv itself. But the attacks appear to have succeeded in drawing Ukrainian reinforcements from other sections of the front, at a time when the country is struggling to recruit enough fighters and obtain new weapons from its Western allies.

“There’s an appreciation in the Russian leadership that this is a long war that will require managing attrition, reconstitution, and defense industrial mobilization,” Michael Kofman, a Washington-based military analyst, said.

Anton Troianovski is the Moscow bureau chief for The Times. He writes about Russia, Eastern Europe, the Caucasus and Central Asia. More about Anton Troianovski

Anatoly Kurmanaev covers Russia and its transformation following the invasion of Ukraine. More about Anatoly Kurmanaev

Our Coverage of the War in Ukraine

News and Analysis

Secretary of State Antony Blinken met with President Volodymyr Zelensky of Ukraine in Kyiv, assuring him that American military aid is on its way  at a “challenging time” for the country.

As Moscow seeks more support for its war in Ukraine, President Vladimir Putin of Russia will visit China’s top leader, Xi Jinping, testing their “no limits” partnership .

Putin replaced his minister of defense , Sergei Shoigu, with the economist Andrei Belousov , shaking up his national security team for the first time since his invasion of Ukraine.

Rebuilding Ukrainian Villages: The people of the Kherson region have slowly rebuilt their livelihoods since Ukraine’s military forced out Russian troops. Now they are bracing for another Russian attack .

Replenishing the Army’s Ranks: Ukraine’s Parliament passed a bill that will allow some convicts to serve in the military  in exchange for the possibility of parole at the end of their service.

Ukraine’s Unidentified Dead: Families of some Ukrainian soldiers say they have spent months trying to get official confirmation of their loved ones’ deaths , adding to their anguish.

How We Verify Our Reporting

Our team of visual journalists analyzes satellite images, photographs , videos and radio transmissions  to independently confirm troop movements and other details.

We monitor and authenticate reports on social media, corroborating these with eyewitness accounts and interviews. Read more about our reporting efforts .