Determinants of perceptions on nursing care among cancer patients admitted in oncology wards at Kenyatta National Hospital, Nairobi County, Kenya.

Abstract

Nursing care is meeting both physical and psychosocial needs of patients. Cancer patients experience more biopsychosocial needs than other patients, hence they require more nursing care. An oncology nurse therefore provides physical, psychosocial and spiritual care to cancer patients. The purpose of this study was to assess the determinants of perceptions on nursing care among cancer patients admitted in oncology wards. The research objectives were to determine cancer patient characteristics that influence their perceptions on nursing care, determine cancer patient expectations on nursing care and lastly cancer patient satisfaction with the nursing care provided while in the ward. The study design was descriptive cross-sectional, using quantitative approach. The sample size was 91 patients who were selected using purposive sampling technique. The target were adult patients (both males and females) aged 18 years and above admitted in oncology wards at KNH (GFD and 8C), with a confirmed diagnosis of cancer and who had received care for at least 48 hours. Data collection tool was a standardised researcher administered, semi structured questionnaire and Likert scale in English and Kiswahili version. This tool was adopted from the caring assessment questionnaire (care-Q) by Larson, and modified as per research objectives and literature review. The tool was pretested in Nakuru PGH. Data was analysed using SPSS version 21 using both descriptive and inferential statistics. Ethical clearance was obtained from MKU, and KNH-UoN ERC, Permit from NACOSTI. Participation in the study was voluntary. Residence and hospital length of stay affected positively the perception on nursing care at p =0.022 and p=0.004 respectively. Cancer Patients, 92.3% (84) had high expectations on nursing care. There was a significant association between patient expectation with perception on physical nursing care, p=0.028. 53.8% of the patients were not satisfied with psychosocial care with 97.8% (89) having their expectations on psychosocial care partially met. A high score, 97.8% (89) of the cancer patients identified emotional support as the priority psychosocial need, with 82.4% (75). Majority (76.5%) had a neutral position with regard to satisfaction status with physical care. Treatment was rated as a priority physical need by most patients (37.4 %= 34). Majority, 52.7% (48) recommended assessment of patient needs to improve physical care. A higher percentage, 59.3% (54) felt both psychosocial care and physical care were important. Generally, 94.5% (88) were satisfied with care in the ward with 96.7% (84) reporting that physical care was most satisfying. In conclusion, cancer patients’ characteristics, expectations, and satisfaction with nursing care had a positive association with their perceptions on nursing care offered in the ward. Psychosocial care was less satisfying to the cancer patients. The researcher recommends that oncology nurses should be keen to meet all patient needs to promote care satisfaction with emphasis to psychosocial care.