This study recognized that the education of patients in various rural areas varies widely and it was due to several reasons affecting the nurses who were to impart this information. There are factors that impacted the education of patients in those numerous rural areas. It is important to study this so as to prevent and to stop the current discrepancies in rural areas.
The main purpose of the study was to explore the matter that there are variations of patient knowledge in terms of their healthcare in different rural areas. It establishes what might be the possible causes of these differences based on nurses and which factors arise in the patient education concerning nurses’ academic preparation, years of experience and job roles of the nurses influenced their attitudes and comfort on the matter.
Do registered nurses’ attitudes and degrees of comfort affect the patient education in a rural area? This study tries to tackle this research question and uses hypotheses to lead it: Is there a variance in patient education in various rural areas? Are nurses involved in imparting patient education? Does the academic preparation, years of experience and job roles of the nurses all affect education of the patients?
Dependent variables are those that rely on another factor. They cannot exist on their own and come up only after the establishment of the independent variable. An independent variable is one that does not need the existence of another factor for it to occur. Nurses’ attitudes and degree of comfort are the dependent variables while years of experience, academic preparation and job roles, are the independent ones.
The theoretical framework is expressed through various statements in the body of the study and is based more on a scientific theory. The scientific theory is whereby a certain aspect is based on knowledge that was gathered from information collected. The study illustrates clearly that the concepts of interest are years of experience, job roles and academic education progression of the nurses.
It also demonstrates how the concepts of interest come together to define the kind of relationship between them. The framework is related to the body of nursing because it describes in detail how the various factors that affect nurses, end up affecting patient education, a part of nursing.
The articles described in the study are very much relevant to previous theories and studies. The independent variables are illustrated through various theories and studies like Kinnaird’s Model of Dynamics of Nurse Participation in Patient Education, the 5 levels of proficiency in the acquisition and the development of the necessary skills to become an expert by Benner, and so much more (Kinnaird, 1987).
The literature review relies more on sources that were established ten years ago and older, with the earliest being 1987 and the latest being 2004. It proves that the research question is valid and that the dependent variables and independent ones are very much correct, through various quoted studies and theories.
The only thing not described here, is how to go about solving this problem and prevent the same so it can never happen again. Therefore, since the research has proven to be valid and of correct information, the gap that needs to be filled is the way forward on how to ensure there is proper patient education in rural areas.
Surveys were majorly used to gather the necessary information in this study. Computerized databases were used to establish the basic information of various nurses for example, their academic background level. Surveys were used to collect a wider range of data in the field.
They are generally used to enable one to sample various individual responses in a target population and are done through different means like questionnaires. It supports improved accuracy and number of responses (Andres, 2012). This was a great method to use because it enabled the gathering of information from a wide number thus widening its scope.
There are two types of criteria involved in sample and setting: The inclusion and exclusion criteria. The inclusion criteria is whereby one establishes a conditions to enable a patient be incorporated in a study while exclusion criteria are those conditions designed to keep particular patients out of the study (Seright, 2010). Specification must be precise enough to enable a professional in the field to carry out the same study and understand these conditions (Rankin & Stallings, 2001).
The method used to identify the sample was the use of these criteria which were: hospitals that the Joint Commission on the Accreditation of Healthcare Organization has accredited, places with acute care and not non-profit hospitals in rural areas and hospitals with more than 200 beds. The questionnaire was sent to 412 nurses but only 273 were filled and sent back. As a result the sample size consisted of 273 (66.3%) nurses. Power analysis was not necessary for there were no statistically insignificant results found.
The demographics used in this study were gender, age, education level, work shifts, year graduated from initial nursing program, years worked in direct patient care, licensure and job role. The attrition impacts the features of the particular sample being examined, whereas mortality selection affects both the classification of the population and directly affects the sample under study (Stickley et al., 2009).
This was revealed in the results after collection of the samples, whereby most of the respondents were female staff nurses with most of them in the 40-49, having an associate’s degree while the highest education level was the master’s degree. Most of them were experienced and with the 7pm-7am work shifts being the most common and held a registered nurse’s license.
The study secured permission from nurse executives who worked at 5 hospitals that passed the inclusion standards and it qualified for an advanced institutional review board authorization which was founded on hospital policy. The setting was 5 rural hospitals which is located on the Eastern Shore of Maryland. This was appropriate for the study for there was collection of important information.
Extraneous variables are those that are not necessarily independent but also affect the conduct of the subject being studied. These may include lack of educational planning and training; impact of peers, physicians, and management; or lack of time because of the complex schedules in the nursing field (Jones, 2010). The use of a database with all collected sample information and the inclusion and exclusion criteria enabled the study to be streamlined hence it focused on only the variables being looked into.
The key instrument and measurement strategy used was the questionnaire. It was designed particularly to measure demographics, patient education attitudes of the nurses’, level of education attained and comfort in teaching self-care. The level of measurement was that of ratio or interval because of the information collected, there were various gaps between a number of scores or measurements.
Reliability is whereby consistent results are released while validity is how well measurements are done by an assessment tool. The questionnaires prove to be reliable for they give a relatively constant data but not necessarily valid depending on those answering them such that, wrong or incomplete information may be given.
Data was collected through the survey method whereby 412 nurses were mailed the questionnaires and upon completion sent them back. This was appropriate for it saved on time and resources while capturing a large audience. The questionnaires did not need indication of name or any other delicate personal details and thus protected the rights of the participants for non-disclosure naturally existed.
Statistical analysis procedures used were frequency, which estimated the particular number of responses on the questionnaires that fell in particular categories (also calculated in percentages) and one-way analysis of variance (ANOVA) with Bonferroni post hoc comparisons of the three independent variables.
As a result of this study, we know that nurses understand that need for patient education and their responsibility. They recognize the learning needs of a patient and can assess their willingness to learn. Though they comprehend the importance, establishment of goals with patients and their families are rarely or never done.
The same applies to the education process coordination and collaboration. The study also demonstrates that the more experience a nurse has, the more comfortable they feel imparting health care knowledge to patients. Nurses more advanced in their education also strongly support patient education. On the other hand the type of licensure did not prove to affect dependent variables. Role ambiguity proved to be a major problem in nursing.
The strengths of the scientific merit of this study is that the information collected was precise and categorized data accordingly therefore enabling focus on important data. Meanwhile the use of only 5 hospitals for sampling and use of anonymous surveys may not have been entirely valid for there is no way to determine if the information was true.
The implications of the study were: nurses play a major role in patient education, and must find a way to impart information in a more efficient and cost effective manner. Investigation of how their education background prepares them for the educator role and the hiring and retaining of experienced nurses (more than 10 years) is also important.
The data was relevant in distinguishing the information needed for the study, demonstrating that the role of nurses in educating, and in establishing job roles and academic preparation are relevant factors in attitudes and comfort of nurses’ towards teaching.
Results can be applied in identifying the most suitable nurses to employ and establishment of nurses as educators. Areas for further study suggested were other health care areas, consequence of the program for nurses and effects for nursing in clinical situations. The study thus proved to be significant for repetition in the future.
This study has enabled me to realize that as a nurse I am required to not only treat patients but also teach them. To be the best, I must advance my knowledge and gain as much experience in the field. I shall make sure I impart as much relevant information to the patient to enable them take care of their health.
Andres, L. (2012).Designing and Doing Survey Research. London: Sage.
Jones, A.R. (2010). Patient Education in Rural Community Hospitals: Registered Nurses’ Attitudes and Degrees of Comfort. The Journal of Continuing Education in Nursing, 41(1), 41-48.
Kinnaird, L. S. (1987). Nurse participation in patient education in a community hospital. Dissertation Abstracts International, 48, 3532 (UMI No. 8802819).
Rankin, S. H., & Stallings, K. D. (2001). Patient education: Principles and practice. Philadelphia: Lippincott.
Seright, T.J. (2010). Clinical Decision Making of Rural Novice Nurses. ProQuest LLC, p. 225.
Stickley, T., Roberts, S., Rush, B., Shaw, R., Smith, A., Collier, R.,…Felton, A. (2009). Participation In Nurse Education: the Pine project. The Journal of Mental Health Training, Education, and Practice, 4(1), 11.