Show simple item record  

dc.contributor.advisorParsons, Matthew
dc.contributor.authorDrake, Emma Rose
dc.date.accessioned2023-06-27T02:13:38Z
dc.date.available2023-06-27T02:13:38Z
dc.date.issued2022
dc.identifier.urihttps://hdl.handle.net/10289/15801
dc.description.abstractBackground: Alongside health outcomes, patient experiences are considered crucial in identifying the quality of a health care setting. General surgery comprise the largest range of pathologies and accounts for the highest number of patient discharges of any surgical specialty. As a way to address the power imbalance between healthcare staff and patients, patient-centred models of care are increasingly being adopted and implemented within hospitals including surgery. This study aims to investigate the current experiences of acutely admitted patients in a general surgical ward at Waikato Hospital, including opportunities for and challenges to improvement initiatives. Furthermore, the study examines relevant staff members perspectives of the inpatient experience and seeks to determine the efficacy of a proposed intervention focusing on empowering patients and their families. Methods: The study was a mixed method design involving two phases. Phase I obtained qualitative data from semi-structured interviews with six patients and twelve staff members. Themes which emerged from the qualitative data in phase I were used to inform the development of phase II, as well as to inform a proposed patient self- assessment intervention. Phase II obtained quantitative data through Likert scale response surveys provided to acute patients on, or near to, their day of discharge from the surgical ward over a two month period. Results: A total of six patients and 12 healthcare staff (senior registered nurses, n=3; surgical registered nurse managers, n=2; surgical fellows, n=2; surgical registrar, n=1; dietitian, n=1; social worker, n=1; occupational therapist, n=1; and physiotherapist n=1) were involved in phase I. A total of 53 surveys were returned from patients in Phase II (63.1% response rate). Qualitative data from phase I was analysed using a general inductive approach. This revealed three themes including power and control concerns for patients, the hierarchy of the health care team and the surrounding stressors of the organisation and environment. Analysis of the quantitative data collected descriptive statistics and calculated chi-squares. Of note were the statistically significant differences particularly between patients of Māori ethnicity comparatively to non-Māori, and according to gender and reason in hospital. There were no statistically significant differences for patients according to age group. Conclusion: This study identified both the experiences of patients and staff in an acute general surgical context. The study found that the proposed patient self- assessment intervention was not immediately recommended. This was due to the current recommendations from patients who identified their strong preference was for face-to-face communication with staff. It was also due to staff members identification of a perceived inability to consistently provide person-centred care which corresponded with the patient self-assessment data. Acute general surgical care needs of patients were perceived by staff as taking precedent and current workplace stressors, including staffing and skill mix deficits and perceived lack of staff wellbeing supports, were strong inhibitors for staff to provide their preferred capacity of patient-centred care.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dc.publisherThe University of Waikato
dc.rightsAll items in Research Commons are provided for private study and research purposes and are protected by copyright with all rights reserved unless otherwise indicated.
dc.subjectNursing
dc.subjectPatient experience
dc.subjectAcute patient
dc.subjectInpatient
dc.subjectSurgical
dc.subject.lcshCritical care medicine -- New Zealand -- Hamilton -- Administration
dc.subject.lcshSurgical emergencies -- New Zealand -- Hamilton
dc.subject.lcshMedical personnel -- New Zealand -- Hamilton -- Attitudes
dc.subject.lcshPatients -- New Zealand -- Hamilton -- Attitudes
dc.subject.lcshSurgery -- New Zealand -- Hamilton
dc.subject.lcshWaikato Hospital -- Patients -- Attitudes
dc.subject.lcshPhysician and patient -- New Zealand -- Hamilton
dc.subject.lcshPatient-centered health care -- New Zealand -- Hamilton
dc.subject.lcshPatient self-monitoring -- New Zealand -- Hamilton
dc.subject.lcshPatient monitoring -- New Zealand -- Hamilton
dc.titleExploring patient experiences and power dynamics in an acute general surgical ward: A mixed methods study exploring patient and staff perceptions of the inpatient experience at Waikato Hospital
dc.typeThesis
thesis.degree.grantorThe University of Waikato
thesis.degree.levelMasters
thesis.degree.nameMaster of Nursing Practice (MNursPrac)
dc.date.updated2023-06-25T22:30:36Z
pubs.place-of-publicationHamilton, New Zealanden_NZ
dc.subject.maoriRongoā
dc.subject.maoriHōhipera
dc.subject.maoriTūroro
dc.subject.maoriNēhi
dc.subject.maoriMahi tapuhi
dc.subject.maoriTākuta


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record