CHAPTER I

INTRODUCTION

1.1 Background of the Study

The WHO global strategy on Human Resources for health identifies that the nursing profession

is the largest occupational group globally. As nurses are the largest part of the professional health

workers, they contribute enormous services, care and treatment worldwide. So, the number of

nurses must be increased to achieve universal health coverage. But even they contribute more to

patients, they are often undervalued and given less concerned (World Health Organization

[WHO], 2017).

Nursing as a caring profession, encircles independent and collaborative care to individuals for all

ages, families and group and communities, sick or well and in all setting which includes the

health promotion, prevention of illness, disabled and dying people (Mukumbang & Oluyinka,

2014).Nursing care is the major determinant of patient satisfaction. The nature of the relationship

between nurse and patient has some degree of significant impact on the overall quality of

healthcare (Dzomeku, Ba-Etilayoo, Pereku & Mantey, 2013) .Quality of care is one of the

important indicator to assess patient satisfaction (Shrestha & Devkota, 2017).

Nursing competency is acquired through theoretical learning and practical experiences

(Fukada,2018). Since nursing is a performance-based profession, clinical learning environments

play an important role in the acquisition of professional abilities and train nursing students to

enter the nursing profession and become a registered nurse (Jonsen, Melender & Hilli, 2013).
The need for hospital-based exposure for nursing students in nursing education has driven

nursing training institutions to allocate hospitals for clinical practice purposes (Parry, 2011).

Student nurses undergo clinical training on live patients as real patients will always be the best

resource in nursing education. Contact with patients naturally gives rise to the student-patient

relationship and provides the foundation for the care experience (Kulkarni, 2009). As a result, the

student nurse-patient relationship is considered to form the basis of the experiences of patients

nursed by student nurses (Richard, 2010).

Patient perceptions toward nursing students are primarily based on personal experience or their

surrounding experience. Patient expressed positive aspects of having nursing students when they

feel comfortable with student nurses and acknowledge their work; when students were

supportive and willing to be of service to patients and when students are skillful and in their

nursing roles. While patient had negative experiences of their encounters with the student nurses

in their therapeutic relationship when students lack competency in some nursing procedures;

displayed poor professional behavior and interpersonal skills. Negative feelings leading to lack

of trust in the student nurses (Mukumbang & Oluyinka, 2014).

According to the study done on Nigerian University, Nigeria in 2012 showed that patient

attitude is affected by age and religion as most of Christianity ( 78% ) accepted the medical

students whereas Muslim ( 40%) are against it. Old aged patients i.e. 91.7% accepted student

involvement in care while young patients of age between 18-27 years (60.5%) did not accept

student participation in a care (Onotai, Asuquo, Amadi, Oparelli & Ali, 2012). Similarly, 52% of

the patients felt comfortable with the presence of students, 81.5% of the patients agreed to be
examined by students in the presence of the supervisor, while 40.2% gave agreement even in the

absence of the supervisor (Sayed-Hassam, Bashour & Koudsi, 2012).

Maternal attitude towards student nurse showed that more than half of the mothers (63%) during

labour and pueperium had negative attitude towards student nurse due to their religious belief,

privacy issues and lack of emotional support from their family and others. According to mothers,

student nurses had deficient knowledge regarding the care and were not satisfied with their care.

(Megahed, Raju, Chithra & Elabas, 2018).

Student nurses involved in the care of patient have to face many challenges in their clinical area

as they have to provide care to the patients who had different perceptions and attitude (Nahid

Jamshidi et al. 2016). Student have to enhance their skills in the clinical area complementing it

with theoretical background and need to update in their knowledge in the era of information

technology (Karaca & Durnaz, 2019). Different studies done in different countries showed both

positive and negative attitude of the patient towards student nurse. But few studies were done in

the context of Nepal. Hence, this study is designed to assess the attitude of the patient towards

student nurse in hospital.

1.2The need for the Study

Clinical experience play a pivotal role in proper clinical-based nursing education, which affects

the quality of learning in nursing students (Tomietto et al., 2015). Clinical learning experiences

require the interaction of nursing students and their presence in clinical settings. Patients’ right to

accept or refuse the involvement of students is a challenging issue (Abdulghani, Al-Rukban &

Ahmad, 2008).  Patients’ willingness to cooperate and contribute to the education and training of

students provide better teaching opportunities for students at most levels of patient care but leads

to difficulty in training students if patients decline their involvement. Conflict can arise between

the educational requirements of students and the needs of the patients (British Medical

Association, 2008).

The study done in Tunisia showed that among 88.8% patients who agreed to participate in the

study found the highest acceptance rates in the situation where there is no direct contact between

patient and the students (e.g., when reading their medical files, attending ward round). As the

degree of student’s involvement increased, the refusal rate increased. Gender, age, educational

level, marital status and the extent of students' involvement in patient's care were identified as

the main factors affecting patients' attitude (Salah et al., 2015).

Many times, the student nurses were forced to take care of patients even without expert skills

(Wagner & Bear , 2009). The patient has negative attitude towards student as student lack skills

in a simple procedure. Due to patient attitude some student drops out of their study, go through

stress and anxiety (Jamsidhi et al.,2016).

A Cross- sectional study was conducted on Patient Attitude towards the participation of medical

student in clinical examination and care was conducted among Saudi and Non-Saudi patient at
two university hospital in Jeddan. Patient attitude is influenced by the student’s manner, skill and

attire. The manner shows by the student through their behavior and communication skill change

the attitude of patients among students. Female and young patient (<45years), obstetrics patient

have negative attitude whereas elderly and male patient has positive attitude towards the student.

By knowing patient attitude student can change their communication skill, manner, competency

in procedure and attire (Aljoudi et al., 2017).

In a study done in BPKIHS Nepal, showed that 96.6 percent of the respondents agreed that

presence of nursing students in ward make the client positively motivated. More than 50 %

patient reported student nurses are helpful, clean & tidy, empathetic, soft spoken and unbiased

but students were reported to have low performance level (Mehtha & Singh, 2013).

In a study done in hospital of Kathmandu to assess patient attitude towards student nurse showed

that most (73.9%) of the respondents have negative attitude. Likewise, 24.3 percent of the

respondents had positive attitude and 1.7 percent had neutral attitude towards student nurses

(Shakya & Aryal, 2018). Positive attitude leads to motivation and developed their skills and

negative attitude makes the student feel sad and less focus on their work (Oster et al., 2015).

There are many nursing colleges in the country so, the number of nursing students are also

increasing in many hospital. The complex relationship between nurse student and patient is of

more importance and responsibility than even before (Mehta & Singh, 2013). The patient

perception helps to modify the care provided to them (Gupta, Shrestha & Thulung ,2014)

.Assessing the patient’s attitude is a great way to give feedback to students about their

communication skills. In the context of Nepal, this type of research is done relatively less so the

researcher is interested to study the patient’s attitude towards student nurse in hospital.
1.3 Objectives

1.3.1 General objective

 To assess the attitude of patients towards student nurse of selected hospital of Lalitpur.

1.3.2 Specific objectives

 To find out the patient’s attitude towards student nurse.

 To measure the differences between patient’s attitude and selected demographics

variables.

1.4 Significance of the study

The finding of this study will help to know about the attitude of the patients toward student

nurse. The finding of the result will give the feedback where the positive results of this study

provide motivation and a better learning opportunity for student nurse and a quality care to

patient whereas negative results provides the room for improvement in communication and

professional skills of students as well as opportunity to improve clinical learning environment for

nurse educators. Additionally, the finding will also be useful as a reference to other future

researcher in this area.

1.5 Conceptual framework

A conceptual framework is a structural diagrams that describes the context and variations of the

study. In this framework researcher aimed to show the relationship between dependent and

independent variables. It shows that how the patient attitude is influenced by age, sex, ethnicity,

religion, and educational level, length of stay at hospital, occupation and type of illness. This

conceptual framework is based on the literature which shows the relationship between dependent

and independent variables.

Age Sex Ethnicity Previous exposure

Educational level Patient attitude

towards Duration of stay in
student nurse hospital.

Presence of health Occupation Religion

personnel in family
Figure 1: A conceptual framework showing variables which influence on the attitude of

respondents towards the nursing student.

1.6Research question

What is the level of patient’s attitude towards student nurse?

1.7 Variables of the study

Independent variables

 Age

 Sex

 Ethnicity

 Educational level

 Occupation

 Religion

 Duration of stay in hospital

 Previous exposure

 Presence of health personnel in family.

Dependent variables

 Patients attitude towards student nurse

1.8 Operational Definition

Attitude towards student nurse

It refers to feelings or opinions of patients towards student nurse who are posted in Medical-

Surgical ward of B&B hospital. Attitude will be measured by self- developed questionnaire in a

5 point Likert scale. The score will be ranged from 22-110. The score will be categorized as

follows:

Positive attitude - Score more than and equal to…(> 50 percent)

Negative attitude - Score less than….(< 50 percent)

(Coban & Kasikci, 2011)

Patients

Patients refers to a client who has been admitted in Medical-Surgical ward of B&B hospital for

at least 3days.
 CHAPTER III

RESEARCH METHODOLOGY

The research methodology was the most important part of the research process which gives an

overall picture of structure and strategy directed towards the intended investigation. The research

methodology includes the study design population and setting, sample and sampling techniques,

inclusion criteria, instrumentation, validity and reliability, data collection techniques, plan for

data analysis including ethical consideration.

3.1 Research design

A descriptive cross- sectional research design on a quantitative approach was used to assess the

attitude of patients towards student nurse.

3.2 Research setting and Population

3.2.1 Research setting

The study was conducted at B&B Hospital which is located in Gwarko, Lalitpur. It was a tertiary

hospital established on 6th November, 1997 A.D. There were total 250 bed with 24 hours of an

emergency and trauma care, outpatient and inpatient services, surgical services, pharmacy, socio-

therapy, optical diagnostics services and radiology services.

3.3.2 Research population

The population for this study will include all the patient admitted in B&B Hospital at least for 3

days.

3.3 Sampling

3.3.1 Sampling size

The final sample size was 60

3.3.2 Sampling techniques

As per the purpose of the study, patients of B&B hospital was selected as the sample. Non-

probability convenience sampling technique was used to select the sample for this study.

3.3.3 Inclusion criteria

 All patients who were admitted in Medical- Surgical ward and stayed for 3 days in B&B

hospital in the day of data collection.

 All patient who was able to participate and give consent in a research study.

 All patient who was able to communicate during data collection.

 All patient aged 18 or above 18 years was included in the study.

3.4 Research Instrumentation

Structured interview questionnaire (Schedule) were developed on the basis of extensive review

of literature and consultation with experts to assess the patient’s attitude towards nursing student.

The instrument consist of following two parts:

Part I: Questions related to Socio-Demographic information

Part II: Questions related to patient’s attitude towards student nurse.

The first part of the instrument was related to Socio- demographic information which includes

age, sex, religion, ethnicity, educational level, and presence of health personnel in family,

previous exposure, duration of stay in hospital, occupation.

The second part of the instrument included questionnaire related to patient attitude towards

student nurse which include 22 items. Questionnaire related to attitude was developed by

Professor Ram Sharan Mehata sir and before using this tool researcher had took permission.

After taking permission tool was modified accordingly. The instrument consisted of four

components which included respondent’s attitude towards grooming of student nurse,

respondents attitude towards communication of student nurse, respondents attitude towards

presence of student nurse and respondent’s attitude towards care provided by student nurse.

The instrument was first developed in English language and then translated in Nepali language.

The instrument was again translated back to English and reviewed to ensured that both the

question would have same meaning while using during the time of research.

Scoring Criteria

The Likert scale was used to measure the attitude of the patient. It was consisted of 15 statement

which consists of 14 positive statement and 8 negative statement. Responses was collected under

categories Strongly agree (5), Agree (4), Uncertain (3), Disagree (2) and Strongly disagree (1)

for a positive statement while reverse scoring was done for negative statements. The total score

of the questionnaire was 110.

Analysis of study was done as:

Positive attitude if respondents scores 50% and above.

Negative attitude if scores below 50%.

Validity and Reliability

Content validity of the instrument was established by extensive literature review, consulting the

research advisor and colleagues. The instrument was first developed in the English version and

translated it into a Nepali version. Back translation was done to saw the accuracy of the

instrument. Pretesting of the instrument was done in similar setting in 10% of the total sample

size of the study among the patient of B&B hospital oncology ward. The respondents in

pretesting was excluded from the study. Reliability of the instrument was tested using

Cronbach’s alpha, where r=0.72

3.5 Data Collection Procedure

The study was conducted only after approval from the research committee of the Janamaitri

Foundation Institute of Health Science (JFIHS). Formal permission was obtained from the

concerned authority of B&B Hospital after briefing about the objectives, process and importance

of the study.

The study was conducted within the period of one weeks. After meeting the inclusion criteria,

respondents was explained about the purpose of the study. Interview was started after getting

verbal and written consent from them. Respondents was informed that they can leave the study

anytime they wanted and was assured for confidentiality. The data was collected using through

face-to-face interview technique by using structured interview schedule in Nepali version by

researcher herself. Privacy was maintained by interviewing respondent in their respective bed

and using scree if necessary. On an average of 9-10 respondents was interviewed per day and the

average time required to complete the interview was 25-30 minutes.

Respondent’s anonymity and confidentiality was be maintained using code number in the

questionnaire instead of the name of the respondents.

3.6 Data analysis procedure

Descriptive and inferential statistics will be used for data analysis. All interview forms was

checked for accuracy, completeness and properly encoded. The encoded data was entered into

Statistical package SPSS version 20. Descriptive statistics was used to find out the attitude of

patients and was presented using frequency, percentage, standard deviation and mean. The

finding of the study was presented in different tables and figures.

 CHAPTER IV
FINDINGS OF THE STUDY
This chapter deals with analysis and interpretation of the finding of the data was obtained from
the interview as well as self-administration of the questionnaire on patient’s attitude towards
student nurse. The collected data were analyzed and interpreted on the basis of research
objectives. 55 patients were respondents were participated from Medical-Surgical ward of B&B
hospital, Gworkhu, Lalitpur. The result were analyzed through statistical package SPSS version
20 from which the frequency, percentage, mean and standard deviation were calculated.
The finding of the study is presented below:
TABLE 1: Respondents’ Age, Sex, Ethnic Group, Religion, Educational level and occupation
TABLE 2: Respondents’ presence of nurse in family, previous hospitalization, duration of
hospital stay and cared by student nurse
TABLE 3: Attitude of Respondents towards grooming of student nurse
TABLE 4: Attitude of Respondents towards the presence of student nurse
TABLE 5: Attitude of Respondents towards the communication of student nurse
TABLE 6: Attitude of Respondents towards care provided by the student nurse
TABLE 7: Level of attitude of respondents
 TABLE 1

Respondents’ Age, Sex, Ethnic Group, Religion, Educational level and occupation
n=55

 Variables Frequency Percentage %

Age in completed years

20-45 37 67.3
46-60 13 23.6
61+ 5 9.1
Mean age ±S.D.: 40.35±13.65 years

Sex
Male 33 60.0
Female 22 40.0

Ethinc Group
Brahmin/Chettri 37 67.3
Janajati 11 20.0
Madeshi 5 9.1
Others a 2 3.6

Religion
Hindu 51 92.7
Buddhist 2 3.6
Kirat 2 3.6

Educational Level
Illiterate 3 5.5
Literate( only read and write) 27 49.1
Basic level (class 1-8) 6 10.9
Secondary level (class 9-12) 12 21.8
University level(Above 12) 7 12.7

Occupation
Agriculture 19 34.5
 Service 12 21.8
Business 8 14.5
Others b 16 29.1

Note: a: Dalit, b: Homemaker

Table 1 shows majority of the respondents (67.3%) belonged to age group 20-45 years.
The mean age of the respondents was 40.35years with standard deviation of 13.65years. Majority
of the respondents (60%) were male and 40% were female. Regarding ethnic group, majority of
the respondents (67.3%) were Brahmin/Chettri while only 3.65% of the respondents were Dalit.
Most of the respondents (92.7%) followed Hinduism while 3.6% of the respondents was
Buddhist. About 49.1% of the respondents were literate while only 5.5% were illiterate.
Regarding occupation 34.5% of the respondents were engaged in agriculture and 14.5% of the
respondents were involved in business.
 TABLE 2

Respondent’s presence of nurse in family, previous hospitalization, duration of hospital

stay and cared by student nurse
n=55

 Variables Frequency Percentage %

Presence of nurse in family
Yes 16 29.1
No 39 70.9
Previous hospitalization
Yes 18 32.7
No 37 67.3
Duration of hospital stay
<= 5days 49 89.1
More than 5days 6 10.9
Cared by student nurse
Yes 9 16.4
No 46 83.6
Table 2 shows that majority of the respondents 70.9% hadn’t presence of nurse in a family.
Similarly, majority of the respondents 67.3% hadn’t visited hospital previously. Most of the
respondents 89.1% were stayed hospital less than or equal to 5days. Similarly, most of the
respondents 83.6% were not cared by student nurse.
 TABLE 3

Attitude of Respondents towards grooming of student nurse

n=55

Strongly Strongly
Items Agree Uncertain Disagree
agree disagree

Patient’s attitude
towards grooming
of student nurse

Students nurses are

identified through 25(45.55) 25(45.5) 4(7.3) 1(1.8) -
their attire

Dress of nursing
student should be 25(45.5) 28(50.9) 2(3.6) -  
neat, clean and tidy

Table 3 shows that about 45.5% of the same percentage of respondents agreed and strongly
agreed that student’s nurses are identified through their attire. Half of the respondents 50.9%
were agreed that dress of nursing should be neat, clean and tidy.
 TABLE 4:

Attitude of Respondents towards the presence of student nurse

n=55

Strongly Strongly
Items Agree Uncertain Disagree
agree disagree
Patient’s
attitude
towards the
presence of
student nurse
You are glad that
there are student
26(47.3) 23(41.8) 5(9.1) - 1(1.8)
nurse in the
hospital
Because of the
student nurses
being around,
you feel more in
16(29.1) 29(52.7) 10(18.2) - -
touch and know
what is going on
about your
disease.
You would have
preferred there to
be no student 8(14.5) 14(25.5) 15(27.3) 9(16.4) 9(16.4)
nurses in the
hospital.

Table 4 shows that about 47.3% of the respondents were strongly agreed that there are student
nurse in the hospital whereas 1.8% were strongly disagreed. More than half of the respondents
52.7% were agreed that because of the student nurses being around, you feel more in touch and
know what is going on about your disease. Surprisingly, 27.3% of the respondents were
uncertain on the statement that you would have preferred there to be no student nurse in the
hospital.

TABLE 5

Attitude of Respondents towards the communication of student nurse

n=55
Strongly Strongly
Items Agree Uncertain Disagree
agree disagree
Patient attitude towards the
communication of student
nurse.
Student nurse have good
18(32.7) 27(49.1) 9(16.4) 1(1.8) -
behavior and temperament.
Student nurse are busy and
11(20) 12(21.8) 20(36.4) 7(12.7) 5(9.1)
always in hurry. *
You can ask student nurses the
16(29.1) 21(38.2) 15(27.3) 3(5.5) -
most trivial questions.
Student nurse behave badly to
2(3.6) 8(14.5) 25(45.5) 5(9.1) 15(27.3)
the patients. *
You also get to learn something
while the senior nurses are
13(23.6) 31(56.4) 8(14.5) 2(3.6) 1(1.8)
teaching students nurses in your
presence.
You like student nurse asking
your every detail and personal
9(18.4) 27(49.1) 16(29.1) 3(5.5) -
questions concerning your
disease.
There is no point of asking
question to student nurse since 3(5.5) 27(49.1) 16(29.1) 13(23.6) 10(18.2)
they do not know anything. *
When student nurses are being
taught in your presence, you 2(3.6) 14(25.5) 20(36.4) 11(20.0) 8(14.5)
rather feel left out or bored. *
Student nurses also know about
8(14.5) 21(38.2) 19(34.5) 6(10.9) 1(1.8)
your disease.
You don’t like student nurse
asking your personal questions 6(10.9) 11(20.0) 21(38.2) 8(14.5) 9(16.4)
regarding your disease. *
Note: *Negative statement

Table 5 shows that about 49.1% of the respondents were agreed that student nurse have good
behavior and temperament. Surprisingly, 49.1% of the respondents were uncertain with
negatively
Phrased item that student nurse are busy and always in hurry, 9.1% of the respondents were
strongly disagree in this statement. About 38.2% of the respondents were agreed that you can ask
student nurses the most trivial questions while 9.1% of the respondents were disagreed.
Surprisingly, 45.5% of the respondents were uncertain that student nurse behave badly to the
patients however, more than half of the respondents 56.4% were agreed that you also get to learn
something while the senior nurses are teaching students nurses in your presence. About 49.1% of
the respondents were agreed that they can ask every detail and personal questions regarding
disease but when same statement asked in negatively phrased item, 38.2% of the respondents
were uncertain. Surprisingly, 49.1% of the respondents were agreed with negatively phrased item
that there is no point of asking question to student nurse since they do not know anything
whereas 18.2% were strongly disagreed. About 36.4% of the respondents were uncertain that
when student nurses are being taught they felt bored and left out. Similarly, 38.2% of the
respondents were agreed that student nurses also know about disease.
 TABLE 6

Attitude of Respondents towards care provided by the student nurse

n=55

Strongly Strongly
Items Agree Uncertain Disagree
agree disagree
Patient‘s attitude
toward care
provided by the
student nurse.
Student nurses do not
know anything about 8(14.5) 10(18.2) 16(29.1) 14(25.5) 7(12.7)
your disease.
You did not really
benefit from student
2(3.6) 13(23.6) 23(41.8) 3(5.5) 14(25.5)
nurses in your
treatment process. *
You do not like
student nurse
examining you 2(3.6) 19(34.5) 15(27.3) 8(14.5) 11(20.0)
repeatedly taking a
long time. *
Student nurse have
7(12.7) 22(40.0) 21(38.2) 3(5.5) 2(3.6)
more time to give.
You like student
nurses examine you
12(21.8) 22(40.0) 19(34.5) 2(3.6) -
because they do it in
detail.
Although student
nurse being around, 4(7.3) 7(12.7) 25(45.5) 8(14.5) 11(20.0)
you did not get much
 to know about your
treatmentnurses
Student process. *
helped
very much in your 21(38.2) 20(36.4) 12(21.8) 2(3.6) -
treatment process
Note: *Negative statement

Table 6 shows that about 29.1% of the respondents were uncertain that student nurses do not
know anything about disease, likewise 41.8% of the respondents were uncertain with negatively
phrased item that they did not really benefit from student nurses in their treatment process where
as 3.6% were strongly agree in this statement. Surprisingly 34.5% were agreed on negatively
phrased item that they do not like student nurse examining repeatedly taking a long time.
However, 40% of the respondents were agreed that student nurse have more time to give.
Similarly, 40% of the respondents agreed that they like to examine by student nurse because they
do it in detail. Likewise 45.5% of the respondents were uncertain that although student nurse
being around, they did not get much to know about your treatment process. About 38.2% of the
respondents were strongly agreed that student nurses helped very much in treatment process.

TABLE 7

Level of attitude of respondents

 Level of attitude Frequency Percent

Negative 1 1.8
Positive 54 98.2
Mean attitude score ±S.D.: 64.96±8.22

Table 7 shows that majority of the respondents 98.2% had positive attitude towards student
nurse whereas only 1(1.8%) of the respondents had negative attitude. The mean attitude score ±
S.D. of the respondents as 64.96±8.22 out of 110.
 CHAPTER V

DISCUSSION CONCLUSION AND RECOMMENDATION

This chapter deals with the discussion of the result, conclusion of the study and recommendation.
The discussion parts present the finding of the study and findings were compared with those of
other study identified through literature review. The conclusions were drawn from each of the
finding of the study. The recommendation provides suggestions to further study for improvement
of the present study and services.
5.1 Discussion
The study was intended to assess the attitude of patient’s towards student nurse of selected
hospital of Lalitpur. The major findings of the study are discussed below. This study was done
on 55 patients, convenience sampling technique and simple descriptive research design was used.
Findings related to Socio-demographics Information
Majority of the respondents (67.3%) belonged to age group 20-45 years. The mean age of the
respondents was 40.35years with standard deviation of 13.65years. Majority of the respondents
(60%) were male and 40% were female. Regarding ethnic group, majority of the respondents
(67.3%) were Brahmin/Chettri while only 3.65% of the respondents were Dalit. Most of the
respondents (92.7%) followed Hinduism while 3.6% of the respondents was Buddhist. About
49.1% of the respondents were literate while only 5.5% were illiterate. Regarding occupation
34.5% of the respondents were engaged in agriculture and 14.5% of the respondents were
involved in business. Majority of the respondents 70.9% hadn’t presence of nurse in a family.
Similarly, majority of the respondents 67.3% hadn’t visited hospital previously. Most of the
respondents 89.1% were stayed hospital less than or equal to 5days. Similarly, most of the
respondents 83.6% were not cared by student nurse
The objective of the study was to assess the level of attitude patients towards student nurse.
Discussion related to level of Attitude of patients towards student nurse
Findings of the study showed majority of the respondents 98.2% had positive attitude while 1.8%
had negative attitude towards student nurse which was in consistent to study conducted in
Damcaus University majority of the respondents 67.8% had positive attitude towards medical
students during medical consultations (Hassan,Bashdour & Koudsi, 2012). This might be due to
the difference in sample size, educational level and marital status.
In present study, it was found that 45.5% of the respondents were agreed that student nurse are
identified through their dress code which was in consistent with study conducted by (Shakya &
Aryal, 2018) which showed 47.8% of the respondents agreed on the same statement. Half of the
respondents 50.9% were agreed that dress of student nurse should be neat, clean and tidy which
was similar to the study conducted in Lalitpur, hospital which revealed that 51.1% were agreed
in the same statement.
The finding of present study showed that 47.3% of the respondents were strongly agreed that
presence of student nurses in ward make the clients glad which was contrast with the study
conducted by (Mehta & Singh, 2013) which showed that 96.7% were agreed. More than half of
the respondents 52.7% were agreed that they know about own disease process which was
inconsistent with the study conducted by (Mehta & Singh, 2013) which showed 76.7% were
agreed on it.
The study conducted in University of Saudi Arabia revealed that majority of the respondents had
negative attitude 61% (Megahed, Raju & Elabs, 2019) which was contradictory to the present
study where 98.2% of the respondents had positive attitude. The respondents had negative
attitude towards student nurse this might be due to religious and cultural factors (privacy issues),
lack of emotional support.
Moreover, the present study showed that 34.5 % disagree on patient didn’t like student nurse
examining repeatedly taking a long time. The present study is contradictory with the study done
by (Mehta & Singh, 2013) which revealed, 57.9 percent of the respondents agree that patient
doesn’t like repeated and longtime examination done by students nurse. Furthermore, the present
study showed that 40% percent of the respondents agree that student nurses have more time to
give. In consistent to the study done by Mehta et al. which showed, 51.7% of the respondents
agree that students have more time for patient.
Likewise, the present study showed that 49.1% of the respondents agreed with student nurses has
good behavior and temperament. In contradictory to the present study conducted by Mehta et al.
which showed almost 93.2 percent of the respondents agree with student have good behavior and
temperament. The present study revealed that 45.5% of the respondents were uncertain about
student nurse behave badly to the patients which was in contrast to the study conducted by Mehta
et.al. which showed that 62.1% were agreed on it.
5.2 Conclusions:
The finding of the study showed that almost all of the respondents had positive and remaining
respondents had negative attitude.
5.3 Limitation of the study:
The study was conducted in only one hospital of Lalitpur, district. So findings may not be
generalized to any other setting. The ward and patient were selected purposively so it becomes
one of the limitations of the study.
5.4 Implications of the study:
The finding of the study can be a baseline for future researchers for further study in future.
It may be helpful to hospital administration and students to maintain continuity of care in further
future.
5.5 Recommendation:
Further studies can take into considerations for the findings and limitations of this study for
better results.
Further focus on skill and communication of students nurses so that the results might be helpful
for quality care and satisfaction of patients.
Further, study can be conducted in another setting of urban and rural areas including large
number of patients.
 REFERENCES

Abdulghani, H.M., Al-Rukban, M.O., & Ahmad, S.S. (2008). Patient attitude towards medical

students in Riyadh, Saudi Arabia. Education for Health 21(2):69. Retrieved from

http://www.educationforhealth.net/.

Aljoudi, B.S., Alsolami, S.S., Farahat, M.F., Alsaywid, B., & Abuznadah, W. (2014). Patient

attitude towards participation of medical student in clinical examination and care in

Western .Saudi Arabia. Journal of Family and Community Medicine, 23(3), 172-179.

Retrieved on 11th March 2020 from http://www.jfcmonline.com/202.51.88.170.

Belete, A., Lamaro, T., & Henok, A. (2015). Assessment of attitude towards nursing profession

among nurses and non-nursing health profession. Journal in Nursing and care S1-003, 2-

7. Retrieved on April 1st from http://dx.doi.org/10.4172/2167-1168.S1-003.

Coban, G.I.,& Kasikci, M. (2011). Development of the Attitude Scale for Nursing Profession.

International Journal of Nursing Practice, 17,518-524. Retrieved from

http://doi:10.1111/j.1440-172X.2011.01961.x

Dzomeku, V.M., Ba-Etilayoo, A., Perekuu, T., Mantey, R.E. In-Patient satisfaction with nursing

care: A case study at Kwame Nkrumah University of Science and Technology Hospital.
 International Journal of Research in Medical and Health Science 2(1). Retrieved on 29th

March from http://www.ijsk.org/ijrmhs.html.

Fukuda, M. (2018). Nursing Competency: Definition, Structure and Development. Yonago acta

medica, 61(1), 1-7. Retrieved on 29th March from

http://dx.doi.org/10.33160/yam.2018.03.001.

Gupta, B.S., Shrestha, S., Thulung, B.K., (2014). Patient’s perception towards Quality Nursing

Care. Journal of Nepal Health Research Council 12(2), 83-87. Available from

http://www.ncbi.nim.nih.gov/

Jamshidi, N., Molazem, z., Sharif, F., Torabizadeh, C., & Kalyani, N.M. (2016). The Challenges

of Nursing students in the Clinical Learning Environment: A Qualitative Study.The

Scientific World Journal 2016, 1-7.Retrieved on 23rd March from

http://dx.doi.org/10.1155/2016/1846178.

Jonsen, E., Melender, H.L., and Hilli, Y. (2013).Finnish and Swedish Nursing Students

Experience of Their First Clinical Practice Placement: A Qualitative Study Nurse

Education 33, 297-302. Retrieved on 30th March from

http://dx.doi.org/10.1016/j.nedt.2012.06.012.

Karaca, A., Durna, Z. (2019). Patient Satisfaction with the quality of nursing care. Doctoral

thesis at Istanbul Bilim University of Health Science 6(2). Retrieved on 24th March from

https://onlinelibrary.wiley.com/doi.org/10.1002/nop2.237.

Kulkarni, G.V. (2009). The Student –patient relationship: A student’s perspective on the grey

areas. International Journal 55(1), 55-72. Retrieved from

http://www.jpgmonline.com/text.asp?2009/55/1/72/48445.
Khatib, Ai.T., Othman , S., & Deek, Ei.B. (2013). Patient Perception towards Medical Student in

their Surgical Care: Single Center Study. Education Research International 2016, Article

ID 8234841. Retrieved on 18th February from http://dx.doi.org/10.1155/2016/8234841.

Mehta, R.S., Singh, B. (2013). Patient attitude towards nursing students of BPKIHS. Journal of

Nepal Health Research Council 4(2), 45-50. Retrieved on 17th February from

https://www.slideshare.net.

Megahed, M.M., Raju, J., Chithra, R.A., & Elabas, A.A.N. (2019). Maternal Attitude and

Satisfaction towards involvement of Nursing Student in their Care. International Journal

of Science and Research 8(2), 86-90. Retrieved on 17th February from www.ijsr.net.

Mukumbang, F.C., Oluyinka, A. (2013). Patients experience of being nursed by student nurses at

a teaching hospital. Journal of the Democratic Nursing Organization of South Africa

37(1), 1230-1236. Retrieved on 18th February from http://dx.doi.org/10.4102/.

Nielsen, K., Norlyk, Annelise., & Henriksen, J. ( 2018). Nursing student’s learning experiences

in clinical placement and simulation- A qualitative study. Journal of Nursing Education

and Practice 9(1). Retrieved on 19th February from

http://www.reseaechgate.net/publication/327560260.

Onotai, L.O., Asuquo, E., Amadi, E., Amadi, O.A., & Ali, D.U. (2012). Patient’s perception and

attitude towards medical student’s involvement in patient care at Nigerian University

Teaching Hospital. International Research Journal 3(9), 732-743. Retrieved on 19 th

February from http://www.interesjournals.org/.

Oster, C., Backstrom, S., Lantz, I., Ramklint, M. (2015). Psychiatric patient’s perspective of

student involvement in their care. BMC Medical Education 15(69)P, 1-10. Retrieved on

20th February from http://creativecommons.org/license/by/4.0.

Papastavrou, E., Andreou, P., Tsangari, H., & Merkouris, A. (2014). Linking patient satisfaction

with nursing care: The case of care rationing –a correlation study. Bio-Med Central

13(26), 1-10. Retrieved on 18th February from http://www.biomedcentral.com/1472-

6955/13/26.

Parry, M. (2011).Student nurse’s experience of their first death in clinical practice. International

journal of palliative Nursing 17(9), 448-453. Retrieved from:

https://dx.doi.org/10.12968/ijpn.2011.17.9.448.

Richard, L.J. (2010). Fostering therapeutic nurse- patient relationships. Nursing made incredibly

Easy 8(3) 4. Retrieved from:

https://journals.www.com/doi:10.1097/01.NME.0000371036.87494.11

Salah, A.B., Mhamdi, E.S., Bounene, L., Sriha, A., & Soltani, M. (2015). Patient attitude

towards bedside teaching in Tunisa. International Journal of Medical Education 6, 201-

207.

Sayed-Hassan, R., Bashour, H., Koudsi, A. (2011). Patient attitude towards medical students at

Damascus University Teaching Hospital. BMC Medical Education 12(13). Retrieved on

18th February from http://www.biomedcentral.com/1472-6920/1213.

Shakya, P., Aryal, P. (2018). Attitude of Patient towards Student Nurse. Journal of Health

Education Research & Development 6(3):271, 1-5. Retrieved on 18th February from

https://www.omicsonline.org/

Shrestha, S., Devkota, R., (2018). Patient Satisfaction in Nepal Medical College Teaching

Hospital. Nepal Medical College Journal 19(4); 196-203. Retrieved on 19th February

from https://www.researchgate.net/publication/327768521.
Tomietto, M.,Comparcini, D., Simonetti, V., Pelusi, G., Troiani, S., Saarikoski, M. & Cicolini,

G. (2015).Work- engaged nurses for a better clinical learning environment: A ward-

Level analysis. Journal of Nursing Management 24(4). Retrieved from:

https://doi.org/10.1111/jonm.12346.

World Health Organization (2017) Report of the Policy dialogue meeting on the Nursing

workforce. Retrieved form https://www.who.int>hrh>news.