How do nurses understand and manage patient culture in caring for older people? An ethnographic study in one hospital in Nigeria

Anyigor, Chukwuma Nwankwo (2022) How do nurses understand and manage patient culture in caring for older people? An ethnographic study in one hospital in Nigeria. University of Southampton, Doctoral Thesis, 378pp.

Record type: Thesis (Doctoral)

Abstract

There is an increasing population of older people in Nigerian hospitals. Empirical
evidence indicates that culture may have a strong influence on the nursing care of patients, including older people (Martin et al. 1986). This is because it forms thecaring approach, such as the use of effective communication to understand theindividuality of the patients, leading to the delivery of holistic care. This indicates that culture underpins the entirety of human lifestyle, which requires adequate attention during the care of patients. However, there is a dearth of literature aboutcultural influences on how nurses care for older people in Nigeria. This knowledge gap prevents the understanding of how culture impacts on the health of older people and the way nurses can provide quality care for this population.
This study used an ethnographic design to explore how nurses understand and
manage patient culture in their care of older people in Nigeria. Purposive sampling was used to recruit 41 full-time Staff Nurses providing direct care to older people on male and female medical and surgical wards in a hospital. Data were collected over15 weeks (December 2016 to April 2017) and included 93 hours of observation and 20 semi-structured interviews, supplemented with writing a reflective diary. A thematic analysis was used to conduct the data analysis,supported by computer software (NVivo 11).
The analysis revealed two main influential themes that show how do nurses
understand and manage patient culture in caring for older people. The first theme is contextual factors influencing nursing care of older people. It is important to understand this context before the second due to its impact on culture and nursing care of older people. The theme mainly discussed the following: National health policy and provision of care: perceived impact on the care of older people, socioeconomic factors, nursing policy and education in cultural care, nurse perceptions about the provision of health care materials in the hospital, and nurse/doctor working relationship influence on the care. The second theme is the articulation and management of older peoples’ cultural beliefs and practices, where nurses demonstrated how they provided the care to older people. These include nurses’ perceptions of older peoples’ belief system, articulation of culture from experiences of professional practice, and managing cultural conflict in nursing care.
The findings indicate that this the first qualitative piece of research that used an
ethnographic approach to explore in detail how nurses understand and manage
patients cultural values and beliefs to demonstrate cultural competence while
providing care to older people. This study demonstrate that Nigeria nurses
recognised the significant infuleunce of culture on nursing care. It showed that the use of good communication is the could help to address the challenges culture during patient care. This result of this study has the potential to improve the principles of good practice among professional nurses. The findings can help the NMCN to bring the desired reform in nursing education and practice in Nigeria that would enhance the nursing care of older people.