1.1 Introduction
Nursing care is a fundamental component of healthcare delivery, and its effectiveness is closely linked to the attitudes, perceptions, and experiences of patients who receive such care. Attitude is defined as an individual's predisposition to respond positively or negatively to a person, object, or situation based on beliefs, feelings, and past experiences (Robbins & Judge, 2019). Perception, on the other hand, refers to the process by which individuals organize, interpret, and make meaning of sensory information, shaped by expectations, cultural background, and personal experiences (Kassin, Fein, & Markus, 2020). In the context of healthcare, patients' attitudes and perceptions are central to determining the level of trust, acceptance, and satisfaction they express toward those who provide care.
This chapter introduces the research by reviewing the background that informed the study, identifying the issues that led to its formulation, and outlining the aim and objectives. It also explains the study's significance, defines its scope, presents the research questions and hypotheses, addresses the limitations, and clarifies important terms used throughout the work.
1.2 Background of Study
The practice of nursing has a long and dynamic history, evolving from basic caregiving to a complex profession that integrates scientific knowledge, technical skills, and interpersonal communication. Historically, the involvement of student nurses in patient care began as an apprenticeship system, where trainees learned directly from experienced nurses through observation and practical engagement (Oyetunde & Akinyele, 2019). Over time, structured nursing education emerged, combining theoretical instruction with supervised clinical practice to ensure that students develop competence, confidence, and professionalism.
Patient perception of care has always been a critical factor in healthcare delivery. According to Johnson and Haigh (2021), patients historically evaluated care providers based on observable behaviors, empathy, and outcomes of treatment, even when interacting with student practitioners. In earlier decades, the role of student nurses was often limited, and patients were generally skeptical of receiving care from those who were not fully qualified, fearing errors or inadequate treatment. As nursing education became more formalized, the integration of student nurses into clinical care settings increased, creating a need to assess patient attitudes and perceptions more systematically (Johnson and Haigh, 2021).
Quality nursing care is a critical determinant of patient satisfaction, safety, and overall healthcare outcomes. As part of their professional development, student nurses actively participate in clinical settings where they render care under supervision. The way patients perceive and respond to these student nurses plays a significant role in shaping both the care experience and the learning opportunities available to the students. According to Johnson and Haigh (2021), patients' attitudes toward student nurses are influenced by their perceived competence, communication skills, and the level of confidence exhibited during care delivery.
Globally, the involvement of student nurses in patient care is an integral component of nursing education. Oyetunde and Akinyele (2019) reported that clinical practice provides students with essential hands-on skills, yet patients tend to assess their performance based on observable behaviors such as empathy, professionalism, and responsiveness. In settings where patients feel anxious or vulnerable, they may be more sensitive to the manner in which student nurses carry out basic procedures, communicate instructions, or demonstrate competence.
Olaore and Ajayi (2020) asserted that negative experiences with student nurses can reduce patients' confidence in the care process, thereby affecting their overall evaluation of healthcare services. The socio-cultural environment also shapes patient attitudes. In many communities, patients expect highly trained professionals to attend to them exclusively. Adeyemi and Nwosu (2022) stated that some patients misinterpret the presence of student nurses as an indication of inadequate staffing or compromised service quality. On the contrary, Williams and Barrett (2019) affirmed that when student nurses exhibit compassion, attentiveness, and clarity in communication, patients are more likely to develop trust and respond positively, enhancing the therapeutic experience for both parties.
Communication remains a central factor that shapes patient perceptions. According to Benson and Walker (2021), inadequate explanation of the student nurse's role within the clinical team contributes to patient distrust. When patients are not properly informed about the scope of student nurses' training and supervision, they may assume that students are unqualified to handle their needs. Conversely, clear communication encourages openness and fosters a patient-centered environment.
At the educational level, clinical instructors and registered nurses play a crucial role in moderating patient–student interactions. Ishola and Adebayo (2020) contend that structured supervision and supportive teaching approaches improve students' confidence, which in turn positively influences patient attitudes. When students feel supported, they demonstrate improved decision-making, problem-solving, and interpersonal skills qualities that patients often interpret as signs of competence. This study is set against the backdrop of assessing patients' attitude and perception towards care rendered by student nurses.
1.3 Statement of Problems
Investigation revealed that the quality of nursing care is often influenced by the level of competence, communication, and empathy demonstrated by those who provide it. In many healthcare settings, student nurses play a significant role in assisting with patient care as part of their clinical training. However, patients' attitudes and perceptions toward these student nurses vary widely, shaped by their personal experiences, cultural background, expectations, and the nature of the care received.
In some hospitals, patients express concerns about the confidence and technical abilities of student nurses, especially when procedures seem prolonged or when students appear unsure of themselves. On the other hand, there are patients who acknowledge the politeness, dedication, and willingness to learn that student nurses show, yet their acceptance is influenced by how well these students communicate, maintain professionalism, and demonstrate respect.
There is also a lingering fear among some patients that the involvement of student nurses in their care is a sign of inadequate staffing or reduced access to experienced professionals. Additionally, misconceptions about the role, level of training, and supervision of student nurses contribute to negative attitudes and skepticism. It is against this backdrop that this study seeks to assess patients' attitude and perception towards care rendered by student nurses.
1.4 Aim and Objectives of Study
The aim of this study is to examine patients' attitude and perception towards care rendered by student nurses in Nigerian hospitals.
To achieve this aim, the following objectives are outlined:
- To identify systemic challenges that affect patients' perception of care provided by student nurses.
- To assess the impact of student nurses' communication skills on patients' satisfaction.
- To examine the influence of patient attitudes on the learning experience of student nurses.
- To determine how patients perceive the competence of student nurses.
- To provide recommendations for improving the interaction between patients and student nurses.
1.5 Research Questions
Based on the stated objectives, the study seeks to answer the following research questions:
- How do patients perceive the competence of student nurses?
- What is the impact of student nurses' communication skills on patients' satisfaction?
- How do patient attitudes affect the learning experience of student nurses?
- What systemic challenges influence patients' perception of care rendered by student nurses?
- What measures can be implemented to improve patient–student nurse interactions?
1.6 Research Hypotheses
Based on the objectives and research questions, the following hypotheses are proposed for the study:
- H01: There is no significant relationship between patients' attitudes and perceptions and the care rendered by student nurses.
- H02: Patients' attitudes and perceptions significantly influence the effectiveness and quality of care rendered by student nurses.
1.7 Significance of Study
The outcome of this research will inform healthcare administrators and policymakers about the importance of creating supportive environments where student nurses can develop clinical competence while ensuring patient satisfaction. In addition, this study will reinforce the importance of patient feedback as a tool for improving healthcare quality and supporting the holistic growth of student nurses within clinical settings.
Furthermore, the findings will contribute to the body of knowledge in nursing and healthcare practice, particularly in local contexts where patient attitudes toward student nurses have not been thoroughly explored.
Lastly, the study will encourage future research on patient–student nurse interactions and promote best practices that enhance healthcare delivery and professional development simultaneously.
1.8 Scope of Study
The scope of this research is focused on assessing patients' attitudes and perceptions towards care rendered by student nurses within selected hospitals in Lagos State, Nigeria. The study will cover both male and female patients across various wards, emphasizing interactions with student nurses during routine clinical care.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund prevented the researcher from utilizing more extensive data collection tools or conducting more in-depth analysis that could have provided richer insights into the topic.
- Initial Cooperation Delay from Respondents: Some participants, particularly employees and customers, were slow to return their completed surveys or to provide feedback during interviews.
1.10 Definition of Terms
Attitude:
Attitude is the predisposition of an individual to respond positively or negatively to a person or situation, shaped by beliefs, feelings, and past experiences (Robbins & Judge, 2019). In this study, it refers to patients' disposition toward student nurses.
Perception:
Perception is the process by which individuals interpret and make sense of sensory information (Kassin, Fein, & Markus, 2020). Here, it relates to how patients interpret the care provided by student nurses.
Patient Satisfaction:
Patient satisfaction is the measure of patients' contentment with the healthcare services they receive, including the competence, communication, and empathy of care providers (Olaore & Ajayi, 2020).
Student Nurses:
Student nurses are individuals undergoing formal training in nursing who provide care under supervision to gain practical experience (Oyetunde & Akinyele, 2019).
Clinical Competence:
Clinical competence refers to the ability of student nurses to effectively perform nursing tasks and interact with patients in a professional and safe manner (Williams & Barrett, 2019).
Communication Skills:
Communication skills involve the ability of student nurses to convey information clearly, listen actively, and respond empathetically to patients (Benson & Walker, 2021).
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