The Relationship between Individual Workload Perception and Individualized Care Perceptions of Nurses

Aim: The purpose of the study was to examine the relationship between nurses’ perceptions of individual workload and perceptions of individualized care. Method: The study was a descriptive cross-sectional and conducted with 424 nurses. “Nurse Information Form”, “The Individual Workload Perception Scale (IWPS-R)”, and “the Individualized Care Scale: Nurse A version (ICS Nurse-A)” were used as data tools. Results: The nurse’s IWPS-R score was 3.50±0.67, and the ICS- Nurse A was 3.48±0.82. The factor that contributed most to nurses’ positive perceptions of their workload was “peer support” and the factor with the least contribution was “manager support”. “Clinical situation” was the subscale with the highest mean score (3.70±0.87), and “personal life situation” was the subscale with the lowest score in ICS-Nurse A (2.99±0.98). The nurses’ perceptions of their workload and individualized nursing care were at moderately positive levels, and there was a significant correlation between them. The one unit increase in the individual workload’ perception of nurses would lead to a 0.447 unit increase in their perception of individualized care. Conclusions: Nurses’ perceptions of individual workload were rated as moderately positive. There was a statistically significant relationship between perceived individual workload and individual nursing care. Place and Time of Research: This descriptive and cross-sectional study was conducted in one of the regions of Turkey between 2 March 2016, and 30 May 2016 in the clinics of a university hospital, a hospital affiliated with a public hospitals association, and a private hospital. In all three hospitals, patient treatment and care services were provided within the framework of the Health Quality Standards of the Ministry of Health (2020) which ensure the continuity of quality and patient safety, and the procedures and principles for the implementation of these standards. The Sample of the Research: The nurse managers in the three hospitals were asked to provide several potential nurses working in the following units: Medical wards (internal medicine, cardiology, neurology, endocrinology, gastroenterology, chest diseases, pediatric services), surgical wards (general surgery, thoracic and cardiovascular surgery, orthopedic surgery, plastic surgery, urology, the obstetrics and gynecology clinic, and the pediatric surgery unit) and intensive care units (anesthesia, surgery, neurology and cardiovascular intensive care units). A total of 97 nurses were excluded from the universe of the study since outpatient nurses and nurse managers did not provide patient care. The universe of the study included of 1573 nurses providing patient care and working in inpatient units in three hospitals. Power analysis was performed to determine the sample size from the known universe. A significance level of 0.05 and an effect size (d) of 0.15 were determined for a power (1-β) of 0.80. In the current study, Cohen’s effect size system was used and the middle effect size was taken as 0.15 for power analysis were used as reference (Özçomak and Cebi, 2017). The sample size was calculated to be 375. It was aimed to reach 424 nurses considering the possible data losses. A total of 424 nurses taking part in the study were used the simple random sampling method, a probability sampling in which individuals are equally likely to be selected from a population. The inclusion criteria of the study were as follows: (1) Providing care to inpatients, (2) parts. In the first part, the extent to which caregiving nurses support individualized care in care practices (ICS-Nurse A) is assessed. The second part assesses conscious patients’ perceptions of individualized care in the nurses’ last shifts (ICS-Nurse B). In this study, only the ICS-Nurse A was used. The Cronbach’s alpha coefficient of the original ICS-Nurse A version is 0.95 (Suhonen et al., 2007). The Turkish version of the scale was made in 2010 by Acaroğlu, Suhonen, Şendir and Kaya. The ICS-Nurse A is Likert-type scale of 5-point including of 17 items. Each item is scored between 1 and 5. High scores indicate that nurses have more supportive perceptions of individualized care. The scale consists of three subscales: Clinical Situation (Clin A), Personal Life Situation (Pers A), and Decisional Control over In this current study, the perception of the individual workload of nurses, according to the institutions where the nurses work, working in public hospitals was found to be quite positive (general nurse satisfaction was high) compared to nurses working in private and university hospital. Moreover, when looking at the details of the institution’s bed capacity, the positive perception of individual workload in hospitals with a bed capacity of 200 and below supports the positive perception in public hospitals. As a result of the study, the individual workload perceptions (general nurse satisfaction) of the nurses who work only during the day and who do not have night shifts were determined to be more positive than the other nurses. The fact that the nurses do not have to do many jobs other than the job description due to the availability of data entry personnel or medical secretaries in the day shift, the higher number of nurses working in the day shift than the number of nurses working in the evening and night shifts, the work that needs to be done is properly distributed among the nurses are thought to be the factors increasing the overall satisfaction of nurses. The results of this study are in similarly with other studies (Saygılı, 2008; Ayaz and Beydağ 2014). The Relation Between IWPS-R and ICS-Nurse A: A moderately positive, significant correlation was found among the nurses’ general perceptions of individual workload and their general perceptions of individualized care. This finding indicates that nurses’ general perceptions of individualized care would become more positive as their perceptions of individual workload (general nurse satisfaction) become more positive. Kutney-Lee, Wu, Sloane & Aiken (2013) summited in their study on the working conditions of nurses that basic nursing duties could not be performed as a result of the increased workload. Most of the nurses reported, in two previous similar studies, that they thought their workload was unreasonable and that their workload exceeded their daily working hours. As a result, nurses informed that they could not ensure of good quality their patients