الفهرس 
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Abstract
SUMMARY
Motivation is exceptionally crucial in influencing the quality of health care work
outcomes. one of the most beneficial skills for effective leadership and management, in
the nursing field, is the ability to motivate and improve patients’ outcomes. in order to
survive and gain a competitive advantage in health care organizations should pay much
more attention to their work motivation. Motivation support nurses in dealing with the
day-to-day work load and problems within health organizations, where nurses suffered
from work stress and should deal with their daily activities. nurses’ motivation enhancing
job satisfaction, and improving job performance and patients’ outcome. Therefore,
examining the relationship between nurses’ motivation and patients’ outcome is important
for all nurses of health care organizations, their job performance is affected by motivation
and lead to good patients’ outcome.
Aim of the study:
Examine the relationship between nurses’ motivation and patients’ outcomes in
hemodialysis departments at Kafr EL-Dawar General, Central and Fever hospitals.
Study design:
A descriptive correlational research design was used in this study.
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Setting of the study:
The ongoing study was carried out in the hemodialysis departments of the
following hospitals:
Kafr El-Dawar General Hospital with bed capacity 32 beds.
Kafr El-Dawar Central Hospital with bed capacity 15 beds.
Kafr El-Dawar Fever Hospital with bed capacity 23 beds.
Subjects of the study:
The study was conducted on:
1- All nurses who are working on the previously mentioned settings with at least
one year of experience and who will be available at the time of data collection,
was included in the study (n=84).
2- All patients who are treated in the previously mentioned settings and who was
available at the time of data collection taken from registration of hospital records,
will be included in the study (n =373).
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Table (1): - Numbers of nurses and patients at Kafr EL-Dawar General,
Central, and Fever hospitals.
Total
Fever
hospital
Central
hospital
General
hospital
84
32
17
35
Nurses numbers
373
138
65
170
Patient numbers
Tools of the study
The study utilized two tools for data collection:
Tool I: Motivating Work Factors Questionnaire:
It was developed by El- Sayed (2008) (186) and used by Ellis and Hartley (2000)
(187) based on Herzberg’s motivator and hygiene theory. It contains 45 items which are
classified into seven domains: Job assurance (10 questions), Hospital policy (14
questions), Work nature (3 questions), Peer interaction (5 questions), Supervision (5
questions), Work responsibility (4 questions), and Achievements (4 questions).
Responses were measured using a five point Likert rating scale ranging from (1) none,
(2) rarely, (3) Sometimes, (4) Often, and (5) always encourages. 75% and more
indicates higher motivation. (Appendix I)
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Tool II: Clinical Patients’ Outcomes Checklist:
It was developed by Simeza (2013) (12), to measure clinical patient outcomes. It
includes 33 items which are classified into two domains. (Appendix II)
First, related to patients’ functional status / outcomes includes (13 items) as (I am
walking comfortably after this dialysis, I am able to work and play after this dialysis …
etc). Second, related to patient satisfaction includes (20 items) as (the nurse treated
me with respect, the nurse was honest about my condition, the nurse fully answered my
questions…etc). (Appendix III) Responses were measured on a five point Likert rating
scale ranged from (1) strongly disagree, (2) disagree, (3) uncertain, (4) agree, (5)
strongly agree.
In addition, demographic characteristics data for nurses that included
questionnaires related to age, gender, educational qualification, years of nursing
experiences, and marital status.
And demographic characteristic data for patients that included questionnaires
related to age, gender, marital status, educational level and duration of dialysis (years).
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Methods:
1- An official written permission was obtained from the Dean of Faculty of Nursing,
Damanhour University, and the responsible authorities of the study settings after an
explanation of the purpose of the study.
2- The two tools were translated into Arabic, and were tested for their content validity
by five experts in the field of the study and accordingly, the necessary
modifications were done. (Appendix III)
3- A pilot study was carried out on 10% of the total sample size of nurses (n=9) and
patients (n=37), who were not included in the nurses in order to check and ensure
the clarity and feasibility of the tools and to identify obstacles and problems that may
be encountered during data collection and the necessary modifications were done.
4- The reliability of the two tools was tested statistically using Cronbach’s Alpha
Coefficient test to measure the internal consistency of the items composing each
dimension of the tools. The result of Cronbach’s Alpha Coefficient test proved to be
strongly reliable for motivation factor 0,935, and 0.897 for patient outcome.
5- Data was collected from the identified nurses, by the researcher through a hand-
delivered questionnaire at their working setting after explaining the aim of the study.
The data collection took about two months from February 2021 to April 2021 and
estimating the time needed for filling the tools, it ranged between 30 to 45 minutes.
6- Data obtained was analyzed using the appropriate statistical tests.
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The main results of the present study were as follows:
1. There is a statistical significant relationship between nurses’ motivation and patient
outcomes.
2.There is a highly significant relationship between nurses’ motivation and the peer
interaction and a low significant relationship between nurses’ motivation, job security,
and the nature of work, as well as an overall decrease in motivation.
3. There is a highly significant relationship between patients’ outcomes and patient
satisfaction, and a moderately significant relationship between patients’ outcomes and
the patient’s functional status.
4. There is a significant relationship between the total clinical outcomes of patients and
demographic characteristics.
5. There is no statistical significant relationship between nurses’ motivation and
demographic characteristics.
In the light of the results of the current study, the following recommendations can
be suggested:
- Hospital administrators and nurse supervisors should:
-
Consistently implementing professional strategies and interventions for managing
nurses’ motivation and patients’ outcome to foster a supportive work environment,
enhance job satisfaction, and reduce turnover.
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-
Improve the nurses’ job motivation by creating a collaborative and cooperative
working environment, and team spirit among nurses.
-
Create an equitable work environment, and maintain open and clear
communication with all nurses, through conducting frequent periodic meetings to
discuss and identify their work problems and complaints.
-
Encourage sharing system (knowledge, practical skills) among nurses to improve
work productivity.
-
Provide the nurses with continuous feedback about their performance and
promote the acceptance of individual differences.
-
Offer continuous training to improve nurses’ skills practice, participative decision
making, problem-solving, and performance.
-
Share the hospital mission and vision, and clarify the hospital goals with nurses,
that help them to understand their roles and responsibilities in the hospital.
Nurses should:
-
Develop their problem-solving ability, participative decision-making and high
performance through attending training program.
-
Improve their communication skills with the top level managers using social
and emotional intelligence technique.
-
Attend orientation program concerning hospital mission, vision, policy.
-
Nurses should continually provide accurate information to their patients because
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this helps the patients in making an informed decision pertaining to the management of
chronic illness.
Future/ further studies should be conducted:
a.
Determine the relationships between nurses’ motivation, health policies, and
healthcare structures.
b.
Develop strategies to enhance positive nurses’ motivation and patients’ outcomes.
c.
Determine the relationship between patients’ outcome and turnover.