RESEARCH PROPOSAL

JOB SATISFACTION AMONG CIVILIAN NURSES IN

THREE MALITARY HOSPITAL.

NORIMAH BINTI ISHAK

OPEN UNIVERSITY MALAYSIA

2010
Acknowledgement

I would like to thank madam Lee Siew Hoon for the guidance and supervision for me in
writing this proposal.

I also would like to take this opportunity to thank my husband and family for giving me
their support and helping me with my coursework.

TABLE OF CONTENT

CONTENTS PAGE

Acknowledgement i.
Table of Content ii
CHAPTER 1: INTRODUCTION
1.1 Background 1
1.2 Theoretical Framework 2
1.3 Problem Statement 3
1.4 Purpose 4

1.5 General and Specific Objectives

1.5.1 General Objectives 4
1.5.2 Specific Objectives 4
1.6 Significance of the Study 4
1.7 Research Questions 4
1.8 Limitation of the Study 5
1.9 Operational Definition 5

CHAPTER 2: LITERATURE REVIEW

2.1 Introduction 7
2.2 Historical Overview and Research Literature 8
2.3 Definition 8
2.4 Previous Studies 9
 2.5 Patient Satisfaction on Health Giving 10
2.6 The Antenatal Patient and Health Information Giving 10
2.7 Barriers to Receive Health Information at Antenatal Clinic 11
2.8 Summary 11

CHAPTER 3: RESEARCH METHODOLOGY

3.1 Introduction 12
3.2 Study Setting 12
3.3 Study Design 12
3.4 Population and Sampling
3.4.1 Population 13
3.4.2 Sample
13
3.5 Ethical Consideration 13
3.6 Instrumentation / Data Collection 14
3.7 Pilot Study 14
3.8 Data Collection 15
3.9 Data Analysis 15
3.10 Summary 15

REFERENCES 16

APPENDICES
1. Gantt Chart
2. Letter to Medical Officer Family Clinic.
3. Letter to Respondents.
4. Questionnaire.
CHAPTER 1. INTRODUCTION

1.1 Background
This chapter will give an introductory background to the topic which is to be studied and
elaborated.

Satisfaction is one of the core outcome measures for health care. It is intuitively more
appealing than measures of health care effectiveness or efficiency that are more difficult to
understand. Satisfaction is the extent of an individual's experience compared with his or
her expectations.

Malaysia’s health delivery system provides a comprehensive health care service as it

focuses on wellness, client friendly, broad care with efficient use of resources and
achieving high quality service in promoting individual wellness for life.

Nursing in Malaysia has evolved in many aspects as it faces external and internal
challenges. Increased competition among private health service providers as well as
improvement in the government health care system has put patient’s satisfaction as an
important benchmark. Other factors that influence patient’s consideration in their choice of
health provider are also being looked into and improve.

According to McDonnel and Nash, patient satisfaction with nursing services gain even
more importance because nursing staff comprises the majority of the health staff
(McDonnel and Nash 1990). Furthermore, they are constantly found at the side of the
patient to satisfy their needs. It is common knowledge that patients' and families count on
nurses to keep them informed, to connect them to their physicians and other caregivers, to
listen to them, to ease their anxiety, and to protect and watch over them during their
healthcare experience. As such, patients are uniquely able to provide information about
their ease or difficulty of obtaining care.

Patient’s satisfaction is very subjective and surveys have been conducted to provide
feedback on the demand and needs of the patients. With these feedbacks, services which
are found to be lacking can be addressed and improve. Avis, Bond and Thomas (1995)
said, studies on patient’s satisfaction provide facts on the health care provider’s success at
the patient’s expectation and need, as well as an important tool for research and
management.

Studies by Lauer, Murphy and Power (1982) and Oberst (1984) demonstrated a strong
relationship between adequacy of information and overall patient satisfaction with care.
Information giving helps to empower patients to take control over health care and to
comply with treatment other than making them happy and comfortable.

According to Longo et al (2001) patient’s satisfaction on information giving in health care

has been a growing consensus that health care environment best characterised as one in
which patient choice in a competitive marketplace where they play an active role in
making decisions about their health care. Factors contributing growing consensus include
patient's movement, advances in science of patient outcome assessment and the
development and dissemination of patient reports and other health care information such as
patient education material.

Nurses are in an ideal position to provide patients with information that could aid them in
their decision in treatment (Schutta and Burnett (2000). Antenatal mothers experienced
more fear, worry and anxiety and they usually trust the health car professionals to provide
any information they need to know (Jones et al (2001).

Based on the studies, patient satisfaction is one area where the quality of service of a
particular discipline can be assessed. Facilitating information during pregnancy can allay
expectant mothers fear and anxiety especially to an inexperienced housewife. Therefore, a
study on patient’s satisfaction on information giving at the Desa Tun Hussein Onn (DTHO)
antenatal clinic is proposed.

1.2 Theoretical Framework

Patients that come to a clinic with the sole aim of getting their complains attended to or
their illness treated and expect to get well after that. However, patients come from a variety
of socio-economic background. Therefore, the health workers should expect a variety of
characters, attitudes, education background, cultural beliefs, experiences and differing
health knowledge among patients. Thus, a particular set of health information may not
fulfil allif not the majority of patients that seek treatment due to differing level of
understanding of the information given. Some patients may need further elaboraion on
certain issues to make them fully understand the subject being discussed.

1.3 Problem Statement

The proposed study centre is a family clinic situated at the military housing area known as
Desa Tun Hussein Onn (DTHO). It is located about two kilometer from the Ministry of
Defence complex and near the Setiawangsa area. It provides outpatient services, maternal
and child health clinic and family planning clinic. The patients seen at this clinic are
female military personnel, and kin of military personnel.

The clinic staff consists of one medical doctor, one nursing sister, two staff nurses (aka
midwives) and three community nurses. The small number of staff compare to the number
of patients they have to handle is unimaginable at times since the number of patients they
have to attend to, on the average, is 150. The number of expectant mother and
immunisation patients is as Table 1.
Year Expectant mother Immunisation Total
2005 3848 4977 8825
2006 4754 4773 9527
2007 3403 3568 6971
2008 3458 3694 7152
2009 3551 3688 7239
Table 1. Number of patients attending the DTHO Family Clinic from 2005 to 2009.
Source: DTHO Family Clinic.

Other than carrying out nursing duties, the staff have to clerical work, documentation,
registration of patients and searching for files/folders, The nursing sister more often than
not also act as the manager of the clinic preparing annual budgeting, monthly
returns/census. It is therefore doubtful if the nursing staff is able to give an effective
nursing care which include health education and counseling and thus meeting the
expectation of the patient’s needs and information on pregnancy and other health matters.

1.4 Purpose
The purpose of this study is to explore level of patient’s satisfaction on health information
given at the DTHO Antenatal Clinic.
1.5 General and Specific Objectives
1.5.1 General Objective
The general objective of the study is to assess patient’s satisfaction on the health
information that was given to them during their visits to the DTHO antenatal clinic.

1.5.2 Specific Objectives

The specific objectives of the study include:
1.5.2.1 To determine patient's satisfaction on the information on health given
during their visit at the antenatal clinic.
1.5.2.2 To identify other health information needs that is required by the antenatal
mother.
1.5.2.3 To explore the relationship between socio-economical factors and patient’s
satisfaction on the information on health given at the antenatal clinic.

1.6 Significance of the study

This study will provide a feedback on the service provided by the clinic. It may provide an
insight into the system and may be use to improve any shortcomings of the services
provided. This study will allow the staff to focus on the requirement of the patients and
improving the services and thus making the staff more competent. Besides that, the
management can identify the education needs of the staff and their need for further training
as well as upgrading the standard of practice.

1.7 Research Questions

Based on the objectives above and the significance of the study, the following questions
are to be raised during the project:
1.7.1 Were the patient’s satisfied with the information on health given at the
antenatal clinic?
1.7.2 Are there any other information on health that the patient’s would like to
know?
1.7.3 Do socio economic factors influence the satisfaction of patient’s on the
information given.

1.8 Limitation of the study

Since the sample will be from the DTHO antenatal clinic who are members of the military
and their kin, the result may not present the general population on health information given
at other antenatal clinics.

1.9 Operational Definitions

1.9.1 Patient
A patient is a person who receives medical attention, care, or treatment (The American
Heritage® Dictionary). In this study, the patient is the pregnant mother who attends the
DTHO antenatal clinic.

1.9.2 Satisfaction
Satisfaction means: (The American Heritage Dictionary)
a. The fulfillment or gratification of a desire, need, or appetite.
b. Pleasure or contentment derived from such gratification.
c. A source or means of gratification.

1.9.3 Patient Satisfaction

Patient satisfaction is an attitude which mainly concerns the emotional state and is
influenced by the information given to patients and the evaluation of the services they
receive (Linder-Peiz (1982). In this study, patient's satisfaction will focus on the
information on health given by nursing staff in the antenatal clinic.’

1.9.4 Information
In this study, information will refer to any communication or reception of knowledge
through consultation sessions with the doctor or nursing staff. Information will also include
booklets, leaflets, pamphlets or posters that are available at the clinic.

1.9.5 Antenatal clinic

It is place where antenatal care is given to a patient who is tested positive for pregnancy
until she delivers the baby. The patient will be managed and monitored by coming to the
clinic in various visits and undergo various examinations and investigations at the clinic.
CHAPTER 2. LITERATURE REVIEW

2.1 Introduction
This chapter will discussed any literature published on the subject matter.
There are many ways and means to evaluate ones performance and for nursing services,
patient satisfaction is one concept for evaluating the service. According to Miller-Bader
(1988) (cited in Merkouris et al (1999)), traditionally, health care providers assumed that
they know the needs of patients based on professional standard and their assessment.
Therefore with an increasingly competitive healthcare environment, escalating costs and
continuously increasing patients need and awareness, patient satisfaction is one area that
healthcare providers should look into.

Nursing staff comprised the majority of all health staff and are constantly found at the side
of the patient to satisfy their needs, which comprises the main component in the treatment,
maintenance and rehabilitation of the patients health. Many patients still prefer to get
health information with nurses as they feel comfortable with nurses.

Leino-Kilpi et al. (1993) (cited in Henderson et al. (2004), mentioned about the provision
of relevant and appropriate information during hospitalization and visits to clinics is a
fundamental aspects of health care. It also stresses the importance in the promotion of
patient autonomy, dignity and self-respect.

Modern technology have made it possible for patient to acquire knowledge either through
the internet, electronic media and other mass media, magazines, books, videos and journals
as mentioned by Jones et al. (2001), “patients have increasing expectations for health
information and can draw on a widening range of resources.”

Therefore, the researcher will focused on patients’ satisfaction on the aspects of

information giving. The researcher considered it as important as any health information
given which can be part of the patient’s health education which is an integral component of
health care.

At the antenatal clinic, nurses play an important role as information providers or health
educators. Furthermore, mothers today are educated and well informed through reading
and are curious and anxious to know more about their pregnancy, what are the do’s and
don’t during pregnancy. Consequently they need more information in the process of
empowerment for their health care (Lauer et al., 1982; Messner, 1993: Luker, 1995).

2.2 Historical Overview of the theory and Research Literature

May be the first attempt to evaluate patients satisfaction with health service began in 1956
in the USA, in the field of nursing (Abdellah & Levine in 1957a-e,1964 cited in Merkouris
et al 1999). Since then several researchers have attempted to find a solution to the
problems of patient satisfaction by examining the different roles of the patient which is
influence by the characteristics, goals and activities of the services. These generate
interaction between the patient and the nurses where satisfaction can be achieved during
these interaction.

Williams (1994) cited in Hyrkas and Paunonen (2000), have examined satisfaction theories
and relate problems of satisfaction surveys in healthcare. Satisfaction can be seen as a
process including expectation, conception and assumption of outcome.
The patient satisfaction research and survey stared to draw attention in the 1980s after the
publication of Deming’s and Donabedian’s classical work on quality assurance and quality
management (Whittington,1996 as cited in Hyrkas and Paunonen,2000). It is common
knowledge that patients enter the health care system with a variety of characteristics,
attitudes and prior experiences and these affect the degree of satisfaction.

2.3 Definition
2.3.1 Patient Satisfaction
Human satisfaction is complex as it is related to a number of factors such as life style, past
experiences, future expectation, individual and social values (Hall and Dornan (1990).
According to Linder-Pelz (1982), cited in Merkouris (1999), patient satisfaction is an
attitude which mainly concerns the emotional state and is influenced by the information
given to patients and the evaluation of the services they receive

Patient satisfaction is a significant concept for health services, health professionals and
patient (Merkoutis et al,1999). According to Lin (1996), “patient satisfaction gave the staff
information about their education needs, problem areas of care and even the success or
failure of the health care organization.”
“Patient satisfaction is also an indication of quality care provided by an organization,
evidence of the efficiency of organization systems and a predictor of a patient overall
compliance with recommended treatment (Luther, 1996).

2.3.2 Health Information

“Health information is information that is obtained on health through many sources such as
from medical personal, friends, books and magazines, internet, touch-screen, and patient-
held record” (Jones et al.,2001).

2.4 Previous Studies

Studies conducted by WHO and collaborating organization on women satisfaction with
antenatal care in four developing countries (Argentina, Cuba, Saudi Arabia and Thailand)
showed that most women expressed satisfaction with information given on their health, test
during pregnancy, treatment they might receive, labor, delivery, family planning,
pregnancy complication and emergency procedures (Langer et al 2002).

Studies by Irena and Eleanor (2002) found that women who had attended antenatal
education were satisfied with the date and time of antenatal classes, and the information
about self and baby care being provided. They, however, felt unprepared for the demands
of motherhood and they prefer personal need for antenatal preparation for motherhood,
unrealistic preparation for breastfeeding problems. They also felt the educator who gave
health education only stressed the positive aspects of breastfeeding and failed to highlight
the difficulties that can arise. As such they wanted more information on breastfeeding and
prepare them to handle the complexity of breastfeeding. They also need information on
baby care and to manage common neonatal problems. Information on self care was
insufficient as the mothers were confused on the episiotomy wound care and perineal care.
Overall, the mothers felt information on self care and baby care was inadequate.

2.5 Patient Satisfaction on Health Information Giving

Patients’ satisfaction is assuming greater importance in the health care service especially
when attempts are being made to measure, change or improve the quality of the health care
services provided. Many researchers suggested that studies on patients’ satisfaction on
information giving facts on the health care providers’ success at meeting the patients’
expectation and needs, as well as an important tool for research and management (Avis et.,
1995: Thomas & Bond, 1996 and Walsh and Walsh, 1999). Recognising the importance of
patient satisfaction has made providers of care aware of the need to listen to the patients
view and fulfill their needs (Jackie, 1997).

Study by Kincey et al.(1975) cited in Jackie (1997), stressed that patient receive adequate
information on their disease diagnosis, prognosis and treatment. However, the information
they received about the etiology of their illness and health education on the disease was
inadequate. Patient found the nurses were more approachable and sympathetic compared to
other medical personnel and expressed greater levels of satisfaction with their care and
information giving [Marks (1985) cited in Jackie (1997)].

2.6 The Antenatal Patient and Health Information Giving

Information giving provides psychological benefits to antenatal mothers (Fahrenfort, 1978
cited by Gammon and Mulholland, 1996) in terms of ideological and practical. It stressed
he patient’s autonomy, dignity and self respect. Furthermore, information will allow
individuals to increase participations in the health care process Gammon and Mulholland
(1996). This will translate into patient’s control, responsibility, freedom and improve
quality of life.

Maternal satisfaction during pregnancy also include communication with the nurse, sense
of being in control, able to participate in the decision making process, ability to get
information about pregnancy, delivery and neonatal cares (Maier et al, 2002). It is just too
bad that practitioners tend to underestimate women’s need for pre-and post-natal
information.

2.7 Barriers to Receive Health Information at Antenatal Clinic

Numerous studies showed that antenatal mothers have problems in receiving information
while nurses experiences difficulties and barriers when giving information needs to
antenatal mother.

Among the barriers to health information include language barrier, poor communication
skills, use of technical jargon and educational background of antenatal mothers. Myfanwy
and Peter (2001) in a study in the United Kingdom, Somali women experienced language
barrier and poor communication that exacerbates feelings of isolation, distressing
experiences during their visits to the antenatal clinic. They are also dependent to the
midwives as they are illiterate.

2.8 Summary
Health information can be considered as a means where antenatal mothers can empower
themselves in health care and decision making. The types of information include
information on their pregnancy, treatment, investigation and health education on antenatal
care, labour and prenatal care.

Information on motherhood, baby care, self care post partum and breastfeeding
(complexity and complications) need to be emphasised at the counseling session.

Health information can be derived from various sources. However, studies have identified
that nurses as the key person in providing health information and health education.
CHAPTER 3. RESEARCH METHODOLOGY

3.1 Introduction
The content of this chapter will discuss on the methodology the research will be conducted.
This includes study setting, research design, specific procedure, sampling, ethical
consideration, instrumentation, pilot study, duration of study, data collection, treatment of
data and analysis and summary.

3.2 Study Setting

The study will be conducted at a family clinic situated at the military housing area known
as Desa Tun Hussein Onn (DTHO). It is located about two kilometre from the Ministry of
Defence complex and near the Setiawangsa area. It provides outpatient services, maternal
and child health clinic and family planning clinic. The patients seen at this clinic are wives,
mothers and children (below 12 years old) of military personnel as well as female military
personnel. The antenatal clinic only conduct antenatal examination on Monday mornings,
Wednesday (morning and afternoon) and Thursday mornings.

The clinic staff consists of one medical doctor, one nursing sister, two staff nurses (aka
midwives) and three community nurses. The small number of staff compare to the number
of patients they have to handle is unimaginable where at times the number of patients they
have to attend to, on the average, is more than 150.

Other than carrying out nursing duties, the staff have to clerical work, documentation,
registration of patients and searching for files/folders, The nursing sister more often than
not also act the manager of the clinic prepare annual budgeting, monthly returns/census. It
is therefore doubtful if the nursing staffs are able to give an effective nursing care which
include health education and counseling and thus meeting the expectation of the patients
needs and information on pregnancy and other health matters.

3.3 Study Design

The study is a quantitative study with a cross sectional survey design to analyse patient’s
satisfaction on information given at the antenatal clinic. The study will take place on the
three designated days per week for a month or until the required number of sample is
reached.
Data collection will be through questionnaires since questionnaires will allow the
researcher to describe and test the relationship and examine the interaction among
variables (Burns and Grove 2002). Cross sectional study design is chosen as it is less
expensive and easier to conduct (Nieswiadomy 1998). The questionnaires will be
distributed to participants with the help of the staff of the antenatal clinic.

3.4 Population and Sampling

3.4.1 Population
The patient’s who came to the DTHO antenatal clinic are military personnel or wives of
military personnel who live in the DTHO military housing complex and nearby areas but
working at the Ministry of Defence complex or nearby military camps. Thus, the
population that will be involved in the study is military personnel or wives of military
personnel or civilians that come to the antenatal clinic for their antenatal checkups. The
duration of the intended study is for a month or until the required number of sample has
been reached. The exact period of the study will be finalised later.

3.4.2 Sample
Sample selection will be done by convenience sampling. All patients who come for their
appointments during the survey period will be included. A total of 50 patients will be taken
as sample.

3.5 Ethical Consideration

All respondent will be given a letter explaining the purpose of the study. All information
will be confidential and anonymity will be assured. However, the patient has the right to
choose not to participate in the study.

3.6 Instrumentation / Data Collection

Data will be collected using a structured self reporting questionnaire. A total of 40 items
questionnaire of 3 sections will be used (see appendix 4). The three sections are as follow:

Section 1. Personal Demographic Data.

This Section will consists of 9 items related to the patient’s personal background such as
age, religion, distance of home to clinic, education, occupation, pregnancy experience, and
others. The demographic statement was developed to determine the socio-economic
background of the sample.

Section 2. Patient’s satisfaction on health information given

This Section will have 18 items to determine the patient’s satisfaction on the information
given at the antenatal clinic. The patients will indicate their level of satisfaction on the
information given based on a 5-point scale (Likert scale) as follows:
1=Very Satisfied; 2=Satisfied; 3=Not Sure; 4=Not Satisfied; 5=Not Very Satisfied

Section 3. Identify the health information to be given at the Antenatal Clinic

This section is to get feedback from the participating patient’s on the health information
that need further clarification. They will have to tick those information that they think are
lacking and should be included. If the topic they wanted to be included is not on the list,
they can suggest at the end of the section.

3.7 Pilot Study

Pilot study is a trial run that will allow the researcher to identify potential problems and
detect any weaknesses. It will represent the proposed study and to test the questionnaires
formulated. A pilot study will be conducted on 5 patients at the DTHO antenatal clinic.
After the trial study, revision to the questionnaires will be made where necessary.

3.8 Data Collection

On all specified days, the researcher will personally hand the questionnaires to the patients
and make sure they understand, answer the questionnaires and collect them after they have
answered them. This is to make sure all questionnaires given out are returned.

Folders of the patients who have participated will tagged or marked so that there will be no
repetition.

3.9 Analysis of Data

The data will be analysed using the software Statistical Package for the Social Science
(SPSS) version 16 for efficient and accurate data analysis as well as saves time.
3.10 Summary
The study to be conducted is a non experiment quantitative study with cross sectional
survey to analyse patient’s satisfaction on health information given at the antenatal clinic
using questionnaires.

The questionnaires will be handed to the participating patients by the researcher personally
and collected after the patient has answered them. The data collected will be analysed
using the software SPSS version 16.

This study will hopefully highlight to the management their strength and weaknesses so
that steps to improve their services can be taken.
REFERENCES

1. Avis M, Bond M, Arthur A (1995). Satisfying solution? A review of some

unresolved issues in the measurement of patient satisfaction. Journal of Advance Nursing,
22, 316-322.
2. Burns PJ, Grove SK (2001). The practice of nursing research: Conduct, critique and
utilization. 4th ed. Philadelphia WB Saunders Company.
3. Gammon J, Mulholland CW (1996). Effect of preparatory information prior to
elective total hip replacement on psychological coping outcomes. Journal of Advance
Nursing. 14(3), 303-308.
4. Hyrkas and Paunonen (2000). Patient satisfaction and research related problems
(Part 2). Is triangulation the answer? Journal of Nursing Management. 8, 237-245.
5. Hyrkas and Paunonen (2000).Patient satisfaction and research related problems
(Part 1). Is triangulation the answer? Journal of Nursing Management. 8, 227-236.
6. Maier KM, Kirkham CM, Lim E, Cheung KW, and Grzybowski S (2002).
Pregnancy planning guide. Evidence-based information for prospective parents. Canadian
Family Physician, 48(7), 1199-1205. Retrieved on 5th March 2010 from
http://171.66.125.180/cgi/reprint/48/7/1199.
7. Langer A, Villar J, Romero M, Berendes H (2002). Are women and providers
satisfied with antenatal care? Views on a standard and a simplified evidence-based care in
four developing countries. Retrieved on 02th march 2010 from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC122068/.
8. Lauer P, Murphy SP Powers MJ (1982). Learning needs of cancer patients. A
comparison of nurses and patients perceptions. Nursing Times. 96(37), 48.
9. Longo DR, Patrick TBG (2001). Consumer reports and health care information. A
call for research. Journal of Health Care Finance. 28 (1), 92-96.
10. Luker KA, Beaver K, Leinster SJ, Owens RG, Degner LF, Sloan JA (1995). The
information needs of women newly diagnosed with breast cancer. Journal of Advanced
Nursing. 22, 134-141.
11. Luther KM (1996). Data-driven interventions to improve patient satisfaction.
Journal of Nursing Care Qualities. 10(4), 33-39.
12. Merkousris A, Ifantopoulus J, Lanara V, Lemondou C (1999). Developing an
instrument to measure patient satisfaction with nursing care in Greece. Journal of Nursing
Management. 7, 91-100.
13. Merkousris A, Ifantopoulus J, Lanara V, Lemondou C (1999). Patient satisfaction a
key concept for evaluation and improving nursing services. Journal of Nursing
Management. 7, 19-28
14. Messner RL (1993). What patients really want from their nurses. American Journal
of Nursing. 9(38), 38-41,
15. Myfanwy MD, Peter AB (2001). The maternity information concern of Somali
women in the United Kingdom. Journal of Advance Nursing. 36 (2), 237-245.
16. Nieswiadomy RM (1998). Foundations of Nursing Research. 3 rd ed. Connecticut:
Appleton and Lange.
17. Oberst MT (1984). Patients perceptions of care. Measurement of quality and
satisfaction. Cancer. 53, 2366-2373.
18. Schutta KM, Burnett CB (2000). Factors that influence a patient’s decision to
participate in a Phase 1 cancer clinical trial. Oncology Nursing Forem. 9(27), 1435-1438.
19. The American Heritage® Dictionary of the English Language, Fourth Edition
copyright ©2000 by Houghton Mifflin Company
20. Walsh M, Walsh A (1999). Measuring patient satisfaction with nursing care
experience of using the Newcastle Satisfaction with Nursing Scale. Journal of Advanced
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 Appendix 1

MONTH MARCH APRIL MAY JUNE JULY

ACTIVITIES / WEEK 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

Prepare research proposal

Letter fo research proposal/Ethics Committee
Awaits approval letter
Pilot Study
Correction of tool
Data collection
Data analysis
Prepare research report
Hand in research report
 Appendix 2
Fauziah bte Ibrahim
Pelajar Program Sarjana Muda Sains Kejururawatan
Open University Malaysia
Jalan Tun Ismail
50480 KUALA LUMPUR.

Hp: 0133040828
4hb Mac 2010

Mejar (Dr) Tanya A/P Anirudhan

Pegawai Perubatan
Klinik Keluarga Angkatan tentera
Desa Tun Hussein Onn
Jalan Jelatik
54200 KUALA LUMPUR
Melalui
Profesor Madya Che An Bte Ahmad
Ketua Pusat Pengajian Kejururawatan Dan Sains Kesihatan Bersekutu
Open University Malaysia
Jalan Tun Ismail
50480 KUALA LUMPUR.
Puan,

MEMOHON KEBENARAN UNTUK MENJALANKAN PROJEK PENYELIDIKAN

KEJURURAWATAN DI KLINIK KELUARGA ANGKATAN TENTERA DESA TUN
HUSSEIN ONN

Dengan segala hormatnya perkara di atas dirujuk.

2. Saya, Fauziah bte Ibrahim, sedang mengikuti Program Sarjana Muda Sains
Kejururawatan dengan Kepujian (BNS) di Open University Malaysia (OUM). Saya di
kehendaki menjalankan satu penyelidikan kejururawatan bagi memenuhi keperluan
program ini.

3. Saya ingin memohon kebenaran dan kelulusan dari pihak puan untuk menjalankan
satu projek penyelidikan kejururawatan di tempat Puan. Butir-butir penyelidikan yang
akan dijalankan adalah seperti berikut:

Tajuk Penyelidikan: “Patients’ satisfaction on health information given at the

antenatal clinic in Desa Tun Hussein Onn Family Clinic”.
Kumpulan Sasaran: Ibu-ibu mengandung yang menerima perkhidmatan di klinik
antenatal.
Tempat kajian: Klinik Keluarga Desa Tun Hussein Onn.
 Kaedah Kajian: Soal Selidik.
Tarikh Penyelidikan: 01 Jul 2010 hingga 31 Jul 2010.

4. Bersama-sama ini disertakan satu set cadangan kajian dan satu lampiran borang
soal selidik yang akan di gunakan untuk makluman puan.

5. Semua maklumat yang diperolehi adalah rahsia dan hanya akan di gunakan untuk
tujuan akademik sahaja. Segala kerjasama dari pihak puan amat saya hargai dan semuga
permohonan saya ini mendapat kelulusan dari puan.

Sekian, terima kasih.

Yang benar,

(FAUZIAH BTE IBRAHIM)

s.k Lt. Kol Adenan bin Abd Rahman

Pegawai Staf 1 Perumahan
Desa Tun Hussein Onn
Jalan Jelatik
54200 Kuala Lumpur
 Appendix 3
Dear Participants,

I, Fauziah bt Ibrahim, student of Bachelor in Nursing, Open University Malaysia, is

undergoing Research and Statistic module. It requires me to conduct a nursing
research project as to fulfil partially the requirement for the course.

My research is about patient’s satisfaction on health information given at the

antenatal clinic. The health information given by the nurses at the antenatal clinic is
important and this project is done to know how satisfied are you with the
information given.

Your participation will most certainly give an very good input and implication to
this project. Your contribution will also give feedback and help to improve any areas
which were found lacking.

All information given is confidential as no names are required to be written on the

questionnaires. Thus, all participants are anonymous. The completion of the
questionnaire is an indication of your consent to participate. Once you have
completed answering the questionnaire, please put it in the envelope provided and
seal them. The envelope is then put into the box provided at the registration counter.

Thank you for your participation and if your have any questions please contact me
at 0123040828. Your cooperation is much appreciated.

Yours truly

……………………………….
(Fauziah bt Ibrahim)
Untuk Semua Peserta,

Saya, Fauziah bt Ibrahim, penuntut Bachelor Kejururawatan, University Terbuka

Malaysia, sedang mengikuti modul Penyelidikan Kejururawatan dan Statistik.
Modul ini memerlukan saya menjalankan satu kajian berkaitan kejururawatan
sebagai sebahagian dari keperluan untuk lulus kursus ini.

Kajian saya ialah mengenai kepuasaan pelanggan (iaitu anda) keatas maklumat
kesihatan yang diberikan oleh jururawat di klinik antenatal (Klinik Ibu
Mengandung). Maklumat kesihatan yang diberikan adalah penting dan projek ini
dijalankan bagi mengetahui tahap kepuasan pelanggan dengan maklumat yang
diberikan.

Penglibatan dan maklumat anda sudah tentu akan memberikan satu input serta
implikasi yang baik. Sumbangan anda juga akan memberi maklumbalas serta dapat
membantu memperbaiki mana-mana keadaan yang perlu diperbaiki.

Semua maklumat yang diberi adalah sulit kerana tiada nama perlu ditulis pada
borang kajiselidik yang diberi. Semua peserta adalah rahsia. Dengan melengkapkan
borang klajiselidik menunjukkan anda telah memberikan kebenaran untuk
menjayakan kajian ini. Setelah anda melengkapkan menjawab borang kajiselidik,
sila letakkan kedalam envelop yang disediakan dan lekatkannya. Envelop itu
kemudiannya letakkan kedalam peti yang disediakan di kaunter pendaftaran.

Terima kasih kerana penyertaan anda. Sekiranya anda mempunyai apa-apa

kemusykilan, sila hubungi saya di 0123040828. Kerjasama anda sangat-sangat saya
hargai.

Yang benar,

……………………………….
(Fauziah bt Ibrahim)
 Appendix 4

QUESTIONNAIRE / SOAL SELIDIK

Instruction / Arahan
The questionnaire comprises of three sections. Please answer all questions. Please fill in
the blanks and tick √ in the boxes provided.
Section 1 consists of 9 items related to personal demographic data.
Section 2 consists of 18 items related to patient’s satisfaction on the health information
given at the antenatal clinic.
Section 3 consists of 15 items related to health information needs required by the expectant
mother.

Borang soal selidik ini mengandungi tiga bahagian. Sila jawab semua soalan. Sila isikan
semua ruang kosong dan tandakan √ didalam kotak berkaitan yang disediakan.
Bahagian 1 mengandungi 9 soalan berkaitan dengan maklumat peribadi.
Bahagian 2 mengandungi 18 soalan berkaiatan kepuasan pelanggan terhadap maklumat
kesihatan yang diberikan di klinik ibu mengandung.
Bahagian 3 mengandungi 13 soalan berkaitan dengan maklumat kesihatan yang
diperlukan oleh ibu mengandung.
Section 1. Personal demographic data / Bahagian 1. Maklumat Peribadi.
Please answer ALL questions. Sila jawab SEMUA soalan.

1 Age / Umur: 20-24 yrs/thn 30-34 yrs/thn

25-29 yrs/thn 35-39 yrs/thn

2. Distance home to clinic / Jarak rumah ke klinik km

3. Religion / Ugama:
Islam Hindu Others/Lain2
Kristian Buddha

4. Education Level / Secondary/ Tertiary/ I P

Tahap Pendidikan: Menengah Tinggi

5. Occupation / Military/ Civilian/Awam

Pekerjaan Tentera
Self Employed/ Unemployed/
Bekerja sendiri Tidak bekerja

6. No. of children/ Bilangan Anak

7. No. of pregnancy including this one / Bilangan kehamilan termasuk kali ini.

8. Weeks of pregnancy / Minggu kehamilan

9. Number of antenatal visit including this one /

Bilangan lawatan ke klinik antenatal termasuk ini:

Section 2. Patient’s satisfaction on health information given

Bahagian 2. Kepuasan pelanggan terhadap maklumat kesihatan yang diberikan

Please answer all questions by ticking √ in the box that best applies to you, according to
the scale given below. Sila jawab semua soalan dengan menandakan √ dalam kotak yang
paling bersesuaian dengan anda menggunakan skala dibawah.

1=Very Satisfied/Sangat Memuaskan; 2=Satisfied/Memuaskan;

3=Not Sure/ Tidak Pasti; 4=Not Satisfied/Tidak Memuaskan;
5=Not Very Satisfied/Sangat Tidak Memuaskan

A. Information about your visit/Maklumat semasa lawatan anda

1. Information about your blood pressure 1 2 3 4 5

Maklumat tentang tekanan darah anda

2. Information about your weight 1 2 3 4 5

Maklumat tentang berat badan anda
3. Information on your blood & urine investigation. 1 2 3 4 5
Maklumat tentang selidikan darah & air kencing.

4. Information on the progress of your pregnancy 1 2 3 4 5

Maklumat tentang perkembangan kehamilan
anda.

5. Information received regarding minor sickness

1 2 3 4 5
(dizziness, nausea, vomit, cramps, etc)
Maklumat tentang penyakit ringan (pening,
loya, muntah, kejang otot, dll)

6. Information on general / physical examination 1 2 3 4 5

Maklumat tentang pemeriksaan am / fizikal

7. Information on abdominal palpation 1 2 3 4 5

Maklumat tentang palpasi perut

B. Information received on Health Education / Maklumat mengenai Pendidikan

Kesihatan

8. Nutrition during pregnancy 1 2 3 4 5

Pemakanan semasa mengandung

9. Exercise during pregnancy 1 2 3 4 5

Senaman semasa mengandung

10. Fetal development 1 2 3 4 5

Perkembangan janin

11. Preparation on delivery for mother & baby 1 2 3 4 5

Persediaan ibu dan anak semasa kelahiran

12. Processof labour 1 2 3 4 5

Proses kelahiran

13. Breast feeding 1 2 3 4 5

Penyusuan badan kepada bayi

14. Immunisation 1 2 3 4 5
Imunisasi

15. Anaemia 1 2 3 4 5
Kurang darah

16. Family planning 1 2 3 4 5

Merancang keluarga

17. High blood pressure 1 2 3 4 5

Tekanan darah tinggi
18. Generally, are you satisfied with all the
1 2 3 4 5
information given
Secara amnya, adakah anda berpuas hati
terhadap maklumat yang diberikan

Section 3. Identify the health information to be given at the Antenatal Clinic

Bahagian 3. Mengenalpasti maklumat kesihatan yang perlu diberi di Klinik Ibu
Mengandung

Please answer all questions by ticking √ in the box that applies to you. Sila jawab semua
soalan dengan menandaan √ dalam kotak yang bersesuaian.

A. I would like to know the following health information:

Saya ingin mengetahui tentang maklumat kesihatan yang dibawah:

Ya Tidak

1. Diabetes during pregnancy/Kencing manis semasa mengandung

2. Low lying Placenta/Uri dibawah

3. Premature contraction/Kontraksi sebelum masa

4. Per vagina bleeding/Pendarahan dari faraj

5. Miscarriage/Keguguran

6. Hepatitis and pregnancy/ Penyakit hepatitis dan mengandung

7. Taking of traditional medicine or herbs during pregnancy/

Pengambilan ubat tradisi atau herba semasa mengandung

8. Massage during and after pregnancy/ Mengurut semasa dan

selepas mengandung

9. Sexual transmitted disease and pregnancy including HIV/

Penyakit kelamin dan kandungan termasuk HIV

10. Sex during pregnancy/Hubungan sex semasa mengandung

11. Taking care of perineal area after delivery/ Menjaga kawasan

kemaluan selepas kelahiran

12. Taking care of the new born/ Menjaga bayi yang baru lahir
B. Other health information that you like to know other than the above:
Lain-lain maklumat kesihatan yang anda ingin ketahui selain yang diatas.

1. …………………………………………………………………………………………….
2. …………………………………………………………………………………………….
3. …………………………………………………………………………………………….
4. …………………………………………………………………………………………….
5. …………………………………………………………………………………………….

Thank you for your cooperation.

Terima kasih atas kerjasama anda.