Student nurses' views on respect towards service users - an interpretative phenomenological study

Abstract

Aim: To explore student nurses' understanding and behaviours of respect towards patients in order to inform educational strategies to optimise respectful care.

Background: There is a causal relationship between the perception of being treated with respect and patient satisfaction. Concerns over standards of care prompted a commissioned report into the quality of nurse education in the United Kingdom.

Design: A hermeneutic phenomenological interview study was used to identify and interpret student nurses' behaviours and understanding of respect towards patients.

Setting: University health and social care faculty in the north-west of England, United Kingdom.

Participants: Eight third-year student nurses (adult branch), on different university sites, with practice placements across different healthcare trusts.

Methods: Interviews about their understanding of respect and their behavioural intentions of respect towards patients were recorded and transcribed, then analysed using interpretative phenomenological analysis (IPA) to produce themes from the data.

Findings: Three themes of relevance to nurse education were identified. Respect is a complex concept that is difficult to apply in practice. Students are not always aware of incongruence between their feelings of respect towards patients and their behaviours towards them. Role-modelling of respectful care is variable, and essential care is often learned from healthcare assistants.

Discussion: Awareness of emotional responses and their relationship to patient perceptions of respect should be facilitated in theory and practice. Rehearsal of the application of respect involving emotional labour, and reflection in and on the practice of respectful care, are needed to address student learning needs. The theory-practice gap in relation to respect, variation in professional practice and the under-recognised importance of healthcare assistants in student nurse education, are barriers to the learning of respect to patients.

Conclusions: Interactive education experiences are important to develop self-awareness and insight into respectful care. Mentorship in practice should encourage reflection in and on the practice of respect towards patients.

Keywords: Congruence; Education; Empathy; Hermeneutic phenomenology; Interpretative phenomenological analysis (IPA); Practice; Respect; Student nurses.