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Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)


Graduate Nursing

First Advisor

Nancy Fahrenwald


The purpose of the study was to evaluate the hospitalized patients' perceptions of their care from nurses on selected patient care units implementing the Relationship-Based Care (RBC) model within a tertiary acute care hospital located in a Northern Plains state. This quasi-experimental research study employed a pretest and posttest design with a control group. There were two hypotheses. The first hypothesis was that patients who are exposed to RBC will report higher perceived levels of satisfaction with their care than patients who are not exposed to RBC. The second hypothesis was that patients' perceived levels of satisfaction with nursing care will improve from pre-implementation of RBC to six months post-implementation.
The instrument used to measure patients' perceived levels of satisfaction with nursing care was the 10 item Caring Factor Survey (CFS). The pretest CFS was administered to the experimental (wave one) units and control (waves two, three, and four) units for a one month period prior to the launch of the RBC intervention on the experimental units. The unit-specific RBC interventions occurred over a six month period on the experimental units. The posttest CFS surveys were then distributed for a one month period on both the experimental units and control units.
CFS data were analyzed using ANOVA to examine both of the hypotheses. Nonparametric analysis using the Kruskal-Wallis test was also conducted due to the unequal sample sizes. There were not differences in the parametric and non-parametric results. The study had a total of 171 pretest and posttest participants, which includes 117pretest participants and 54 posttest participants on the 10 selected patient care units included in the four waves of the study. The first hypothesis examined the experimental group (wave one) compared to the control group (waves two, three, and four) differences in posttest scores. The mean CFS score (range 10-70) between the experimental group and the control group post tests only had a 2.13 difference as the control group started with a high posttest score indicating an already established caring environment within the health care organization. The first hypothesis results were not statistically significant (p = 0.21).
The second hypothesis examined the experimental group (wave one) pretest and posttest scores. The mean CFS score (range 10-70) from pretest to posttest had a 5.72 difference, which is almost a six point improvement. The second hypothesis results were statistically significant (p = 0.02). The study found RBC implementation improved patients' perceived levels of satisfaction from pretest to posttest. Through RBC focused interventions on acute patient care units, patients' were more satisfied with their care while hospitalized. This study confirms the necessity for nurses to meet the patients' and their families' needs and desires while ensuring colleagues are caring for each other as well as themselves using the RBC model.

Library of Congress Subject Headings

Patient satisfaction
Hospital patients -- Care
Nurse and patient


Includes bibliographical references (page 53-57)



Number of Pages



South Dakota State University


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