The purpose of this study was to find out if nurses who were responsible for planning patient care functioned primarily on the basis of hospital routines and physicians' orders or on the basis of known patient needs.

The interview technique was use to obtain data about determinants of nursing activities of twenty-five head nurses and team leaders in three hospitals. The interview questions were focused on the nursing activities involved in planning the care of three patients selected by the nurses.

Data were collected and analyzed to answer questions about (1) the way in which nurses perceived patients' nursing problems, (2) the determinants of the nursing activities, (3) the difference in the determinants of activities between nurse with college degrees and those without degrees, (4) the barriers to the achievement of patient-centered nursing care that were perceived by the nurses.

The analysis of the data relative to recognition of nursing problems showed that more than one-half of the nursing problems described by the nurses were physical in nature. No significant difference was found between the number of physical and psycho-social problems reported by nurses who were college graduates and those who were graduates of hospital schools of nursing.

Approximately one-half of the nursing activities reported were determined by hospital routines and physicians' orders and one-half were determined by patients' expressed needs and by the nurses' interpretation of the patients' needs. There seem to be no difference between the determinants of activities of nurses who were graduates of college and those who were graduates of hospital schools.

Analysis of expressed barriers revealed the greatest percentage of problems in the area of obtaining knowledge about patients' nursing needs and problems in knowing how to meet the needs of patients with known emotional problems.

On the basis of the filings of this study, it was recommended that nursing service administration give careful study to the possibility of providing an environment in which patient-centered nursing can practiced. This would include the development of clear objectives of nursing care, re-definition of jobs to a patient-centered orientation and possibly reorganization of staffing responsibilities. It was suggested that staff education programs be planned to assist nurses in developing skills in nurse-patient relationships.

It was further recommended that research be done to find out what proportion of nursing activities ought to be based on routines and what proportion should be based on patients' desires and needs. It was also recommended that a similar study be done to validate the findings of this study.

LLU Discipline





Graduate Studies

First Advisor

R. Maureen Maxwell

Second Advisor

Gertrude Haussler

Third Advisor

Bessie Wat

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Nurses; Nursing Care



Page Count

ix; 79

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives