ASSESSMENT OF NURSES' KNOWLEDGE AND ATTITUDE REGARDING NURSING PROCESS IN SECONDARY CARE HOSPITAL IN KOHAT, PAKISTAN.

Abstract

The nursing process (NP) is the systematic, five-step framework (assessment, diagnosis, planning, implementation, evaluation) that underpins individualized, evidence-based patient care. Despite its central place in nursing education, its practical implementation in public-sector hospitals in Pakistan remains inconsistent, and nurses' underlying knowledge and attitude toward it are a key determinant of that gap.

Objective: To assess nurses' knowledge and attitude regarding the nursing process at District Headquarter (DHQ) Hospital Kohat, and to determine whether knowledge and attitude are associated with demographic characteristics.

Methods: A descriptive cross-sectional survey was conducted among 113 registered nurses at DHQ Hospital Kohat, selected through convenience sampling. A structured, self-administered questionnaire captured demographic data, a 10-item knowledge scale, and a 5-item attitude scale (five-point Likert format). Data were analysed in SPSS using descriptive statistics and the chi-square test of association, with p < 0.05 considered significant.

Results: Overall, 58 nurses (51.3%) demonstrated good knowledge of the nursing process and 55 (48.7%) demonstrated poor knowledge (mean score 39.74/50, SD 5.44). Knowledge was highest for the purpose of the NP (86.7% correct) and lowest for recognising that NP implementation should not depend on physician judgement (34.5% correct). 66 nurses (58.4%) held a positive attitude and 47 (41.6%) a negative attitude toward the NP (mean score 18.9/25, SD 4.16). Attitude was significantly associated with professional qualification (χ² = 6.79, p = 0.034) and clinical ward (χ² = 23.38, p = 0.002); no demographic variable was significantly associated with knowledge level (p > 0.05 for all).

Conclusion: Nurses at DHQ Hospital Kohat showed moderately divided knowledge and generally more favourable attitudes toward the nursing process, with a persistent misconception regarding nurse autonomy in NP implementation. Targeted in-service training, particularly addressing nursing diagnosis and independent clinical decision-making, is recommended to strengthen both knowledge and consistent application of the nursing process.