BARRIERS AND FACILITATORS TO PATIENT EDUCATION FROM A NURSING PERSPECTIVE IN A TERTIARY CARE HOSPITAL, LAHORE: A DESCRIPTIVE CROSS-SECTIONAL STUDY

Abstract

Background: Patient education is a core nursing responsibility that improves treatment adherence, self-care, and satisfaction, yet it is frequently reported as inadequate in tertiary care settings ^[5,8]. Evidence on the specific barriers and facilitators experienced by nurses in tertiary care hospitals in Lahore, Pakistan, remains limited. Objective: To determine the barriers confronted by nurses in delivering patient education and to identify the facilitators that enable effective patient education in a tertiary care hospital in Lahore. Methods: A descriptive cross-sectional study was conducted over six months among staff nurses at Sheikh Zayed Hospital, Lahore. Using Slovin's formula (N = 160, e = 0.05), a sample of 114 nurses was recruited through convenience sampling. Data were collected using a structured, self-administered questionnaire comprising demographic items, a 9-item barriers scale, and a 10-item facilitators scale, each rated on a 5-point Likert scale. Composite scores (range 1-50) classified barrier/facilitator identification as excellent (≥35), moderate (16-34), or poor (≤15). Data were analysed in SPSS v30 using descriptive statistics, chi-square tests, and one-way ANOVA. Results: All 114 participants were female; 74.6% were aged 20-30 years, 51.8% held generic nursing qualifications, and 37.7% had 4 years of clinical experience. Shortage of nurses (mean = 4.32 ± 0.74) and time limitations (mean = 4.19 ± 0.79) were rated as the most significant barriers, yielding an excellent composite barrier score of 40.6/50. Raising interest in patient education (mean = 4.30 ± 0.76) was the most endorsed facilitator, with an excellent composite facilitator score of 41.6/50; the difference between barrier and facilitator scores was not statistically significant (p = 0.72). Barrier identification differed significantly by years of experience (ANOVA, p = 0.003) and by age for specific items (time limitations, p = 0.021; lack of trust, p = 0.034). Facilitator identification differed significantly by education level (p = 0.008-0.041) and was strongly associated with self-reported confidence among more experienced nurses (χ² = 12.5, p = 0.002).

Conclusion: Nurses demonstrated excellent awareness of both the barriers and facilitators to patient education. Staffing shortages and time constraints were the dominant barriers, while structured, skill-building approaches were the most valued facilitators.