1

CHAPTER I

INTRODUCTION

Background of the Study

Treatment adherence is one of the significant problems in healthcare, which has a substan-

tial impact on patient outcomes, the quality of services provided, and healthcare costs. Failure to

adhere to the prescribed treatment could cause complications, rehospitalization, long-term mor-

bidity, and high medical costs (Kardas et al., 2024). One of the most critical components of ad-

herence is nurse-patient communication, since it enables the transfer of information, provides

emotional support, and allows for a mutual decision-making. The communication style, includ-

ing a patient-centered, empathetic, or task-oriented approach, may have a direct impact on how

patients interpret their treatment plans and their willingness to adhere to them (Kwame &

Petrucka, 2020).

Nurse-patient communication is considered to be a crucial aspect of promoting treatment

adherence worldwide. Research has shown that failures by healthcare providers and patients to

communicate are a significant hindrance to adherence. One of the reasons why patients do not

stick to treatment plans is the lack of clear information on how to take medication or follow up

with the doctor or nurse, being denied a chance to participate and make these decisions, leading

to poor health outcomes (Jenstad et al., 2023). Indicatively, in the study by White et al. (2020),

patients with diabetes in the US were less likely to adhere to their medication when they lacked a

good rapport with their healthcare provider due to poor communication. The foundation of the

nurse-patient connection is communication, which fosters trust, enhances patient satisfaction,

and elevates the overall standard of treatment (Afriyie, 2021). Other methods of therapeutic com-

munication, such as active listening, contribute to a better understanding of treatment, enhanced

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compliance, and adherence to the treatment plan among patients (Aldhafeeri et al., 2022). How-

ever, ineffective communication can result in misunderstandings, a decline in trust, patient dis-

satisfaction, and non-adherence (Kindie et al., 2024).

Non-adherence is a significant issue in the Philippine healthcare setting, especially among

chronic disease patients such as those with diabetes and hypertension. Low health literacy levels,

cultural beliefs, and excessive nurse-to-patient ratios can hinder effective communication be-

tween nurses and patients (Gutierrez & Sakulbumrungsil, 2021).Nurses' ability to sustain patient-

centered communication in public hospitals is generally limited by excessive workloads, which

sometimes exceed 20 patients per shift (Cantos, 2023). Nurses' communication skills and the

standard of care they deliver are also impacted by workplace problems, understaffing, and

burnout (Sabei et al., 2019)

On the local level, one study that was carried out in Lanao del Sur, Philippines, in public

hospitals examined the determinants, obstacles, and compliance of nurses to patient education

and revealed that nurses are not able to give proper and consistent patient education due to time

constraints, workload, and lack of institutional support (Omar et al., 2024). However, this re-

search was based on nurses' views and did not address patients' perceptions to communication

styles or how these perceptions affect treatment adherence.

Moreover, current studies in international, national, and local settings tend to focus on

communication efficacy, therapeutic relationships, or the intervention as a whole. Few studies

examine the specific styles of nurse-patient communication and their role in patient adherence

behavior, especially in the Philippine medical context. This gap demonstrates the necessity of a

particular research on patients' perceived style of nurse communication and its impact on treat-

ment adherence.
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This work attempts to bridge this information gap by investigating the relationship be-

tween nurse-patient communication styles, as perceived by patients, and treatment adherence. In

particular, the research will seek to find out the impact of communication styles that the patients

have encountered, e.g., patient-centered or task-oriented communication, on patient comprehen-

sion of care instructions and compliance to the recommended treatment regimens. The study

presents an evidence-based perspective on patient-oriented communication, focusing on patients'

perceptions to inform evidence-based nursing practice.

The results of the research can be used to help nurses make informed decisions about ap-

plying effective communication to enhance patient knowledge, improve treatment adherence,

and ultimately improve clinical outcomes. The findings may be utilized to shape nursing schools'

curricula, may assist health care institutions to designing training programs to enhance their com-

munication abilities, and may be used as a guideline in a more in-depth research on the practice

of patient-centered care in Philippine hospitals.

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Statement of the Problem

This study, entitled “The Relationship Between Nurse–Patient Communication Styles and

Treatment Adherence,” aims to determine the relationship between patient-perceived nurse–pa-

tient communication styles and the level of treatment adherence among hospitalized patients.

Specifically, it seeks to investigate how different communication styles, as perceived by patients,

are related to their adherence behavior within the hospital setting. The study will involve admit-

ted patients as the sole respondents and will be conducted during the Academic Year 2025–2026.

Specifically, it aims to answer the following questions:

1. What is the perceived level of nurse–patient communication among patients in terms of:

a. Patient-centered communication style?

b. Task-centered communication style?

2. What is the level of treatment adherence among hospitalized patients?

3. Is there a significant relationship between nurse–patient communication and treatment adherence

in terms of:

a. Patient-centered communication and treatment adherence?

b. Task-centered communication and treatment adherence?

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Hypothesis

The following hypotheses shall be tested at a 0.05 level of significance:

[Link] there a significant relationship between nurse–patient communication and treatment adherence in

terms of:

a. Patient-centered communication and treatment adherence?

b. Task-centered communication and treatment adherence?

Theoretical Framework

The theoretical framework of this study, titled "The Relationship Between Nurse-Patient

Communication Styles and Treatment Adherence," is anchored on Peplau`s Interpersonal Rela-

tion Theory and supported by the Health Belief Model.

Interpersonal Relations Theory

Peplau's Interpersonal Relations Theory emphasizes that nursing is an interpersonal, ther-

apeutic process that extends to the interaction between a nurse and a patient. According to the

theory, communication is one of the fundamental aspects of nursing care, especially during ori-

entation, working, and termination periods of the nurse-patient relationship (Barta, 2023). Effi-

cient communication enables nurses to accurately assess patient needs, deliver clear information,

and establish trust, which is crucial for patient cooperation and engagement in their care (Cher-

aghi et al., 2021).

The independent variable in this study is the nurse-patient communication styles as per-

ceived by hospitalized patients. Empathic, informative, respectful, and patient-centered are some

of the communication styles that determine how patients understand the instructions, how they
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view the care, and gain confidence in those providing it (Deane & Fain, 2020). The theory of Pe-

plau also contributes to the fact that the positive relationship between nurses and patients contrib-

utes to patient involvement and compliance with the treatment regimen.

Health Belief Model

The Health Belief Model also demonstrates the relationship between communication and

treatment adherence, as it describes how health-related behaviors are influenced to patients' be-

liefs. According to the model, the perceived severity of illness, perceived benefit of treatment,

perceived barriers, and action cues influence adherence in patients (Yang et al., 2021).

A significant signal to action within this framework is the nurse-patient communication.

Patients can understand their condition, therapy, and gain confidence in their control over the

suggested activities; perceived barriers (fear or misunderstanding) can be reduced, and adherence

to prescribed treatment can be stimulated through clear explanations, reassurance, and encour-

agement of nurses (Hu et al., 2022). Therefore, the communication styles indirectly affect the

treatment adherence, which is the dependent variable of the study.

The framework is based on these theories, and it is assumed that in the case of effective,

supportive nurse-patient communication, patients admitted to hospitals will better understand

their treatment, trust healthcare providers, and become more involved in their care. This will lead

to an increased rate of treatment adherence. The framework also enables one to determine the

most effective communication style that can facilitate adherence in line with the study's objec-

tives.
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Conceptual Framework

Treatment Adherence
Patient- Perceived Nurse-
 Medication Compliance
Patient Communication Styles
 Compliance with
 Patient-centered
treatment instruction
 Task-centered
 Follow-up adherence

Figure 1. The Conceptual Framework of the Study

The conceptual framework of the study is presented in the schematic diagram in Figure 1.

The figure demonstrates that the independent variable is patient-perceived nurse-patient commu-

nication styles, such as patient-centered and task-centered communication. Communication

styles reflect how patients view the interaction, explanations of care, and directions from nurses

while in the hospital. The dependent variable, in turn, is adherence to the treatment, which mani-

fests in the following dimensions: medication compliance, compliance with treatment instruc-

tions, and follow-up compliance. The measures included in these indicators are the degree to

which hospitalized patients adhere to medications prescribed to them, adhere to instructions of

care, and follow-up plans.

The framework indicates that patient-perceived nurse–patient communication styles may

influence treatment adherence among hospitalized patients. Effective communication, especially

patient-centered communication, is likely to increase patient understanding and cooperation, re-

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sulting in better adherence behaviours. This theoretical framework is used to analyse the connec-

tion between communication styles and treatment adherence. It offers guidelines to selecting

variables, conducting data collection, and analyzing the study.

Significance of the Study

This study highlights the significance of patient-perceived nurse–patient communication

styles in nursing care and their impact on patients’ willingness to adhere to prescribed treatment

plans and achieve improved health outcomes.

In particular, this will be significant to the following groups.

Patients. This research should be used to enhance the nurse-patient relationships through

the identification of effective communication approaches to facilitate better comprehension of

treatment instructions, trust, and adherence to prescribed treatment plans that have been identi-

fied to produce better health outcomes.

Nurses. The research can be applied as a guide to nurses in choosing and implementing

the right communication styles that enhance the strength of therapeutic relationships, lead to pa-

tient adherence, and enhance quality of care and job satisfaction.

Healthcare Institutions. Its results can help hospital administrators and management to

create communication-based training programs and policies that generate improvements in pa-

tient care, adherence, and service quality.

Nursing Education. The study can include clinical practices related to effective communi-

cation in nursing programs, as it would allow equipping nurses with the necessary skills to be-

come effective, efficient, and caring communicators.

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Nursing Students. The research can equip nursing students with a deeper understanding

of the importance of communication in facilitating treatment adherence, as they develop the nec-

essary communication skills required in realistic clinical practice.

Future Researchers. The results of the proposed research can serve as the basis for future

studies to nurse-patient communication and adherence during treatments. They may promote

new research in various clinical conditions or larger populations.

Scope and Delimitations of the Study

The purpose of this study is to investigate the relationship between patient-perceived

nurse-patient communication styles and treatment adherence in hospitalized patients. The study

will be carried out in a chosen hospital in the Academic Year 2025-2026, and the study will only

involve the hospitalized patients as the only respondents, all of whom are already on prescribed

treatment schedules.

The study scope will involve identifying the most prevalent types of nurse-patient

communication as perceived by the patient, assessing the degree of compliance with treatment as

rated by the patient, and correlating these variables. In particular, the project concentrates on two

communication styles: task-centered communication and patient-centered communication.

The research is restricted to those patients who can answer the questionnaire tools

cognitively and physically. Outpatients, minors who lack legal guardians, patients with cognitive

impairment, and healthcare workers, including nurses, are not going to be included. Moreover,

the research will be based on self-reporting, which can be affected by subjective viewpoints, and

the findings may be limited in their generalizability to other healthcare environments.

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Definition of Terms

Treatment Adherence. How adherent the patients are to their healthcare plan, which in-

volves medication, follow-ups, and lifestyle modifications. Good adherence yields better out-

comes and reduces complications and costs; poor adherence increases the risk of treatment fail-

ure and hospitalization (Tang et al., 2024).

Substantial. A significant or meaningful effect in healthcare, such as measurable im-

provements in treatment outcomes, not minor changes (Oxford Languages, 2023).

Rehospitalization. Readmission to the same or another hospital within a set period (usu-

ally 30 days) is used as a quality-of-care and cost indicator (Dhaliwal & Dang, 2024).

Morbidity. The burden of illness, disease, or disability in an individual or population, in-

cluding acute and chronic conditions (Definitive Healthcare, 2019).

Nurse–Patient Communication. The verbal and nonverbal exchange between nurses and

patients to share information, provide support, and involve patients in care, improving safety,

satisfaction, adherence, and outcomes (Grøndahl et al., 2022).

Patient-Centered. A care approach that respects patients' needs, preferences, and values,

engages them in decision-making, and emphasizes communication and coordination, leading to

better satisfaction and adherence (Levit et al., 2020).

Task-Oriented. A care approach that focuses on completing tasks efficiently and safely.

Excessive focus on tasks may reduce patient engagement and emotional support if not balanced

with communication (Figini et al., 2020).

Rapport. A trusting, respectful relationship between patient and healthcare professional

that fosters open communication, adherence, and satisfaction (Al Ali & Elzubair, 2019).
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Therapeutic Communication. Communication that fosters understanding, trust, and emo-

tional support can lower anxiety, encourage adherence, and provide high-quality care (Mersha et

al., 2023).

Efficacy. Effectiveness is the measure of a treatment's actual performance rather than its

ability to produce desirable results under controlled conditions (NCI Dictionary of Cancer

Terms, 2021).

Regimens. A structured plan of care including medications, dosages, schedules, and other

interventions; adherence is essential for effective disease management (RNA Transfer, THR –

MESH – NCBI, 2020).

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CHAPTER II

RESEARCH METHODS

This chapter presents the study's research methodology. It discusses the research design,

research environment, sampling method, research participants, research instruments, data gather-

ing procedure, data analysis, and ethical considerations employed in the conduct of the study.

Research Design

The study utilized a quantitative descriptive-correlational research design to examine the

relationship between patients' perceived nurse–patient communication styles and treatment ad-

herence among hospitalized patients. Quantitative research enables the measurement of variables

and the statistical examination of their relationships (Miksza et al., 2023). The descriptive-corre-

lational approach is appropriate for identifying the intensity and direction of correlations between

variables without manipulating or controlling them (Ban, 2022). Through this design, measurable

data were obtained regarding patients' perceptions of nurse–patient communication and their ad-

herence to prescribed treatments.

Research Environment

Figure 2. Map of Zamboanga del Sur Medical Center (ZDSMC)

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The research was undertaken at Zamboanga del Sur Medical Center (ZDSMC), which is

located at the Provincial Government Complex, Barangay Dao, Pagadian City, Zamboanga del

Sur. ZDSMC is a tertiary government hospital and the primary referral center in the province,

and therefore provides a good environment to study the patterns of nurse-patient communication

and adherence to treatment among hospitalized patients.

Sampling Method

Stratified random sampling was used to select hospitalized patients at Zamboanga del Sur

Medical Center who met the inclusion criteria. It is a form of probability sampling that divides

the population into subgroups based to relevant characteristics and randomly selects members of

each group to ensure proper representation (Makwana, 2023). The researchers targeted patients

who were directly engaged in nurse-patient interactions during hospitalization and were able to

provide information about treatment adherence. To guarantee that the type of data gathered was

representative, balanced, and suitable to conduct the research, the researcher selected the partici-

pants of the various hospital wards, and there were varying concentrations of stays, thus ensuring

that the data gathered remained representative, balanced, and suitable to conduct a study on the

association between nurse-patient communication style and treatment adherence.

Research Participants

A total of one hundred twenty-two (122) hospitalized patients admitted to Zamboanga del

Sur Medical Center were the target participants in this study. Stratified random sampling was

used to make sure that patients with varying levels of experience with nurse-patient communica-

tion were represented (Parsons, 2019). This sampling method reduced selection bias and enabled

a sound investigation of the correlation between patients' perceived communication style and

treatment adherence, as all patients directly interacted with nurses during their hospitalization.
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To ensure participants provide reliable and meaningful answers, specific inclusion crite-

ria will be used. Eligible patients were at least eighteen (18) years old, were mentally stable, had

spent at least three (3) days in the hospital, and had a direct contact with nurses during their hos -

pital stay. The study excluded patients who were less than 18 years old, cognitively impaired,

medically unstable, and unable to express themselves effectively at the time of data collection.

Research Instrument

A seven-point Likert-scale questionnaire was the primary tool used in this study to collect

quantitative data on patients' perceptions of communication between nurses and patients and

their level of treatment adherence. Respondents can express how much they agree with particular

claims using a standardized, closed-ended tool called a Likert scale (Kendra, 2023). The ques-

tionnaire assessed communication-related domains, including clarity, empathy and respect, re-

sponsiveness, and adherence behaviors. Responses were rated using the following scale: 7 –

strongly agree, 6 – agree, 5 – slightly agree, 4 – neutral, 3 – slightly disagree, 2 – disagree, and 1

– strongly disagree. As results improved, there were more positive perceptions of nurse-patient

communication and greater treatment adherence.

To ensure research instrument validity, a panel of experts conducted content validation,

and the questionnaire was reviewed by nursing faculty to assess its relevance and suitability to

the study's objectives. In contrast, an English language instructor reviewed the instrument for

grammar, sentence structure, clarity, and readability to ensure respondents could easily under-

stand the questions. Revisions were made based on the experts' recommendations before data

collection.
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Data Gathering Procedure

Preparation of Validation of Request for

Questionnaire Questionnaire Permission

Enhancement of Questionnaire
Final Yield Testing
Questionnaire Tryout

Figure 3. Flow of Data Gathering

Preliminary Procedure. The data collection section will begin with the processing of a

research questionnaire, designed to achieve the study's aim regarding nurse-patient communica-

tion styles and treatment adherence. The format of the questionnaire will be designed to address

the communication strategies nurses use when communicating with patients, as well as how pa-

tients adhere to the treatment instructions given to them. After preparing the draft of the instru-

ment, several experts in nursing and research will be requested to review it to verify its under-

standing of the different items and their content validity.

Once the experts' approval has been obtained, an official request for authorization is to be

sent to the administrators of Blancia Hospital to grant the right to conduct the study and deliver

the questionnaires to the chosen respondents. Ethical issues will also be observed to ensure that

participants understand that the study is an academic undertaking, that their decision to partici-

pate in the research is voluntary, and that their responses will not be disclosed to any third party

but will be used in a strictly academic context.

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A pilot testing process will follow this, during which a questionnaire will be administered

to a few patients who were not part of the main study population. The pilot test will be conducted

to assess the comprehensibility, reliability, and overall efficiency of the research instru-

ment. Based on the pilot test results and the provided feedback, revisions and relevant improve-

ments will be made to refine the questionnaire. In a pilot testing process of the research tool, a

sample of about 30 individuals will be picked to go through the trial survey. Internal consistency

would be used to determine the questionnaire's reliability using Cronbach's alpha (α), which is

calculated in Jamovi to provide a precise and objective analysis. The following are the results:

Table 1. Reliability Analysis Using Cronch`s Alpha

Cronbach's alpha (α)

Scale 0.718

Based on the table shown above, the instrument's total internal consistency, as measured

to Cronbach's alpha, is 0.718, which is considered Acceptable. This value indicates a satisfactory

level of reliability among the questionnaire items used to measure the variables in the study. Be-

sides, the individual item scores fell within the acceptable range of 0.70, indicating that no ques-

tions or items needed to be removed or substantially revised due to reliability reasons. This indi-

cates a fair degree of internal consistency among the questionnaire items, which supports the re-

liability of the research instrument.

Regarding content validity, the questionnaire was reviewed by experts, including nursing

and research specialists, who confirmed its relevance, clarity, and suitability to the research ob -
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jectives. According to these analyses, the research instrument has been confirmed to have accept-

able reliability and content validity and can be used in the data collection process.

Final Procedure. After the research instrument was validated and confirmed to possess

acceptable reliability, the researchers proceeded with the actual data collection. The researchers

first prepared and secured a letter of permission from the school administrator and the Dean of

the College of Nursing. The approved letter was then formally endorsed and submitted to the ad -

ministration of Zamboanga del Sur Medical Center (ZDSMC) to request authorization to conduct

the study within the hospital setting.

Upon receiving the necessary approval, the researchers coordinated with the appropriate

hospital personnel to facilitate the distribution of the questionnaires to the selected respondents.

The researchers briefly explained the objectives and purpose of the study before handing out the

survey to help participants understand their role in the study. The respondents were also as-

sured that their responses would remain confidential and that participation was voluntary. They

were also encouraged to answer the questionnaire honestly, based on their own experiences, to

obtain accurate and reliable data.

After the respondents completed the questionnaires, the researchers collected the survey

forms and carefully checked them for completeness to ensure that all required items were an-

swered. After that, the completed surveys were gathered and arranged in preparation for data

processing. After being coded, the gathered replies were input into the relevant statistical pro-

gram for examination. To examine the relationship between treatment adherence and nurse-pa-

tient communication styles, the data were finally statistically analyzed.

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Scoring Procedure

The survey questionnaire utilized in this study was measured using a seven-point Likert

scale to determine the perceived level of nurse–patient communication styles and treatment ad-

herence among hospitalized patients. Each statement in the questionnaire was rated according to

the degree of agreement expressed by the respondents. The response options were interpreted as

follows lows: Strongly Disagree (1), Disagree (2), Moderately Disagree (3), Neutral (4), Moder-

ately Agree (5), Agree (6), and Strongly Agree (7).

To interpret the responses, the mean scores and their corresponding descriptive interpre-

tations were used. The computed mean values were classified according to the following scale

range presented in Table 2.

Table 2. Scale Interpretation for Survey Responses on Nurse-Patient Communication and

Treatment Adherence

Scale Mean Score Average Description Interpretation

1 1.00 – 1.49 Strongly Disagree

2 1.50 – 2.49 Disagree

3 2.50 – 3.49 Moderately Disagree

4 3.50 – 4.49 Neutral

5 4.50 – 5.49 Moderately Agree

6 5.50 – 6.49 Agree

7 6.5 – 7.00 Strongly Agree

Treatment of Data
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Frequency Distribution. This quantitative study analyzed the collected data using both descrip-

tive and inferential statistical tools. The survey questionnaires were administered to the selected

hospitalized patients at Zamboanga del Sur Medical Center (ZDSMC). The responses gathered

from the participants were categorized and tabulated to determine the distribution of answers for

each item in the questionnaire. Frequency distribution was used to present the number and per-

centage of responses for each variable included in the study. This statistical tool helped describe

the overall pattern of responses regarding nurse–patient communication styles and treatment ad-

herence among the respondents.

Mean. The mean was utilized to determine the level of nurse–patient communication styles and

treatment adherence based on the responses of the participants. The mean, commonly known as

the average, represents the most frequently used measure of central tendency. It was computed

for each item in the questionnaire to determine the extent to which respondents agree with the

statements related to patient-centered communication, task-centered communication, and treat-

ment adherence. The responses were measured using a seven-point Likert scale, and the scores

for each item were totaled and divided by the number of responses to determine the average rat-

ing.

Pearson Product–Moment Correlation Coefficient. The Pearson Product–Moment Correlation

Coefficient was used to determine the strength and direction of the relationship between nurse–

patient communication styles and treatment adherence among the respondents. This statistical

tool measures the degree of linear relationship between two variables and is commonly denoted

by the symbol r when derived from sample data (Lane, 2022). In this study, Pearson’s correlation
 20

was applied to determine whether a significant relationship exists between nurse–patient commu-

nication styles (patient-centered and task-centered communication) and the level of treatment ad-

herence of the respondents. The interpretation of the correlation coefficient followed the scale

suggested by Napitupulu et al. (2018): 1.00– 1.49 (Strongly Disagree), 1.50 – 2.49 (Disagree),

2.50 – 3.49 (Moderately Disagree), 3.50 – 4.49 (Nuetral), 4.50 – 5.49 (Moderately Agree),

5.50 – 6.49 (Agree), and 6.5 – 7.00 (Strongly Agree). A significance level of 0.05 was used to

determine whether the relationship between the variables is statistically significant.

Data Analysis

Quantitative statistical methods suitable for a descriptive-correlational design were used

to examine the gathered data. Before coding, tabulating, and organizing the responses for analy-

sis, the researchers verified that every questionnaire was complete. The demographics and per-

spectives of participants regarding communication clarity, empathy, respect, responsiveness, and

adherence behaviors were summarized using descriptive statistics, such as mean, standard devia-

tion, frequency, and percentage. A correlational study was conducted to assess the degree and di-

rection of the association between treatment adherence and nurse-patient communication styles

(task-centered or patient-centered). To ensure results were reliable and accurate, all analyses

were conducted at a standard level of significance, enabling the researchers to make meaningful

inferences about the communication style of hospitalized patients and their treatment adherence.

Ethical Considerations

Before the study's execution, the following factors are given weight:
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Consent/Permission. The endorsement of the Dean or designated instructor. The re-

searchers will ask the Dean of the College of Nursing or TIC for permission to undertake the

study.

Informed consent. It gives research participants enough details about the study. To allow

the research participants to read, sign, and return the informed consent form to the researchers,

the researchers will provide a hard copy of the form.

Voluntary participation. We are very grateful to the research participants for their volun-

tary cooperation. The decision to continue or discontinue participation in the study is entirely up

to the research participants, and those who choose not to continue will not be under any pressure.

Confidentiality. For safety reasons, the research participants' information is being stored.

The researchers will guarantee the study subjects' privacy and confidentiality regarding their

identification and personal data outside the research team.

CHAPTER III
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RESULTS AND DISCUSSION

This chapter presents the results and discussion of the data gathered in the study entitled

“The Relationship Between Nurse–Patient Communication Styles and Treatment Adherence.”

The data are presented according to the Statement of the Problem using tables, followed by

interpretation and discussion of the findings.

Demographic Profile of the Respondents

This section presents the demographic characteristics of the respondents who participated

in the study. The demographic variables include age, gender, and number of days stayed in the

hospital. These characteristics provide a general description of the respondents and help in un-

derstanding the context of their level of nurse–patient communication and treatment adherence

during hospitalization.

Age of Respondents
66-above; 9; 7%
56-65; 10; 8%
18-25; 40; 33%
46-55; 17; 14%

26-35; 28; 23%

36-45; 18; 15%

Figure 4. Age of Respondents

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Figure 4 presents the age distribution of the respondents according to age groups. The

figure shows that the majority of the respondents (33%) were within the age range of 18–25

years old. This was followed by those aged 26–35 years old (23%) and 36–45 years old (15%).

Meanwhile, respondents aged 46–55 years old comprised 14% of the sample. A smaller propor-

tion of participants were 56–65 years old (8%), while the least number of respondents were 66

years old and above (7%).

These findings indicate that most respondents belong to the young adult age group, par-

ticularly those between 18 and 35 years old, which represents the largest portion of the sample.

The inclusion of respondents from middle adulthood and older age groups indicates that the

study involved patients across different age ranges. Understanding the age distribution of respon-

dents is important because age may influence communication patterns with healthcare providers

and adherence to prescribed treatments, which are relevant factors in examining nurse–patient

communication and treatment adherence among hospitalized patients.

Gender of Respondents

Male; 52; 43%

Female; 68; 57%

Figure 5. Gender of Respondents

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Figure 4. Age of the Respondents

Figure 5 shows the gender distribution of the respondents. The majority of the respon-

dents were female, comprising 68 or 57% of the total sample, while 52 or 43% were male. The

distribution indicates that the sample was predominantly composed of female patients. The

higher number of female respondents may have some influence on the findings of the study, par-

ticularly in relation to nurse–patient communication and treatment adherence. Previous studies

suggest that gender differences may affect communication patterns and health-related behaviors,

which can influence patient participation in care and adherence to treatment (Street, 2015).

Therefore, although females constitute the larger proportion of the respondents, the inclusion of

both male and female participants contributes to a broader understanding of nurse–patient com-

munication and treatment adherence among hospitalized patients.

No. of Days Stayed in Hospital

16-above days; 5; 6%

11–15 days; 10;

11%

3–5 days; 46; 52%

6–10 days; 27; 31%

Figure 6. No. of Days Stayed in Hospital

Figure 6 presents the distribution of respondents according to the number of days they

stayed in the hospital. The figure shows that the majority of the respondents (52%) stayed in the

hospital for 3–5 days, with a total of 46 patients. This was followed by those who stayed for 6–
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10 days (31%), comprising 27 patients. Meanwhile, 10 respondents (11%) stayed in the hospital

for 11–15 days. A smaller proportion of respondents, 5 patients (6%), stayed in the hospital for

16 days and above, representing the least number in the distribution.

These findings indicate that most patients had short hospital stays, particularly 3–5 days,

suggesting that many required only brief treatment or recovery. A smaller number of patients

stayed longer than 10 days, which may indicate the need for extended care and monitoring. The

length of hospital stay provides relevant context for this study as patients’ experiences during

hospitalization may influence the level of nurse–patient communication (patient-centered and

task-centered) and their level of treatment adherence.

SOP [Link] Level of Nurse–Patient Communication Among Hospitalized Patients

Table 3 .Patients Perceived Level of Patient-Centered Nurse–Patient Communication

(Patient-Centered Communication Style)

Indicators Mean SD Remarks

1. The nurse listens attentively when I express my concerns. 5.68 1.18 Agree

2. The nurse explains my treatment in a way that I can easily under-

5.67 1.27 Agree
stand.

3. The nurse shows empathy and genuine concern for my feelings. 5.52 1.27 Agree

4. The nurse respects my opinions and preferences regarding my care. 5.62 1.12 Agree

5. The nurse encourages me to ask questions about my treatment. 5.57 1.12 Agree

Overall 5.61 1.01 Agree

Table 3 presents the level of patient-centered nurse–patient communication among

hospitalized patients. The results revealed that the overall mean score is 5.61 with a standard
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deviation of 1.01, interpreted as “Agree.” This indicates that patient-centered communication

behaviors are generally practiced by nurses during their interactions with patients. Among the

indicators, “The nurse listens attentively when I express my concerns” obtained the highest mean

score of 5.68, followed by “The nurse explains my treatment in a way that I can easily

understand” with a mean score of 5.67. Similarly, the indicators on showing empathy toward

patients’ feelings (M = 5.52), respecting patient opinions and preferences (M = 5.62), and

encouraging patients to ask questions about treatment (M = 5.57) were all interpreted as Agree.

These results indicate that nurses commonly demonstrate patient-centered

communication practices, such as attentive listening, empathy, respect, and clear explanation of

treatment. Such communication behaviors may support better patient understanding and

cooperation with treatment during hospitalization, which is relevant to the study’s focus on

nurse–patient communication and treatment adherence.

Table 4. Patients Perceived Level of Task-Centered Nurse–Patient Communication (Task-Centered

Communication Style)

Mea
Indicators SD Remarks
n

1. The nurse focuses mainly on completing tasks rather than interact- 1.6
3.78 Neutral
ing with me. 9

1.6
2. The nurse provides instructions without asking for my feedback. 3.65 Neutral
7

1.8
3. The nurse communicates in a brief and business-like manner. 3.75 Neutral
0
 27

4. The nurse prioritizes routines over individualized patient interac- 1.7

3.75 Neutral
tion. 3

1.6 Moderately Dis-

5. The nurse gives directions without explaining their purpose. 3.26
9 agree

1.2
Overall 3.64 Neutral
0

Table 4 presents the level of task-centered nurse–patient communication among

hospitalized patients. The results showed an overall mean score of 3.64 with a standard deviation

of 1.20, interpreted as “Neutral.” This indicates that nurses do not primarily use a task-focused

communication style, and patients neither strongly agree nor disagree that such behaviors are

common. Indicators such as “The nurse focuses mainly on completing tasks rather than

interacting with me” (M = 3.78), “The nurse provides instructions without asking for my

feedback” (M = 3.65), and “The nurse communicates in a brief and business-like manner” (M =

3.75) were all interpreted as Neutral, suggesting that these behaviors may occur occasionally but

are not dominant. The indicator “The nurse gives directions without explaining their purpose”

obtained the lowest mean score of 3.26 (Moderately Disagree), indicating that nurses usually

explain the reason for instructions rather than just giving orders. Overall, these findings suggest

that task-centered communication behaviors exist but are not the primary style used by nurses,

which supports the predominance of patient-centered communication in nurse–patient

interactions.

Table 5. Level of Treatment Adherence

Indicators Mean Sd Remarks

11. I follow the nurse’s instructions regarding my medications. 5.93 0.95 Agree

12. I comply with the prescribed treatments and procedures. 5.94 0.94 Agree
 28

13. I follow the nurse’s advice regarding my care and recov-

5.93 1.04 Agree
ery.

14. I take my medications at the prescribed time and dosage. 5.86 1.13 Agree

15. I cooperate with nurses during treatment and monitoring. 5.98 1.01 Agree

Overall 5.93 0.88 Agree

Table 5 presents the level of treatment adherence among hospitalized patients. The results

revealed that the overall mean score is 5.93 with a standard deviation of 0.88, interpreted as

“Agree.” This indicates that patients generally follow treatment instructions and cooperate with

nurses during their hospital stay. Among the indicators, “I cooperate with nurses during

treatment and monitoring” obtained the highest mean score of 5.98, indicating that patients

actively participate during procedures and monitoring activities. Other indicators such as

following nurses’ instructions regarding medications (M = 5.93), complying with prescribed

treatments and procedures (M = 5.94), following nurses’ advice regarding care and recovery (M

= 5.93), and taking medications at the prescribed time and dosage (M = 5.86) were all interpreted

as Agree. These results indicate that hospitalized patients generally demonstrate a high level of

treatment adherence, suggesting that they are willing to cooperate and follow healthcare

instructions provided by nurses. High treatment adherence is important in ensuring effective

treatment outcomes, preventing complications, and promoting faster recovery among patients.

Table 6 Test of Significant Relationship Between Nurse–Patient Communication and

Treatment Adherence

Variables Pearson “r” Interpretation p-value Interpretation

 29

Patient – Centered With Significant

Moderate Positive
and Treatment 0.600 <.001 Relationship
Linear Relationship
Adherence

Task – Centered and

No Linear
Treatment 0.001 0.991 Not Significant
Relationship
Adherence

Table 6 presents the test of significant relationship between nurse–patient communication

styles and treatment adherence. The results revealed that patient-centered communication and

treatment adherence have a Pearson correlation coefficient of 0.600 with a p-value of < .001.

This indicates a moderate positive linear relationship and a statistically significant association

between the variables. This finding implies that when nurses demonstrate patient-centered

communication behaviors—such as active listening, empathy, respect for patient preferences,

and encouraging patient participation—patients are more likely to follow treatment instructions

and cooperate with healthcare interventions. On the other hand, task-centered communication

and treatment adherence show a Pearson correlation coefficient of 0.001 with a p-value of 0.991,

which indicates no significant relationship between the variables. This suggests that

communication focused mainly on completing tasks or giving brief instructions does not

significantly influence whether patients adhere to their treatment plans. Overall, the findings

highlight that patient-centered communication plays a more significant role in improving

treatment adherence among hospitalized patients compared to task-centered communication.

 30

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