rns: practice and perception research report 2018 · srna: rns practice and perception research...

2018

RNs: Practice and Perception Research Report – 2018

SRNA: RNs Practice and Perception Research Report May 2018

Strategian Applied Research 2

Table of Contents 1 Letter of Transmittal .............................................................................................................. 3 2 Consultant Overview, Comments and Observations ............................................................ 4 3 Summary of Findings .............................................................................................................. 7 4 Introduction and Description of the Research ...................................................................... 11 5 Survey Coverage .................................................................................................................... 15 6 Change in Level of Nursing Care 6.1 Overview ................................................................... 22 7 Integral Partners in Health .................................................................................................. 26 8 Professional Practice: The Health-Care Setting................................................................... 28 9 Public Confidence: Comparison to Other Professions ......................................................... 34 10 Professional Practice: Client Service Outcomes ................................................................. 38 11 Nurse Practitioners: Awareness and Attitudes .................................................................... 42 12 Public Support for a Public Health System ......................................................................... 47 13 SRNA Awareness and Understanding of Its Role ............................................................... 49 14 Comparison of Significant Differences of Means; 2018 to 2016 Surveys ............................. 54 Appendix 1 ................................................................................................................................87 2018 SRNA Questionnaire ...................................................................................................87 APPENDIX 2 .......................................................................................................................... 103 SRNA ENDs (effective January, 2018) ............................................................................... 103 APPENDIX 3 .......................................................................................................................... 104 Interaction with the healthcare system – the new demographic variable ....................... 104



1 Letter of Transmittal

May 2018 Saskatchewan Registered Nurses’ Association Attention: Carolyn Hoffman, RN, Executive Director

Strategian would like to thank you for the opportunity to undertake this project. We trust that the following report will satisfy the agreement made between us, and hope that the information contained in this report will be useful to your organization as was intended.

C. Brooke Dobni, Ph. D., MBA, B. Comm Brian Nickel, B.A., MBA Strategian

This is a confidential document prepared by the consultant. It is solely for the use of the SRNA. Any reproduction of the report, in whole or in part, without the expressed consent or knowledge of the consultant or the SRNA is strictly prohibited.



2 Consultant Overview, Comments and Observations

To better serve the needs of the public and their members, and in efforts to get a pulse of the general public’s attitudes and perceptions toward nursing practice in Saskatchewan, the Saskatchewan Registered Nurses’ Association (SRNA) conducts bi-annual surveys. This survey and report is designed to help the SRNA receive independent and valid feedback on the attainment of their strategic goals and to inform their future governance and operational decisions.

This is the seventh Practice and Perception research report since 2006 that has been completed for the SRNA. To the extent possible we have taken efforts to ensure that the survey is comparable from year to year. To this end, we have been able to statistically compare databases between this year’s outcomes to the results in 2016, and report any significant differences. As well, we also captured value added information necessary to assist the SRNA in their planning for the future by considering demographic breakouts of the 2018 data.

The methods used in this report were developed in efforts to maximize the breadth of information necessary in consideration of the descriptive nature of the SRNA’s information needs. It will also be important to balance the breadth of analysis with depth of analysis in specific areas, based on the demographic variables chosen.

All efforts have been made in the survey design to ensure commonality across measures from year to year. As mentioned, we were able to make statistical inferences (i.e. analysis of variance) from previous year’s results (2016). In respect to validity and reliability, the results are representative of the Saskatchewan population, and they are statistically significant. The level of statistical significance for this report is 95% with a margin of error of +/-4.9%, exceeding our original objective of +/- 5%.

This report elaborates further on these and other findings. We have highlighted the findings and our comments in the next section, Consultant’s Comments and Observations.



Consultant’s Comments and Observations We have highlighted findings and observations related to the data. The following comments should be interpreted as discussion items for SRNA:

Comparison to 2016. With respect to significant differences in responses from 2016 to 2018, there were few of note. Responses are generally very positive and consistent with previous years. Perhaps the most important is that there is a statistically significant increase in the perception of “safe” care provided by RNs.

Differences based upon demographics of the sample. Once again, the analysis reveals that there are some differences in results based upon demographics. There are, in particular, differences to note relative to the gender, age, region, education, and income. These relationships are identified throughout the report. Consideration of these relationships will be instrumental with respect to future planning.

Levels of interaction with the system. The degree to which participants interacted with the healthcare system over the past two years was examined. Almost 80% of respondents have had interaction with the system either as patients, and/or care givers or guardians of patients. Pertinent observations resulting from this analysis include a higher propensity on the part of recent patients to positively assess their treatment by RNs, and a seemingly less positive view on the part of caregivers regarding confidence in the work of RNs.

Continue to build the information database. The level of interpretation in this study has a high level of confidence, similar to that of the 2016, 2014, 2012 and 2010 research. As was the case in the 2016 report, interpretation of survey responses is based on statistical analysis as opposed to professional judgement.

Public Perception of Registered Nurses continues to be strong. Similar to the results in 2016, the level of confidence in registered nurses is consistently high and practically matches the same level as that of several other professions studied. This may present an opportunity to enhance the brand of Registered Nurses specifically, and the SRNA in general.

Strategically positioning the Nurse Practitioners. The level of confidence in RN(NP)s is continually strong and there is an evident desire to see this profession grow.

There is strong support for profession-led regulation especially if accompanied by public participation. 81.2% of respondents either somewhat or strongly supported the statement that regulation should continue to be led by people in the profession along with public participation, an increase from 60.8% registered in 2016. Note



that public participation [reps] on Council and Committees has been in place for some time). A possible explanation of this increase is that this year’s query went beyond simply asking participants to evaluate the concept of profession-led regulation by adding the possibility of public participation in the regulatory process. Of note in this year’s study is the significant reduction in those that oppose profession-led regulation.

Support for a Public Health System remains high. In 2018, the overall mean score was 4.52, comparable to 4.54 in 2016, with 87.4% of respondents strongly agreeing and agreeing in the importance of the operational model of the healthcare system. Given the importance of this issue, SRNA should continue to monitor any advocacy efforts directed to this issue.

Thank-you,

C. Brooke Dobni, PhD

Brian Nickel, MBA



3 Summary of Findings

Strategian conducted a practice and public perception survey for the Saskatchewan Registered Nurses’ Association (SRNA). The results shown in this report are drawn from a survey of respondents across Saskatchewan. In total, there were 400 respondents in 2018, the same number that were surveyed in 2016. This compares with 405 in 2014 and 2o12, 401 respondents in 2010, and 605 completions in 2008.

The profiles are normally distributed by gender, age, household income, location and education, and are representative of the population in question. This report also assesses performance towards the SRNA ENDs that are effective January 2018. These ENDs are included in Appendix 2, and to the extent possible, are identified in the reported data throughout the report.

3.1 Regulation (END 1)

58.3% of the respondents indicated they were aware that the SRNA could be contacted if they had a concern about the competence or conduct of Registered Nurses in the Province, compared to 57.9% in 2016.

Respondents were also asked questions related to SRNA perceived responsibilities. The results of these questions are presented in Figure 13.2. All questions continued to score relatively high with positive responses ranging from 80.5% to 89.7% as compared to the 2016 result (a range from 77.5% to 88.2%).

31.8% of respondents were aware that the public may go to the SRNA website to check to see if a Registered Nurse is licensed, compared to 25.8% in 2016.

In terms of RN regulation, 81.2% of respondents either somewhat or strongly supported the statement that regulation should continue to be led by people in the profession along with public participation. This is a significant increase from 60.8% registered in 2016. A possible explanation of this increase is that this year’s query included the new possibility of public participation along with those in the profession. Alongside this increase is the significant reduction in those that oppose profession-led regulation. The responses are outlined in Figure 13.1. While the result seems quite dramatic, there is no apparent statistical significance in the change.

With regard to the crosstab comparison, there are numerous statistically significant observations. Highlights include: profession-led regulation is supported by all age groups, more by rural respondents than by those in urban centers, and those with a University degree. Those with no interaction with the



system support it less. Regarding awareness of the SRNA contact points, caregivers are more likely to say that they are aware of the direct contact and website options.

3.2 Professional Practice (END 2)

Between the 2016 and 2018 studies, there have been no statistically significant changes in the opinion of level of care provided by Registered Nurses. However, they have been some notable positive shifts. The percentage of those who responded ‘better’ is 31.6%. This is higher than the percentage registered in 2016 of 22.8% and the 21.7% registered in 2014. There were also important shifts in the other categories: those who felt the level was the same moved from 47.7 in 2016 to 39.0 in 2018 and those who thought the level of care was worse moved from 14.1 in 2016 to 7.4 in 2018.

With regard to statistically significant differences across the demographic data, male respondents were more likely to say that care was ‘better’ compared to females and, as was the case in the 2016 report, respondents who were 55 years of age and older were less likely to say ‘better’ when compared to other age groups. The younger the age group, the more likely respondents were likely to say that care was ‘better’.

Survey respondents were asked to indicate their level of agreement with statements pertaining to the perception of client service from Registered Nurses. These statements included four from previous studies: “When I get health care from a Registered Nurse, I am treated with respect”, “When I get health care from a Registered Nurse, I am treated fairly”, “When I seek health care from a Registered Nurse, I am confident I will get the right care for my condition”, and “I can count on a Registered Nurse to provide me with safe health care.” Three new queries were: “When I get health care from an RN, I get ethical care”, “When I get health care from an RN, I get culturally appropriate care”, and “When I get health care from an RN, I get individual and/or family centered care”.

Perception of client service from Registered Nurses has remained positive and, for the most part, stable. There was only one statistically significant change in the 2018 results: “I can count on an RN to provide me with safe health care.” The other results were in line with the 2016 figures.

It can be said that females have a more positive view than males of the way they are treated by RNs. Younger, rural and higher income respondents also have a more positive perception of care than comparative demographic groups.

Throughout the study it is clear that those with a University degree have high regard for the level of care provided by RNs.



With respect to those that have not had interaction with the healthcare system, they are more likely to say that they have been treated fairly by RNs and are more confident that they are getting safe care. Recent patients are more likely to strongly agree in positive assessments of care, whereas caregivers express a certain reticence to give an overly positive evaluation.

The level of confidence in the competence in various professions has maintained a similar pattern since 2006. The level of confidence in Registered Nurses remains high and is only slightly lower than the confidence expressed in pharmacists and firefighters. Firefighters was a new comparator in the 2018 version of the survey.

Crosstab comparisons have resulted in quite a number of statistically significant differences that are outlined in the report. To note are significant differences in levels of confidence based on gender, the higher levels of confidence in all professions by rural respondents, and the polarized assessments (extremely high or extremely low) by low income respondents.

With regard to RNs specifically, recent patients express high levels of confidence. Caregivers are less likely to highly agree with the positive view of the work of RNs.

The survey statements “Registered Nurses and RN(NP)s conduct themselves in a professional manner in the workplace” at 4.5, “Registered Nurses and RN(NP)s support me to make informed decisions about my health” and “RNs and RN(NP)s support me to make informed decisions about my health” at 4.3 had the highest means. “I always know who the RN is when one is present in a health care setting,” had the lowest mean at 3.8, yet it continued its increasing trend over the past four years (3.1 in 2014 and 3.4 in 2016).

With regard to comfort levels about treatment functions carried out by Nurse Practitioners, relative to 2016, the mean score figures are higher: four of the five have increased; and three of the statements have seen increases over the past three surveys. These are: “performing surgical procedures”, “prescribing drugs” and “ordering diagnostic tests.”

3.3 Integral Partners in Health (END 3)

With regard to the question of need for more RNs, 73.3% of the respondents responded that the Province should have more RNs, 2.1% that there should be fewer (down from 7.2% in 2016) and 15.7% that the current number is sufficient. As in previous studies, those that feel there should be more RNs significantly outnumber those responding fewer or the same. To note is the difference in the numbers of those who wanted fewer RNs (2.1% in 2018), which was statistically



significant relative to the 2016 study (7.2% in 2016). This supports the desire for more RNs in the healthcare system.

In response to the question for support of a publicly-funded health care system, the mean response level was 4.52 (or 87.4% strongly agreed or agreed), very much in line with the 2016 result.

Younger respondents, those with grade 12 or less, and those who have not interacted with the healthcare system are less likely to strongly support a publicly-funded health care system. Urban respondents express stronger support for a publicly-funded health care system.

The 2016 report commented on evidence of an upward trend in three categories. Those statements were “The RNs and RN(NP)s support me to make informed decisions about my health”, “RNs consistently introduce themselves personally to patients or family”, “The RNs and RN(NP)s involve me and my family in planning my care”. In all three cases, this upward trend is confirmed once again in 2018.

77.1% of the respondents believe that the Province should have more Nurse Practitioners in the health care system. This percentage represents an increase from 74.9% in 2016 and a tendency toward the 79% recorded in 2014. While there are no statistically significant increases relative to 2016, the evident desire expressed by respondents to have more RN(NP)s continues to be strong.

With regard to crosstab comparisons, while those who live on farms and acreages are more likely than other groups to have received care from RN(NP)s, groups that are most comfortable with the care received by these RN(NP)s are females, younger respondents, University graduates, and rural and small urban centre residents.



4 Introduction and Description of the Research

4.1 Overview Strategian conducted a survey in February 2018 to gather information that will assist the Saskatchewan Registered Nurses’ Association (SRNA) in serving its members’ needs through on-going strategic planning around the Association’s mission and ENDs. As part of this process, a wide range of issues related to professional practice and standards are assessed, as well as the role of Registered Nurses (RNs) within the health care system, and general public perceptions of RNs. SRNA uses results from a biannual public survey to monitor progress in achieving its group of 3 “ENDs,” or Mission which form the cornerstone of its professional practice charter. Effective January 2018, these ENDs included i.) Regulation, ii.) Professional Practice, and iii.) Integral Partners in Health. These ENDs are highlighted below as well as included in full form in Appendix 2. The survey questions (Appendix 1) related to these ENDs are also identified in the context of this report where possible. END 1: Regulation Accountable, effective, transparent profession-led regulation in the public interest. END 2: Professional Practice Excellence in Professional Practice. END 3: Integral Partners in Health RNs and RN(NP)s are integral partners in the health-care system. The methodology for the 2018 survey is outlined below:

In co-operation with the consultant, the SRNA developed the survey. The survey was based on the survey platform used in previous surveys and is consistent for comparative purposes across many of the practice charter areas.

Under the supervision of the consultant, a telephone survey was conducted by Social Sciences Research Laboratory (SSRL) at the University of Saskatchewan. The survey was administered using CATI technology (computer assisted telephone interviewing) from a random sample of Saskatchewan residents. Survey methodology is further outlined in section 4.2.

The SSRL delivered survey results electronically (in SPSS file format) to Strategian. The consultant then undertook a comprehensive analysis of the data and produced



a report on the findings, including means, analysis of variance (crosstab chi-square analysis, and t-tests to determine statistically significant differences in means from 2016 to 2018 results) frequencies, and interpretation of the results.

As indicated, the survey used in 2018 was based on the platform established from surveys undertaken by the SRNA in the past. This is the seventh time that the survey has been conducted, and as a result there are year over year comparable results in select areas. These comparisons have been made where possible in this report.

In addition this year, further analysis of the results has been conducted to determine if responses differ based by age, gender, location, education or household income. Statistically relevant differences are included in this report. Statistical inferences (i.e. analysis of variance) from the 2016 results have also been made and are addressed within the report, in Sections 14 and 15.

4.2 Survey Methodology

The sample frame was restricted to Saskatchewan-based households, and generated on a randomized basis, subject to pre-established parameters respecting age and geographic location. The sample was weighted as necessary to ensure representation of the population group of interest.

The survey was conducted by phone due to the time sensitivity of the project, as well as the necessity to ensure coverage and obtain the necessary response rate. The data was captured via CATI (computer-aided telephone interviewing software) and downloaded in SPSS v23 format.

The survey sample frame was constructed to obtain surveys from a random selection of provincial residents. The proportionately distributed sample of 400 provincial residents assumes a 95% level of certainty that the overall results of the survey are within +/- 4.9% of what they would be if the entire population of the province were polled.

The target sample included 400 completed surveys, and was set in effort to facilitate statistical and comparative analysis with a confidence level of .95, and within a margin of error of +/- 5% or lower. This yielded an aggregate survey response that is statistically reliable. This number represents enough observations to support analysis of variance (ANOVA) techniques (i.e. gender, geographic location, age). To the extent possible, all attempts were made to identify respondents who have the knowledge to provide the information necessary for the completion of the survey. To this end, efforts were made through screening to ‘talk to the right person’ in the household. As indicated, attention was taken in effort to yield a cross-sectional sample, which eventually involved quota sampling management for some gender categories such as age and geographic location.



The sample list for this research was purchased through RDD Records Sampling. To ensure proportionate representation from all areas of Saskatchewan, the province was divided into sampling districts based on census division and quotas were set based on five geographic regions: Regina, Saskatoon, South, Central and North. The sample frame for the survey was constructed to facilitate relatively proportionate representation of Saskatchewan adult residents in terms of gender, age, employment status, level of education and household income. This ensures that the opinions of all types of Saskatchewan residents are represented in the statistical measurements documented in the report and that they can be broken out for segmentation analysis.

Data collection occurred during the dates of February 26th to March 5th, 2018. Calls to Saskatchewan residents occurred during evenings between the hours of 5:00pm and 9:00 p.m. CST, and weekends between the hours of 10:30 a.m. and 4:00 p.m. CST.

4.3 A Note on Data Presentation and Interpretation of Survey Scales

It should also be noted that percentage based responses show absolute or actual percentages from respondents, and as a result may not equal 100% due to rounding and ‘don’t know/not sure’ responses. In questions where the ‘don’t know/not sure’ responses were comparatively large (i.e. greater than a few percentage points), then these differences are noted. Also, because percentages have been recorded to at least one decimal point, responses may also not equal 100%, rather they may vary between 99% and 101% when summed for a category as we have not rounded the responses to the closest whole percentage. When considering mean scores, the mean overall is a weighted average mean of all respondents, and therefore may not be consistent with the average of the sums of the Group means.

Given the history of this research dating back to 2006, there is historical data; however it is not possible to effectively and efficiently report survey to survey comparisons across all categories as the survey has differed slightly over the years. Noting this, efforts have been made to glean data that is longitudinally comparable dating back to 2006.

Verbatim information was collected and provided separately to the SRNA. It is advised that the SRNA review these comments and consider the information in respect to their goals and objectives. These comments are very important in identifying the thoughts and perceptions of respondents – and as a result should be given due consideration. Verbatim comment themes have been identified and included in this report.

Finally, this report has been prepared for the SRNA based on data collected in respect to perceptions and practice of the SRNA and RNs. A number of terms may be used throughout the report that refers to the SRNA. Any references in this report to the organization in general (i.e. ‘the organization’) refers to the SRNA specifically.



The use of symmetrical, five-point response scales offers several advantages for interpreting survey results.

For individual questions they provide:

A method of determining whether responses are generally “positive” or “negative” by comparing the percentage of responses on either side of the midpoint.

A direct way of identifying whether the response pattern is skewed or polarized.

A direct way of identifying whether strongly held opinions occur more frequently than expected.

For more in-depth analysis they provide:

An opportunity to create a single measure for each response scale question by calculating the average of all number responses.

The calculated mean response level can be used to assess whether the response pattern is generally “positive” or “negative.”

The mean is a very useful tool for comparing response levels between demographic subgroups.

The mean response level is also a very useful tool for comparing results between questions with the same response scales.

Since the response scales are made up of the numerical options of 1,2,3,4, or 5, the strongly held opinions are represented by either a 1 on the “negative” side or by a 5 on the “positive” side of the scale. The midpoint of the scale is 3 so, when responses are average, an “average” or “neutral” response would be 3.00. Thus, for example, mean response levels above 3.00 suggest a “positive” general response while those below 3.00 suggest a “negative” general response.

Mean response levels of, say, 2.50 or 3.50 can be considered representative of substantially “negative” or “positive” opinions. When there is a slight deviation (i.e. 4.32 to 4.24), the change is likely due more to a surveying effect than a measurable change in public perception or attitude. Thus, when interpreting comparative results, it is important not to get too concerned about slight variances from year to year.

Mean response levels are not intended for use as exact estimates of population parameters, rather as guidelines to the strength of response to an individual question or as a convenient way of comparing response levels between questions.



5

Survey Coverage

5.1 Overview

The results shown in this report are drawn from a survey of respondents across Saskatchewan. In total, there were 400 respondents in 2018, the same as in 2016.

Respondent profiles are provided in section 5.2. The profiles are adequately distributed, and weighted where necessary, by gender, age, household income, location and education, and are representative of the population in question.

5.2 Respondent Profile

While there were 400 respondents, demographics were also recorded of the sample population. Respondents are segmented based upon age, gender, salary, location and education level (see Figures 5.1 through 5.5). In some instances, in efforts to support advanced statistical analysis, it was necessary to recode demographic data where appropriate. These have been identified in the report. Given the size of the response overall, the distributions are normalized and consistent for the statistical analysis performed. To support analysis of variance, some categories were collapsed. These adjustments are consistent with the recoding done in previous years, and are identified in the report.

Beyond the historic parameters of demographic analysis, for the first time this year respondents were also asked to provide information on their interaction with the healthcare system over the last two years. Respondents indicated if they had interacted with the health care system as a patient, as the guardian or caregiver of a patient, or as one who had had no interaction with the healthcare system at all. Commentary on how interaction with the healthcare system affects perception of service is provided.

For a full explanation of how this data was collected and reported, see Appendix 3.

The respondent profile was 51% female, 37% over the age of 55, and representatively profiled on the

demographic attributes of income, urban/rural, and education.



Figure 5.1: 2018 - Male and female respondents (%)

0 10 20 30 40 50 60 70

Men

Women

42.0

58.0

49.1

50.9

36.0

64.0

49.0

51.0

49.0

51.0

2018 2016 2014 2012 2010



Figure 5.2: 2018 - Age profile of respondents (%)

Note: For 2018, the age categories were recoded into 3 categories from 6 for crosstabs (18-34, 35-54, 55+). These were the same age categories used in 2010, 2012, 2014 and 2016.

0 20 40 60 80

18-34

35-54

55 or older

17.2

42.1

40.6

16.3

41.7

42.0

14.8

29.1

54.5

9.6

27.2

62.6

29.3

32

36.6

2018 2016 2014 2012 2010



Figure 5.3: 2018 - Salary profile of respondents (%) (% may not equal 100 due to ‘non-response/did not indicate’ in this Figure and other Figures to follow)

Note: as in 2012, 2014 and 2016, the Income categories were transformed into 4 categories from 5 for crosstabs (under $30,000, $30,000-$59,999, $60,000-$90,000, over $90,000).

0 5 10 15 20 25 30 35 40 45 50

Under $30,000

$30,000 to just under $60,000

$60,000 to just under $90,000

Over $90,000

15.5

30.1

23.2

31.3

18.5

19.3

14.8

47.4

16.8

16.3

17.8

22.7

18.1

17.5

16.7

25.9

16.1

19

15.4

32.3

2018 2016 2014 2012 2010



Figure 5.4: 2018 - Location profile of respondents (%) (% may not equal 100 due to ‘non-response/did not indicate’ in this Figure and other Figures to follow)

0 10 20 30 40 50 60

Farm or acreage

Community under 5,000 people

Community of 5,000 to 20,000 people

City over 20,000 people

Northern Resident

21.4

24.6

8.3

45.7

14.3

15.8

5.7

55.6

21.0

25.9

10.6

38.8

3.0

20.1

24.1

12.4

40.4

2.8

20.8

19.5

8.5

45.7

3.8

2018 2016 2014 2012 2010



Figure 5.5: 2018 - Education profile of respondents (%) (% may not equal 100 due to ‘non-response/did not indicate’ in this Figure and other Figures to follow)

0 5 10 15 20 25 30 35

Less than Grade 12

Grade 12

Some post-secondary

Technical/diploma

University degree

10.9

22.0

19.5

19.0

28.6

12.6

22.0

13.0

19.0

22.0

13.8

22.5

17.5

20

24.4

11.4

23.7

15.8

20

28.2

8.8

25.5

10.2

20.6

33.3

2018 2016 2014 2012 2010



Figure 5.6: 2018 – Nature of respondent interaction with the healthcare system (%) (% may not equal 100 due to ‘non-response/did not indicate’ in this Figure)

Note: see Appendix 3 for full explanation of data collection and groupings seen in this chart.

0 10 20 30 40 50 60

No interaction

Patient within the system

Guardian or care giver for a patient within the system

Both a patient and guardian or care giver

20.1

51

14.7

14.2

2018



6 Change in Level of Nursing Care

6.1 Overview

Respondents were asked to provide their opinion on the level of care provided by Registered Nurses today in comparison to 5 years ago. They were given the options of “better”, “worse”, “the same”, “don’t know” or “refusal to answer.” In efforts to prevent data skewing, those that responded “don’t know” or who refused to answer were removed. Comparison is made to 2016, 2014, 2012, 2010, 2008 and 2006 results.

6.2 Results

Between the 2016 and 2018 studies, there have been no statistically significant changes in the opinion of level of care provided by Registered Nurses. However, they have been some apparently important shifts. The percentage of those who responded “better” is 31.6%. This is notably higher than the percentage registered in 2016 of 22.8% and the 21.7% registered in 2014. There were also important shifts in the other categories: those who felt the level was the same moved from 47.7 in 2016 to 39.0 in 2018 and those who thought the level of care was worse moved from 14.1 in 2016 to 7.4 in 2018. This is a positive sign.

The public perception of RNs providing a “better” level of

care in 2018 (31.6%) is higher than the percentage registered in 2016 (22.8%).



Figure 6.1: *Opinion of level of care provided by Registered Nurses in comparison to 5 years ago (%) (END 2)

*In 2018, a number of respondents (22.1%) answered "Unsure or Don't Know" to the question: "Is the care that Registered Nurses provide today, better, worse or about the same as five years ago?" This compares to 15.4% of respondents answering the same in 2016 and 17% in 2014. As has been noted in previous reports, this is a logical response worth noting. Percentages were not recast over a smaller ‘n’ in efforts not to skew the data.

6.3 Crosstab Analysis

A crosstab analysis was performed to ascertain whether statistically significant differences were present across the demographic data. The following results were found regarding the “opinion of level of care provided by Registered Nurses in comparison to 5 years ago”:

o With respect to the cross-tab analysis, male respondents were more likely to say “better” compared to females.

0 10 20 30 40 50 60 70

Better

Worse

Same

15.4

24.2

60.4

13.6

31.3

55.1

21.6

26.0

52.4

17.3

13.6

47.2

21.7

13.1

48.1

22.8

14.1

47.7

31.6

7.4

39.0

2018 2016 2014 2012 2010 2008 2006



o As was the case in the 2016 report, respondents who were 55 years of age and older were less likely to say ‘better’ when compared to other age groups. The younger the age group, the more likely respondents were likely to say ‘better’.

o Low income households were more likely to say ‘better’.

o There were no significant relationships relative to this query and the type of interaction with the healthcare service.

6.4 Verbatim Responses

(Note: open ended comments were removed from report that is being posted on the SRNA website for public view. This was done to protect the identity of people or places that may have been referenced in the comments). General themes are still included.

All respondents were asked to elaborate on why they thought that care compared to 5 years ago was “better”, “worse”, or the same. The summarized verbatim responses are provided below. Note that these responses have been edited for grammar only, and are also themed to the extent possible.

The follow verbatim comments are from respondents who indicated the care Registered Nurses provided today is better, as compared to five years ago. Note that they have been grouped by similarity of response (content).

More knowledgeable/better educated/better technology and resources More empathetic approach to patients Improvements in the system and its approach to patients Awareness brought about by recent experiences with medical care

The follow verbatim comments are from respondents who indicated the care Registered Nurses provided today is worse, as compared to five years ago. Note that they have been grouped by similarity of response (content).

Lack of nurses/staffing shortage/excessive workload Necessary empathy and professional rigour lacking System needs to improve to provide better care/service Concerned only about salaries/wages



Administrative work impedes them from giving care or permits neglect of care

The follow verbatim comments are from respondents who indicated the care Registered Nurses provided today is the same, as compared to five years ago. Note that they have been grouped by similarity of the nature of the response.

Experience based – seemingly neutral perspective A structural issue: system constraints and/or no motivation to improve or

innovate The service is good – it doesn’t necessarily have to be better No way to judge; infrequent use or no frame of reference



7

Integral Partners in Health

7.1 Overview

Survey respondents were asked, based on their understanding of their role, if the province should have more, less or about the same number of Registered Nurses. 73.3% of the 400 respondents responded that the Province should have more RNs.

In previous reports, the question was framed differently: “Currently, more registered nurses are needed in the province’s health care system”. Level of agreement was measured with this statement. Previous results indicated a high level of agreement with mean scores ranging between 4.2 and 4.4 over the past four studies. Figure 7.1 and Table 7.2 have been included for comparative purposes. A response of 1 indicated that they “strongly disagreed” while a response of 5 indicated that they “strongly agreed”.

7.2 Results

73.3% of the 400 respondents responded that the Province should have more RNs. 2.1% that there should be fewer and 15.7% that the current number is sufficient. 8.5% of respondents did not know what to answer. As in previous studies, those that feel there should be more RNs significantly outnumber those responding fewer or the same.

The difference in the numbers of those who wanted fewer RNs registered a statistically significant difference relative to the 2016 study.

Table 7.1: Should the Province have more, less or about the same number of RNs

More Fewer Same Don’t Know

Should the Province have more, less or the same numbers of RNs (END 3)

73.3% 2.1% 15.7% 8.5%

73.3% of respondents think that there should be more

Registered Nurses.



Figure 7.1: Agreement with statements regarding health care system and Registered Nurses (mean out of 5)

Table 7.2: Comparison of 2008, 2010, 2012, 2014 and 2016 level of agreement to statements regarding Registered Nurses and the health care system


o There were no significant crosstab relationships noted in the 2018 study

0.0 1.0 2.0 3.0 4.0 5.0

Currently, the Province needs more RNs in thehealthcare system (END 3.0 & 3.2)

4.5

4.7

4.3

4.2

4.4

4.3

2016 2014 2012 2010 2008 2006

Strongly Strongly Disagree Agree

1 2 3 4 5

Currently, the Province needs more RNs in the health care system (END 3) 2016

3.0% 4.3% 14.8% 23.0% 51.2%

2014 2.3% 2.9% 14.8% 17.9% 62.1%

2012 3.0% 2.7% 16.0% 23.7% 51.1%

2010 4.6% 3.1% 9.3% 22.2% 60.8%

2008 1.2% 2.2% 4.7% 14.4% 77.6%



8 Professional Practice: The Health-Care Setting

8.1 Overview

Respondents were asked to think of recent experiences with getting ‘health care’, and to rate their level of agreement with six different statements pertaining to their experiences. While the 2016 survey presented the same 9 questions used in 2014, the 2018 survey eliminated three of the nine questions.

The following 6 statements were repeated in the 2018 survey:

“RNs and RN(NP)s involve me and my family in planning my care (END 3).”

“Registered Nurses consistently introduce themselves personally to patients or family (END 3).”

“I understand the role of the Registered Nurse (END 3).”

“I always know who the Registered Nurse is, when one is present in a health-care setting (END 3).”

“Registered Nurses and RN (NP)s conduct themselves in a professional manner in the workplace (END 2).”

“RN and RN(NP)s support me to make informed decisions about my health (END 3).”

The following three statements were not included in the 2018 survey.

“I receive enough information from RNs to make decisions about my health care (END 2).”

“I have confidence in the professional ability of Registered Nurses (END 2).”

“The RN and RN(NP)s always wear a name tag with first and last name and RN title (END 3).”

8.2 Results

As shown in Figure 8.1, five of the six statements experienced increases in the mean scores between 2016 and 2018. One remained the same. As in previous studies, there is



consistency in the means. Means were statistically analyzed between 2016 and 2018 data sets, and no statistically significant differences were found.

The survey statements “Registered Nurses and RN(NP)s conduct themselves in a professional manner in the workplace” at 4.5, “Registered Nurses and RN(NP)s support me to make informed decisions about my health” and “RNs and RN(NP)s support me to make informed decisions about my health” at 4.3 had the highest means. “I always know who the RN is when one is present in a health care setting,” had the lowest mean at 3.8, yet it continued its increasing trend over the past four years (3.1 in 2014 and 3.4 in 2016).

The 2016 report comments on evidence of a three-time consecutive upward trend in three of this year’s categories. Those statements were “The RNs and RN(NP)s support me to make informed decisions about my health”, “RNs consistently introduce themselves personally to patients or family”, “The RNs and RN(NP)s involve me and my family in planning my care”. In all three categories, this upward trend is confirmed once again.



Figure 8.1: Level of agreement with statements pertaining to Registered Nurses depending upon recent experience (mean out of 5)

0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5

RNs and RN(NP)s support me to make informeddecisions about my health

RNs and RN(NP)s conduct themselves in aprofessional manner in the workplace

I always know who the RN is, when one ispresent in a healthcare setting

I understand the role of the RN

RNs consistently introduce themselvespersonally to patients or family

RNs and RN(NP)s involve me and my family inplanning my care

4.2

3.3

4.0

3.6

4.1

3.2

4.1

3.5

4

3.3

4.2

3.6

3.8

4.1

3.2

4.0

3.6

3.5

4.0

4.4

3.1

4.2

3.8

3.8

4.1

4.3

3.4

4.2

4.1

4.1

4.3

4.5

3.8

4.2

4.2

4.3

2018 2016 2014 2012 2010 2008 2006



Table 8.1 below compares overall aggregate response rates for the level of agreement from as far back as 2008 where applicable. Please note that the responses highlighted in red are the 2018 responses.

Table 8.1: Comparison of 2008, 2010, 2012, 2014, and 2018 response rates to level of agreement with statements pertaining to experience with health care


1 2 3 4 5

RNs and RN(NP)s involve me and my family in planning my care (END 3) 3.5% 5.7% 16.1% 33.0% 29.3%

2016 3.4% 6.4% 20.9% 30.8% 29.2%

2014 5.1% 8.4% 22.7% 32.2% 30.4%

2012 6.7% 9.6% 24.4% 30.4% 17.8%

Registered Nurses consistently introduce themselves personally to patients or family (END 3) 3.6% 6.7% 15.9% 32.1% 31.9%

2016 2.6% 6.6% 20.8% 31.9% 27.7%

2014 5.9% 8.8% 22.4% 28.3% 34.3%

2012 6.4% 12.1% 22.2% 28.1% 25.2%

2010 6.7% 12% 27.6% 24.7% 29%

2008 6.3% 12.5% 31% 27.5% 22.6%

I understand the role of the Registered Nurse

(END 3) 2.7% 2.7% 16.0% 34.9% 40.1%

2016 1.3% 5.8% 13.3% 36.8% 40.3%

2014 1.5% 5.1% 14.5% 33.2% 45.7%

2012 2.2% 4.4% 17.5% 36.3% 37.3%

2010 2.5% 1.8% 14.5% 35.1% 46.1%

2008 2.7% 5.5% 13.9% 36.1% 41.7%

I always know who the Registered Nurse is, when one is present in a health care setting (END 3)

8.4%

13.2%

20.8%

27.0%

22.2%

2016 10.9% 19.2% 19.9% 21.8% 22.8%

2014 16.3% 17.6% 26.7% 18.7% 20.8%

2012 13.3% 16.8% 25.4% 21.7% 18.0%




o Female respondents highly agree that they understand the role of the RN. They were more likely to agree that RNs and RN(NP)s ‘involve me and my family in planning my care, support me to make informed decisions, and conduct themselves professionally.’

o Younger respondents are less likely to agree that RNs and RN(NP)s ‘involve me and my family in planning my care, support me to make informed decisions, conduct themselves professionally.’ They also are less likely to say that they ‘understand the role of the RN.’

o Rural respondents say that they ‘understand the role of the RN’ and are

aware of their presence in the health care setting. They are likely to agree that ‘RNs and RN(NP)s involve me and my family in planning my care, support me to make informed decisions, conduct themselves professionally, and introduce themselves personally.’

o With regard to levels of education, those with a University degree are likely to agree that ‘there are a range of high levels of service from RNs and

2010 9.2% 19.5% 24.1% 24.8% 22.3%

2008 10.4% 20.6% 25.7% 23.1% 20.2%

Registered Nurses and RN (NP)s conduct themselves in a professional manner in the

workplace (END 2) 2.6% 1.4% 9.8% 32.2% 48.2%

2016 1.5% 4.1% 8.7% 39.3% 42.5%

2014 0.5% 2.6% 11.1% 31.1% 54.7%

2012 2.0% 3.7% 14.6% 41.0% 36.3%

2010 3.5% 5.9% 17.4% 36.6% 36.6%

2008 1.8% 3.2% 17% 36.9% 41.1%

RN and RN(NP)s support me to make informed decisions about my health (END 3) 3.6% 2.7% 14.9% 36.8% 33.9%

2016 3.4% 4.9% 16.0% 36.3% 31.4%

2014 3.4% 6.0% 19.3% 31.5% 39.2%

2012 4.0% 5.2% 23.7% 36.5% 23.3%



RN(NP)s.’ Those with less than Grade 12 education are less likely to say that they ‘understand the role of the RN.’

o Low income households are less likely than other groups to strongly agree that RNs and RN(NP)s ‘involve me and my family in planning my care, support me to make informed decisions, and conduct themselves professionally.’

o Recent patients (those who have had an interaction with the healthcare system in the past 2 years) are most likely to strongly agree that RNs and RN(NP)s ‘support patients to make informed decisions and to conduct themselves professionally.’ Caregivers are less likely to strongly agree that ‘RNs and RN(NP)s involve families in care.’ Those who have had any kind of interaction are more likely to strongly agree that they ‘understand the role of the RN.’



9 Public Confidence: Comparison to Other Professions

9.1 Overview

Perceptions of the competence level of various professions were measured as a means of comparing them to Registered Nurses. A response of 1 indicated a very low level of confidence and a 5 indicated a very high level of confidence.

Similar to previous years, professions included Registered Nurses, police officers, doctors, teachers and pharmacists. The 2018 study added firefighters to this list. The query was worded as follows:

“I am going to ask you to rate your level of confidence in the competence of 5 different professions including registered nurse, police officers, doctors, teachers, pharmacists and firefighters.”

9.2 Results

As can be seen in Figure 9.1, the highest score (4.5) was attributed to the level of confidence in the competence of firefighters. In the various professions, these levels have been similar since 2006. To note, the level of confidence in has increased for teachers and pharmacists. That of Registered Nurses has remained stable since the last study in 2016. In the 2016 study, Registered Nurses ranked the highest along with pharmacists in terms of public confidence. The current study indicated that RNs are superseded by pharmacists and firefighters.

Table 9.1 compares response levels between 2008, 2010, 2012, 2014, 2016 and 2018 with 1 being ‘very low’ and 5 being ‘very high.’

The level of confidence in RNs is stable relative to the last study. However, where RNs ranked first in terms of public confidence in 2016,

they are now slightly behind pharmacists and

firefighters.



Figure 9.1: Level of confidence in the competence of various professions in the province (mean out of 5) (END 2)

0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5

Pharmacists

Registered Nurses

Doctors

Police Officers

Teachers

Firefighters

4.4

4.2

4.0

3.8

3.8

4.4

4.2

4.0

3.9

3.8

4.4

4.1

4.0

3.9

3.8

4.3

4.0

4.0

3.8

3.7

4.4

4.2

4.0

3.8

3.8

4.3

4.3

4.0

4.0

3.9

4.4

4.3

4.0

3.9

4.0

4.5

2018 2016 2014 2012 2010 2008 2006



Table 9.1: Comparison of 2018 results to those of 2008, 2010, 2012, 2014 and 2016 re: level of confidence in various professions

Profession

Very Very Low High

1 2 3 4 5

Registered Nurses 2018 2.7% 2.0% 9.2% 39.6% 45.0%

2016 1.1% 2.1% 11.5% 41.5% 42.3%

2014 0.5% 1.2% 15.9% 45% 37.3%

2012 1.0% 3.7% 17.8% 44.9% 32.1%

2010 2% 3.3% 13.6% 40.4% 40.7%

2008 0.8% 2.3% 10.7% 48% 38.2%

Police Officers 2018 5.1% 4.2% 18.7% 40.7% 28.5%

2016 1.9% 6.4% 20.8% 39.5% 29.2%

2014 2.0% 6.9% 28.2% 38.3% 24.6%

2012 4.2% 6.2% 23.2% 37.0% 27.9%

2010 2.6% 6.9% 20.5% 42.1% 27.9%

2008 2.2% 5.7% 21.9% 44.3% 25.9%

Doctors 2016 4.9% 2.7% 14.8% 41.8% 34.7%

2016 2.1% 4.9% 17.6% 42.3% 31.8%

2014 1.7% 3.2% 21.1% 43.4% 30.5%

2012 1.7% 4.4% 18.8% 45.9% 28.9%

2010 2.8% 3.3% 16.3% 42.5% 35.2%

2008 1.3% 3.7% 20.1% 45.9% 29.0%

Teachers 2018 4.2% 2.8% 24.8% 33.6% 30.7%

2016 0.9% 9.9% 23.9% 37.8% 23.9%

2014 1.5% 6.7% 29.0% 38.6% 24.2%

2012 3.2% 7.4% 28.6% 37.8% 20.1%

2010 2.6% 5.0% 23.7% 42.5% 26.1%

2008 1.9% 6.6% 25.6% 43.0% 22.9%




o Females have higher levels of confidence than males with respect to RNs, police officers, teachers, pharmacists and firefighters.

o Males are slightly more confident in doctors than are females.

o With regard to confidence in RNs, doctors, teachers, and pharmacists, younger respondents are most likely to say ‘very high.’

o Younger respondents are least likely to say ‘very high’ with regard to police officers.

o Respondents in rural centers express higher levels of confidence with

all professions.

o Those with diploma/certificate are more likely to say ‘very high’ for police officers and teachers but less so for the other professions.

o Low income respondents express polarized assessments with regard

to police officers, doctors and firefighters.

o Caregivers have less propensity to give high assessments to RNs, police officers, teachers and doctors. Instead they seem to have the highest regard for firefighters. Patients share this high regard for firefighters and the lower propensity to highly regard doctors. Patients also are more likely to express great confidence in pharmacists where those with no interaction are the least likely to do so.

Pharmacists 2018 2.9% 0.2% 8.4% 33.7% 51.7%

2016 1.7% 2.4% 11.4% 36.8% 46.9%

2014 0.5% 0.7% 9.2% 36.8% 52.7%

2012 0.7% 1.7% 9.4% 40.5% 47.2%

2010 1.0% 1.8% 6.5% 36.7% 54%

2008 0.7% 1.2% 6.1% 39.3% 52.7%

Firefighters 2018 2.7% 0.3% 4.7% 33.9% 52.8%



10 Professional Practice: Client Service Outcomes

10.1 Overview

Survey respondents were asked to indicate their level of agreement with seven statements pertaining to the perception of client service from Registered Nurses. Four of these statements have been included in previous studies. They are:

“When I get health care from a Registered Nurse, I am treated with respect”

“When I get health care from a Registered Nurse, I am treated fairly”

“When I seek health care from a Registered Nurse, I am confident I will get the right care for my condition”

“I can count on a Registered Nurse to provide me with safe health care”

Three of the statements are new to the 2018 study. They are:

“When I get health care from an RN, I get ethical care”

“When I get health care from an RN, I get culturally appropriate care”

“When I get health care from an RN, I get individual and/or family centered care”

These statements were assessed once again using a Likert scale, ranging from ‘1’ indicating a strong disagreement, and ‘5’ indicating a strong agreement.

10.2 Results

Figure 10.1 highlights that perception of client service from Registered Nurses has remained positive and, for the most part, stable.

Table 10.1 highlights the response difference between 2006, 2008, 2010, 2012, 2014, 2016 and 2018. Overall response percentages are shown re: respondents indicating either 1 through 5. There was one statistically significant change in the 2018 results: “I can count on an RN to provide me with safe health care.” The other results were in line with the 2016 figures.

The 2018 study once again indicates a strong

perception of service provided by RNs.



Figure 10.1: Level of agreement with statements on perception of client service from Registered Nurses (mean out of 5)

0.0 1.0 2.0 3.0 4.0 5.0

I am treated fairly

I am treated with respect

I receive safe health care

Right care for my condition

I get ethical care

I get culturally appropriate care

I get individual and/or family centered care

4.3

4.3

4.2

4.1

4.3

4.2

4.1

4.0

4.2

4.1

4.1

4.0

4.2

4.2

4.2

4.0

4.4

4.5

4.3

4.1

4.4

4.4

4.3

4.1

4.4

4.3

4.4

4.2

4.4

4.3

4.3

2018 2016 2014 2012 2010 2008 2006



Table 10.1: Comparison of 2008, 2010, 2012, 2014, 2016 and 2018 response levels


1 2 3 4 5

When I get health care from a Registered Nurse, I am treated with respect (END 2) 2018

3.1% 1.9% 10.0% 32.5% 51.6%

2016 1.3% 1.3% 9.2% 35.3% 50.6%

2014 0.8% 1.0% 9.9% 29.5% 58.8%

2012 1.2% 4.0% 12.1% 38.5% 43.5%

2010 2.4% 5.2% 14% 32.5% 45.8%

2008 1.3% 2.2% 13.5% 38.8% 44.2%

When I get health care from a Registered Nurse, I am treated fairly (END 2) 2018

2.7% 1.6% 9.2% 30.1% 55.2%

2016 1.9% 1.3% 8.8% 37.0% 48.9%

2014 0.0% 1.5% 10.4% 30.8% 57.3%

2012 0.7% 2.7% 14.3% 40.0% 40.7%

2010 0.4% 4.9% 12.7% 34.9% 47.2%

2008 1.2% 1.2% 13.2% 38.4% 46%

When I seek health care from a Registered Nurse, I am confident I will get the right care for my condition

(END 3 & 2) 2018 2.6% 2.5% 10.8% 45.6% 37.8%

2016 0.7% 3.6% 18.8% 36.3% 39.1%

2014 1.3% 2.0% 17.6% 43.7% 35.3%

2012 1.0% 3.7% 18.3% 42.7% 32.1%

2010 1.4% 6.7% 18% 38.4% 35.6%

2008 1.7% 5.1% 15.1% 48.1% 30%

I can count on a Registered Nurse to provide me with safe health care (END 2) 2018

2.5% 2.1% 4.3% 35.7% 53.8%

2016 0.6% 3.4% 13.3% 35.0% 46.4%

2014 0.8% 1.8% 14.0% 36.6% 46.9%

2012 0.2% 4.0% 12.3% 43.0% 39.5%

2010 1.1% 5.6% 12.6% 39.3% 41.4%

2008 1.5% 2.9% 14.3% 42.3% 39.1%

When I get health care from an RN, I get ethical care (END 2) 2018

2.7% 2.1% 7.8% 35.4% 47.1%

When I get health care from an RN, I get culturally appropriate care (END 2) 2018

3.4% 2.2% 11.9% 29.2% 46.5%

When I get health care from an RN, I get individual and/or family centered care (END 2) 2018

2.5% 1.7% 13.9% 38.8% 35.8%




o Females are more likely than males to agree that they are treated with respect and treated fairly by RNs. The same gender tendency is found with regard to confidence in getting the right care, safe care, ethical care and culturally appropriate care.

o With respect to age differences, younger respondents are less likely to agree that they are treated with respect while older respondents are less likely to feel that they are treated fairly.

o Rural respondents are more likely to ‘strongly agree’ that they are treated with

respect, and they are more confident that they are getting the right care, safe care, ethical care and culturally appropriate care. Farmers seem to have less propensity to express confidence in the care that is received.

o Those with a university degree are more likely to have a very positive

perception of the level of care that is received. o With respect to income differences, higher income households have a very

positive perception of respect, fairness and ethical care, relative to other groups. Lower income households are more confident that they are getting the right care but slightly less confident that they are getting safe and culturally appropriate care.

o Recent patients express the strongest agreement that they are treated by

respect by RNs. With regard to the question of fair treatment, those with no interaction and recent patients are most likely to highly agree. The same groups are most likely to express strong confidence in the level of safe care. Recent patients also assess highly the levels of ethical and culturally appropriate care.



11

Nurse Practitioners: Awareness and Attitudes

11.1 Overview

Respondents were asked their level of comfort with seeing a Nurse Practitioner rather than a doctor for a variety of health care services including:

“assessing and diagnosing illnesses”

“prescribing drugs”

“ordering diagnostic tests”

“promoting a healthy lifestyle”

“performing minor surgical procedures (such as suturing/stitches)”

In addition, respondents were asked “Based on your understanding of their role, should the province have more, less, or about the same number of Nurse Practitioners in the health care system?”

11.2 Results

Relative to 2016, four of the five means have increased by .1. When it pertains to assessing and diagnosing illnesses, the mean has decreased from 4.0 to 3.9. Three of the statements have seen three consecutive increases in mean scores. These include “performing surgical procedures,” “prescribing drugs,” and “ordering diagnostic tests.”

Table 11.1 highlights the aggregate responses by level of comfort with 1 being not at all comfortable and 5 being very comfortable.

When asked about the number of RN(NP)s in the Province, 77.1% of the respondents believe that the Province should have more Nurse Practitioners in the health care system. This percentage is lower than the 79% recorded in 2014 but higher than the 74.9% recorded in 2012. Figure 11.2 highlights this response. There are no significant difference between results in 2016 and 2018, yet it is clear that the trend for respondents wanting to see more RN(NP)s in the system is strong.

In general, comfort levels with Nurse Practitioners is either

stable, or on the rise.

A significant percentage of those interviewed feel

that the number of Nurse Practitioners should increase. This is in

keeping with the results from previous studies.



Figure 11.1: Level of confidence with seeing Nurse Practitioners for a variety of health care services (mean out of 5) (END 2)

Table 11.1: Aggregate responses to level of confidence with Registered Nurses providing variety of health care services comparing 2010 – 2016 (END 2)

0.0 1.0 2.0 3.0 4.0 5.0

Assessing and diagnosing illnesses

Ordering diagnostic test

Prescribing drugs

Promoting a healthy lifestyle

Performing minor surgical procedures

3.4

3.8

3.4

4.4

4.1

3.3

3.8

3.3

4.3

3.9

3.8

4.1

3.7

4.5

4.1

4.0

4.1

3.9

4.4

4.2

3.9

4.2

4.0

4.5

4.3

2018 2016 2014 2012 2010

Not at all Very Comfortable Comfortable

1 2 3 4 5

Assessing and diagnosing illnesses 2018 4.2% 5.7% 19.3% 39.3% 26.0%

2016 2.6% 5.6% 21.4% 41.1% 22.6%

2014 3.9% 9.1% 23.1% 35.8% 28.1%

2012 8.1% 14.6% 27.7% 33.3% 13.8%

2010 7.0% 10.9% 33.6% 29.9% 18.5%

Ordering diagnostic tests 2018 4.3% 2.3% 12.0% 33.9% 41.8%

2016 1.7% 6.3% 17.8% 33.7% 34.3%

2014 2.1% 4.9% 16.1% 39.9% 37.0%

2012 3.5% 6.2% 24.0% 37.8% 26.2%



2010 5.2% 5.8% 23.4% 37.5% 28.1%

Prescribing drugs 2018 5.0% 7.8% 17.3% 31.9% 31.8%

2016 3.9% 10.9% 19.9% 33.7% 24.8%

2014 5.1% 9.0% 23.1% 36.8% 26.0%

2012 9.4% 12.3% 29.4% 30.4% 15.3%

2010 9.4% 11.2% 30.5% 28.5% 20.4%

Promoting a healthy lifestyle 2018 3.4% 2.8% 4.2% 26.3% 58.0%

2016 0.8% 3.9% 10.3% 30.1% 50.0%

2014 0.8% 0.5% 11.4% 25.0% 62.4%

2012 1.2% 2.0% 12.1% 34.3% 48.6%

2010 1.8% 1% 9.3% 31.9% 56%

Performing minor surgical procedures (such as suturing/stitches) 2018

4.3% 2.1% 12.1% 33.5% 40.6%

2016 2.6% 5.2% 11.6% 34.2% 39.1%

2014 2.1% 3.6% 18.4% 30.6% 45.2%

2012 3.2% 5.7% 18.0% 37.5% 33.3%

2010 3.4% 4.2% 15.7% 34.3% 42.4%



Figure 11.2: Based on your understanding of their role, should the province have more, less, or about the same number of Nurse Practitioners in the health-care system? (%) (END 3)

11.3 Crosstab Analysis o Farm/acreage residents are more likely than other groups to have received

care from Nurse Practitioners.

o Females are more likely than males to be comfortable with the care received from RN(NP)s.

o Younger respondents are more likely to be very comfortable with the care

received from RN(NP)s.

o Respondents in smaller centres and rural areas are more comfortable with the services provided by RN(NP)s.

0 10 20 30 40 50 60 70 80 90

More

Less

Same

86.9

2.6

10.6

85.1

1.9

13.0

71.9

3.0

15.6

79.0

1.5

11.6

74.9

2.8

13.7

77.1

1.1

12.3

2018 2016 2014 2012 2010 2008



o Respondents with a University degree are more likely to feel very comfortable with the services provided by RN(NP)s.

o Medium income households are less likely to be very comfortable with the services provides by RN(NP)s.

o Recent patients are more likely to have received care by RN(NP)s than are

others.

o Those with interaction with the health care system are more likely to feel comfortable with the minor surgical functions of RN(NP)s.



12

Public Support for a Public Health System

12.1 Overview

Survey respondents were asked if they supported a publicly-funded health care system. Likert scales were employed where 1 was ‘strongly disagree’ while 5 was ‘strongly agree’.

12.2 Results

In response to the question for support of a publicly funded health-care system, the mean response level was 4.52, essentially stable relative to the 2016 report.

Table 12.1 highlights aggregate responses in all years in which the statement was included. A higher number of respondents have chosen the “strongly agree” and “agree” options (87.4%) compared with 86.6% in 2016, 83.9% in 2014 and 74.8% in 2012).

Figure 12.1: Mean response in support for a Public Health System (mean out of 5) (END 3)

0.0 1.0 2.0 3.0 4.0 5.0

4.32

4.30

4.30

4.19

4.42

4.54

4.52

2018 2016 2014 2012 2010 2008 2006

Support for publicly funded health-care is

consistently strong



Table 12.1: Comparison of aggregate responses between 2008 – 2018 (END 3)


o Younger respondents and those with grade 12 or less are less likely to strongly support a publicly-funded health care system.

o Urban respondents express stronger support for a publicly-funded health care system.

o Those who have not interacted with the healthcare system are less likely to

strongly agree with a publicly-funded healthcare system.


1 2 3 4 5

I support a publicly funded health care system 2018 3.4% 1.1% 6.8% 18.3% 69.1%

2016 2.4% 2.3% 4.5% 25.0% 61.6%

2014 3.3% 3.0% 9.8% 16.5% 67.4%

2012 4.9% 4.2% 14.3% 18.5% 56.3%

2010 6.9% 3.1% 7.9% 17.8% 64.4%

2008 3.7% 4.7% 12.5% 16.7% 62.5%



13 SRNA Awareness and Understanding of Its Role

13.1 Overview Respondents were asked a variety of questions pertaining to awareness of the SRNA and its role. These questions included:

“Regulation of RNs should continue to be led by people in the profession, with public participation” (In previous studies, this element was measured according to the wording “Registered Nurses should self-regulate”. Note that public participation [reps] on Council and Committees has been in place for some time).

“Are you aware that you can contact the Saskatchewan Registered Nurses’ Association if you have concern about the competence or conduct or Registered Nurses in the province?”

“Are you aware you can go to the SRNA website to check to see if a registered nurse is licensed; and

To the best of your knowledge which of the following do you think the SRNA is responsible for doing:

o Setting standards for how registered nurses should practice, o Setting standards for the education of registered nurses, o Enforcing a code of ethics or ethics standard for registered nurses, o Ensuring that registered nurses that are educated outside of Canada

who work in Canada have the necessary qualifications, o Addressing concerns about registered nurses; and o Licensing registered nurses to practice.

In this latter category regarding SRNA responsibility, the following was not assessed in the 2018 study.

o Setting boundaries for what registered nurses can do as part of their work.

13.2 Results A total of 58.3% of the respondents indicated they were aware that the SRNA could be contacted if they had a concern about the competence or conduct of Registered Nurses in the province compared to 57.9% in 2016 and 49.4% in 2014.



31.8% of respondents were aware that the public may go to the SRNA website to check to see if a Registered Nurse is licensed, compared to 25.8% in 2016.

In terms of RN regulation, 81.2% of respondents either somewhat or strongly supported the statement that regulation should continue to be led by people in the profession along with public participation. This is a marked increase from 60.8% registered in 2016. A possible explanation of this increase is that this year’s query went beyond simply asking participants to evaluate the concept of profession-led regulation by adding reference to public participation in the regulatory process. To note alongside this increase is the reduction in those that oppose profession-led regulation. The responses are outlined in Figure 13.1. While the result seems quite dramatic, there is no apparent statistical significance in the change.

Figure 13.1: 2018 Level of support for “Regulation of registered nurses should continue to be led by people in the profession, with public participation (note that the percentages in the chart from the data of reports from 2016 and earlier are relative to the wording “Registered Nurses should be led by people in the profession”(END 1).



Respondents were also asked questions related to SRNA perceived responsibilities. The results of these questions are presented in Figure 13.2. All questions continued to score relatively high with positive responses ranging from 80.5% to 89.7% as compared to the 2016 result (a range from 77.5% to 88.2%). The top two responsibilities perceived by respondents were “Setting standards for how RNs should practice” (an increase of almost 12%), and “Enforcing a code of ethics or ethics standard for Registered Nurses” (89.1%).

Figure 13.2: 2018 respondents who answered “yes” to the question, “to the best of your knowledge which of the following do you think the SRNA is responsible for doing…”(%) (END 1)

0 10 20 30 40 50 60 70

Strongly support

Somewhat support

Neither support nor oppose

Somewhat oppose self-regulation

Strongly oppose

14.3

31.1

18.0

21.7

16.1

26.0

27.9

18.6

40.6

20.2

11.4

10.9

13.2

62.1

19.1

8.4

3.1

1.9

2018 2016 2014 2012




o With regard to profession-led regulation, all ages support but those 55+ support it more strongly. Rural respondents support the concept more strongly than those in urban centres. Those with a University degree are more likely to strongly support the concept as are those households with lower incomes and those that have had recent interaction with the health care system. Those who have not interacted with the healthcare system are less likely to strongly agree with a publicly-funded healthcare system.

0 10 20 30 40 50 60 70 80 90

Setting standards for how Registered Nursesshould practice

Setting standards for the education of RegisteredNurses

Enforcing a code of ethics or ethics standard forRegistered Nurses

Ensuring that RNs that are educated outsideCanada have the necessary qualifications

Addressing concerns about Registered Nurses

Licensing Registered Nurses

85.7

80.2

88.1

80.7

87.9

74.1

83.2

83.5

85.9

84.7

84.9

77.5

77.5

79.6

85.2

88.2

81.3

78.8

89.7

80.5

89.1

86.3

87.1

87

2018 2016 2014 2012



o With regard to awareness that you can contact the SRNA if you have concerns, males demonstrate more awareness of this than females.

o With regard to awareness of the SRNA website to check an RN’s license, males are more likely to be aware than females and younger respondents are more aware of the website.

o With regard to the SRNA responsibility of setting standard for RN education, females are more aware than males, as are urban versus rural dwellers. Younger respondents and those with lower levels of education are less likely to be aware of this.

o With regard to enforcing a code of ethics for RNs, younger respondents and rural respondents are relatively unaware of this.

o With regard to SRNA responsibility for setting standards of how RNs should practice, rural respondents were less aware than other groups.

o With regard to SRNA responsibility for ensuring that RNs educated outside of Canada are qualified, there is less awareness on the part of those with Grade 12 education and those households with lower income.

o With regard to finding information about SRNA either by direct contact or through the website, caregivers are more likely to say that they are aware of this possibility.



14 Comparison of Significant Differences of Means; 2018 to 2016 Surveys

Survey Year Analysis for SRNA RNs: Practice and Perception Research Report

Selected questions from the 2016 survey were merged into the 2018 survey results for comparative purposes in SPSS.

The Chi-Square test examines whether there is an association between two categorical variables. We may have a hypothesis that one variable has an effect on another variable. For example, we may hypothesize that the age of a respondent in a survey may have an effect on how they feel about other questions. Suppose we look at whether respondents aged 55+ has an effect on whether they feel that ‘the Province should have more RNs in the healthcare system’. A cross tabulation will be run in SPSS, and a Chi-Square statistic will be generated. In this example, let’s assume the value is .000. When looking at whether there is significance between two variables, we look to see if the p-value of the test statistic is less than 0.05. If the p-value is less than 0.05, there will be less than a 5% chance that the variables being compared are NOT associated. In our example, the p-value is .000 which means that the age of the respondent is very highly associated with their belief that the Province should have more RNs. If the Chi Square statistic is less than 0.05, when we run a test between two variables, we are very confident that the two variables are associated.

14.1 T-Tests & Crosstabs

Because many questions were exactly the same or similar in both surveys, the data was able to be merged into one SPSS data file for analysis. Having the data merged into one group allows for statistical tests such as crosstabs and T-Tests to determine if results were significantly different between respondents in each year. However, the weighted variable had to be eliminated for the comparisons between years to be calculated.



Questions that were examined include:

Question

Subject 2018 2016

A1 A1 Opinion of RN care: better, same or worse?

A5 A2 Does the province need more RNs in the health care system?

A10 A6 Should the province have more Nurse Practitioners?

A7 A4 Agreement level of statements concerning RNs

A12 A8 I support a publicly-funded health care system

A13 A9 Registered nurses should self-regulate

Recoding of Raw Survey Data

Many of the results to survey questions needed to be transformed (recoded) as they were not appropriate for statistical analysis in their original form. For example, the inclusion of “don’t know” or “refusal” in some questions had to be filtered out of the final results to ensure crosstabs and T-Tests would run successfully. Recoding these questions is a normal process and would not affect results.

Any outlying data points in the results that did not apply directly to the original questions were ignored or recoded.

A1. In your opinion, is the care that Registered Nurses (RNs) provide today better, worse or about the same compared to 5 years ago?

CROSSTAB

Question A1 was cross tabbed between the two years of the survey. The comparison of 2016 versus 2018 respondents did not yield a significant chi square statistic (sig level = .437).

However, a greater percentage of the 2018 respondents felt that RN care was better over the last 5 years compared to the 2016 respondents (31.7% compared to 28.6%).

While the chi square statistic is not significant, the percentage of respondents indicating “Better” has increased over the last four surveys: 22.2% in 2012, 26.2% in 2014, 28.6% in 2016, and 31.7% in 2018. When comparing the 2014 and 2018 results, the crosstab becomes statistically significant.



T-TEST

An Independent Samples T-Test was also performed to investigate whether there was a significant difference between the means of the 2016 and 2018 survey results. It was necessary to recode the question into three categories (3=better, 2=same and 1=worse) in order to calculate means properly.

Even though there was a slight difference in the means (2.11 to 2.18), the T-Test is inconclusive in terms of significance for this question (sig. level = .218). It can be noted, however, that the mean response did increase from 2.05 in 2012, to 2.10 in 2014, to 2.11 in 2016, and now to 2.18 in 2018 (on a three point scale).

A1. In your opinion, is the care that Registered Nurses (RNs) provide today better, worse or about the same compared to 5 years ago?



A5. Currently, the province needs more RNs in the health care system.

(A2 in 2016 survey)

CROSSTAB

This question was re-worded in the 2018 survey and the scale changed slightly. The 2016 survey used a 5 point scale, and the 2018 survey used a 3 point scale. The 2016 survey was collapsed to match the 2018 survey for comparison.

The 2016 and 2018 respondent results were cross tabbed for question A5, which asked whether the province needs more RNs in the health care system.

The chi-square statistic for this question indicates that there was a significant difference between the groups (sig level = .013). Although the percentage of respondents who wanted more RNs in the health care system was very similar between 2016 and 2018, the numbers who wanted less RNs decreased from 7.2% to only 2.7% in 2018.



A5. Currently, the province needs more RNs in the health care system.

(A2 in 2016 survey)

T-Test

An Individual Samples T-Test was also performed on question A5 to test for any significance between the means of the two years.

The T-Test is insignificant (sig. level = .133), meaning that there was not a statistically significant difference in the mean response for each year.

However, the mean did increase slightly when comparing different years. The mean in 2016 was 2.72, and the mean in 2018 was 2.78 (out of a possible 3 points).



A10. Should the province have more, less or about the same number of Nurse Practitioners?

(A6 in 2016)

CROSSTAB

The 2016 and 2018 respondents were compared to each other for question A10 that asked whether the province should have more, less, or about the same number of Nurse Practitioners.

The crosstab was not significant (sig. level = .619). There was a very small difference between respondents who said “More” when comparing the two years (83.2% in 2016 and 85.8% in 2018) which is why the cross tab came back as insignificant. However, the “More” numbers were very high in both years. This highlights a very strong trend for the respondents in both years of wanting to see more Nurse Practitioners in the health care system.



A10. Should the province have more, less or about the same number of Nurse Practitioners?

(A6 in 2016)

T-TEST

An Individual Samples T-Test was also performed on question 10 to test for any significance difference between the means of the 2016 and 2018 respondents.

The T-Test indicates that there was not a significant difference in the means between the two years in question (sig. level = .352). However, the mean response increased between the two years: from 2.80 in 2016 to 2.84 in 2018. In other words, the trend for respondents wanting to see more Nurse Practitioners in the health care system continues to be very strong in both 2016 and 2018.



A7. Rate level of agreement with statements respecting RNs in general on a scale of 1-5 where 1 is strongly disagree and 5 is strongly agree. (A4 in 2016 – only the first four are comparable since three additional questions were added in 2018.)

For this question it is more useful to look at T-Tests first and then crosstabs

T-TESTS

For this question, Independent Samples T-Tests were calculated to examine the differences in means between 2016 and 2018 respondents. The table below outlines the means (out of 5) for each group.

The T-Tests were insignificant for the first three questions. In other words, the differences in means between the two years were too similar to have significance overall. While the T-Tests were insignificant, the results point to a strong trend again in 2016 and 2018 of respondents having a very favorable view of RNs.

“When getting care from a RN I am treated with respect” (sig. level = .703).

“When getting care from a RN I am treated fairly” (sig. level = .393).

“When I seek health care from an RN I am confident I will get the right care” (sig. level = .151)

However, the fourth question, “I can count on an RN to provide me with safe health care”, yielded statistically significant results (significance level of .011). This significance is evident when looking at how the overall means increased between 2016 and 2018. The mean increased dramatically from 4.26 in 2016 to 4.41 in 2018.

“I can count on a RN to provide me with safe health care” (sig. level = .011).



A7. Rate level of agreement with statements respecting RNs in general on a scale of 1-5 where 1 is strongly disagree and 5 is strongly agree. (A4 in 2016)

CROSSTABS

Crosstabs were also calculated for all four questions versus the Survey Year.

7a. “I am treated with Respect” was insignificant (sig. level = .819). In 2018, the percentage of respondents who indicated, “strongly agree” increased slightly from 53.2% to 53.9%. However, this increase was too small to yield significance.



CROSSTABS continued,

7b. “I am treated fairly” came back as insignificant as well (sig. level = .263). However, the percentage of respondents who said “strongly agree” jumped considerably from 51.0% in 2016 to 56.5% in 2018, indicating a positive trend in the overall data.


7c. “I am confident I will get the right care for my condition” did come back as statistically significant between 2016 and 2018 (sig. level = .014). While the percentage who said “strongly agree” dipped slightly, when combining “agree” and “strongly agree”, the numbers improve dramatically from a total of 77.4% in 2016 to 85.8% in 2018.




7d. “I can count on RNs to provide me with safe health care” was also significant (sig. level = .019). The percentage who indicated “strongly agree” jumped from 47.2% in 2016 up to 53.4% in 2018.



A12. Level of agreement with statement: “I support a publicly-funded health care system”.

(A8 in 2016)

CROSSTAB

In this cross tab, the values were recoded from the original five levels of agreement and collapsed into only three (1=disagree, 2=neutral, and 3=agree) to help summarize the data.

This cross tab was not statistically significant (sig level = .447). Interestingly, the percentage of respondents who either agreed or strongly agreed that they support a publicly funded health care system increased from 84.2% in 2014 to 89.8% in 2016 to 90.7% in 2018. When comparing the 2014 and 2018 results, the crosstab becomes statistically significant.



A12. Level of agreement with statement: “I support a publicly-funded health care system” .

(A8 in 2016)

T-TEST

An Individual Samples T-Test was also performed to look for any significance between the means of the two groups.

To help clarify response, the recoded results from the cross tab analysis were also included here: (1=disagree, 2=neutral, 3=agree).

The T-test indicates no significant differences in the means (sig. level = .422).

While insignificant, in is useful to note that the mean response for the question increased from 2.77 in 2014 to 2.84 in 2016, to 2.87 in 2018. This again points to increasing support for a publicly funded health care system.



A13. Level of support with “Registered nurses should continue to be led by people in the profession, with public participation. (A9 in 2016)

CROSSTAB

The cross tab shows a chi-square level of significance between the two years (sig level=.000). The results show that a much higher percentage of 2018 respondents (65.5%) support profession-led regulation compared to 2016 respondents (43.0%).

T-Tests were also run for this question but were inconclusive.



14.2 Crosstab comparative analysis

Crosstab Analysis for SRNA RNs: Practice and Perception Research Report

Cross tabulations were conducted for a majority of the survey questions compared with demographic information provided by respondents. The demographic questions from the questionnaire that were utilized in crosstab analysis were:

Variable Name Question

Gender (Intro7) Gender of respondent

Age (D21) Age of respondent

Region (D18) Region respondent lives in

Education (D19) Education level of respondent

Income (D20) Income of Respondent

Interaction with Health Care System (Intro 8)

Whether respondent had interaction with system, was a patient in the system, or was a guardian or care giver for a patient in the system

Recoding of Raw Survey Data

Many of the results to survey questions needed to be transformed (recoded) as they were not appropriate for crosstab analysis in their original form. For example, the inclusion of “don’t know” or “refusal” in many questions needed to be filtered out of the final results to ensure crosstabs would run successfully. Recoding these questions is a normal process and would not affect results.

Some questions were also recoded to reduce the number of categories to ensure crosstabs would have a chance to be Chi-square significant.

The data in this year’s survey was more heavily skewed towards certain demographic groups compared to past years, so a weighted variable was utilized when running cross tabs. The weighted variable pre-existed in the data set and was simply activated for cross tabulation analysis.

Crosstab Results

The following tables outline significant crosstab results. Each demographic question was compared against questions A1, A5, A6, A7, A8, A9, A10, A11, A12 and A13 from the questionnaire.



Gender of Respondents (INTRO 7)

Male versus Female respondents.

Crosstab: Gender of Respondents

(male or female)

Variable Crosstab relationship Chi square sig. level

A1. In your opinion, is the care that RNs provide today better, worse or about the same as 5 years ago?

Male respondents were more likely to say “better” compared to females.

.016

A5. On a scale of 1 to 5 – currently the province needs more RNs

No significant relationship

A6. Level of confidence in competency of positions

See below

A6a. Confidence in RNs Females more likely to have a “very high” level of confidence compared to males

.002

A6b. Confidence in police officers Females much more likely to have “very high” confidence in police officers compared to males

.000

A6c. Confidence in doctors Males slightly more confident in doctors compared to females

.004

A6d. Confidence in teachers Females more likely to have “very high” confidence in teachers compared to males

.006

A6e. Confidence in Pharmacists Females much more likely to have “very high” confidence in pharmacists compared to males

.000

A6f. Confidence in Firefighters Females much more likely to have “very high” confidence in firefighters compared to males

.006

A7. We are going to provide 7 statements respecting RNs in general – rate on scale 1-5.

See below

A7a. Treated with respect Females much more likely to “strongly agree” compared to males

.014

A7b. Treated Fairly by RN Females more likely to “strongly agree” compared to males

.017



A7c. Confident getting right care Females more likely to “strongly agree” compared to males

.008

A7d. Confident getting safe care Females slightly more likely to “strongly agree” compared to males

.002

A7e. Confident getting ethical care

Females much more likely to “strongly agree” compared to males

.000

A7f. Culturally appropriate care Females much more likely to “strongly agree” compared to males

.000

A8. Received care from a NP over the last 2 years


A9. Level of comfort with NPs See below

A9a. Diagnosing illnesses Females much more likely to feel “very comfortable” compared to males

.004

A9b. Ordering diagnostic tests Females much more likely to feel “very comfortable” compared to males

.000

A9c. Prescribing drugs Females much more likely to feel “very comfortable” compared to males

.000

A9d. Promoting healthy lifestyle Females much more likely to feel “very comfortable” compared to males

.000

A10. Should province have more, less or about the same number of NPs?


A11. Statements concerning RNs and RN (NP)s

See below

A11a. They involve me and my family in planning my care

Females slightly more likely to “strongly agree” compared to males

.017

A11b. They support me to make informed decisions

Females more likely to “strongly agree” compared to males

.005

A11c. They conduct themselves professionally

Females more likely to “strongly agree” compared to males

.018

A11e. I understand the role of the RN

Females much more likely to “strongly agree” compared to males

.000

A12. I support a publicly-funded health care system


A13. Regulation of RNs should cont. to be led by people in the




profession with public participation

A14. Awareness that you can contact SRNA if you have concerns

Males more likely to be aware .000

A15. Awareness of SRNA website to check RN license

Males more likely to be aware .000

A16. Which of the following is SRNA responsible for doing?

See below

A16b. Setting standards for the education of RNs

Females more likely to say “yes” .004

A17. Are you able to find info about SRNA either by contacting directly or through website?




Age of Respondent (D21)

The Age categories were recoded into three groups from the original six for crosstab purposes (18-34, 35-54, 55+). Reports in previous years used the same age categories.

Crosstab: Age of Respondent

(18-34, 35-54, 55+)



Younger respondents (18-34) were more likely to say “better” compared to 35-54, while respondents 55+ were much less likely to say “better”

.000




See below

A6a. Confidence in RNs All groups rated confidence high, but younger respondents (18-34) were most likely to rate “Very high)

.000

A6b. Confidence in police officers Younger respondents (18-34) least likely to say “very high” compared to others

.004

A6c. Confidence in doctors Younger respondents (18-34) much more likely to say “very high” compared to others

.000

A6d. Confidence in teachers Younger respondents (18-34) much more likely to say “very high” compared to others

.000

A6e. Confidence in Pharmacists Younger respondents (18-34) less likely to say “very high” compared to others

.002

A6f. Confidence in Firefighters 35-54 respondents slightly lower than others in rating “very high”

.005


See below

A7a. Treated with respect Younger respondents (18-34) less likely to “strongly agree” or “agree”

.008

A7b. Treated Fairly by RN Older respondents (55+) slightly less likely to “strongly agree”

.009



A7c. Confident getting right care Older respondents (55+) slightly more likely to “strongly agree”

.001

A7d. Confident getting safe care 35-54 respondents slightly less likely to “strongly agree”

.001


Older respondents (55+) slightly less likely to “strongly agree”

.005

A7f. Culturally appropriate care Younger respondents (18-34) slightly more likely to “disagree” and “strongly disagree”

.015




A9a. Diagnosing illnesses Younger respondents (18-34) slightly more likely to be “very comfortable”

.015

A9c. Prescribing drugs Younger respondents (18-34) slightly more likely to be “very comfortable”

.008

A9d. Promoting healthy lifestyle Older respondents (55+) less likely to be “very comfortable”

.000




See below


Younger respondents (18-34) much less likely to “strongly agree”

.004



.001



.003

A11d. I always know when they are present in a health care setting

Older respondents (55+) less likely to strongly agree”

.014



.001


Younger respondents (18-34) less likely to “strongly agree”

.001

A13. Regulation of RNs should cont. to be led by people in the

All ages strongly support, but 55+ slightly higher to “strongly support”



profession with public participation

.000




Younger respondents (18-34) much more aware of website

.025


See below


Younger respondents (18-34) much less likely to say “yes”

.000

A16c. Enforcing a code of ethics for RNs

Younger respondents (18-34) slightly less likely to say “yes”

.013





Region of Respondent (Which of the following best describes where you live?) (D18)

Region was recoded from five categories into three for crosstabs: over 20000 (urban), 5000 and under plus northern (rural), and farms/acreages (farmers).

Crosstab: Region of Respondent

(Urban, Rural, Farm/Acreage)







See below

A6a. Confidence in RNs Rural much more likely to say “very high” .000

A6b. Confidence in police officers Rural much more likely to say “very high” .000

A6c. Confidence in doctors Rural much more likely to say “very high” .000

A6d. Confidence in teachers Rural much more likely to say “very high” .000

A6e. Confidence in Pharmacists Rural slightly more likely to say “very high” .000

A6f. Confidence in Firefighters Rural more likely to say “very high” .000


See below

A7a. Treated with respect Rural more likely to “strongly agree” .000

A7b. Treated Fairly by RN Farmers less likely to “strongly agree” .000

A7c. Confident getting right care Rural more likely to “strongly agree” .000

A7d. Confident getting safe care Rural more likely to “strongly agree”, famers much less likely

.000


Rural more likely to “strongly agree” .000

A7f. Culturally appropriate care Rural much more likely to “strongly agree” .000




Farmers much more likely to have received care from NP, followed by rural

.000


A9a. Diagnosing illnesses Rural much more likely to feel “very comfortable”

.000

A9b. Ordering diagnostic tests Rural slightly more likely to “strongly agree” .001

A9c. Prescribing drugs Rural more likely to “strongly agree” .000

A9d. Promoting healthy lifestyle Rural more likely to “strongly agree” .000

A9e. Performing minor surgery such as suturing or stiches

Rural much more likely to “strongly agree” .000




See below


Rural more likely to “strongly agree” .000





A11d. I always know when they are present in a health care setting




A11f. RNs introduce themselves personally to [patients or family



Urban most likely to “strongly agree”, followed by rural and somewhat less for farmers

.000

A13. Regulation of RNs should cont. to be led by people in the profession with public participation

Rural most likely to “strongly support”, followed by farmers and slightly less for Urban

.022








See below

A16a. Setting standards of how RNs should practice

All were very high, but Rural slightly less than others

.014


All were very high, but Urban slightly less than others

.009

A16c. Enforcing a code of ethics for RNs

Again, Rural slightly lower .027





What is your highest education level? (D19)

Comparing respondents by education level. The respondents were collapsed into three groupings: Grade 12 or less, some post-secondary or diploma/certificate, and having a University degree.

Crosstab: Education Level of Respondent

(Grade 12 or less, Diploma/Certificate/Some Postsecondary, University Degree)







See below

A6a. Confidence in RNs Those with diploma/certificate slightly less likely to say “very high”

.000

A6b. Confidence in police officers

Those with University degree much more likely to rate “very high”

.000

A6c. Confidence in doctors Those with diploma/certificate slightly less likely to say “very high”

.001

A6d. Confidence in teachers Those with University degree much more likely to rate “very high”

.009

A6e. Confidence in Pharmacists Those with diploma/certificate slightly less likely to say “very high”

.000

A6f. Confidence in Firefighters Those with diploma/certificate slightly less likely to say “very high”

.000


See below

A7a. Treated with respect Those with University degree more likely to say “strongly agree”

.006

A7b. Treated Fairly by RN Those with University degree more likely to say “strongly agree”

.000



A7c. Confident getting right care Those with University degree more likely to say “strongly agree”

.000

A7d. Confident getting safe care Those with University degree more likely to say “strongly agree”


Those with University degree more likely to say “strongly agree”

.000

A7f. Culturally appropriate care Those with University degree more likely to say “strongly agree”

.000




A9b. Ordering diagnostic tests Those with University degree more likely to feel “very comfortable”

.000

A9c. Prescribing drugs Those with University degree slightly more likely to feel “very comfortable”

.000

A9d. Promoting healthy lifestyle Those with University degree much more likely to feel “very comfortable”

.000

A9e. Performing minor surgery such as suturing or stiches

Those with University degree more likely to feel “very comfortable”

.000




See below


Those with University degree more likely to “strongly agree”

.005



.003



.000


Grade 12 or less much less likely to “strongly agree”

.000


Those with University degree more likely to “strongly agree”, Less than Grade 12 much lower

.000


Those with Grade 12 or less, less likely to “strongly agree”

.001




Those with University degree more likely to “strongly support”

.004






See below


Grade 12 or less, slightly less likely to say “yes” .027

A16d. Ensuring RNs educated outside of Canada are qualified

Grade 12 or less, slightly less likely to say “yes” .036





Which range best describes your annual household income (before tax)? (D20)

The Income categories were transformed into three categories from five for crosstabs: Under $30000 (low income), $30000 to $89999 (mid income), and $90000 and over (high income).

Crosstab: Household Income or Respondent

(Low income, Medium income, High income)



Low income households more likely to say “Better”

.035




See below

A6a. Confidence in RNs All were high, some low income households rated trust low

.000

A6b. Confidence in police officers Low income households more likely to say “very high” as well as “very Low”

.000

A6c. Confidence in doctors Low income households more likely to say “very high” as well as “very low”

.000

A6d. Confidence in teachers Mid-income households slightly more likely to say “very high”

.000

A6e. Confidence in Pharmacists Trust slightly lower for low income households

.000

A6f. Confidence in Firefighters Low income households more likely to say “very high” as well as “very low”

.000


See below

A7a. Treated with respect High income households slightly higher for “strongly agree”

.000

A7b. Treated Fairly by RN High income households slightly higher for “strongly agree”

.000



A7c. Confident getting right care Low income households more likely to “strongly agree”

.000

A7d. Confident getting safe care Low income households slightly lower .000


High income households more likely to “strongly agree”

.000

A7f. Culturally appropriate care Low income households slightly less .000




A9a. Diagnosing illnesses Medium income households slightly less likely to say “very comfortable”

.000

A9b. Ordering diagnostic tests Medium income households slightly less likely to say “very comfortable”

.000

A9c. Prescribing drugs Medium income households slightly less likely to say “very comfortable”

.000

A9d. Promoting healthy lifestyle Medium income households slightly less likely to say “very comfortable”

.000




See below


Low income households less likely to “strongly agree”

.000


Low income households slightly less likely to “strongly agree”

.000


Low income households slightly less likely to “strongly agree”

.000


Medium income households slightly less likely to “strongly agree”

.000




Low income households slightly higher to “strongly support”

.004








See below

A16d. Ensuring RNs educated outside of Canada are qualified

Low income households slightly lower .000





Interaction with the Health Care system during the last two years (PREQ_1, PREQ_2, PREQ_3)

Crosstab: Interaction with Health Care System in past two years

(No, Yes as patient, Yes as caregiver, Yes both patient and caregiver)







See below

A6a. Confidence in RNs Caregivers were less likely to say “very high” .000

A6b. Confidence in police officers

Caregivers were less likely to say “very high” .036

A6c. Confidence in doctors Caregivers were much less likely to say “very high”, Patients and Patient/caregivers also much lower

.000

A6d. Confidence in teachers Caregivers were less likely to say “very high” .011

A6e. Confidence in Pharmacists Patients most likely to say “very high” while those with no interaction rated lowest

.034

A6f. Confidence in Firefighters Those who have been patient and caregiver rated highest

.000


See below

A7a. Treated with respect Recent patients most likely to “strongly agree” .000

A7b. Treated Fairly by RN Those with no interaction most likely to say “very high”, followed by recent patients. Caregivers slightly lower.

.017

A7c. Confident getting right care Recent patients most likely to “strongly agree” .001

A7d. Confident getting safe care No interaction respondents most likely to “strongly agree” followed by recent patients

.000




Recent patients more likely to “strongly agree” .000

A7f. Culturally appropriate care Recent patients most likely to “strongly agree” and no interaction people much less

.001


Recent patients more likely to received care .000


A9b. Ordering diagnostic tests Those with no interaction less comfortable .000




See below


Caregivers less likely to “strongly agree” .001


Recent patients most likely to “strongly agree” .002


Recent patients most likely to “strongly agree” .000


Those with interaction much more likely to “strongly agree”

.016


Those with no interaction less likely to “strongly agree”

.002


Those with no interaction less likely to “strongly support”

.007








Caregivers much more likely to say “yes” .001



Appendix 1

2018 SRNA Questionnaire



Market Perception of Nurses in Saskatchewan February 2018

INTRO 1/INTRO 3. Hello! My name is _______ . The University of Saskatchewan is conducting a study on behalf of the Saskatchewan Registered Nurses’ Association. We’re doing research about the role that Registered Nurses (RNs) play in providing health care to Saskatchewan people. INTERVIEWERS (ONLY NEED TO READ IF THE RESPONDENTS WANT TO KNOW WHO THE SRNA IS): The Saskatchewan Registered Nurses’ Association (SRNA) is a profession-led regulatory body and association established in 1917 by the provincial legislature. The SRNA is accountable for public protection by ensuring members are competent and promotes the professional interest of its members in the public interest. INTRO 2. May I please speak with the person in your household who is 18 years of age or older and who is having the next birthday?

1. Yes, speaking CONTINUE 2. Yes, I’ll get him/her REPEAT INTRODUCTION AND CONTINUE 3. Not available ARRANGE CALLBACK - REQUEST RESPONDENT FIRST NAME

(RECORD IN NOTES) AND ARRANGE CALLBACK (PRESS THE CTRL AND END KEYS)

INTRO 4. I would like to invite you to participate in this short survey. Participation is voluntary, and your participation implies consent that you are willing to take this survey. This has been approved by the University of Saskatchewan Behavioural Research Ethics Board. If you have any questions about the research, you may contact the principal investigator, Dr. Brooke Dobni (Edwards School of Business) at 306-966-8442. If you have any questions concerning your participation, please contact the University of Saskatchewan’s Research Ethics Committee [email protected] (306) 966-2975. Out of town participants may call toll free (888) 966-2975. You can stop the survey at any time. If you stop the survey before we complete the all of the questions, the data that we have collected will remain part of the data for the project. Let me assure you that the information we collect is kept strictly confidential and none of the answers that you provide will be attributed to you personally. This call will be recorded for quality control purposes. The findings of this study will be available in May on the SRNA website at www.srna.com The survey should take about 10 minutes, and you have the right to withdraw at any time. Are you willing to participate in the survey?

1. Yes CONTINUE 2. No THANK AND END INTERVIEW 3. Later/Not right now ARRANGE CALLBACK -

http://www.srna.com/



INTRO5. Before we begin, can I please the first three characters of your postal code? IF RESPONDENT IS RELUCTANT, YOU CAN ASSURE THEM THAT THEIR POSTAL CODE WILL BE USED FOR STATISTICAL PURPOSES ONLY (TO UNDERSTAND DIFFERENCES BY REGION/GEOGRAPHY) AND WILL NOT BE USED TO IDENTIFY THEM IN ANY WAY. ENSURE RESPONDENT PROVIDES POSTAL CODE IN PROPER FORMAT (EXAMPLE : S7N). THE FIRST BOX WILL ONLY ACCEPT AN 'S' (SK). ENTER RESPONDENTS POSTAL CODE CHARACTERS: 1. (RECORD POSTAL CODE)

INTRO 7. (DO NOT READ)

RECORD SEX FROM RESPONDENT VOICE.

1. Male 2. Female PREQ. We are interested to know if you have any interaction with the healthcare system in Saskatchewan over the past 2 years. To the best of your knowledge, could you please indicate which of the following situations most closely describes your interaction? (choose all that apply) (READ LIST) 1. I have not had any interaction with the healthcare system 2. I have been a patient within the system (clinic, hospital, care home) 3. I have been a guardian or care giver for a patient within the system (for a parent, child, spouse, or friend) 4. Other: (please specify) 5. (Refused) A1. In your opinion, is the care that Registered Nurses (RN’s) provide today … better, worse, or about the same … as five years ago? (DO NOT READ LIST) 1.Better 2. Worse (SKP to A3) 3. Same (SKP to A4)



4. (Don’t Know)Refused (SKP to A5)

A2. Why do you feel the care is better? (Insert open ended response) (SKP to A5) (Don’t Know)(Refused)

A3. Why do you feel the care is worse? (Insert open ended response) (SKP to A5) (Don’t Know)(Refused) A4. Why do you feel that the care is the same?

(Insert open ended response) (SKP to A5) (Don’t Know)(Refused)

A5. Based on your understanding of their role, should the province have more, less, or about the same number of Registered Nurses in the health care system? 1. More 2. Less 3. Same 4. (Don’t Know) 5. (Refused) A6INTRO. I am going to ask you to rate your level of confidence in the competence of 6 different professions including registered nurses, police officers, doctors, teachers, pharmacists, and firefighters. On a 1 to 5 scale, where 1 is “Very low”, and 5 is “Very high”, please indicate your level of confidence in the competence of the following professions....

(A6A TO A6F ARE RANDOMISED)

A6A. Registered Nurses (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY)

1. very low 2 low 3 neither low or high 4 high 5. very high 6. (Don’t Know) 7. (Refused)



A6B. Police officers (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY)

1. very low 2 low 3 neither low or high 4 high 5. very high 6. (Don’t Know) 7. (Refused) A6C. Doctors (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY)

1. very low 2 low 3 neither low or high 4 high 5. very high 6. (Don’t Know) 7. (Refused) A6D. Teachers (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY)

1. very low 2 low 3 neither low or high 4 high 5. very high 6. (Don’t Know) 7. (Refused) A6E. Pharmacists (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY)

1. very low 2 low 3 neither low or high 4 high 5. very high 6. (Don’t Know) 7. (Refused)



A6F. Firefighters (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY)

1. very low 2 low 3 neither low or high 4 high 5. very high 6. (Don’t Know) 7. (Refused) A7INTRO. We are going to provide 7 statements respecting RN’s in general. Based upon interactions you may have experienced or witnessed, on a 1 to 5 scale where 1 is “Strongly disagree and 5 is “Strongly agree”, please indicate your level of agreement with the following statements?

(A7A TO A7G ARE RANDOMISED)

A7A. When I get health care from an RN, I am treated with respect. (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused)

A7B. When I get health care from an RN, I am treated fairly. (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused)



A7C. When I seek health care from an RN, I am confident I will get the right care for my condition (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) A7D. I have confidence that an RN will provide me with safe health care. (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) A7E. When I get health care from an RN, I get ethical care. (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) A7F. When I get health care from an RN, I get culturally appropriate care. (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused)



A7G. When I get health care from an RN, I get individual and/or family centered care. (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused)

A8. In Saskatchewan there are Nurse Practitioners who are educated and licensed to assess, diagnose, prescribe, and treat common medical disorders. Nurse Practitioners are registered nurses that work in an expanded role as part of health care teams. Have you received care from a Nurse Practitioner over the past two years? 1. Yes 2. No 3. Not sure 4. (Refused) A9INTRO. As indicated, Nurse Practitioners are registered nurses that work in an expanded role as part of health care teams. On a 1 to 5 scale where 1 is “Very uncomfortable” and 5 is “Very comfortable”, please indicate your level of comfort with seeing a Nurse Practitioner for the following health care services: (A9A TO A9E ARE RANDOMISED)

A9A. Assessing and diagnosing illnesses (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. Very uncomfortable 2 uncomfortable 3 neither comfortable or uncomfortable 4 comfortable 5. Very comfortable 6. (Don’t Know) 7. (Refused)



A9B. Ordering diagnostic tests (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. Very uncomfortable 2 uncomfortable 3 neither comfortable or uncomfortable 4 comfortable 5. Very comfortable 6. (Don’t Know) 7. (Refused)

A9C. Prescribing drugs (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. Very uncomfortable 2 uncomfortable 3 neither comfortable or uncomfortable 4 comfortable 5. Very comfortable 6. (Don’t Know) 7. (Refused)

A9D. Promoting a healthy lifestyle (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. Very uncomfortable 2 uncomfortable 3 neither comfortable or uncomfortable 4 comfortable 5. Very comfortable 6. (Don’t Know) 7. (Refused)

A9E. Performing minor surgical procedures (such as suturing/stitches) (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. Very uncomfortable 2 uncomfortable 3 neither comfortable or uncomfortable 4 comfortable 5. Very comfortable 6. (Don’t Know) 7. (Refused)



A10. Based on your understanding of their role, should the province have more, less, or about the same number of Nurse Practitioners in the health care system? (DO NOT READ LIST) 1. More 2. Less 3. Same 4. (Don’t Know) 5. (Refused)

A11INTRO. Thinking of your recent experience with getting health care in the past two years, please indicate whether you agree or disagree with the following statements, using the same five-point scale in which 1 is “Strongly disagree” and 5 is “Strongly agree,”. (A11A TO A11F ARE RANDOMISED)

A11A. RNs and RN(NP)s involve me and my family in planning my care (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) 8. (No health care experience in last 2 years)

A11B. RNs and RN(NP)s support me to make informed decisions about my health (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) 8. (No health care experience in last 2 years)



A11C. RNs and RN(NP)s conduct themselves in a professional manner in the workplace (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) 8. (No health care experience in last 2 years)

A11D. I always know who the RN or RN (NP) is, when one is present in a health care setting (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) 8. (No health care experience in last 2 years)

A11E. I understand the role of the RN (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) 8. (No health care experience in last 2 years)



A11F. RNs consistently introduce themselves personally to patients or family (REPEAT THE SCALE IN THE QUESTION BELOW IF NECESSARY) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) 8. (No health care experience in last 2 years)

A12. On a 1 to 5 scale where 1 is “Strongly disagree” and 5 is “Strongly agree”, do you agree or disagree with the following statement: “I support a publicly-funded health care system.” (DO NOT READ LIST) 1. strongly disagree 2 disagree 3 neither agree or disagree 4 agree 5. strongly agree 6. (Don’t Know) 7. (Refused) A13. Please indicate your level of support for the following statement:

“Regulation of registered nurses should continue to be led by people in the profession, with public participation.” Would you… (READ LIST) 1. strongly support 2. somewhat support 3. neither support nor oppose 4. somewhat oppose 5. Strongly oppose 6. (Don’t Know) 7. (Refused)



A14. Are you aware that you can contact the Saskatchewan Registered Nurses’ Association if you have a concern about the competence or conduct of Registered Nurses and Nurse Practitioners in the province? 1. Yes 2. No 3. (Don’t Know) 4. (Refused)

A15. Are you aware you can go to the SRNA website to check to see if a registered nurse is licenced? (If they ask you can give the website www.srna.org)

1. Yes 2. No 3. (Don’t Know) 4. (Refused)

A16INTRO. To the best of your knowledge, do you think the SRNA is responsible for doing the following? Please respond either “yes” or “no”.

(A16A TO A16F ARE RANDOMISED) A16A. Setting standards for how registered nurses should practice 1. Yes 2. No 3. (Don’t Know) 4. (Refused)

A16B. Setting standards for the education of registered nurses 1. Yes 2. No 3. (Don’t Know) 4. (Refused)

http://www.srna.org/



A16C. Enforcing a code of ethics for registered nurses 1. Yes 2. No 3. (Don’t Know) 4. (Refused)

A16D. Ensuring that registered nurses practicing in Saskatchewan that are educated outside of Canada who work in Canada have the necessary qualifications 1. Yes 2. No 3. (Don’t Know) 4. (Refused)

A16E. Addressing concerns about registered nurses 1. Yes 2. No 3. (Don’t Know) 4. (Refused)

A16F. Licensing registered nurses to practice 1. Yes 2. No 3. (Don’t Know) 4. (Refused) A17. Are you able to easily find information regarding the SRNA, services, licensure requirements and resources either by contacting the SRNA or by accessing the SRNA website?

1. Yes 2. No 3. Have never made an attempt 4. (Don’t Know) 5. (Refused)

D18. Finally, I have a few questions for classification purposes.



Which of the following best describes where you live? (READ LIST) 1. Farm or acreage 2. Community under 5,000 population 3. City 5,000 to 20,000 population 4. City over 20,000 population 5. Northern Saskatchewan Resident (please indicate closest town or city…………….) 6. (Don’t Know) 7. (Refused)

D19. What is your highest education level? (READ LIST IF NECESSARY) 1. Less than Grade 12 2. Grade 12 3. Some post-secondary 4. Technical certificate/diploma 5. University degree 6. (Don’t Know) 7. (Refused)

D20. Which range best describes your annual household income (before tax) in 2017? Is it…? (READ LIST) 1. Under $19,000 2. $19,000 to less than $30,000 3. $30,000 to less than $60,000 4. $60,000 to less than $90,000 5. Over $90,000 6. (Don’t Know) 7. (Refused)

D21. What category does your age fall in to? (READ LIST) 1. 18 to 24 2. 25 to 34 3. 35 to 44 4. 45 to 54 5. 55 to 64 6. 65 and over 7. (Don’t Know)



8. (Refused) END. This survey has been approved by the University of Saskatchewan Research Ethics Board. If you have any questions about this survey, please feel free to contact them at 306-966-2975 or 1-888-966-2975 if you live outside of Saskatoon. We appreciate you taking time today to complete this survey. Thank you.



APPENDIX 2

SRNA ENDs (effective January, 2018)

END 1: Regulation Accountable, effective, transparent profession-led regulation in the public interest END 2: Professional Practice Excellence in Professional Practice 2.1. RNs and RN(NP)s practice safe, competent, ethical and culturally appropriate individual and family-centred care 2.2. RNs and RN(NP)s understand their role and practice to their full legislated scope 2.3 RNs and RN(NP)s integrate Primary Health Care (PHC) principles into all practice settings 2.4 RNs and RN(NP)s demonstrate nursing leadership END 3: Integral Partners in Health RNs and RN (NP)s are integral partners in the health-care system. 3.1. RNs and RN(NP)s articulate and demonstrate their roles 3.2. RNs and RN(NP)s advocate for evidence-informed practice 3.3. RNs and RN(NP)s are leaders in influencing healthy public policy, including seniors health, mental health, and Indigenous health



APPENDIX 3

Interaction with the healthcare system – understanding the new demographic variable

In the 2018 report, participants were asked about their interaction with the healthcare system. They were asked to check all responses that applied to their personal level 0f interaction.

As was mentioned previously, this question was asked as a “check all that apply” type question in the original survey. This simply means that a respondent could give multiple answers to the question, which were then coded into the four variables provided in the original SPSS data. The specific variables were PREQ_1, PREQ_2, PREQ_3, and PREQ_OTH1. Potentially, one respondent could have an answer for PREQ_2, PREQ_3, and PREQ_OTH1.

Because of the question being asked this way, many people said they were both a patient and a guardian/caregiver. It obviously would not make sense to simply guess which they thought was the more important role, so the only recourse was to recode those people into a new category; namely a person who was a patient as well as a guardian/caregiver. This table shows the resulting frequency table from SPSS.

Interaction with healthcare system

Frequency Percent Valid Percent Cumulative Percent

Valid I have not had any interaction with

the healthcare system

70 17.4 17.4 17.4

I have been a patient within the

system (clinic, hospital, care home)

197 49.3 49.3 66.7

I have been a guardian or care giver

for a patient within the system (for a

parent, child, spouse, or friend)

54 13.6 13.6 80.3

Other: (please specify) 21 5.3 5.3 85.6

(Refused) 2 .6 .6 86.2

I have been both a patient and

guardian or care giver

55 13.8 13.8 100.0

Total 400 100.0 100.0



However, many of the people who said “other” should have never been coded as such, because they actually fit into one of the pre-existing categories. For example, quite a few respondents were coded as a “4” or “other” but the open-ended response in SPSS simply said “None” (as in no interaction). The researcher moved these into the “1” category as someone with no interaction with the system. Several other respondents were also moved based on what the person provided as an open-ended response. Some could NOT be moved and were left as “Other”. Most that were not moved said they worked in the health care system or have family that work in the health care system. There were too few of these people to include as an individual category in crosstabs. However, in subsequent surveys they could be added as a category in the original question.

The next table shows the results after considering the limitations expressed on the previous page. After recoding, there are four distinct groups: those with no interaction, those that had been a patient, those that had been a guardian or caregiver, and those that had been a patient and a guardian or caregiver in the past two years. Nine of the respondents were removed (7 that said “other” and 2 that refused to answer). The frequency table in presented below.

Interaction with healthcare system

Frequency Percent Valid Percent Cumulative Percent

Valid I have not had any interaction with

the healthcare system

79 19.6 20.1 20.1

I have been a patient within the

system (clinic, hospital, care home)

199 49.8 51.0 71.1

I have been a guardian or care giver

for a patient within the system (for a

parent, child, spouse, or friend)

57 14.4 14.7 85.8

I have been both a patient and

guardian or care giver

55 13.8 14.2 100.0

Total 391 97.6 100.0

Missing Other: (please specify) 7 1.8

(Refused) 2 .6

Total 9 2.4

Total 400 100.0

rns: practice and perception research report 2018 · srna: rns practice and perception research...

Documents