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Quality of care from patients' perspective: impact of the combination of person-related and external objective care conditions
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.ORCID iD: 0000-0002-8296-7682
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.ORCID iD: 0000-0003-3385-3731
Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Economics and Statistics.ORCID iD: 0000-0002-9356-8767
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2011 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 17/18, p. 2540-2551Article in journal (Refereed) Published
Abstract [en]

Aims and objectives. To describe patients' perceptions of quality of care and to explore combinations of person-related and external objective care conditions as potential predictors of these perceptions. Background. Several studies have examined various single factors of person-related and external objective care conditions in relation to quality of care. None of these has included the effect of over-occupancy on patients' perception of quality of care. Furthermore, little is known about how combinations of different factors are related to each other and to the perception of quality of care using multivariate analysis. Design. A cross-sectional design. Method. A total of 528 patients (83·7%) from 12 medical, surgical or medical-surgical wards in five hospitals in Norway participated. Perceptions of quality of care and person-related conditions were measured with the 'Quality from Patient's Perspective' instrument. Data on external objective care conditions was collected from ward statistics provided by head nurses. Multivariate general linear modelling was used ( p < 0·05). Results. The combination of person-related and external objective care conditions revealed five factors that predict patients' perception of quality of care. Three of these are person-related conditions: sex, age and self-reported psychological well-being and two of them are external objective care conditions: RNs (headcount) on the wards and frequency of over-occupancy. These five factors explained 55% of the model. Patients rated the quality of care high. Conclusions. Sex, age, psychological well-being, frequency of over-occupancy and the number of RNs are important factors that must be emphasised if patients are to perceive the quality of care as high. Relevance to clinical practice. Head nurses and healthcare authorities must continually prepare the wards for over-occupancy and they must consider the number of RNs working on the wards.

Place, publisher, year, edition, pages
2011. Vol. 20, no 17/18, p. 2540-2551
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-9305DOI: 10.1111/j.1365-2702.2011.03810.xISI: 000293748900016OAI: oai:DiVA.org:kau-9305DiVA, id: diva2:482874
Available from: 2012-01-24 Created: 2012-01-24 Last updated: 2019-07-12Bibliographically approved
In thesis
1. Patients’ perceptions of actual care conditions and patient satisfaction with care quality in hospital
Open this publication in new window or tab >>Patients’ perceptions of actual care conditions and patient satisfaction with care quality in hospital
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There are theoretical and methodological difficulties in measuring the concepts of quality of care and patient satisfaction, and the conditions associated with these concepts. A theoretical framework of patient satisfaction and a theoretical model of quality of care have been used as the theoretical basis in this thesis.

Aim. The overall aim was to describe and explore relationships between person-related conditions, external objective care conditions, patients’ perceptions of quality of care, and patient satisfaction with care in hospital.

Methods. Quantitative and qualitative methods were used. In the quantitative study (I-III), 528 patients (83.7%) from eight medical, three surgical and one mixed medical/surgical ward in five hospitals in Norway agreed to participate (10% of total discharges). Data collection was conducted using a questionnaire comprising four instruments: Quality from Patients’ Perspective (QPP); Sense of Coherence scale (SOC); Big Five personality traits – the Single-Item Measures of Personality (SIMP); and Emotional Stress Reaction Questionnaire (ESRQ). In addition, questions regarding socio-demographic data and health conditions were asked, and data from ward statistics were included. Multivariate statistical analysis was carried out (I-III). In the qualitative study 22 informants were interviewed (IV). The interviews were analysed by conventional content analysis.

Main findings. Patients’ perceptions of quality of care and patient satisfaction ranged from lower to higher depending on whether all patients or groups of patients were studied. The combination of person-related and external objective care conditions explained 55% of patients’ perceptions of quality of care (I). 54.7% of the variance in patient satisfaction was explained, and the person-related conditions had the strongest impact, explaining 51.7% (II). Three clusters of patients were identified regarding their scores on patient satisfaction and patients’ perceptions of quality of care (III). One group consisted of patients who were most satisfied and had the best perceptions of quality of care, a second group of patients who were less satisfied and had better perceptions, and a third group of patients who were less satisfied and had the worst perceptions. The qualitative study revealed four categories of importance for patients’ satisfaction: desire to regain health, need to be met in a professional way as a unique person, perspective on life, and need to have balance between privacy and companionship (IV).

Conclusions. Patients’ perceptions of quality of care and patient satisfaction are two different concepts. The person-related conditions seem to be the strongest predictors of patients’ perceptions of quality of care and patient satisfaction. Registered nurses need to be aware of this when planning and conducting nursing care. There is a need of guidelines for handling over‑occupancy, and of procedures for emergency admissions on the wards. The number of registered nurses on the wards needs to be considered. Healthcare personnel must do their utmost to provide the patients with person‑centred care.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2012. p. 94
Series
Karlstad University Studies, ISSN 1403-8099 ; 2012:2
Keywords
emotion, external care conditions, inpatient, patient perspective, patient satisfaction, person-related conditions, quality of care
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-9023 (URN)978-91-7063-406-2 (ISBN)
Public defence
2012-02-24, Lagerlöfsalen 1A 305, Karlstads universitet, Karlstad, 11:00 (Swedish)
Opponent
Supervisors
Available from: 2012-01-26 Created: 2012-01-02 Last updated: 2019-07-12Bibliographically approved

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Abrahamsen Grøndahl, VigdisKarlsson, IngelaHall-Lord, Marie-LouiseAppelgren, JariWilde-Larsson, Bodil

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