Development of an instrument to measure patient perception of the quality of nursing care

Effect of Virtual Reality Glasses Application on Pain, Anxiety, and Patient Satisfaction During a Transrectal Prostate Biopsy: A Randomized Controlled Trial

BACKGROUND

This study aims to determine the effect of virtual reality glasses application on pain, anxiety, and patient satisfaction during a transrectal prostate biopsy.

MATERIALS AND METHODS

The study was conducted with pre-tests, post-tests, and a control group, using a randomized controlled experimental research design. A total of 70 patients (35 in the intervention group and 35 in the control group) were included in the study. The intervention group watched a video with virtual reality glasses during the biopsy process. A Descriptive Information Form, State-Trait Anxiety Inventory (STAI-I, STAI-II), Scale of Patient Perception of Hospital Experience with Nursing Care (PPHEN), and Visual Analog Scale for Pain (VAS) were used for data collection. To evaluate the data, numbers, percentages, mean, standard deviation, chi-square, paired sample t test, independent samples t test, regression analysis, and Cronbach's alpha Reliability Coefficient were used.

RESULTS

There was no significant difference between the groups in terms of descriptive and clinical characteristics (p > .05). The mean VAS and STAI post-test scores of the patients in the intervention group were lower than the control group, and the difference between them was statistically significant (p < .05). The mean PPHEN post-test scores of the patients in the intervention group were significantly higher than those in the control group (p < .05).

CONCLUSION

The application of virtual reality glasses during a transrectal prostate biopsy significantly reduced the level of pain and anxiety and increased patient satisfaction.

Predictors of sleep quality components in patients undergoing transarterial chemoembolisation: a cross-sectional study

PURPOSE

Patients undergoing transarterial chemoembolisation experience postembolisation symptoms and interferences affecting sleep quality, which require intervention. The study aimed to identify the predictors of sleep quality components in patients undergoing transarterial chemoembolisation.

METHODS

This study included two groups of participants: 50 patients undergoing transarterial chemoembolisation and 45 nurses caring for them. Data were collected from September to November 2022 using a structured questionnaire, and analysed using descriptive statistics, the t-test, analysis of variance, Spearman's rank correlation, and multiple regression analysis using the SPSS 27.0 program (IBM Corp., Armonk, NY, USA).

RESULTS

The mean sleep quality score was 40.28±14.10. Heat sensation (t=-2.08, p=.043) and fatigue (t=-4.47, p<.001) predicted sleep fragmentation in 38.6% of the patients. Abdominal pain (t=-2.54, p=.014), vomiting (t=-2.21, p=.032), and the expected fatigue by the nurses (t=2.68, p=.014) predicted sleep length in 41.7% of patients. Abdominal pain (t=-2.05, p=.046) explained 42.9% of sleep depth.

CONCLUSION

Based on the predictors of sleep quality components obtained in this study, strategies to improve sleep quality tailored to patients undergoing transarterial chemoembolisation should be developed. This study highlighted the need to bridge the gap between patients' and nurses' expected fatigue and its contribution to sleep fragmentation and sleep length. It also highlighted the importance of noncontact temperature measurement, controlling vomiting, and pain relief for improving sleep length in patients undergoing transarterial chemoembolisation.

The Determination of Patient Learning Needs After Day Surgery: A Cross-Sectional Study

PURPOSE

This study was conducted to investigate the care perception and learning needs of patients undergoing day surgery.

DESIGN

A descriptive and cross-sectional model was used.

METHODS

The study was conducted with 234 patients who underwent day surgery in a general surgery clinic of a university hospital. Data were collected using a sociodemographic characteristics form, the Patient Perception of Hospital Experience with Nursing Scale (PPHEN) and the Patient Learning Needs Scale (PLNS).

FINDINGS

The PPHEN mean score was 67.99 ± 11.98 and the PLNS total score was 211.15 ± 38.49. The subscales showed that the highest scores were 38.47 ± 6.93 for activities of life, while the lowest score was 20.60 ± 4.23 for feelings related to condition. There was a statistically significant negative correlation in the PPHEN and PLNS subscales in terms of medications, activities of living, treatment, and complications. There was no statistically significant relationship between the demographic data of the patients (age, gender, and educational status).

CONCLUSIONS

This study demonstrated that patients had high information needs and greater concerns, particularly about "activities of life." Nurses should be aware of the importance of identifying high learning needs to increase the level of satisfaction with nursing care in day surgery patients.

Elements of patient satisfaction: An integrative review

AIM

To summarize the scientific literature on the elements essential to understanding a nursing definition of patient satisfaction.

DESIGN

Whittemore and Knafl's methodology was used for this integrative review.

METHODS

Articles were included if the studies they explored patient satisfaction in patient populations and measured patient satisfaction using standardized, validated instruments. Elements in this review were defined as the essential components that create the complex concept of patient satisfaction.

RESULTS

Thirty articles were found and analysed in full. Five definitions of patient satisfaction were used, all of which were at least 20 years old. Twenty-two different measures of patient satisfaction were used, six of which were nursing-specific. Sixty-eight elements of patient satisfaction were studied in the included articles. Forty-three elements were reported as having a significant relationship with patient satisfaction, 25 were reported as having no significant relationship. Eight elements had both significant and non-significant relationships.

The relationship between the level of trust in nurses and nursing care quality perceptions of patients treated for Covid-19

BACKGROUND

During the pandemic process, nursing care has gained more importance. So, it is critical to evaluate the level of trust in nurses and the perception of care in terms of the patient, in order to improve the care service provided, to achieve the desired successful patient results, to ensure patient satisfaction in nursing care and to create a healthy society in the long term.

AIM

This study aimed to examine the relationship between the level of trust in nurses, care perceptions of patients receiving care with the diagnosis of Covid-19, and the level of trust in nurses and care quality perceptions of patients.

METHODS

This descriptive, cross-sectional, correlational study was conducted in the Covid-19 unit of a state hospital in the Western Black Sea Region of Turkey between May and October 2021. The sample size was calculated as 227 using the sample calculation formula whose population is unknown in the literature. 'Personal Information Form', 'Trust in Nurses Scale' and 'Patient Perception of Hospital Experience with Nursing (PPHEN)' was used to collect data. Ethical approval was obtained from the clinical research ethics committee, RESULTS: The total mean score of the patients' trust in nurses scale was 27.67 ± 3.29 (min: 15, max: 30); the mean score of the patients' Perception of Nursing Care scale was determined as 69.52 ± 12.51 (min:15, max:75). It has been determined that the level of trust in nurses and the perception of nursing care of patients receiving Covid-19 treatment are high. A positive, significant and weak relationship (r = 0.348, p < 0.01) was found between the patients' level of trust in nurses and their perceptions of nursing care.

CONCLUSION

During the pandemic process, trust in the patient-nurse relationship increases the patient's perception of nursing care and positively affects the quality of care.

The Inpatient Experience with Nursing Care Scale (IPENCS): Development, Validation and Psychometric Properties

AIM

To develop a patient experience with nursing care scale and to evaluate its psychometric properties.

BACKGROUND

Patient experience is increasingly recognized as one of the pillars of quality in healthcare. Nevertheless, few instruments reflecting the preferences, needs and values of the healthcare recipients were developed to measure and improve patient experience with nursing care.

METHODS

Instrument development and psychometric analysis were used, and a total of 1050 individuals participated in this study. The validity and reliability of the scale were evaluated.

RESULTS

An exploratory factor analyses yielded a seven-dimension structure, and explained 70.785% of the variance. Confirmatory factor analyses supported the factor structure of the instrument. The content validity was very good (Mean I-CVI 0.96). Criterion validity was demonstrated with the general satisfaction question. Internal consistency reliability was found to be acceptable, as indicated by a Cronbach's alpha of 0.945, split-half reliability of 0.878 and item-total correlations of 0.328-0.803, respectively.

CONCLUSIONS

This study produced a 30-item instrument, which exhibits good psychometric properties.

IMPLICATIONS FOR NURSING MANAGEMENT

This scale could be used to determine to what extent patients' nursing care needs are met, examine the strength and weakness of current care delivery, and analyze the gap between patients' expectations and healthcare providers' behaviors.

Patients' Perceptions of Nursing Care in a University Hospital

Patient satisfaction with nursing is an important indicator of the quality of the nursing services. This study used The Patient Perception of Hospital Experience With Nursing (PPHEN) scale (Dozier, Kitzman, Ingersol, Holmberg, & Schultz, 2001) to determine the nursing care perception of patients in a Turkish tertiary care hospital. The study design was descriptive comparative and used convenience sampling. In total, 566 patients volunteered to take part in the study. The patient satisfaction level with nursing was found to be below average; patient satisfaction showed no meaningful differences between genders, marital status, or the clinics where the patient was hospitalized, but significantly higher levels of satisfaction were found with higher levels of education, younger age, higher incomes, and being employed. Overall, the patients considered that nursing care needs improvement, especially in terms of the provision of information and psychosocial support.

Validation of the patient measure of safety (PMOS) questionnaire in Australian public hospitals

Objective

Patients can provide a unique perspective on the safety of care in hospitals. Understanding that the extent to which the way hospitals are organized for quality and safety is associated with patient perceptions of care is becoming increasingly valued and necessary for the direction of targeted interventions across healthcare systems. The UK-developed patient measure of safety (PMOS) assesses eight domains of ward safety from the patient point of view and has recently been adapted and piloted in Australia. The aim of this study is to test the psychometric properties of PMOS-Australia (PMOS-A) amongst a large cohort of hospitalized patients.

Design

Cross-sectional questionnaire validation assessment.

Setting and participants

As part of the DUQuA project, the PMOS-A survey was distributed within acute myocardial infarction, hip fracture and stroke departments across 32 large public hospitals in Australia. Patients could complete the PMOS-A independently, or request the assistance of a family member/guardian, or staff on the wards—space was included to record mode of completion.

Main outcome measures

Confirmatory factor analysis (CFA) was undertaken on a calibration sample to generate the model, and a validation sample was used to cross-validate the model. A subset of only those participants who received assistance for PMOS-A completion was also tested using CFA on a calibration and validation sample. Model fit indices (chi-square to degrees of freedom ratio [Chi-square:DF], root mean square error of approximation [RMSEA], comparative fit indices [CFI], standardized root mean squared residual [SRMR]), Cronbach’s α, average inter-item correlations, construct reliability and cross-loadings were examined with reference to recommended thresholds to establish the extent of convergent validity and discriminant validity. A marker of criterion validity was assessed through testing associations between the PMOS-A and adherence to clinical guidelines.

Results

Across the calibration and validation samples of the full (N = 911) and assisted completers only subset (N = 490), three (Chi-square:DF, SRMR, RMSEA) of the four indices consistently or almost always met thresholds for acceptable model fit. CFI indices did not meet the recommended limits (0.72–0.78, against a target &gt; 0.9). Positive relationships were found for all tests between PMOS-A and adherence to clinical guidelines, and these were significant when assessed in the calibration datasets for the full and assisted completion samples.

Conclusion

A sufficiently reliable and valid measure of patient perceptions of safety has been developed. These findings should provide adequate support to justify the use of this measure to assess patient perceptions of safety in Australian hospitals and can be modified for use elsewhere.

Validity and Reliability of the Korean Version of the Watson Caritas Patient Score

BACKGROUND

The increasing use of information technology in healthcare settings has reduced human contact with healthcare providers and is hampering human-centered intrinsic nursing work associated with patient discomfort, emotional distress, and desire. The caring attitude of nurses affects patient compliance with medication instructions as well as the promotion of health behaviors and patient satisfaction.

PURPOSE

This study was designed to develop a Korean version of the Watson Caritas Patient Score (WCPS) developed by Watson and then verify its reliability and validity.

METHODS

This was a methodological study. Data were collected from 240 patients in wards of the departments of internal medicine and surgery of a general hospital with more than 500 beds in Kunsan City between May 1 and June 8, 2017. Exploratory factor analysis and confirmatory factor analysis were used to verify the construct validity and model fit. The Patient Perception of Hospital Experience with Nursing was used to confirm convergence validity. Data were analyzed using descriptive analysis, Cronbach's alpha, factor analysis, and Pearson's product-moment correlation analysis.

RESULTS

The internal consistency of the Korean version of the WCPS assessed using Cronbach's alpha was .94. The content validity index for each of the five items was 1.0. The communality ranged from .75 to .87, and the overall model fit was good. In addition, the average variance extracted was .61, the composite reliability was .89, and the convergent validity was .72 (p < .001).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The original English version and the Korean version of the WCPS both address a single factor, which confirmed the reliability and good fit of the model and showed both convergent and criterion-related validity. The Korean version of the WCPS is expected to contribute to improving the quality of nursing care in Korea by providing a simple scale that assesses patient perceptions of nursing care easily and accurately.

Patients' perception of quality of nursing care; a tertiary center experience from Ethiopia

Background

Nursing care closely influences patients' satisfaction with the overall quality of care, and the importance of measuring patient satisfaction with nursing care cannot be emphasized enough. Data are however scarce regarding patients' perception of quality of nursing care in Ethiopia. We performed this study to assess patient's perception of the quality of nursing care in a tertiary center in Ethiopia.

Methods

Data were collected prospectively using Quality of Nursing Care Questionnaires-patient of Safford & Schlotfeldt. A total of 340 patients were included using systematic random sampling and data were analyzed using SPSS for windows version- 20.

Result

The nursing care performance was highest for nurse-physician relation (mean = 3.95) and low for education and home care preparation and physical care (mean score of 2.79 and 2.89 respectively). The emotional care and nurse administration mean score were 3.5 and 3.83 respectively. The overall nursing quality was neither satisfying nor dissatisfying (mean of 3.39). While only 36% of the respondents were satisfied with the nursing care, patient education has the strongest (AOR of 7.4) association with satisfaction.

Conclusion

Patients perceived low quality of physical care, education and preparation for home care but better nurse-physician relation and nursing administration. However the overall quality measure was neither satisfying nor dissatisfying. This calls for an action from the health care administrators, educators and other stakeholders to improve the patient perception of quality nursing care.

Routine patient surveys: Patients' preferences and information gained by healthcare providers

BACKGROUND

Patient feedback after contact with a hospital is regarded as an important source of information for the improvement of local healthcare services. Routine patient surveys are in widespread use to obtain such feedback. While general principles for the composition of this kind of surveys have been described in the literature, it is unknown which method of contact and topics of feedback are important to patients in postcontact healthcare surveys.

MATERIAL AND METHODS

We invited 2931 consecutive patients who had in- or outpatient contact with the Department of Orthopaedics and Traumatology at the University Hospital Basel to an anonymous survey. They were asked whether they were generally in favor of feedback surveys. They also had the opportunity to state their preferred form of contact (text message, app, email, online or letter) and provide up to three topics that they regarded as specifically important in patient surveys.

RESULTS

A total of 745 patients participated in the survey (25.4%), of these 61.9% expressed the preference to be surveyed, and 69.1% selected `letter' as one of the preferred forms of contact. Favoring only `letter' contact increased substantially with age. Overall 54.6% of patients stated at least one topic that they wished to give feedback on. The most frequent topics were related to treatment and rather general aspects regarding staff and overall impression. The wish to include suggestions for improvements was rarely mentioned as specific topic.

CONCLUSIONS

The majority of patients seem to be rather indifferent to the existence and content of patient surveys. They mention a wide range of topics from general to specific ones, but do not express interest in the opportunity to suggest changes. There is a need to effectively engage patients in healthcare planning using new approaches to obtain valuable feedback on patients' hospital stay and contact experiences. These new approaches should ideally be more informative and cost-effective than the current practice.

[Development of the Patient Caring Communication Scale]

PURPOSE

This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity.

METHODS

The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha.

RESULTS

This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing . The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability.

CONCLUSION

The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.

The association of nursing care perception with coping skills and posttraumatic growth in mental disorders

WHAT IS KNOWN ON THE SUBJECT?: Although it is well known that coping with mental disorder is a traumatic experience, studies of the relationships between posttraumatic growth and the variables that can affect it are rarely found in the literature. The studies that do exist usually focus on posttraumatic growth after posttraumatic stress disorder has developed as a result of traumatic life events such as earthquakes, wars, accidents or physical disease. In the literature, there exist few studies of patients diagnosed with psychosis. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This study shows that posttraumatic growth can be seen in patients after the diagnosis of mental disorders. Patients who use effective coping methods show more posttraumatic growth. In addition, patients who are satisfied with the nursing care received in the clinic show more posttraumatic growth. This indicates that care delivered by psychiatric nurses contributes to the posttraumatic growth of the patients. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric nurses who recognize that suffering a mental disorder is a traumatic experience and that patients can grow from this experience can contribute to the posttraumatic growth of those in their care. When they see signs of posttraumatic growth, nurses can teach patients how to cope with that stress effectively and how to share their feelings, thoughts and experiences related to the situation. In addition, psychosocial interventions such as trauma-focused cognitive behavioural therapy and eye movement desensitization can be used to aid posttraumatic growth.

ABSTRACT

Introduction Although it is recognized that suffering a mental illness is a traumatic experience, the fact that this can lead to posttraumatic growth and the variables that may affect the situation are rarely discussed in the literature. Aim This study was conducted to determine the effects of coping styles and nursing care perceptions on posttraumatic growth in mental disorders. Method The descriptive study was conducted at a psychiatric clinic with a personal information form and three-scale test. Results In the study, completed with 122 psychiatric inpatients, it was found that patients were using effective methods to cope with stress, were satisfied with nursing care and had high posttraumatic growth. Moreover, it was found that effective coping styles and satisfaction with nursing care positively affected the posttraumatic growth level of patients. Discussion The results support the proposition that using effective coping styles and seeking professional support after traumatic life events influence posttraumatic growth levels. Implications for practice Psychiatric nurses should be aware of the fact that developing a mental disorder is a traumatic life event after which posttraumatic growth can occur. They should encourage posttraumatic growth by teaching effective coping methods, providing psychiatric care and using psychosocial interventions such as trauma-focused cognitive behavioural therapy and eye movement desensitization.

Finding a Focus for Nursing: The Caring Concept

Many nursing theorists claim caring as the aspect of nursing that differentiates it from other health care professions. Newman et al defined the focus of nursing as "the study of caring in the human health experience," yet there is little consensus among nurses about the validity of this statement. The purpose of this article is to explore the concept of caring as it has been defined by various nursing scholars and to determine whether the focus of nursing knowledge development can appropriately be defined as "the study of caring in the human health experience."

Extending the assessment of patient-centredness in health care: Development of the updated Valuing Patients as Individuals Scale using exploratory factor analysis

AIMS AND OBJECTIVES

To update and re-validate the Valuing Patients as Individuals Scale for use as a patient appraisal of received healthcare.

BACKGROUND

Healthcare in the United Kingdom and beyond is required to deliver high quality, person-centred care that is clinically effective and safe. However, patient experience is not uniform, and complaints often focus on the way patients have been treated. Legislation in United Kingdom requires health services to gather and use patients' evaluations of care to improve services.

DESIGN

This study uses scoping literature reviews, cognitive testing of questionnaire items with patient and healthcare staff focus groups, and exploratory factor analysis.

METHODS/SETTING/PARTICIPANTS

Data were collected from 790 participants across 34 wards in two acute hospitals in one National Health Service Health Board in Scotland from September 2011-February 2012. Ethics and Research and Development approval were obtained.

RESULTS

Fifty six unique items identified through literature review were added to 72 original Valuing Patients as Individuals Scale items. Face validity interviews removed ambiguous or low relevance items leaving 88 items for administration to patients. Two hundred and ninety questionnaires were returned, representing 37% response rate, 71 were incomplete. Thus 219 complete data were used for Exploratory Factor Analysis with varimax orthogonal rotation. This revealed a 31 item, three factor solution, Care and Respect; Understanding and Engagement; Patient Concerns, with good reliability, concurrent and discriminant validity in terms of gender. A shortened 10 item measure based on the top 3 or 4 loading items on each scale was comparable.

CONCLUSIONS

The Updated Valuing Patients as Individuals Scale is sufficiently developed to capture patient appraisals of received care.

RELEVANCE TO CLINICAL PRACTICE

The short scale version is now being routinized in real-time evaluation of patient experience contributing to this United Kingdom, National Health Service setting meeting its policy and legislative requirements.

The Turkish adaptation of scale to measure patient perceptions of the quality of nursing care and related hospital services: A validity and reliability study

OBJECTIVE:

This study aimed to test the validity and reliability of a version of the tool developed in Sri Lanka in 2011 to assess patient perceptions of the quality of nursing care and related hospital services created for use with Turkish patients.

METHODS:

This methodological study was conducted between November 2013 and November 2014 after obtaining ethical approval and organizational permission. Data was collected during discharge from 180 adult patients who were hospitalized for at least 3 days at a medical school hospital located in Istanbul. After language validation, validity and reliability analyses of the scale were conducted. Content validity, content validity index (CVI), construct validity, and exploratory factor analysis were assessed and examined, and reliability was tested using the Cronbach’s alpha coefficient and item-total correlations.

RESULTS:

Mean CVI was found to be 0.95, which is above expected value. Exploratory factor analysis revealed 4 factors with eigenvalues above 1, which explained 82.4% of total variance in the Turkish version of the tool to measure patient perceptions of nursing care and other hospital services. Factor loading for each item was ≥.40. Cronbach’s alpha coefficient of sub-dimensions and total scale were found to be 0.84-0.98 and 0.98, respectively. Item-total correlations ranged from 0.56 to 0.83 for the entire group, which was above expected values.

CONCLUSION:

The Turkish version of the scale to assess patient perceptions of the quality of nursing care and related hospital services, which comprised 4 sub-dimensions and 36 items, was found to be valid and reliable for use with the Turkish population.

The impact of a creative play intervention on satisfaction with nursing care: A mixed-methods study

PURPOSE

Hospitalisation can lead to distress for children. Creative play may reduce the adverse effects of hospitalisation on children, as it could lead to children associating satisfaction and fun with their hospital experience. The aim of the current study is to investigate the impact of a creative play intervention on service-care satisfaction measurements of children and their parents.

DESIGN AND METHODS

A mixed-methods design consisting of quantitative pre/post-assessments and qualitative interviews was used within this study. The research was conducted with 30 children (n_{experimental group} = 15; n_{control group =} 15). Their parents (n = 30) and their nurse practitioners (n = 20) were also contacted in order to capture their reflections of this intervention which included creative activities with unused clean medical materials. Child participants completed the Patient's Nursing Care Perception Tool and their parents completed the PedsQL Health Care Satisfaction Tool.

RESULTS

The two groups did not differ in relation to the Patients' Nursing Care Satisfaction Tool (PNCST) (t(28): 0.348, p = .730) and the PedsQL (t(28): -0.189, p = .852) scores at Time 1 before the intervention; however, significant differences were observed at the end at Time 2 (PNCST: t(28): -11.63, p < .001; PedsQL: t(28): -12.416, p < .001). In qualitative interviews, nurses indicated that their play skills with children had been enhanced by this intervention. Family attendants reported that the intervention improved the nurse-child relationship and their satisfaction with care.

PRACTICE IMPLICATIONS

The results have shown that creative play intervention are a feasible nursing intervention which has a strong potential to be effective on child patients' and their attendants' satisfaction with care services.

Evaluation of Patients' Satisfaction With Nursing Students' Care on a Perinatology Ward

BACKGROUND

The aim of this study was to evaluate patient satisfaction with the care provided by nursing students on a perinatology ward.

METHOD

The sample for this descriptive study included 210 patients. Data were collected using an interview form and the Turkish version of the Oncology Patients' Perceptions of the Quality of Nursing Care Scale-Short Form.

RESULTS

According to the mean scores for all subscales in the instrument, patients were highly satisfied with the care they received from the nursing students. Multivariate analysis revealed that the reason for hospitalization was found to be the most statistically significant factor affecting patient perceptions of quality of care.

CONCLUSION

A high level of satisfaction with the care provided by nursing students indicates that the students were able to meet the patients' needs, which may serve as an indicator of the quality of nursing education and quality of care provided by future nurses.

The Evaluation of Nursing Care Satisfaction and Patient Learning Needs in day Case Surgery

Patients in surgical service units have higher expectations for treatment and care. The aims of this study were to determine nursing care satisfaction and information requirements at the time of discharge of patients from a day surgery unit and to assess the effects of demographics. The study was conducted on 291 patients undergoing day case surgery. Patient perception scale for nursing care (PPSN) and the patient learning needs scale (PLNS) were used and total and sub-dimension points averages were calculated and then compared with demographic data using the Kruskal-Wallis test. The results were evaluated at the p < 0.05 significance level with 95 % confidence intervals. Of the patients, 58.8 % (n = 171) were females and the average age was 49.5 ± 15.3 years. PPSN and PLNS total point averages were 68.16 ± 10.17 and 178.53 ± 27.59, respectively. A significant difference was determined in PPSN total point average with regard to previous hospitalisations; the PPSN total point average was higher for patients with prior hospitalisations (p < 0.001). Significant differences were determined between PLNS total point average and age group, marital status, receiving discharge training, and education level (p = 0.008, 0.006, <0.001, and 0.015, respectively). Differences were found in the PLNS sub-dimension point averages between groups, especially with regard to age group and educational level. We showed that patient satisfaction and patient information requirements could change according to demographic features of the patients at a day case surgery unit. In this respect, healthcare providers should offer healthcare services by evaluating the personal characteristics of patients because this is important for their satisfaction.

Care quality instruments

PURPOSE

The purpose of this paper is to describe instruments used for quality assessment in acute care. Quality care assessment is essential for improving care delivery. Quality instruments can be used to evaluate nurse and patient perspectives in multi-professional care. Therefore, valid and reliable measurement instruments are vital.

DESIGN/METHODOLOGY/APPROACH

A literature search identified several instruments that measure quality from a nurse and patient perspectives. The questionnaires were appraised in several steps with specific criteria: psychometric properties, underlying construct or test theory, study context, sample characteristics and target population.

FINDINGS

Overall, 14 instruments were evaluated, but only eight questionnaires represented nurse and patient views regarding quality. Instruments showed several disparities in their theoretical foundations and their psychometric properties. Two instruments did not provide validity data and one questionnaire did not report reliability data.

PRACTICAL IMPLICATIONS

To inform healthcare managers about acute care quality, the authors demonstrated the need for more valid and reliable measurements by using the Guidelines for Critiquing Instrument Development and Validation Reports to evaluate quality care instruments' psychometric properties.

ORIGINALITY/VALUE

There is a long tradition in quality care evaluations using questionnaires. Only a few instruments can be recommended for practical use.

Measuring patient satisfaction with health care treatment using the Short Assessment of Patient Satisfaction measure delivered superior and robust satisfaction estimates

OBJECTIVES

Reviews of patient satisfaction suggest seven dimensions, each of which should be assessed. This study reports development of a short generic patient satisfaction measure for use in routine clinical practice.

STUDY DESIGN AND SETTINGS

Participants were randomly recruited from two Australian incontinence clinics. Participants completed a follow-up questionnaire including patient satisfaction items. Iterative Mokken and Rasch analyses derived the Short Assessment of Patient Satisfaction (SAPS) scale from the item bank.

RESULTS

The SAPS psychometric properties illustrated the following features, namely its descriptive system covers all seven patient satisfaction dimensions, there were no misfitting items, and the scale exceeded the Loevinger H criteria for a strong unidimensional scale. The reliability of the SAPS was Cronbach α=0.86. When discriminatory function was examined, the SAPS scale was more sensitive than two other generic patient satisfaction instruments.

CONCLUSION

The SAPS scale is based on a firm theoretical model of patient satisfaction and its descriptive system covers the known dimensions contributing to patient satisfaction. Its internal psychometric properties exceeded standard psychometric standards, and it discriminated at least as well as other longer patient satisfaction measures. Although it needs further validation, the study results suggest that it may be useful for assessing patient satisfaction with health care.

Can and should nurses be aware of patients' expectations for their nursing care?

Patients' expectations for their care have long been identified as a critical factor in patient satisfaction that has become a decisive element in hospital reimbursement. But the standard definition of expectations as the level of care patients imagine they would receive in the ideal hospital setting may be off the mark. Most patients do not enter the ideal hospital, so we need to focus on patients' expectations of their real nurses in the actual hospital they are entering. Nurses who are aware of patients' expectations of them may have a distinct advantage in influencing patients' expectations and thus positively affect patients' level of satisfaction with their nursing care. The author discusses what changes may need to occur to shift our focus toward the advantages of nurses becoming aware of patients expectations and reports on her initial efforts to study nurses' awareness of patients' expectations of them.

The relationship between cancer patients' perception of nursing care and nursing attitudes towards nursing profession

Objective:

The aim of this study is to evaluate the patients’ perceptions of nursing care with different types of cancer in Turkey and its relationship with nursing attitudes towards nursing profession.

Methods:

An exploratory approach utilizing cross-sectional design with a structured questionnaire, administered to patients nurses a face-to-face, with specific questions about demographic and health status and two standardized scales: Patient Perception of Hospital Experience with Nursing Care (PPHEN) and Attitude Scale for Nursing Profession (ASNP). This study was conducted at the Research and Application Hospital of Ataturk University in Erzurum, Turkey with a convenience sample of 100 patients who were discharged from medical and radiation oncology clinics and 30 nurses that give care to these patients.

Results:

It was found that patients’ satisfaction had low levels with nursing care and similarly the nurses’ attitudes from nursing profession were negative. There was a high correlation between the scales.

Conclusion:

The nurses’ attitudes towards nursing profession are affecting the nursing care of patients’ perception with cancer. We suggest that the researchers must be evaluating nurse's attitudes when they determine the patient perceptions of nursing care.

Meanings of quality of care: perspectives of Portuguese health professionals and patients

OBJECTIVES

The main goal of this study is to explore what is meant by "quality of care" (QoC) by both health professionals and patients. This research also intends to compare the perspectives of nurses, doctors and patients in order to understand whether these different actors share similar views on what represents QoC.

DESIGN AND METHODS

A qualitative study was conducted. The study consisted in 44 semi-structured individual interviews (11 doctors; 23 nurses; 10 patients) and in three focus groups (20 participants: doctors, nurses, patients). Participants were doctors, nurses and patients from several Hospitals in Portugal. Data were analysed using content analysis methodology with MaxQDA software.

RESULTS

The main content analysis' results revealed that all participants emphasize technical and interpersonal dimensions of QoC. Nevertheless, professionals stressed the availability of equipment and supplies and the conditions of health care indoor facilities. Patients focused more on their access to health services, namely the availability of health professionals, and on the health status outcome after care. In what the differences between doctors and nurses are concerned, the former tend to highlight the technical aspects of care more than the nurses, who tend to refer interpersonal aspects immediately.

CONCLUSIONS

Although nowadays the importance of health care quality has become well-recognized, its definition is still complex. Given that specific aspects are more valued by certain groups than others, it is important to take in consideration all the stakeholder's perspectives when measuring QoC in order to continuously improve it in the 'real' settings.

Perception: a concept analysis

PURPOSE

Concept analysis methodology by Walker and Avant (2005) was used to define, describe, and delimit the concept of perception.

DATA SOURCE

Nursing literature in the Medline database was searched for definitions of "perception."

DATA SYNTHESIS

Definitions, uses, and defining attributes of perception were identified; model and contrary cases were developed; and antecedents, consequences, and empirical referents were determined.

CONCLUSIONS

An operational definition for the concept was developed.

IMPLICATIONS FOR NURSING PRACTICE

Nurses need to be cognizant of how perceptual differences impact the delivery of nursing care. In research, a mixed methodology approach may yield a richer description of the phenomenon and provide useful information for clinical practice.

Cross-cultural validation and psychometric properties of the Greek version of the Caring Behaviors Inventory: a methodological study

RATIONALE

Translation, adaptation and cross-cultural validation of instruments or scale to measure concepts of interest among different populations can facilitate sharing of knowledge and advance cross-cultural research globally, especially in countries with diverse populations.

AIMS AND OBJECTIVES

This is a two-phase study aiming to: (1) translate, adapt and cross-validate the 24-item English version of Caring Behaviors Inventory into Greek; and (2) evaluate the psychometric properties of the Greek version (CBI-GR).

METHODS

A descriptive correlational design was used to conduct the study. The procedure involved professional translators, committee approach, and a sample of nurses and patients. The psychometric evaluation of the CBI-GR used a sample of 245 Greek and Cypriot medical-surgical nurses. Data analyses comprised internal consistency reliability (Cronbach's alpha coefficient), stability (test-retest) reliability, item analysis and confirmatory factor analysis.

RESULTS

The Cronbach's alpha for the overall CBI-GR was 0.92 and ranged from 0.76 to 0.87 for the subscales. Correlation coefficients between test and retest for the overall CBI-GR was r = 0.83 and ranged from r = 0.69 to 0.78 for its subscales. Confirmatory factor analysis of the scale supports its four-factor structure and the model indexes were adequate: X(2) (239) = 515.54, P < 0.001; comparative fit index = 0.91; incremental fit index = 0.91; and Tucker Lewis index = 0.90; parsimony normed fit index = 0.73; parsimony comparative fit index = 0.79; and root mean square of approximation = 0.07.

CONCLUSIONS

The CBI-GR is comparable with the original 24-item English version of the CBI and it is suitable to measure nurse caring among Greek-speaking nurses. Further psychometric testing of the instrument among nurses and patients is warranted.

Quality nursing care for hospitalized patients with advanced illness: concept development

The quality of nursing care as perceived by hospitalized patients with advanced illness has not been examined. A concept of quality nursing care for this population was developed by integrating the literature on constructs defining quality nursing care with empirical findings from interviews of 16 patients with advanced illness. Quality nursing care was characterized as competence and personal caring supported by professionalism and delivered with an appropriate demeanor. Although the attributes of competence, caring, professionalism, and demeanor were identified as common components of quality care across various patient populations, the caring domain increased in importance when patients with advanced illness perceived themselves as vulnerable. Assessment of quality nursing care for patients with advanced illness needs to include measures of patient perceptions of vulnerability.

Individualized care scale - nurse version: a Finnish validation study

RATIONALE

Nurses' work is inextricably linked to the evaluation of the quality of care provision in health care. Within this evaluation, individualized care is a topical theme in western countries. Currently, there is no suitable instrument to measure the level of individualized care from the nurses' point of view.

AIM

To report the development process of the individualized care scale - nurse (ICS-Nurse) and to ensure its validity and reliability.

METHODS

A methodological design was used. Data were obtained from 544 nurses (N = 923, response rate 59%) from inpatient wards in one university, two regional and two psychiatric hospitals as well as four health centres. Three expert analyses were used to ensure content validity. Cronbach's alpha coefficients and item analysis were used to examine internal consistency reliability. A principal components analysis, Spearman's correlation coefficients, multiple regression analysis and structural equation modelled by LISREL were conducted to evaluate construct validity.

RESULTS

The expert analyses provided good content validity evidence. The ICS-Nurse was easy to administer and able to be completed quickly. There were few missing data. Cronbach's alpha coefficients ranged 0.72-0.84. All item-to-total correlations were acceptable (>0.30), but some of the inter-item correlations were high. The principal components analysis supported the three-component structure explaining 52% of the variance in ICS-A-Nurse and 56% in ICS-B-Nurse. LISREL supported the theoretical model.

CONCLUSIONS

The ICS-Nurse is a valid and reliable instrument that can be used to measure nurses' perceptions of individualized nursing care in inpatient wards. There is a need to test instrument further, both nationally and internationally.

Impact of Organizational and Project Factors on Acceptance and Usage of Project Management Software and Perceived Project Success

This study surveyed 497 participants to determine the factors that affect project professionals’ acceptance of project management software and the perceived impact of software usage on their performance. The study finds that greater information quality and higher project complexity are the dominant factors explaining higher levels of system utilization, that greater system functionality and ease of use have a significant positive relationship with increased software usage, and that a strong positive relationship exists between higher usage of project management software and perceived project managers’ improved performance. Inconsistent with prior research, more training was not found to be associated with project management software usage. The study explains more than 40% of the variation in project management software acceptance and adds project management software usage to project success factors by empirically confirming for the first time that project management software enhances project professionals’ perceived performance and provides a positive impact on the results of their projects. The study provides practical implications for project professionals, their organizations, senior management, decision makers, software developers, and vendors. These findings support the call for further research that investigates the diffusion of information technologies in the project management field and their impact on project success and competitive position.

Social desirability in the measuring of patient satisfaction after treatment of coloproctologic disorders: on shortcomings of general bipolar satisfaction scales for quality management

BACKGROUND AND AIMS

Within the field of medicine, much attention is being paid to quality management, whereby patient satisfaction plays a major role. In order to measure this construct, usually rather general, bipolar rating scales are applied. However, these scales are often susceptible to social desirability biases.

PATIENTS-METHODS

Coloproctological patients were asked to complete a questionnaire with ratings of satisfaction and anxiety at two different points of measurement: One group while in treatment (N = 86) and a second group approximately 1 year after their treatment (N = 328).

RESULTS

Even when controlling for relevant demographic influences, a clear decrease in intensity of the evaluation ratings is shown when the survey was administered 1 year after release from hospital as compared to during the patients' stay in hospital. For generally formulated scales of patient satisfaction, social desirability constitutes a significant bias.

CONCLUSION

The usual conceptualization of a bipolar continuum of patient satisfaction or dissatisfaction must be renounced. Instead, questionnaires might be constructed in three steps which investigate problem dimensions at a medium level of concreteness. Only in this way can quality management gain credibility and trust within as well as beyond the field of medicine.

Measuring individualized nursing care: assessment of reliability and validity of three scales

AIM

This paper is a report of a study to assess the reliability and convergent validity of three measures of nursing care individualization.

BACKGROUND

Individualized care is a key element of nursing care quality, yet little is known about the extent to which it is implemented, its effects, and the factors that help or hinder nurses in giving individualized care. Therefore reliable and valid instruments are needed to measure individualized nursing care.

METHOD

A cross-sectional correlational survey design was used. The purposive sample consisted of 861 patients from six hospitals in Finland (response rate 82%). Data were collected in 2004. The Individualized Care Scale was administered simultaneously with translated versions of the Schmidt's Perceptions of Nursing Care Survey and the Oncology Patients' Perceptions of the Quality of Nursing Care Scale. Internal consistency reliability and convergent validity were assessed for each scale.

FINDINGS

Evidence for convergent validity was identified between the Individualized Care Scale (part A/B), the Individualization subscale (r = 0.64 with Part A, r = 0.66 with part B) and the Seeing the Individual Patient subscale (r = 0.68 with part A, r = 0.71 with part B). Cronbach alpha coefficient was 0.97 for the Individualized Care Scale, 0.82 for Seeing the Individual Patient and 0.87 for the Individualization subscale.

CONCLUSION

Data provided preliminary evidence for the convergent validity of the individualized care scales, as well as acceptable internal consistency reliability for each scale. These scales represent useful measures for assessing patients' perceptions of the individualization of nursing care received.

The Patient Satisfaction Scale--an empirical investigation into the Finnish adaptation

RATIONALE AND AIMS

The aim of this paper is to empirically investigate the performance characteristics of the Finnish adaptation PSS-Fin of the Patient Satisfaction Scale (PSS) intended to measure patient satisfaction with nursing care. The PSS-Fin includes three sub-scales: technical-scientific, informational and interaction/support care-needs.

METHODS

The PSS-Fin was used in a cross-sectional survey measuring the satisfaction of Finnish surgical patients (n=454) with the nursing care they received. The feasibility, internal consistency, stability, equivalence and construct validity of the measure were investigated. Evaluation was based on statistical methods.

RESULTS

The PSS is brief and easy to use, and it produced low missing data. Cronbach's alpha coefficient ranged from 0.79 to 0.89 for the sub-scales. The items correlated strongly with the sub-scales and the sub-scales with the total PSS as well. Test-retest reliability of 0.7 showed reasonable stability over time. Three factor analytic procedures supported for the three-factor solution with a technical-scientific, informational and interaction/support factors, explaining approximately 77% of the variance. The PSS had some equivalence with another satisfaction instrument, but also exhibited the ability to discriminate between each other. In multiple regression analysis the informational care-needs sub-scale was the most significant factor explaining patient satisfaction.

CONCLUSION

The PSS-Fin demonstrated good psychometric properties and conceptual rigour and is thus reliable tool for examining patient satisfaction with nursing care.

Provision of individualised care improves hospital patient outcomes: An explanatory model using LISREL

BACKGROUND

Previous studies propose the efficacy of individualised care for hospital patients. Individualised care and proposed correlates have not been tested by means of a single multivariate analyses simultaneously.

OBJECTIVES

The aim of this study is to examine predicted relationships between individualised care and patient satisfaction, patient autonomy and health-related quality of life.

DESIGN

A cross-sectional correlational survey.

SETTINGS

This study was carried out in six acute hospitals in Southern Finland.

PARTICIPANTS

A sample of 861 (response rate 84%) pre-discharged hospitalised adult patients were recruited from surgical, gynaecological and internal medicine units.

METHODS

A correlational survey design was used to investigate to complete a battery of instruments measuring individualised care (the ICS), patient satisfaction with nursing care (the PSS), patient autonomy and perceived health-related quality of life (the 15D). The data from these instruments were used to test the proposed model using LISREL implementing the Maximum Likelihood estimation procedure.

RESULTS

The findings support the proposed model linking individualised nursing care directly to the positive patient outcomes defined. The initial model, permitting all possible covariances, showed a good fit between the variables. Independent variables, supported individuality through nursing interventions (ICS-A) and perception of individuality in their own care (ICS-B) accounted for 58% of the variance in the frequency of individualised care. Individualised care explained the variance on the dependent variables patient satisfaction and patient autonomy. A low but significant association was also found between individualised care and perceived health-related quality of life.

CONCLUSIONS

The results of this study highlight the contribution of individualised nursing care to positive patient outcomes, such as patient satisfaction, patient autonomy and perceived health-related quality of life. Not only clinically important, this model also has implications for further research into individualised care and its relationship with positive patient outcomes.

Patient characteristics in relation to perceptions of how individualized care is delivered--research into the sensitivity of the Individualized Care Scale

The purposes of this study were to examine how hospital patients' backgrounds and clinical illness are related to their perceptions of the individualized care they receive and to test the sensitivity of the Individualized Care Scale (ICS). Cross-sectional explorative survey data were obtained using questionnaires completed by 861 (response rate = 88%) predischarge hospital patients from six hospitals in Southern Finland in 2004. Self-administered questionnaires included the ICS as well as the 15D, a measure of health-related quality of life, and gathered information about the patients' backgrounds. Based on association tests, younger age, poorer state of health, and higher level of education were associated with more critical perceptions of individualized care. Using simultaneous regression analysis and presenting the results from stronger to weaker, we found age to be the strongest predictor of patients' positive perceptions of the individualized care they received. This was followed by health-related quality of life (HRQoL) as measured by the 15D, vocational education, and type of admission. The ICS was found to be a valid tool for the measurement of individualized care in hospitals. The self-reported patient data from this survey suggest that some patient characteristics are associated with the patients' perceptions about the individualized care they receive. There is now a need to consider how these characteristics can be taken into account in nursing care delivery to increase individualized care for hospital patients. The results also support use of the ICS in the measurement of individualized care in hospitals.