Understanding and Measuring Patients' Assessment of the Quality of Nursing Care

Satisfaction of intensive care unit patients linked to clinical and organisational factors: A cross-sectional multicentre study

BACKGROUND

The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care.

OBJECTIVES

The objectives of this study were to analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and sociodemographic, clinical, and organisational variables.

DESIGN

This was a prospective, descriptive correlational study.

SETTING AND METHODS

The population consisted of all patients discharged from the intensive care units (ICUs) of 19 hospitals in Spain between December 2018 and December 2019. The level of satisfaction was measured using the validated Nursing Intensive Care Satisfaction Scale, and sociodemographic, clinical, and organisational data were collected.

RESULTS

Participants' mean age (n = 677) was 59.7 (standard deviation: 16.1), and 62.8% of them were men (n = 426). Satisfaction with the nursing care received was 5.66 (SD: 0.68) out of a possible 6. The score for overall satisfaction presented statistically significant relationships with the hours of mechanical ventilation (p = 0.034), with the participant's perception of own health status (p = 0.01), with the participant's perceived degree of own recovery (p = 0.01), with the hospital's complexity level (p = 0.002), with the type of hospital (p = 0.005), and with the type of ICU (p = 0.004). Finally, the logistic regression model shows that the Nursing Intensive Care Satisfaction Scale score was not linked to age or sex but did have a statistically significant relationship with the perceived degree of recovery (p < 0.001) and the type of ICU (p=<0.001). The variables that predicted satisfaction were age, degree of recovery, and the type of ICU.

CONCLUSION

Several studies show that patient satisfaction is related to the patient's perceived health status and perceived degree of recovery, a finding that is confirmed in our study. Our study moves beyond these outcomes to show that the hours of mechanical ventilation and the characteristics of the hospital also have a significant relationship with patients' satisfaction.

National validation of the nursing Intensive-Care satisfaction scale: Research protocol

AIM

Validate the Nursing Intensive-Care Satisfaction Scale in ICUs throughout Spain. Identify the improvement strategies recommended by the patients and professionals.

DESIGN

Quantitative psychometric methodology and a cross-sectional descriptive correlational design.

METHODS

The study population will be all patients discharged from 19 participating ICUs in Spain. Consecutive sampling (n = 564). Once discharged from the ICUs, they will receive the questionnaire and then, after 48 hours it will be given to them again to analyse the temporal stability. To validate the questionnaire, the internal consistency (Cronbach's Alpha) and temporal stability (test-retest) will be analysed.

RESULTS

Improve the quality of nursing care by modifying, changing or strengthening behaviours, skills, attitudes or areas for improvement involved in the process.

Psychometric properties of the Nursing Intensive Care Satisfaction Scale: A multicentre cross-sectional study

BACKGROUND

Patient satisfaction with nursing care is an indicator of patient satisfaction with the hospital stay in general. The Nursing Intensive Care Satisfaction Scale is the only scale about patient satisfaction with nursing care received in an intensive care unit that incorporates the critically ill patient's perspective into its design and validation. We validated the scale nationally, incorporating intensive care units at public and private hospitals of different levels of complexity in Spain.

OBJECTIVES

The objective of this study was to validate in Spanish intensive care units the Nursing Intensive Care Satisfaction Scale, a patient-centred questionnaire that evaluates recently discharged intensive care patients' satisfaction with the nursing care they received.

DESIGN

We used a psychometric quantitative methodology and a descriptive cross-sectional design.

SETTING AND PARTICIPANTS

The study was conducted in intensive care units at level II and III public and private hospitals throughout Spain. The study population was all patients discharged from intensive care units from December 2018 to December 2019 from the 19 participating hospitals. We used consecutive sampling until reaching a sample size of 677 patients. The assessment instruments were given to patients at discharge and 48 h later to measure temporal stability.

METHODS

The validation process included the analysis of internal consistency (Cronbach's α coefficient), temporal stability (test-retest), construct validity through a confirmatory factor analysis, and criterion validity using the Pearson correlation coefficient and three criterion items that assessed similar constructs.

RESULTS

The reliability of the scale was 0.97, and the factors obtained values between 0.87 and 0.96. The intraclass correlation coefficient for the total scale was 0.83, indicating good temporal stability. Construct validity showed a good fit and a four-factor structure, in accordance with the theoretical model. Criterion validity presented a correlation that was between moderate and high (range: 0.46 to 0.57).

CONCLUSIONS

The Nursing Intensive Care Satisfaction Scale has good psychometric properties, demonstrating its ability to accurately measure patient satisfaction across a range of contexts in Spain. Continuous monitoring of satisfaction will allow nurses to identify areas for improvement that can increase the quality of care.

Patients' and Nurses' Perceptions of Importance of Caring Nurse-Patient Interactions: Do They Differ?

Nurse−patient interaction is a professional and therapeutic relationship created to enable nurses to assess, plan, and deliver health care aimed at meeting patients’ basic human needs. The main aim of this study was to identify distinctive characteristics and differences in perceptions between patients and nurses related to the importance of caring interactions and to examine the contribution of independent variables in explaining their perceptions. A total of 446 respondents were included in the research (291 patients and 155 registered nurses). Data were collected using the translated and standardized 70-item version of the Caring Nurse−Patient Interactions Scale (CNPI-70) version for patients and version for nurses. According to the overall CNPI-70 scale, there was a significant difference in patients’ and nurses’ perception (p < 0.001). Patients assessed caring nurse−patient interactions significantly higher (4.39) than nurses (4.16). Additionally, nurses assessed all subscales significantly lower than patients who assessed them high (p < 0.05), except for the subscales for “environment” (p = 0.123) and “spirituality” (p = 0.132). Independent variables did not contribute to an explanation of respondents’ perceptions. Providing quality physical assistance in meeting human needs through effective communication and teaching is crucial for promoting a holistic patient approach, improving psychosocial support and nurse−patient interaction, and attaining greater satisfaction with health care provided without additional financial investments.

The Role of Clinical Activity, Loneliness, and Satisfaction with e-Health Services as Factors Affecting Quality of Life in Patients with Rheumatoid Arthritis During the SARS-CoV-2 Pandemic

INTRODUCTION

During the SARS-CoV-2 pandemic, most primary and specialist care outpatient clinics have started to offer their patients teleconsultation appointments as well as electronic prescriptions and referrals. For many patients, it was the only available way to access medical care.

PURPOSE

The aim of the study was to assess the quality of life in rheumatoid arthritis (RA) patients and determine whether loneliness and satisfaction with telemedicine service can affect their perceived QoL during the SARS-CoV-2 pandemic.

MATERIAL AND METHODS

One hundred and forty-three RA patients (mean age 45.83±13.5 years) were included in the study. The De Jong-Gierveld Loneliness Scale (DJGLS), The Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and the questionnaire of satisfaction with teleconsultations were used in the study. The following statistical tests were used in the study: Spearman correlation test, multivariate linear regression. A significance level of 0.05 was used in the analysis.

RESULTS

The patients presented a moderate level of loneliness (DJGLS; 31.1 points). The mean ASQoL score was 11.49±4.64. The correlation analysis showed a significant positive relationship between the level of loneliness and QoL - the higher the level of loneliness, the poorer the QoL (rho=0.283; p=0.001). An analysis of the relationship between satisfaction with teleconsultations and perceived QoL showed a statistically significant negative relationship - the higher the level of satisfaction with teleconsultations, the better the QoL (b=-0.166; p=0.047). The linear multivariate regression analysis showed that the loneliness (rho=0.1; p=0.01) was significant (p<0.05) independent predictor of QoL.

CONCLUSION

During the SARS-CoV-2 pandemic, RA patients experienced loneliness and their QoL was low. Teleconsultation visits proved to be unsatisfactory and negatively perceived by patients. Higher severity of RA symptoms (weakness, fatigue), being unemployed and loneliness during the blockade are independent determinants of reduced QoL in RA patients.

Preliminary construction of evaluation indicator system for inpatients’ nursing service needs in tertiary general hospital

Objectives

To construct a comprehensive evaluation indicator system for inpatients’ nursing service needs in tertiary general hospital and to provide evidence for identifying and meeting the needs of inpatients’ nursing services.

Method

We used the Delphi method to conduct two rounds of expert consultations with 41 experts.

Result

The indicator system consisting of 5 first-level indicators and 48 second-level indicators was preliminarily constructed.

Conclusions

We formed an evaluation indicator system for inpatients’ nursing service needs in tertiary general hospital and classified it into five categories: hospital environment, nursing attitude, nursing skills, information exchange, and emotional support. The indicator system is scientific and reliable. It can provide a basis for nursing staffs to identify and meet the needs of inpatients’ care services.

Assessment of the Quality of Nursing Care of Postoperative Pain in Patients Undergoing Vascular Procedures

PURPOSE

The purpose of this study was to evaluate the quality of nursing care of postoperative pain management in patients who underwent vascular procedures.

DESIGN

A survey using patient questionnaires.

METHODS

The sample was composed of 100 patients, aged 52 to 86 years, admitted to the Clinic of Cardiac and Vascular Surgery, University Clinical Centre, Gdansk, Poland. The study included the use of an interview questionnaire, that is,.e. a standardized research tool-the Strategic and Clinical Quality Indicators in Postoperative Pain Management scale and a questionnaire designed to record sociodemographic characteristics.

FINDINGS

Analysis of the data indicated that the most numerous group of patients were men (80%). The total mean score obtained with the Strategic and Clinical Quality Indicators in Postoperative Pain Management scale was 59.2 points (range, 14 to 70) meaning that the high quality of nursing care in each area was not provided. The results of this research revealed areas for improvement in postoperative pain management on the subscales: communication (12.9 points), action (15.3 points), and environment (12.5 points).

CONCLUSIONS

The overall level of quality of nursing care in terms of postoperative pain management as reported by patients after vascular procedures was not fully satisfying, and nursing care should improve. This indicates the need to educate nurses in postoperative pain management, its monitoring and prophylaxis, and communication techniques with patients. Our study indicates that gender, place of residence, education level, and satisfaction with pain management influence the assessment of the quality of care.

Patient Satisfaction with Navigator Interpersonal Relationship (PSN-I): item-level psychometrics using IRT analysis

BACKGROUND

Patient navigation (PN) is a promising intervention to eliminate cancer health inequities. Patient navigators play a critical role in the navigation process. Patients' satisfaction with navigators is important in determining the effectiveness of PN programs. We applied item response theory (IRT) analysis to establish item-level psychometric properties for the Patient Satisfaction with Interpersonal Relationship with Navigators (PSN-I).

METHODS

We conducted a confirmatory factor analysis (CFA) to establish unidimensionality of the 9-item PSN-I in 751 cancer patients (68% female) between 18 and 86 years old. We fitted unidimensional IRT models-unconstrained graded response model (GRM) and Rasch model-to PSN-I data, and compared model fit using likelihood ratio (LR) test and information criteria. We obtained item parameter estimates (IPEs), item category/operating characteristic curves, and item/test information curves for the better fitting model.

RESULTS

CFA with diagonally weighted least squares confirmed that the one-factor model fit the data (RMSEA = 0.047, 95% CI = 0.033-0.060, and CFI ≈ 1). Responses to PSN-I items clustered into the 4th and 5th categories. We aggregated the first three response categories to provide stable parameter estimates for both IRT models. The GRM fit the data significantly better than the Rasch model (LR = 80.659, df = 8, p < 0.001). Akaike's information coefficient (6384.978 vs. 6320.319) and Bayesian information coefficient (6471.851 vs. 6443.771) were lower for the GRM. IPEs showed substantial variation in items' discriminating power (1.80-3.35) for GRM.

CONCLUSIONS

This IRT analysis confirms the latent structure of the PSN-I and supports its use as a valid and reliable measure of latent satisfaction with PN.

Level of satisfaction of critical care patients regarding the nursing care received: Correlation with sociodemographic and clinical variables

BACKGROUND

The satisfaction of critical care patients regarding the nursing care received is a key indicator of the quality of hospital care. It is, therefore, essential to identify the factors associated with the level of satisfaction of critical care patients.

OBJECTIVES

To analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and the sociodemographic and clinical variables.

METHODS

This is a prospective and descriptive correlational study. The population were all patients discharged (January 2013 to January 2015) from three intensive care units of a third-level hospital (n = 200). The data on the satisfaction level were collected using the previously validated Nursing Intensive-Care Satisfaction Scale, and the sociodemographic and clinical data were recorded by means of a questionnaire.

RESULTS

Mean participants' age in the study (n = 200) was 65.9 years (standard deviation 13.4 years), with a 66% proportion of men (n = 132). There was a very high level of satisfaction regarding the nursing care received during the patients' stay in the intensive care unit, with a rating of 5.73 (standard deviation 0.41). There is no correlation between the level of satisfaction and the sociodemographic variables collected. However, there were statistically significant differences in the average score of the overall level of satisfaction (rho = 0.182, p = 0.010) with respect to the perception of the state of health.

CONCLUSION

Critical care patients expressed very high rates of satisfaction, for both the scale as a whole and each of the factors. A high level of satisfaction is strongly influenced by the perception of the state of health.

Nursing Intensive-Care Satisfaction Scale [NICSS]: Development and validation of a patient-centred instrument

AIM

The aim of this study was to develop and validate the Nursing Intensive-Care Satisfaction Scale to measures satisfaction with nursing care from the critical care patient's perspective.

BACKGROUND

Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units.

DESIGN

Instrument development.

METHODS

The population were all discharged patients (January 2013 - January 2015) from three Intensive Care Units of a third level hospital (N = 200). All assessment instruments were given to discharged patients and 48 hours later, to analyse the temporal stability, only the questionnaire was given again. The validation process of the scale included the analysis of internal consistency, temporal stability; validity of construct through a confirmatory factor analysis; and criterion validity.

RESULTS

Reliability was 0.95. The intraclass correlation coefficient for the total scale was 0.83 indicating a good temporal stability. Construct validity showed an acceptable fit and factorial structure with four factors, in accordance with the theoretical model, being Consequences factor the best correlated with other factors. Criterion validity, presented a correlation between low and high (range: 0.42-0.68).

CONCLUSIONS

The scale has been designed and validated incorporating the perspective of critical care patients. Thanks to its reliability and validity, this questionnaire can be used both in research and in clinical practice. The scale offers a possibility to assess and develop interventions to improve patient satisfaction with nursing care.

Testing Nursing Sensitive Outcomes in Out-Patient Drug Addicts, with "Nursing Role Effectiveness Model"

Our aim was to identify factors that contribute to a better outcome in drug users and to understand the effectiveness of nursing interventions, by applying "Nursing Role Effectiveness Model" (NREM). It's a correlational, cross-sectional study with 180 drug users in a methadone program, randomly selected from three community services. We identified that treatment time, lower co-morbidities, less poly-drug use, family support and being employed contribute to a better quality of life, better mental health, less substance addiction consequences and more satisfaction with nursing care (p < 0.05). Those data were also related with nursing interventions using Structural Equation Model and we found that nursing care contributes 29% to health outcome improvement. The model revealed itself adequate to assess the effectiveness of nursing interventions (X²: 82.51/(34) = 2.426; p < 0.01, NFI = 0.927, CFI = 0.955, RFI = 0.903, GFI = 0.917, PGFI = 0.567, PCFI = 0.722, PNFI = 0.700, RMSEA = 0.089). Compared with the NREM original model, our findings reveal new relationships between the users' structural variables and the health outcomes and also relationship between units' structural variables and nurses' structural variables.

A new approach in exploring satisfaction with nursing care by nurses themselves

AIMS AND OBJECTIVES

To examine the level of satisfaction with nursing care from nurses' perspectives, as patients and/or as caregivers for hospitalised relatives.

BACKGROUND

Many studies that have examined patients' satisfaction with nursing care in Jordan and worldwide found high ratings of satisfaction with nursing care among patients. These ratings may be inflated because patients, as the recipients of care, are often unequipped to judge specific aspects of care, unless the patient is also a nurse.

METHODS

A descriptive cross-sectional design was used. Data were collected using the Patients Satisfaction with Nursing Care Quality Questionnaire. The total sample size was 231 registered nurses from eight hospitals in Jordan. All participating nurses had either experienced hospitalisation for a minimum of 24 hr for themselves or as caregivers for one of their close relatives, currently or within the last year.

RESULTS

The average age of participants was 31.7 (SD = 0.40) years. Most of the participants were female with <10 years of work experience. The average score for the level of satisfaction was 2.96 of 5, which reflects a moderate level of satisfaction with nursing care. None of the 19 items of the satisfaction scale exceeded the moderate level. The highest mean score of satisfaction level was 3.20 (SD = 1.17) for the skills and competence of nurses, while the lowest mean score was 2.68 (1.22) for the coordination of care after discharge.

CONCLUSION

Nurses as patients and/or caregivers evaluated the nursing care during their hospitalisation differently in comparison with public patients. The findings indicated that nurses perceived only moderate levels of satisfaction when undergoing experiences of hospitalisation.

RELEVANCE TO CLINICAL PRACTICE

The findings from this study may help nurses to become more alert for meeting the patients' needs as desired under the best practice.

The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction

BACKGROUND

Nurses' voluntary turnover is a worrying global phenomenon which affects service quality. Retaining nursing staff within a hospital is important to eliminate the negative influence of voluntary turnover on the quality of care and organisation costs.

OBJECTIVES

This research helps explain nurses' voluntary turnover by analysing the role of self-efficacy, agentic capacities, job satisfaction, and work engagement on hospital turnover intention, and to study the relationships between these variables and patient satisfaction.

SETTING AND PARTICIPANTS

This study gathered data from 194 nurses and 181 patients from 22 inpatient wards at two hospitals in southern Italy.

RESULTS

Correlation analysis revealed that job satisfaction, work engagement, self-efficacy and agentic capacities were positively interrelated and negatively correlated with turnover intention. Path analysis showed that self-efficacy, some agentic capacities (anticipation and self-regulation), job satisfaction, and work engagement had direct or indirect effects on nurses' turnover intention, and that job satisfaction exerted a stronger effect on turnover intention. Also, patient satisfaction was positively correlated with nurses' job satisfaction, work engagement, self-efficacy, self-regulation and anticipation and negatively correlated with nurses' turnover intention.

CONCLUSION

Results highlighted the importance of implementing actions (for example through feedforward methodology and the goal setting technique) to improve self-efficacy, self-regulation skill, work engagement and job satisfaction in order to reduce nurses' turnover intention and increase patient satisfaction with nursing care.

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.

Healthcare service quality model

Purpose

The purpose of this paper is to develop and test a multi-level healthcare service quality (HSQ) model in Jakarta, Indonesia.

Design/methodology/approach

The research used a quantitative research method. Data were collected via a survey with questionnaire. The respondents are 154 patients of a healthcare institution in Jakarta, Indonesia.

Findings

The research result shows a multi-level HSQ model. The HSQ model consists of three primary dimensions, namely, healthcare service outcome, healthcare service interaction, and healthcare service environment. Healthcare service outcome has three subdimensions, i.e. waiting time, medicine, and effectiveness. Healthcare service interaction has three dimensions, namely, soft interaction, medical personnel expertise, and hard interaction. Healthcare service environment has two dimensions, which are equipment condition and ambient condition.

Research limitations/implications

This research was only conducted in one healthcare institution in Jakarta, Indonesia. The data collection using convenience sampling method as well as the use of small sample size caused the limitation of the research results in representing across the customer of the healthcare institution. This study can be replicated with larger sample size and involving more healthcare institutions in order to examine the stability of the HSQ model.

Practical implications

Healthcare institution’s managers can use the HSQ model to monitor, measure, and improve their service quality.

Originality/value

There is a lack of research that develops and tests HSQ model based on multi-level approach in the context of developing country. This paper has fulfilled the gap.

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.

Construction and validation of the quality of oncology nursing care scale (QONCS)

Background

There is scarcity of questionnaires specifically on the quality of the nursing care provided to patients diagnosed with cancer. The available questionnaires have been developed without attributing a holistic approach to the care provided with important patient’s needs remaining without assessment. The main aim was to develop a self-administered cancer specific questionnaire exploring patients’ views on quality nursing care provided in oncology settings.

Methods

The development of the scale proceeded through three phases. As part of the first development phase areas of concern and items of interest were identified through a literature review. The second phase included a pilot study of the QONCS and a subsequent validation phase through a multicentre study in 3 hospitals, 4 departments and 418 patients diagnosed with cancer and receiving care as inpatients. The study was designed to select items, identify dimensions, measure reliability, content and construct validity.

Results

The QONCS consisted of 34 items. A factorial analysis grouped the items into five categories that define quality nursing care: a) Being supported and confirmed, b) Spiritual caring c) Sense of belonging, d) Being valued and e) Being respected. Cronbach’s alpha was 0.95 for the entire questionnaire. The factor solution explained 68.53% of the variance.

Conclusions

QONCS appears to measure with adequate reliability and validity the attributes of quality nursing care within the oncological settings and to patients with a variety of cancer diagnoses and at different phases of the cancer trajectory. The instrument is quick to disseminate and easy to complete, making it a suitable instrument for nursing professionals to evaluate patients’ self-perceived quality of nursing care as a mean to promote the quality of the care provided in oncological settings.

Cultural adaptation and psychometric evaluation of the Polish version of the Newcastle Satisfaction with Nursing Scale

INTRODUCTION

The paper presents the methods of cultural adaptation of the Newcastle Satisfaction with Nursing Scale (NSNS) to the conditions in Polish hospitals.

MATERIAL AND METHODS

The process of cultural adaptation of the research tool took into consideration an analysis of different equivalence levels, the translation procedure and the estimation of psychometric parameters. The Polish version of the NSNS questionnaire was correctly completed by 787 patients making up 59.36% of the total number of patients who received the scale.

RESULTS

The Polish version of the NSNS questionnaire was correctly completed by 787 patients making up 59.36% of the total number of patients who received the scale. Cronbach's α coefficient was 0.921 for the "experience" scale and 0.981 for the "satisfaction" scale. The values of Spearman's rank correlation coefficient were from 0.224 to 0.797 for "experience" and 0.815-0.894 for "satisfaction". All questionnaire items of the Polish NSNS version exerted a statistically significant influence on the total results of the scale (p = 0.0001).

CONCLUSIONS

The Polish NSNS version, similarly as the original version, can identify differences referring to "experience" and "satisfaction" with nursing care between the particular departments and between hospitals. The Polish NSNS version was conducted among patients during multicentre studies and it meets the criteria of functional, psychometric and façade equivalences.

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.

Instruments to measure patient experience of health care quality in hospitals: a systematic review protocol

BACKGROUND

Improving and sustaining the quality of care in hospitals is an intractable and persistent challenge. The patients' experience of the quality of hospital care can provide insightful feedback to enable clinical teams to direct quality improvement efforts in areas where they are most needed. Yet, patient experience is often marginalised in favour of aspects of care that are easier to quantify (for example, waiting time). Attempts to measure patient experience have been hindered by a proliferation of instruments using various outcome measures with varying degrees of psychometric development and testing.

METHODS/DESIGN

We will conduct a systematic review and utility critique of instruments used to measure patient experience of health care quality in hospitals. The databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information (Psych Info) and Web of Knowledge will be searched from inception until end November 2013. Search strategies will include the key words; patient, adult, hospital, secondary care, questionnaires, instruments, health care surveys, experience, satisfaction and patient opinion in various combinations. We will contact experts in the field of measuring patient experience and scrutinise all secondary references. A reviewer will apply an inclusion criteria scale to all titles and abstracts. A second reviewer will apply the inclusion criteria scale to a random 10% selection. Two reviewers will independently evaluate the methodological rigour of the testing of the instruments using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Disagreements will be resolved through consensus. Instruments will be critiqued and grouped using van der Vleuten's utility index. We will present a narrative synthesis on the utility of all instruments and make recommendations for instrument selection in practice.

DISCUSSION

This systematic review of the utility of instruments to measure patient experience of hospital quality care will aid clinicians, managers and policy makers to select an instrument fit for purpose. Importantly, appropriate instrument selection will provide a mechanism for patients' voices to be heard on the quality of care they receive in hospitals. PROSPERO registration CRD42013006754.

Adapting cognitive interviewing for nursing research

Cognitive interviewing (CI) has been used by instrument developers to examine how well an instrument generates the intended data when tested with prospective respondents. In using CI to test a new instrument to measure patients' perceptions of the quality of nursing care, the authors found challenges in applying a theory-based traditional CI approach derived from experimental psychology to more clinically oriented nursing research. The purposes of this article are to describe these challenges and the modifications of CI to capture the nursing care perspectives of hospitalized participants, and to present interpretive phenomenology as a theoretical orientation for clinically situated CI.

Risser patient satisfaction scale: a validation study in Greek cancer patients

Background

The current healthcare climate is characterized by a constant battle for the provision of quality care with limited resources and with patient satisfaction receiving increased attention, there is a need for reliable and valid assessment measures. This study describes the adaptation, testing and validation of the Risser Patient satisfaction Scale in an oncology care setting in Greece. The rationale for this study lies in the scarcity of such measures in the Greek language.

Methods

This is a test retest validation study in Greece. Data were collected from 298 hospitalized cancer patients. The validation methodology included the assessment of the item internal consistency, using the Cronbach alpha coefficient. The test-retest reliability was tested by the Kappa correlation coefficient.

Results

The scale demonstrated very good psychometric properties. The internal consistency of the instrument was good, Cronbach’s alpha was found to be 0.78 (p<0.001) and Kappa coefficient for reproducibility was found to be K=0.89 (95% CI: 0.83-0.91 p<0.0001).

Conclusion

The findings demonstrated strong agreement of the scale, suggesting that the Greek version offers substantial reliability. This study provides a valid and reliable tool to assess patient satisfaction in oncology settings. Means to monitor patient satisfaction, a key aspect of the policy agenda for quality care remain important for nurse leaders to develop better care in oncology settings.

Counselling for patients and family members: a follow-up study in the emergency department

Although the research indicates that patients and family members are not fully satisfied with the counselling they receive, little is known about the quality of counselling in more detail. The purpose of the study was to describe patients' and their family members' experiences about counselling in emergency department, and follow how these experiences possibly change after the educational intervention for the whole nursing staff of the ED ward. The pre-test-post-test follow-up design was implemented including online continuing education for ED staff. The data were collected via questionnaires from patients and their family members in two phases and analyzed statistically. After online education of staff, experiences of patients and family members concerning counselling were better than before the education. Especially, family members' satisfaction had increased. However, our results also indicated that patients and family members desire more information for example, regarding medications. Care practices had developed towards family-centeredness, which patients and family members appreciate. Online education proved also in some degree its usefulness in educating ED staff, by offering the same education to a staff which works in shifts. Furthermore, family presence and participation practices should be developed by offering possibilities for families to stay with each other on ED ward.

Patient satisfaction in home health care

AIMS AND OBJECTIVES

  To assess the current use of patient satisfaction measures in home health care and to examine the reliability and validity of current measures of patient satisfaction in home health care.

BACKGROUND

  Patient satisfaction has been one of the widely used measures in home health care as an indicator of quality of care. A few efforts have been made to develop psychometrically sound patient satisfaction scales for use in home health care.

DESIGN

  A critical review of the literature.

METHODS

  Electronic databases were systematically searched to identify the studies or publications that measured and addressed patient satisfaction and its measurement in home health care.

RESULTS

  The review of the literature showed that patient satisfaction measures have been used in the evaluation of care programmes including rehabilitation programmes, discharge and home follow-up programmes, care process and management practices. Also, patient satisfaction measures were used to evaluate new care protocols and treatments.

CONCLUSIONS

  Home healthcare agencies need valid and reliable patient satisfaction scales. Frameworks of patient satisfaction are still in their early developmental stage. Only some of the variables related to patient satisfaction are explained by many frameworks.

RELEVANCE TO CLINICAL PRACTICE

  Home healthcare mangers and researchers need to take in consideration the reliability and validity of measures and tools of patient satisfaction.

Measuring patient satisfaction with the Polish version of the Newcastle Satisfaction with Nursing Scale

The measurement of patients' satisfaction is increasingly becoming legal and ethical duty of healthcare providers worldwide. Till now, there were no validated, widely available Polish scales to assess patients' satisfaction with nursing care. The aim of this study was to assess the experiences and satisfaction with nursing care of patients hospitalized in surgical and nonsurgical wards in Poland using Polish version of the Newcastle Satisfaction with Nursing Scale. This is a multicentre, cross-sectional, descriptive study. Eight hospitals were qualified to participate in a convenience manner. The correlations between variables were analysed using the Mann-Whitney or the Kruskal-Wallis tests. In the case of a significant correlation, the Dunn's test was used to conduct multiple comparisons for the group of variables. A significance of α = 0.05 was assumed for the tests. A total 918 patients participated in the study, and 787 (85.72%) questionnaires were correctly filled out. The average result on the 'experience' scale was 73.22 (Me 73.07) and on the 'satisfaction' scale, 74.98 (Me 76.31). Education levels did not affect the experiences of nursing care levels p = 0.2204 and satisfaction with nursing care p = 0.1075. Patient age had a statistically significant impact on the results of the 'experiences of nursing care' scale p = 0.0005 and the 'satisfaction with nursing' scale p = 0.0194. The experiences of nursing care (p = 0.0002) and patients satisfaction (p = 0.0000) were significantly higher in surgical wards than in nonsurgical wards. The experiences of nursing care were significantly lower in the university hospital than in provincial hospitals (p = 0.0374) and district hospitals (p = 0.0183). A comparison of patient satisfaction with nursing in various hospitals shows that patients were most satisfied in district hospitals (average 78.10, Me 82.89), followed by provincial hospitals (average 72.11, Me 76.31) and the university hospital (average 70.64, Me 71.05).

Cross-cultural validation of a Patient Satisfaction with Interpersonal Relationship with Navigator measure: a multi-site patient navigation research study

BACKGROUND

Patient navigators are trained to help patients effectively access and use healthcare resources in order to facilitate timely completion of recommended cancer screening, diagnostic care, and treatment. Patient navigators provide logistic, instrumental, and psychosocial support to cancer patients. Yet few studies have examined patient-navigator relationships, particularly for Spanish-speaking patients with low English proficiency. We aimed to validate a Spanish version of the Patient Satisfaction with Interpersonal Relationship with Navigator (PSN-I-Sp) scale.

METHODS

We translated and back-translated the PSN-I into Spanish and administered the resulting PSN-I-Sp to 222 Spanish-fluent participants. We conducted a principal components analysis and assessed Cronbach's coefficient alpha (α) to evaluate the latent structure and the internal consistency of the PSN-I-Sp. We also completed correlation analyses to examine divergence and convergence of the PSN-I-Sp with the Spanish version of the Patient Satisfaction with Cancer-Related Care (PSCC-Sp) and the patients' demographics.

RESULTS

The principal components analysis revealed a one-dimensional PSN-I-Sp measure that explained 82.0% of the variance. The reliability assessment revealed high internal consistency (α = 0.97). The PSN-I-Sp demonstrated good face validity and adequate convergent and divergent characteristics as indicated by a moderate correlation with scores on the PSCC-Sp (all ps < 0.0001) and a non-statistically significant correlation with marital status (all p > 0.05).

CONCLUSION

The PSN-I-Sp is a valid and internally consistent measure of satisfaction with interpersonal relationship with a patient navigator for Spanish-speaking participants.

Psychometric development and reliability analysis of a patient satisfaction with interpersonal relationship with navigator measure: a multi-site patient navigation research program study

BACKGROUND

Patient navigation (PN) is a method for addressing racial-ethnic and socioeconomically based disparities in cancer-related care. Patient navigators provide logistic and emotional support to underserved patients to facilitate successful completion of diagnostic and treatment care. Yet, little is known about patient satisfaction with the relationship with a navigator due to a dearth of instruments measuring satisfaction.

OBJECTIVE

The objective of this study was to validate the Patient Satisfaction with Interpersonal Relationship with Navigator (PSN-I) measure for patients undergoing diagnostic and/or therapeutic cancer care.

METHODS

We administered the PSN-I to 783 participants from the nine different sites of the National Cancer Institute sponsored Patient Navigation Research Program. We evaluated the latent structure and internal consistency of the PSN-I using principal components analysis (PCA) and Cronbach coefficient alpha (α), respectively. We used correlation analyses to examine divergence and convergence of the PSN-I with the Patient Satisfaction with Cancer-related Care (PSCC), the Rapid Estimate of Adult Literacy in Medicine (REALM) Long Form, and patients' demographics.

RESULTS

The PCA revealed a coherent set of items that explicates 76.6% of the variance in PSN-I. Reliability assessment revealed high internal consistency (α ranging from 0.95 to 0.96). The PSN-I had good face validity as well as convergent and divergent validities as indicated by moderate correlations with score on the PSCC (all ps < 0.0001) and non-significant correlations with primary language, marital status, and scores on the REALM Long Form (all ps > 0.05).

CONCLUSION

The PSN-I is a valid and suitable measure of satisfaction with a patient navigator for the present sample.

Raising nurses' job satisfaction through patient-oriented perception and organizational citizenship behaviors

BACKGROUND

Because nurses deliver care to patients on behalf of hospitals, hospitals have to enhance first-line nurses' patient-oriented perception and spontaneous organizational citizenship behaviors for the sake of higher patient satisfaction and better patient care.

OBJECTIVES

The purpose of this study was to investigate how patient-oriented perception among nurses could affect their organizational citizenship behaviors and job satisfaction.

METHODS

SPSS 12.0 and Amos 7.0 (structural equation modeling) statistical software packages were used for data analysis and processing. Of the 500 questionnaires distributed, 232 valid ones were collected, with a valid response rate of 46.4%.

RESULTS

Nurses' patient-oriented perception has a positive influence on organizational citizenship behaviors (γ11 = .795, p < .05), and their organizational citizenship behaviors (β21 = .681, p < .05) have a positive influence on job satisfaction.

DISCUSSION

Nurses' patient-oriented perception has the most positive influence on interpersonal altruistic behavior but the least positive influence on organizational public welfare behavior.

What does quality care mean to nurses in rural hospitals?

AIM

This paper is a report of a study conducted to answer the question: 'How do rural nurses and their chief nursing officers define quality care?'

BACKGROUND

Established indicators of quality care were developed primarily in urban hospitals. Rural hospitals and their environments differ from urban settings, suggesting that there might be differences in how quality care is defined. This has measurement implications.

METHODS

Focus groups with staff nurses and interviews with chief nursing officers were conducted in 2006 at four rural hospitals in the South-Eastern United States of America. Data were analysed using conventional content analysis.

FINDINGS

The staff nurse and chief nursing officer data were analysed separately and then compared, exposing two major themes: 'Patients are what matter most' and 'Community connectedness is both a help and a hindrance'. Along with conveying that patients were the utmost priority and all care was patient-focused, the first theme included established indicators of quality such as falls, pressure ulcers, infection rates, readmission rates, and lengths of stay. A new discovery in this theme was a need for an indicator relevant for rural settings: transfer time to larger hospitals. The second theme, Community Connectedness, is unique to rural settings, exemplifying the rural culture. The community and hospital converge into a family of sorts, creating expectations for quality care by both patients and staff that are not typically found in urban settings and larger hospitals.

CONCLUSION

Established quality indicators are appropriate for rural hospitals, but additional indicators need to be developed. These must include transfer times to larger facilities and the culture of the community.

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.

Point of care documentation impact on the nurse-patient interaction

Electronic medical record (EMR) point-of-care (POC) documentation in patients' rooms is a recent shift in technology use in hospitals. POC documentation reduces inefficiencies, decreases the probability of errors, promotes information transfer, and encourages the nurse to be at the bedside. However, EMR POC documentation has the potential to distract the nurse's attention away from the patient and compromise the nurse-patient interaction.

Measuring patient satisfaction in oncology units: interview-based psychometric validation of the 'Comprehensive Assessment of Satisfaction with Care' in Greece

The aim of this study is to validate the 'Comprehensive Assessment of Satisfaction with Care' (CASC) in Greece. A total of 84 cancer inpatients met the inclusion criteria. Of them, 32 (38%) refused to participate, leading to a 62% response rate. For the translation of the scale, we followed the European Social Survey procedures encompassing four stages. Interview-based administration was chosen in order to obtain more reliable results in terms of time of assessment, response rate and data omission. Multitrait scaling analyses along with construct, scale-discriminant validity and reliability tests were carried out to establish the Greek version of CASC. Scales on doctors' technical skills, care organization and general satisfaction were in support of the European structure. In general, Doctors' scales had the anticipated structures. Most variations were noticed in the Nurses' scales, leading to a revised item-scale formation, and may reflect different importance patients attribute to various aspects of health care in different countries. Greek version of CASC may be a practical, valid and reliable tool for assessing patient satisfaction in oncology settings. Cross-cultural validation of the existing tools is necessary to enable comparison between various countries and settings. Interview-based administration should be considered when validating patient satisfaction instruments.

Call bell requests, call bell response time, and patient satisfaction

Based in the center of nursing activity, the nurse call system has potential to gather basic data such as the number of calls and the response time. Analyzing this information may shed light on performance and patient satisfaction. This study used a correlational design to examine results from a patient satisfaction survey administered at discharge in relation to the number of call bell requests from the patient's room and call bell response time.