IMPORTANT ATTRIBUTES OF QUALITY HEA...

IMPORTANT ATTRIBUTES OF QUALITY HEALTH CARE: CONSUMER PERSPECTIVES M H Oermann, T Templine Journal of Nursing Scholarship Vol 32 no 2 (1998) 167-172

Personnel at contemporary health care agencies are identifying patient consequences to evaluate services and patient care. This research focuses forward consumer perspectives of high quality health care. Consumer perspectives or expectations have been set to be based on demographic characteristics, health care experiences, and specific disturbs related to consumers' unique health point in disputes Further, patients evaluate their experiences by way of comparing their expectations to actual ends Satisfaction occurs when events match expectations. The design of this research was to allow consumer to identify important attributes of quality health and nursing care and to examine the relationship of consumer perspectives to health status and fix uponed demographic variables.

process and sample. This exploratory application of mind examined a convenience sample of 239 health care consumer of which 50% were recruited from abiding-places in neighborhoods of a large metropolitan area (ie, urban and suburban) in the Midwest, and 50% were recruited from waiting steads of clinics in the same neighborhoods. These participants included 149 women (631%) and 87 men (369%) These inflection for sex totals equal 236, whereas previously stated the sample size was 239 This discrepancy was not addressed in the article. The age range varied from 18 to 92 years of age. The mean age was 508 years. One-half of the enthralls were married. Although half of the participants had a high educate diploma, education levels ranged from les than high sect to post-graduate education. Participants included 163 (712%) Caucasians and 66 (288%) African Americans. This totals 229 The ethnicity of the remainder of the participants was not identified.

Participants were asked to completed a SF-36 Survey that measured health status in eight general areas, including

* physical function,

* part limitation due to physical health problems

* bodily pain,

* general health,

* vitality (ie, vigor fatigue),

* social functioning,

* part limitations due to emotional enigmas and

* mental health.

Additionally, a Quality Health Care Questionnaire (QHCQ) was given to the participants. The investigators cause to growed this instrument, which included demographic information and 27 attributes of health care and nursing quality. Participants complet the QHCQ based forward a Likert-type scale--rating the importance of each attribute forward a scale from one (ie, not at all important) to five (ie, self-same important). This tool was evolveed from the literature regarding health care quality and research forward consumers' perspectives of quality care, as well as research about patient satisfaction with nursing care. A factor analysis with Eigenvalues greater than united resulted in six factors, including medical care, teaching by the agency of the nurse, provider competence, choice of provider, nurse-patient interaction, and appointment convenience. Teaching by the agency of the nurse included such items as having a feed at the breast teach about illness, medication, and treatment.

Findings. A rating of the 27 items showed attributes of health and nursing care that participants judgeed important. These attributes included understanding physicians' explanations, having access to specialists when necessary, having the opportunity to communicate with physicians, being included in making health care decisions, and having diagnostic ordeals performed for early identification of diseases.

The chiefly important indicators of quality nursing care included

* being cared for according to nurses who are up-to-date and well informed;

* being able to communicate with the nurse;

* spending enough time with the nurture and not feeling rushed during the visit; and

* having the encourage teach about illnesses, medications, and treatments.

Interestingly, replys differed significantly between these sampled Caucasians and African Americans. African Americans rated medical care as les important than Caucasians (F [1229] = 995 P [is les than] 01); however, they rated teaching at the nurse as significantly more important (F [1229] = 677 P [is les than] 01)

Participants with a number of chronic illnesses rated the importance of teaching from the nurse (r = 25 P [is les than] 001) choice of provider (r = 24 P [is les than] 001) and convenience of appointments (r = 0145 P = 03) as important attributes of quality care. Additional findings showed that participants with les education and lower incomes rated teaching on the nurse as more important in their care than those with higher education and incomes.

Discussion. The researchers believe the findings from this subject of attention are consistent with findings from other research exploring ambulatory care. Attributes of importance have included access to care, coordination of services, education, being treated with defer to and processes of care (eg waiting times for appointments); however, not many previous studies have examined the importance of nursing care in participants' views of quality. This cogitation shows it is important to be cared for by means of nurses who are up-to-date and well informed and have the ability to communicate in an unhurried atmosphere conducive to effective teaching. The close attention also shows that patients who were not well educated build nurse information more beneficial than participants with greater education.