Chou Shu-Chiung, Boldy Duncan P, Lee Andy H
Center for Quality of Care Research and Education, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Gerontologist. 2003 Aug;43(4):459-72. doi: 10.1093/geront/43.4.459.
The aim of this study was to identify the important factors influencing residents' satisfaction in residential aged care and to provide a better understanding of their interrelationships.
A cross-sectional survey design was used to collect the required information, including resident satisfaction, resident dependency levels, and staff satisfaction. A stratified random sampling approach was utilized to select facilities. All residents satisfying the selection criteria (i.e., understand English, be sufficient cognitive competence, have a sufficient energy level to participate in the survey, and live in the facility for more than 4 weeks) and all care staff were invited to participate. A total of 996 residents and 895 staff from 62 facilities (36 hostels and 26 nursing homes) provided the required data. Structural equation modeling was used to examine the interrelationships among three sets of contributing factors, related to the facility, staff and residents, and resident satisfaction components, separately for nursing home and hostel residents.
Overall fits of both nursing home and hostel models were satisfactory. This study has revealed that staff satisfaction plays a crucial and central role in determining resident satisfaction in nursing homes, whereas it has less impact in hostels. The provision of more care hours has only a small, yet positive, impact on resident satisfaction. Larger facility size has a negative impact on resident involvement. Older residents were found to be more satisfied with staff care.
The results provide a comprehensive understanding of what influences resident satisfaction. By accounting for important factors identified by residents, a resident-focused care model can be developed and implemented, leading to better service for aged care residents.
本研究旨在确定影响老年护理机构居民满意度的重要因素，并更好地理解这些因素之间的相互关系。
采用横断面调查设计来收集所需信息，包括居民满意度、居民依赖程度和员工满意度。利用分层随机抽样方法选择机构。邀请所有符合选择标准的居民（即懂英语、有足够的认知能力、有足够的精力参与调查且在机构居住超过4周）和所有护理人员参与。来自62个机构（36个宿舍型和26个养老院）的996名居民和895名员工提供了所需数据。使用结构方程模型分别研究养老院和宿舍型机构中与机构、员工和居民相关的三组影响因素以及居民满意度各组成部分之间的相互关系。
养老院和宿舍型机构模型的整体拟合度均令人满意。本研究表明，员工满意度在决定养老院居民满意度方面起着关键核心作用，而在宿舍型机构中的影响较小。提供更多护理时长对居民满意度仅有微小但积极的影响。机构规模较大对居民参与度有负面影响。发现年长居民对员工护理更满意。
研究结果全面揭示了影响居民满意度的因素。通过考虑居民确定的重要因素，可以制定并实施以居民为中心的护理模式，从而为老年护理居民提供更好的服务。
