患者对护理质量的认知与三个因素之间的关系：护理人员工作满意度、组织特征和患者年龄。
The relationship between patients' perceptions of care quality and three factors: nursing staff job satisfaction, organizational characteristics and patient age.
作者信息
Kvist Tarja, Voutilainen Ari, Mäntynen Raija, Vehviläinen-Julkunen Katri
机构信息
Department of Nursing Science, University of Eastern Finland, P,O, BOX 1627, FI-70211 Kuopio, Finland.
出版信息
BMC Health Serv Res. 2014 Oct 18;14:466. doi: 10.1186/1472-6963-14-466.
BACKGROUND
The relationship between nurses' job satisfaction and their perceptions of quality of care has been examined in previous studies. There is little evidence, however, about relationships between the job satisfaction of nursing staff and quality of care perceived by the patients. The aim of this study was to analyze, how the job satisfaction of nursing staff, organizational characteristics (hospital and unit type), and patients' age relate to patients' perceptions of the quality of care.
METHODS
The study was cross-sectional and descriptive, based on a secondary analysis of survey data acquired during the At Safe study in Finland. The study included 98 units at four acute care hospitals between autumn 2008 and spring 2009. The participants were 1909 patients and 929 nursing staff. Patients' perceptions of quality of care were measured using the 42-item RHCS questionnaire. Job satisfaction of nursing staff was measured with the 37-item KUHJSS scale. Statistical analyses included descriptive statistics, principal component analysis, t-tests, analysis of variance, linear regression, and multivariate analysis of variance.
RESULTS
Patients' perceptions of overall quality of care were positively related to general job satisfaction of nursing staff. Adequate numbers of staff appeared to be the clearest aspect affecting quality of care. Older patients were more satisfied with staff number than younger patients. Patients cared for in outpatient departments felt more respected than patients in wards, whereas patients in wards reported better care of basic needs (e.g., hygiene, food) than outpatients.
CONCLUSIONS
The evaluation of resources by nursing staff is related to patients' perceptions of the adequacy of nursing staff levels in the unit. The results emphasize the importance of considering patients' perceptions of the quality of care and assessments by nurses of their job satisfaction at the hospital unit level when evaluating quality of care.
背景
以往研究探讨了护士工作满意度与其对护理质量认知之间的关系。然而，关于护理人员工作满意度与患者所感知的护理质量之间的关系，证据较少。本研究旨在分析护理人员的工作满意度、组织特征（医院和科室类型）以及患者年龄如何与患者对护理质量的认知相关。
方法
本研究为横断面描述性研究，基于对芬兰“At Safe”研究期间收集的调查数据进行二次分析。研究纳入了2008年秋季至2009年春季期间四家急症医院的98个科室。参与者为1909名患者和929名护理人员。使用包含42个条目的RHCS问卷测量患者对护理质量的认知。用包含37个条目的KUHJSS量表测量护理人员的工作满意度。统计分析包括描述性统计、主成分分析、t检验、方差分析、线性回归和多变量方差分析。
结果
患者对整体护理质量的认知与护理人员的总体工作满意度呈正相关。充足的工作人员数量似乎是影响护理质量最明显的方面。老年患者对工作人员数量的满意度高于年轻患者。在门诊部接受护理的患者比病房患者感觉更受尊重，而病房患者报告其基本需求（如卫生、饮食）的护理比门诊患者更好。
结论
护理人员对资源的评估与患者对科室护理人员水平充足性的认知相关。研究结果强调了在评估护理质量时，考虑患者对护理质量的认知以及护士对其在医院科室层面工作满意度评估的重要性。
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