MERESUM JURNAL KEPERAWATAN “PATIENT EXPERIENCES OF

CARING AND PERSON-CENTREDNESS ARE ASSOCIATED WITH

PERCEIVED NURSING CARE QUALITY”

BAHASA INGGRIS DALAM KEPERAWATAN

Oleh:

Rimanda Safitri Dewi 162310101044

Indra Setiawan 162310101207

Risa Idamanira Putri L. 172310101095

Aulia Nindita Sari 172310101096

Riky Ahmad Fahrezi 172310101097

PROGRAM STUDI SARJANA KEPERAWATAN

FAKULTAS ILMU KEPERAWATAN

UNIVERSITAS JEMBER

2018
Patient Experiences of Caring and Person-Centredness are Associated with Perceived
Nursing Care Quality

Quality in hospital settings is affected not only by the quality of technical care
received but also by the quality of the interpersonal relationships and the quality of the
practice environment. Evidence directly links positive patient experiences with
improved patient safety, clinical effectiveness, and better health outcomes. Patient
experience is widely recognized as a core component of a quality healthcare system.
Self-reported patient experiences have had limited attention in conceptualizations of
healthcare quality as described in policy, national standards, and in health and nursing
practice. The impact of central nursing concepts such as caring and person-centredness
on patient ratings of nursing care quality in the acute-care context is largely unknown.
This study explores the extent to which patient ratings of perceived caring and person-
centredness are associated with perceived nursing care quality in an acute hospital
sample of inpatients. The results indicate that the caring behaviours of staff and the
extent to which the ward was perceived as being person-centred were significantly
associated with and accounted for more than half of the total variance in nursing care
quality as perceived by patients.

The study participants were recruited from 13 inpatient wards at a metropolitan

tertiary acute-care hospital in Victoria, Australia and last during 2 weeks in December
2012. To be eligible for this study, patients had to be admitted to the wards during the
time of data collection, be aged above 18 years, literate in English and able to consent
to and participate in data collection. The study survey included demographic data, such
as age, gender, marital status, education, and employment. In addition, four established
self-report measures were used to explore the research questions, namely the Caring
Behaviours Inventory, the Person-centred Climate Questionnaire (PCQ), the SF-36,
and the Distress thermometer.
 The six-item version of the Caring Behaviours Inventory was included to
measure the extent to which patients’ perceived caring behaviours in nursing staff. The
Person-centred Climate Questionnaire (PCQ-S) was included to measure to what extent
patients experienced care as being person-centred and focussing on their psychosocial
needs. The SF-36 was included to evaluate participants’ self-reported health. The
‘distress thermometer’ was included to assess perceived distress among participating
patients. The sampling method used, the way the questionnaire was administered, and
the single site for data collection are some of the limitations of this study. Therefore,
the results of this study are only valid for this population of English-speaking,
Australian acute hospital inpatients and other populations need additional studies.

Descriptive statistics were used to explore sampling characteristics, and the

Pearson product moment correlation coefficient was used to explore the strength of
associations between perceived nursing care quality, caring, and person-centredness.
Hierarchical linear regression analysis was conducted to explore the extent to which
the total score of ‘caring’ and ‘person-centredness’ could explain the variation in the
dependent variable ‘nursing care quality’. Correlation coefficients of > 0.5 were
considered high and P-values of 0.05 or less were considered significant. All statistical
analyses were performed using SPSS Statistics 21.0. From a total of 528 patients
admitted to the participating wards during the time of data collection, 210 surveys were
returned (40% response rate). Most of the perceived staff caring behaviours were
highly associated with nursing care quality, as evidenced by a majority of the bivariate
correlations being significant and exceeding the pre-set cut-off of r > 0.5. Furthermore,
most variables relating to perceived person-centredness was also highly associated with
nursing care quality as perceived by patients, as evidenced by significant and high (r >
0.5) correlation coefficients. The confounding variables contributed to 4% of the
variance in nursing care quality. The unique contribution of person-centredness (P <
0.01) and caring (P = 0.05) was significant and borderline significant with person-
centredness (0.65) having a higher contribution to perceived nursing care quality
compared with caring (0.15). Thus, the perceived person-centredness and caring
contributed to explain 53% of the variance in the extent to which patient perceived
nursing care quality when confounding factors h and place of care were accounted for.

The findings indicate that the perceived caring behaviours of staff and the extent
of ward environment was perceived as being person-centred, accounted for more than
half of the total variance in nursing care quality. These findings suggest patient-centred
information and patient experience ratings have an important role in quality and safety
assessment, management and improvement for health services and nursing care. The
data showed that the aspects most highly correlated to perceived nursing care quality
were perceptions of receiving the best possible care from knowledgeable staff, as well
as staff taking the time to make themselves available and open for communication with
patients. The data also showed that the aspects relating to the physical environment of
the ward, for example, the extent to which the ward was neat and clean, also were
highly correlated to perceived nursing care quality. Thus, using the environment as a
nursing intervention may have the potential to maximize patient perceptions of quality
in nursing care. Also, the concept of caring surfaced as highly correlated to perceived
quality which empirically confirms previous theoretical conceptualizations of caring as
being the interpersonal quality marker of nursing care through its attributes of
manifesting expert nursing practice, interpersonal sensitivity and the creation of
intimate relationships.

Patients’ self-report ratings of caring and person-centredness were highly

associated with patient ratings of nursing care quality at an Australian tertiary acute
hospital. Patient experiences of the extent to which wards and staff manifest caring and
person-centredness seem to have an influential role in the extent to which patients
experience the quality of nursing care. This implies that knowledgeable and
communicable staff, timeliness of assistance and environmental support stands out as
most significantly related to patient perceived nursing care quality and can have a
significant impact on practice.