In the eyes of the beholder: Shared and unique constructs of quality of care by nurses and patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/147437
Type:
Presentation
Title:
In the eyes of the beholder: Shared and unique constructs of quality of care by nurses and patients
Abstract:
In the eyes of the beholder: Shared and unique constructs of quality of care by nurses and patients
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Board, Ruth, PhD
P.I. Institution Name:Wayne State University
Title:Assistant Professor
Appropriate measurements of quality of care are lacking in

population-specific specialty hospital units. The purpose of

this study was the identification of constructs of care relevant

to the assessment of quality of care for women hospitalized

during pregnancy. Research questions were (1) What is the factor

structure for the construct of quality as seen by nurses and

patients together in an antenatal hospital setting? (2) What is

the factor structure for the construct of quality of care as seen

by patients in an antenatal hospital setting and (3) What is the

factor structure for the construct of quality as seen by nurses

in an antenatal hospital setting? The conceptual base was the

relationship of perceptual differences in cognition to varying

levels of expertise (Drefus,1979, Kaplan, 1977). Cognitive

distinctions between experts and novices have been shown across

disciplines (Benner, 1982; Kaplan and Kaplan, 1982; Larkin, 1983).

Using a convenience sample (n=430), registered nurses (n=171) and

patients (n=259) in eight hospitals rated the importance of

selected nursing activities to the construct of quality. The

Quality of Care in Hospitals During Pregnancy (Q.C.H.P.) rating

Instrument is a probabilistic, monotonic, summated 55 item scale

(a=.94). Nurses were approached as a group and patients

individually for data collection. Using confirmatory and

exploratory factor analysis, a three dimensional model was

selected for the shared construct, based on conceptual clarity,

explained variance, and degree of internal consistency. Items

were reduced for clinical feasibility, retaining items with high

inter-item and item-total correlation and high variance. Using

principal axis factor analysis, three dimensions emerged:

Enabling Functions (a=.90), Technical Functions (a=.72), and

Environment (Spearman-Brown inter-item r=.80). The same

dimensions resulted when items were factored for each group

alone, with reliability coefficients between .78 and .90, except

for the Technical Dimension, demonstrating a=.67 for patients and

a=.64 for nurses. The Technical dimension was rated higher in

importance than other dimensions by both groups (p=.000). These

dimensions represent a shared construct of quality of care in

this sample of nurses and patients. The technical dimension,

while rated highest by both groups, is least reliable when

considered by either group separately. The Q.C.H.P. is being

tested further for the valid assessment of quality in high risk,

antepartum hospital care.



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleIn the eyes of the beholder: Shared and unique constructs of quality of care by nurses and patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/147437-
dc.description.abstract<table><tr><td colspan="2" class="item-title">In the eyes of the beholder: Shared and unique constructs of quality of care by nurses and patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Board, Ruth, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Wayne State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr><td colspan="2" class="item-abstract">Appropriate measurements of quality of care are lacking in<br/><br/>population-specific specialty hospital units. The purpose of<br/><br/>this study was the identification of constructs of care relevant<br/><br/>to the assessment of quality of care for women hospitalized<br/><br/>during pregnancy. Research questions were (1) What is the factor<br/><br/>structure for the construct of quality as seen by nurses and<br/><br/>patients together in an antenatal hospital setting? (2) What is<br/><br/>the factor structure for the construct of quality of care as seen<br/><br/>by patients in an antenatal hospital setting and (3) What is the<br/><br/>factor structure for the construct of quality as seen by nurses<br/><br/>in an antenatal hospital setting? The conceptual base was the<br/><br/>relationship of perceptual differences in cognition to varying<br/><br/>levels of expertise (Drefus,1979, Kaplan, 1977). Cognitive<br/><br/>distinctions between experts and novices have been shown across<br/><br/>disciplines (Benner, 1982; Kaplan and Kaplan, 1982; Larkin, 1983).<br/><br/>Using a convenience sample (n=430), registered nurses (n=171) and<br/><br/>patients (n=259) in eight hospitals rated the importance of<br/><br/>selected nursing activities to the construct of quality. The<br/><br/>Quality of Care in Hospitals During Pregnancy (Q.C.H.P.) rating<br/><br/>Instrument is a probabilistic, monotonic, summated 55 item scale<br/><br/>(a=.94). Nurses were approached as a group and patients<br/><br/>individually for data collection. Using confirmatory and<br/><br/>exploratory factor analysis, a three dimensional model was<br/><br/>selected for the shared construct, based on conceptual clarity,<br/><br/>explained variance, and degree of internal consistency. Items<br/><br/>were reduced for clinical feasibility, retaining items with high<br/><br/>inter-item and item-total correlation and high variance. Using<br/><br/>principal axis factor analysis, three dimensions emerged:<br/><br/>Enabling Functions (a=.90), Technical Functions (a=.72), and<br/><br/>Environment (Spearman-Brown inter-item r=.80). The same<br/><br/>dimensions resulted when items were factored for each group<br/><br/>alone, with reliability coefficients between .78 and .90, except<br/><br/>for the Technical Dimension, demonstrating a=.67 for patients and<br/><br/>a=.64 for nurses. The Technical dimension was rated higher in<br/><br/>importance than other dimensions by both groups (p=.000). These<br/><br/>dimensions represent a shared construct of quality of care in<br/><br/>this sample of nurses and patients. The technical dimension,<br/><br/>while rated highest by both groups, is least reliable when<br/><br/>considered by either group separately. The Q.C.H.P. is being<br/><br/>tested further for the valid assessment of quality in high risk,<br/><br/>antepartum hospital care.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T09:32:24Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:32:24Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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