Quality nursing care for hospitalized patients with advanced illness: Concept development

Abstract

The quality of nursing care as perceived by hospitalized patients with advanced illness has not been examined. A concept of quality nursing care for this population was developed by integrating the literature on constructs defining quality nursing care with empirical findings from interviews of 16 patients with advanced illness. Quality nursing care was characterized as competence and personal caring supported by professionalism and delivered with an appropriate demeanor. Although the attributes of competence, caring, professionalism, and demeanor were identified as common components of quality care across various patient populations, the caring domain increased in importance when patients with advanced illness perceived themselves as vulnerable. Assessment of quality nursing care for patients with advanced illness needs to include measures of patient perceptions of vulnerability.

A qualitative study about palliative care patients’ experiences of comfort: Implications for nursing diagnosis and interventions

“…The sense of vulnerability caused by disability and dependence plays an important role in patient self-control, as reported by other authors in previous research. [31,32] Comfort is perceived as a holistic experience, and psycho-spiritual dimension is connected to physical, sociocultural and, also, environmental factors.…”

Functional decline and satisfaction with nursing care among older hospitalized adults

“…Assessing patient satisfaction with nursing care is limited by at least two issues: these assessments are subjective responses, and scores among instruments have been inconsistent. However, the satisfaction scale accounted for patients' expectations, as is the recommendation of research in the field . Lastly, the patient satisfaction survey in this study was conducted by interviewers who were not employed by the hospital and who had established a relationship with the patient through the repeated interviews during this longitudinal study, thereby avoiding the bias of obtaining more positive responses for fear of repercussions by the nurses.…”

Adapting Cognitive Interviewing for Nursing Research

“…There are a number of quality measures, such as the Press Ganey patient survey and data collected for the National Database of Nursing Quality Indicators®, to assess structures and outcomes of quality nursing care or patient satisfaction, but only a limited number of scales assess the quality of the nursing care process, and these focus on specific populations such as patients with infectious diseases, acute illness, or cancer (Lynn, McMillen, & Sidani, ; Radwin, Alster, & Rubin, : Wilde, Larrson, Larsson, & Starrin, ). Quality measures for the process component of care from the perspective of patients with advanced illness are lacking, and the QNCI© was developed to fill this gap (Izumi, Baggs, & Knafl, ). While the process of developing the QNCI© is discussed elsewhere (Izumi, Knafl, & Baggs, ), a brief description of the QNCI© follows.…”