Validating a measure of patient satisfaction with community nursing services

Abstract

This study describes an attempt to develop and validate a measure of patient satisfaction with a district nursing service in a south-west London inner city borough. The patients were 126 house-bound elderly people living alone and dependent upon district nursing services. The patient satisfaction measure was derived from an earlier North American questionnaire assessing satisfaction with hospital nursing services. The results indicated that the measure chosen reflected multiple dimensions of patient satisfaction that were differentially sensitive to factors such as the degree of personalization of care and the impact of disruptions to the service. Scores on the questionnaire were also related in a systematic way with the number and type of spontaneous comments made about the service. Overall the results suggest that self-report questionnaire measures of satisfaction can be devised that are sensitive to variations in the style and level of community nursing offered to older house-bound people.

Development and Psychometric Testing of the Relational Care Scale

“…As predicted, a positive correlation between the RCS and the Relationship VAS existed; that is, residents who rated their care providers as reliable and empathic also rated their relationships as close. The positive association between close relationships and care providers who relate well is consistent with Nussbaum's (1991) and Gilleard and Reed's (1998) findings. Nussbaum proposed that the talk within the nurse-resident interaction reveals the nature and the closeness of the relationship and suggested that researchers focus not only on the institutional level (i.e., skill mix, care models, number of personnel) when evaluating quality of care, but also on the relational level.…”

“…Understanding the factors, such as workload, that prevent care providers from relating well to persons during care delivery is crucial to any attempt to change the current relational care provided to residents in these environments. Relationships between increased staff-resident ratios and resident dissatisfaction with care are consistent with Gilleard and Reed's (1998) results. These investigators found that following a reduction in services, patients reported that nurses seemed busier and had less time than before.…”

“…The reasoning was that staff cannot spend the same amount of quality time relating with residents in the evening because of lower staffing levels. Gilleard and Reed (1998) concur and found that following a reduction in staff, residents show a decline in their level of satisfaction with the personal domains of nursing care. Twenty participants rated the staff who cared for them on days, and the other 52 rated the staff who cared for them on evenings.…”

“…It was hypothesized that the RCS composite score would moderately correlate with the Relationship VAS score because they were measuring a similar construct. Evidence exists that a positive care provider-resident relationship is associated with staff relating well to the resident (Gilleard & Reed, 1998). Pearson's correlation coefficient was used to examine this association.…”

“…Resident outcomes expected to be influenced when care providers relate well to residents in LTC include a closer resident-care provider relationship (Gilleard & Reed, 1998;Winnicott, 1970), improved quality of care (Hartrick, 1997), and enhanced resident wellbeing and life satisfaction (Agich, 1990;Huss et al, 1988;Nunley et al, 2000;Winnicott, 1970).…”