Person-centered Care and Nursing Service Quality of Nurses in Long-term Care Hospitals

Hae Sagong; Ga Eon Lee

doi:10.12799/jkachn.2016.27.4.309

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Original Article
Person-centered Care and Nursing Service Quality of Nurses in Long-term Care Hospitals: Hae Sagong, Ga Eon Lee; Journal of Korean Academy of Community Health Nursing 2016;27(4):309-318.
DOI: https://doi.org/10.12799/jkachn.2016.27.4.309
Published online: December 31, 2016

¹Gwangan Chamsarang Long-term Care Hospital, Busan, Korea.

²Department of Nursing, Dong-A University, Busan, Korea.

• Received: May 30, 2016 • Revised: October 27, 2016 • Accepted: October 29, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract

Abstract

Purpose
This study investigated the correlation between person-centered care (PCC) and nursing service quality of nurses in long-term care hospitals.
Methods
The subjects were 114 nurses working in 8 long-term care hospitals. Instruments for evaluating PCC and nursing service quality were used. The data were analyzed by descriptive statistics, two samples-test, one-way ANOVA, Pearson's correlation and Multiple regression.
Results
The mean of PCC was 3.25±0.45 out of 5 and the nursing service quality was 3.87±0.40. There were significant differences in PCC in terms of age and income satisfaction, the application of their opinions, the satisfaction of hospital managers, administrators and nurse managers. There were significant differences in nursing service quality according to age, position, the satisfaction of hospital managers, administrators and nurse managers. Nurses' PCC showed a significant positive correlation with nursing service quality. Factors influencing nursing service quality included PCC, their position and age and the most influencing one was PCC.
Conclusion
This study suggests that the PCC is the strongest affecting element to the quality of nursing service in long-term care hospitals. Therefore, the strategies to improve the practice of person-centered care should be carried out to enhance the quality of nursing service.
Key Words: Long-term care; Patient-centered care; Nursing services; Quality of health care

Table 1

Person-centered Care of Participants

Factors	Items	M±SD (Sum±SD)
Personalizing care	․ We often discuss how to give person-centered care	3.61±0.78
	․ We have formal team meetings to discuss resident’s care	2.49±1.07
	․ The life history of the residents is formally used in the care plans we use	3.27±0.84
	․ The quality of the interaction between staff and residents is more important than getting the tasks done	3.37±0.74
	․ We are free to alter work routines based on residents’ preferences	3.55±0.74
	․ Residents are offered the opportunity to be involved in individualized everyday activities	2.95±0.84
	․ Assessment of residents’ needs is undertaken on a daily basis	3.41±0.80
	Subtotal	3.24±0.54 (22.66±3.81)
Organization and environmental support	․ I simply do not have the time to provide person-centered care^†	3.37±0.80
	․ The environment feels chaotic^†	3.69±0.82
	․ We have to get the work done before we can worry about a homelike environment^†	3.19±0.83
	․ This organization prevents me from providing person-centered care^†	3.30±0.95
	․ It is hard for residents in this facility to find their way around^†	3.58±0.93
	․ Residents are able to access outside space as they wish	2.53±1.04
	Subtotal	3.28±0.54 (19.66±3.25)
Total		3.25±0.45 (42.32±5.86)

^†Reverse coding.

Table 2

Nursing Service Quality of Participants

Factors	Items	M±SD
Tangibility	․ Concerning about hygiene of the pt's room	4.00±0.58
	․ Providing comfortable environment at resting	3.54±0.71
	․ Providing nursing service in good facilities	3.11±0.85
	․ Providing good feeling by nurse's good-looking	3.73±0.61
	Subtotal	3.59±0.51
Reliability		3.72±0.56
	․ Giving information & getting permission	3.88±0.63
	․ Giving concern & solving pt's problems	4.00±0.58
	․ Being reliable as nurse	3.87±0.51
	Subtotal	3.87±0.45
Responsiveness	․ Immediately correcting environment problem of pt's room	3.97±0.57
	․ Helping pt willingly whenever help is needed	4.09±0.54
	․ Providing nursing service immediately even if too much busy	3.84±0.63
	․ Providing medication & treatment at correct time	4.23±0.52
	Subtotal	4.03±0.45
Assurance	․ Possessing nursing knowledge as performing own job	3.79±0.62
	․ Giving information about hospitalization	3.89±0.56
	․ Giving assurance about reliable nursing care	3.95±0.55
	․ Providing nursing service with a sense of duty	3.96±0.66
	Subtotal	3.89±0.48
Empathy		3.97±0.54
	․ Respecting pt's personality	4.08±0.50
	․ Listening pt's complaints	3.99±0.51
	․ Providing courage & hope	3.82±0.66
	Subtotal	3.96±0.47
Total		3.87±0.40

Table 3

Person-centered Care and Nursing Service Quality according to Participants' Characteristics

Characteristics	Categories	n (%)	M±SD	Person-centered care		Nursing service quality
Characteristics	Categories	n (%)	M±SD	M±SD	t or F (p)	M±SD	t or F (p)
Age (year)	23~<40	32 (28.0)	45.53±9.67	3.07±0.49a	3.92 (.023)	3.69±0.39^a	6.64 (.002)
	40~<50	37 (32.5)		3.30±0.35		3.86±0.34
	50~62	45 (29.5)		3.34±0.47^b		4.01±0.40^b
Religion	Have	85 (74.6)		3.30±0.45	1.85 (.067)	3.88±0.42	0.51 (.608)
Religion	None	29 (25.4)		3.12±0.44	1.85 (.067)	3.84±0.31	0.51 (.608)
Marital status	Single	19 (16.7)		3.12±0.48	−1.34 (.182)	3.75±0.29	−1.27 (.206)
Marital status	Married	95 (83.3)		3.27±0.45	−1.34 (.182)	3.89±0.41	−1.27 (.206)
Position	Staff	71 (62.3)		3.28±0.41	0.67 (.507)	3.81±0.36
Position	Charge/Head	43 (37.7)		3.22±0.51	0.67 (.507)	3.97±0.44
Education	Diploma	60 (52.6)		3.26±0.48	0.86 (.428)	3.86±0.38	0.13 (.882)
	Bachelor	46 (40.4)		3.29±0.44		3.88±0.40
	≥Master	8 (7.0)		3.06±0.34		3.93±0.51
Income/month (10,000 won)	180~<200	26 (22.8)	209.09±20.42	3.29±0.42	0.24 (.785)	3.86±0.34	0.25 (.779)
	200~<210	45 (39.5)		3.27±0.51		3.84±0.48
	210~270	43 (37.7)		3.22±0.41		3.90±0.34
Satisfaction of income	Unsatisfied	53 (46.5)		3.13±0.41	4.32 (.016)	2.94±0.28	0.64 (.532)
	Moderate	55 (48.2)		3.34±0.47		2.90±0.33
	Satisfied	6 (5.3)		3.54±0.37		3.03±0.34
Duty shift	Regular	90 (78.9)		3.27±0.45	0.67 (.501)	3.89±0.39	1.07 (.286)
Duty shift	Shift	24 (21.1)		3.20±0.48	0.67 (.501)	3.79±0.40	1.07 (.286)
Career of nurse (year)	0.25~<10	43 (37.7)	12.81±7.87	3.25±0.45	0.06 (.956)	3.80±0.40	1.24 (.294)
	10~<15	28 (24.6)		3.27±0.59		3.90±0.44
	15~37.67	43 (37.7)		3.24±0.56		3.92±0.36
Career of long-term care hospital (year)	0.08~<2	29 (25.4)	3.66±2.64	3.24±0.48	0.57 (.565)	3.88±0.38	0.43 (.655)
	2~<4	36 (31.6)		3.32±0.45		3.82±0.41
	4~≤13	49 (43.0)		3.22±0.44		3.90±0.39
Career of present hospital (year)	0.08~<1	39 (34.2)	1.81±1.52	3.27±0.42	0.05 (.948)	3.86±0.36	0.20 (.816)
	1~<2	24 (21.1)		3.23±0.42		3.92±0.49
	2~7.17	51 (44.7)		3.25±0.50		3.86±0.38
Application of opinion	Difficult	54 (47.4)		3.13±0.48^a	5.96 (.003)	3.82±0.39	1.21 (.302)
	Moderate	50 (43.8)		3.33±0.42		3.91±0.42
	Easy	10 (8.8)		3.59±0.17^b		4.00±0.26
Satisfaction of hospital managers	Unsatisfied	37 (32.5)		3.06±0.50^a	11.09 (<.001)	3.81±0.34^a	4.63 (.012)
	Moderate	59 (51.8)		3.26±0.38^a		3.83±0.41^a
	Satisfied	18 (15.7)		3.62±0.34^b		4.12±0.38^b
Satisfaction of administrators	Unsatisfied	33 (28.9)		3.00±0.48^a	10.39 (<.001)	3.77±0.30^a	3.80 (.025)
	Moderate	57 (50.0)		3.30±0.38^b		3.86±0.43
	Satisfied	24 (21.1)		3.50±0.42^b		4.05±0.38^b
Satisfaction of nurse manager	Unsatisfied	14 (12.3)		2.88±0.47^a	9.76 (<.001)	3.81±0.41^a	3.97 (.022)
	Moderate	45 (39.5)		3.19±0.37^a		3.76±0.41^a
	Satisfied	55 (48.2)		3.41±0.44^b		3.97±0.35^b
Number of beds	195~<240	95 (83.3)	242.50±37.44	3.26±0.46	0.15 (.882)	3.87±0.40	−0.10 (.920)
Number of beds	240~316	19 (16.7)	242.50±37.44	3.24±0.43	0.15 (.882)	3.88±0.37	−0.10 (.920)
Number of nurses	8~<17	52 (45.6)	16.00±5.37	3.23±0.45	−0.55 (.583)	3.90±0.39	0.61 (.546)
Number of nurses	17~≤24	62 (54.4)	16.00±5.37	3.28±0.46	−0.55 (.583)	3.85±0.40	0.61 (.546)

Scheffé test (a<b).

Table 4

Correlation between Person-centered Care and Nursing Service Quality of Participants

Variable	Nursing service quality
Person-centered care	.42 (<.001)

Table 5

Factors influencing Nursing Service Quality

Factors	B	SE	β	t	p
Person-centered care	0.40	0.07	.46	5.62	<.001
Position	0.16	0.07	.19	2.34	.021
Age	0.14	0.07	.17	2.02	.046
	R²=.30, Adj. R²=.28, F=15.81, p<.001

This article is a revision of the first author's master's thesis from Dong-A University.

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Person-centered Care and Nursing Service Quality of Nurses in Long-term Care Hospitals

Factors	Items	M±SD (Sum±SD)
Personalizing care	․ We often discuss how to give person-centered care	3.61±0.78
	․ We have formal team meetings to discuss resident’s care	2.49±1.07
	․ The life history of the residents is formally used in the care plans we use	3.27±0.84
	․ The quality of the interaction between staff and residents is more important than getting the tasks done	3.37±0.74
	․ We are free to alter work routines based on residents’ preferences	3.55±0.74
	․ Residents are offered the opportunity to be involved in individualized everyday activities	2.95±0.84
	․ Assessment of residents’ needs is undertaken on a daily basis	3.41±0.80
	Subtotal	3.24±0.54 (22.66±3.81)
Organization and environmental support	․ I simply do not have the time to provide person-centered care^†	3.37±0.80
	․ The environment feels chaotic^†	3.69±0.82
	․ We have to get the work done before we can worry about a homelike environment^†	3.19±0.83
	․ This organization prevents me from providing person-centered care^†	3.30±0.95
	․ It is hard for residents in this facility to find their way around^†	3.58±0.93
	․ Residents are able to access outside space as they wish	2.53±1.04
	Subtotal	3.28±0.54 (19.66±3.25)
Total		3.25±0.45 (42.32±5.86)

Factors	Items	M±SD
Tangibility	․ Concerning about hygiene of the pt's room	4.00±0.58
	․ Providing comfortable environment at resting	3.54±0.71
	․ Providing nursing service in good facilities	3.11±0.85
	․ Providing good feeling by nurse's good-looking	3.73±0.61
	Subtotal	3.59±0.51
Reliability		3.72±0.56
	․ Giving information & getting permission	3.88±0.63
	․ Giving concern & solving pt's problems	4.00±0.58
	․ Being reliable as nurse	3.87±0.51
	Subtotal	3.87±0.45
Responsiveness	․ Immediately correcting environment problem of pt's room	3.97±0.57
	․ Helping pt willingly whenever help is needed	4.09±0.54
	․ Providing nursing service immediately even if too much busy	3.84±0.63
	․ Providing medication & treatment at correct time	4.23±0.52
	Subtotal	4.03±0.45
Assurance	․ Possessing nursing knowledge as performing own job	3.79±0.62
	․ Giving information about hospitalization	3.89±0.56
	․ Giving assurance about reliable nursing care	3.95±0.55
	․ Providing nursing service with a sense of duty	3.96±0.66
	Subtotal	3.89±0.48
Empathy		3.97±0.54
	․ Respecting pt's personality	4.08±0.50
	․ Listening pt's complaints	3.99±0.51
	․ Providing courage & hope	3.82±0.66
	Subtotal	3.96±0.47
Total		3.87±0.40

Characteristics	Categories	n (%)	M±SD	Person-centered care		Nursing service quality
Characteristics	Categories	n (%)	M±SD	M±SD	t or F (p)	M±SD	t or F (p)
Age (year)	23~<40	32 (28.0)	45.53±9.67	3.07±0.49a	3.92 (.023)	3.69±0.39^a	6.64 (.002)
	40~<50	37 (32.5)		3.30±0.35		3.86±0.34
	50~62	45 (29.5)		3.34±0.47^b		4.01±0.40^b
Religion	Have	85 (74.6)		3.30±0.45	1.85 (.067)	3.88±0.42	0.51 (.608)
Religion	None	29 (25.4)		3.12±0.44	1.85 (.067)	3.84±0.31	0.51 (.608)
Marital status	Single	19 (16.7)		3.12±0.48	−1.34 (.182)	3.75±0.29	−1.27 (.206)
Marital status	Married	95 (83.3)		3.27±0.45	−1.34 (.182)	3.89±0.41	−1.27 (.206)
Position	Staff	71 (62.3)		3.28±0.41	0.67 (.507)	3.81±0.36
Position	Charge/Head	43 (37.7)		3.22±0.51	0.67 (.507)	3.97±0.44
Education	Diploma	60 (52.6)		3.26±0.48	0.86 (.428)	3.86±0.38	0.13 (.882)
	Bachelor	46 (40.4)		3.29±0.44		3.88±0.40
	≥Master	8 (7.0)		3.06±0.34		3.93±0.51
Income/month (10,000 won)	180~<200	26 (22.8)	209.09±20.42	3.29±0.42	0.24 (.785)	3.86±0.34	0.25 (.779)
	200~<210	45 (39.5)		3.27±0.51		3.84±0.48
	210~270	43 (37.7)		3.22±0.41		3.90±0.34
Satisfaction of income	Unsatisfied	53 (46.5)		3.13±0.41	4.32 (.016)	2.94±0.28	0.64 (.532)
	Moderate	55 (48.2)		3.34±0.47		2.90±0.33
	Satisfied	6 (5.3)		3.54±0.37		3.03±0.34
Duty shift	Regular	90 (78.9)		3.27±0.45	0.67 (.501)	3.89±0.39	1.07 (.286)
Duty shift	Shift	24 (21.1)		3.20±0.48	0.67 (.501)	3.79±0.40	1.07 (.286)
Career of nurse (year)	0.25~<10	43 (37.7)	12.81±7.87	3.25±0.45	0.06 (.956)	3.80±0.40	1.24 (.294)
	10~<15	28 (24.6)		3.27±0.59		3.90±0.44
	15~37.67	43 (37.7)		3.24±0.56		3.92±0.36
Career of long-term care hospital (year)	0.08~<2	29 (25.4)	3.66±2.64	3.24±0.48	0.57 (.565)	3.88±0.38	0.43 (.655)
	2~<4	36 (31.6)		3.32±0.45		3.82±0.41
	4~≤13	49 (43.0)		3.22±0.44		3.90±0.39
Career of present hospital (year)	0.08~<1	39 (34.2)	1.81±1.52	3.27±0.42	0.05 (.948)	3.86±0.36	0.20 (.816)
	1~<2	24 (21.1)		3.23±0.42		3.92±0.49
	2~7.17	51 (44.7)		3.25±0.50		3.86±0.38
Application of opinion	Difficult	54 (47.4)		3.13±0.48^a	5.96 (.003)	3.82±0.39	1.21 (.302)
	Moderate	50 (43.8)		3.33±0.42		3.91±0.42
	Easy	10 (8.8)		3.59±0.17^b		4.00±0.26
Satisfaction of hospital managers	Unsatisfied	37 (32.5)		3.06±0.50^a	11.09 (<.001)	3.81±0.34^a	4.63 (.012)
	Moderate	59 (51.8)		3.26±0.38^a		3.83±0.41^a
	Satisfied	18 (15.7)		3.62±0.34^b		4.12±0.38^b
Satisfaction of administrators	Unsatisfied	33 (28.9)		3.00±0.48^a	10.39 (<.001)	3.77±0.30^a	3.80 (.025)
	Moderate	57 (50.0)		3.30±0.38^b		3.86±0.43
	Satisfied	24 (21.1)		3.50±0.42^b		4.05±0.38^b
Satisfaction of nurse manager	Unsatisfied	14 (12.3)		2.88±0.47^a	9.76 (<.001)	3.81±0.41^a	3.97 (.022)
	Moderate	45 (39.5)		3.19±0.37^a		3.76±0.41^a
	Satisfied	55 (48.2)		3.41±0.44^b		3.97±0.35^b
Number of beds	195~<240	95 (83.3)	242.50±37.44	3.26±0.46	0.15 (.882)	3.87±0.40	−0.10 (.920)
Number of beds	240~316	19 (16.7)	242.50±37.44	3.24±0.43	0.15 (.882)	3.88±0.37	−0.10 (.920)
Number of nurses	8~<17	52 (45.6)	16.00±5.37	3.23±0.45	−0.55 (.583)	3.90±0.39	0.61 (.546)
Number of nurses	17~≤24	62 (54.4)	16.00±5.37	3.28±0.46	−0.55 (.583)	3.85±0.40	0.61 (.546)

Variable	Nursing service quality
Person-centered care	.42 (<.001)

Factors	B	SE	β	t	p
Person-centered care	0.40	0.07	.46	5.62	<.001
Position	0.16	0.07	.19	2.34	.021
Age	0.14	0.07	.17	2.02	.046
	R²=.30, Adj. R²=.28, F=15.81, p<.001

Table 1 Person-centered Care of Participants

^†Reverse coding.

Table 2 Nursing Service Quality of Participants

Table 3 Person-centered Care and Nursing Service Quality according to Participants' Characteristics

Scheffé test (a<b).

Table 4 Correlation between Person-centered Care and Nursing Service Quality of Participants