Please use this identifier to cite or link to this item: http://ktisis.cut.ac.cy/handle/10488/8496
Title: Linking patient satisfaction with nursing care: the case of care rationing - a correlational study
Authors: Papastavrou, Evridiki 
Andreou, Panayiota 
Tsangari, Haritini 
Merkouris, Anastasios 
Keywords: Nursing care
Professional environment
Patient satisfaction
Rationing
Issue Date: Sep-2014
Publisher: BioMed Central Ltd
Source: BMC Nursing, 2014, Volume 13, Issue 26
Abstract: Background Implicit rationing of nursing care is the withholding of or failure to carry out all necessary nursing measures due to lack of resources. There is evidence supporting a link between rationing of nursing care, nurses’ perceptions of their professional environment, negative patient outcomes, and placing patient safety at risk. The aims of the study were: a) To explore whether patient satisfaction is linked to nurse-reported rationing of nursing care and to nurses’ perceptions of their practice environment while adjusting for patient and nurse characteristics. b) To identify the threshold score of rationing by comparing the level of patient satisfaction factors across rationing levels. Methods A descriptive, correlational design was employed. Participants in this study included 352 patients and 318 nurses from ten medical and surgical units of five general hospitals. Three measurement instruments were used: the BERNCA scale for rationing of care, the RPPE scale to explore nurses’ perceptions of their work environment and the Patient Satisfaction scale to assess the level of patient satisfaction with nursing care. The statistical analysis included the use of Kendall’s correlation coefficient to explore a possible relationship between the variables and multiple regression analysis to assess the effects of implicit rationing of nursing care together with organizational characteristics on patient satisfaction. Results The mean score of implicit rationing of nursing care was 0.83 (SD = 0.52, range = 0–3), the overall mean of RPPE was 2.76 (SD = 0.32, range = 1.28 – 3.69) and the two scales were significantly correlated (τ = −0.234, p < 0.001). The regression analysis showed that care rationing and work environment were related to patient satisfaction, even after controlling for nurse and patient characteristics. The results from the adjusted regression models showed that even at the lowest level of rationing (i.e. 0.5) patients indicated low satisfaction. Conclusions The results support the relationships between organizational and environmental variables, care rationing and patient satisfaction. The identification of thresholds at which rationing starts to influence patient outcomes in a negative way may allow nurse managers to introduce interventions so as to keep rationing at a level at which patient safety is not jeopardized.
URI: http://ktisis.cut.ac.cy/jspui/handle/10488/8496
ISSN: 1472-6955
DOI: 10.1186/1472-6955-13-26
Rights: © Papastavrou et al.; licensee BioMed Central Ltd. 2014
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