Perceptions of behavioral health care quality for justice-involved veterans: a multi-jurisdictional analysis of Veterans Treatment Court team insights

OZET Amac: Bu calismanin amaci, cerrahi hastalarinin ameliyat sonrasi hemsirelik bakim kalitesi algisini degerlendirmektir. Yontem: Tanimlayici turde olan bu calisma 2014-2015 yillari arasinda bir universite hastanesinin genel cerrahi kliniklerinde, 271 hasta ile yapildi. Verilerin toplanmasinda kisisel bilgi formu ve Bakim Davranislari Olcegi-24 kullanildi. Veriler SPSS 20.0 programinda tanimlayici analizler, Kolmogorov-Smirnov, Mann Whitney U, Kruskal-Wallis, Friedman testleri ile degerlendirildi. Bulgular: H astalarin % 55’inin kadin (n=149), % 70.8’inin (n=192) ilkogretim mezunu, % 90.4’unun (n=245) evli, yas ortalamalarinin 55.54±14.59 yil oldugu belirlendi. Hastalarin h emsirelik bakim kalitesi algilama puan ortalamasi 4.68±0.96; olcek alt boyut puan ortalamalari; guvence 4.78±1.04, bilgi-beceri 4.99±0.91, saygili olma 4.50±1.07, baglilik 4.41±1.13 olarak bulundu. Alt olceklerden bilgi-becerinin puan ortalamasi ve cerrahi hemsireleri tarafindan bilgilendirilen hastalarin hemsirelik bakim kalitesi algisi istatistiksel olarak anlamli duzeyde yuksek belirlendi (p<0.001). Sonuclar: Cerrahi hastalarinin ameliyat sonrasi hemsirelik bakim kalitesi algisi biraz yuksek belirlendi. Cerrahi hastalarinda bakim kalitesi algisinin arttirilmasi icin cerrahi hemsirelerinin bakim uygulamalarinda bilgili, becerili olmalarini ve hastalari bilgilendirmelerini onermekteyiz. Anahtar Kelimeler: Bakim kalitesi algisi; cerrahi hastasi; cerrahi hemsireligi; hemsirelik bakimi. ABSTRACT Surgical patients’ perception of the postoperative nursing care quality Aim: The aim of this study is to evaluate the surgical patients’ perception of postoperative nursing care quality. Method: This descriptive study was conducted with 271 patients in the general surgery clinics of a university hospital between 2014 and 2015. In data collection, a personal information form and the Caring Behaviors Inventory-24 were used. Statistical analysis were completed in the SPSS 20.0 program using descriptive analyses, the Kolmogorov-Smirnov, Mann Whitney U, Kruskal-Wallis, and Friedman tests. Results: I t was determined that 55% of the patients were female (n=149), 70.8% (n=192) had elementary education, and 90.4% (n=245) were married and the mean age was 55.54±14.59 years. The perception of nursing care quality mean score of the patients was 4.68±0.96, with sub scale mean score of assurance 4.78±1.04, knowledge and skill 4.99±0.91, respectfulness 4.50±1.07, and connectedness 4.41±1.13. Among sub scales, the mean score of skills and knowledge and the perception of nursing care quality of the patients who were informed by surgical nurses was found to be significantly higher (p<0.001). Conclusion: Surgical patients’ perception of postoperative nursing care quality was determined to be slightly higher. In order to increase perception of care quality in surgical patients, we suggest that nurses should have the sufficient skills and knowledge on care behaviors and inform patients. Key Words: Nursing care; perception of care quality; surgical nursing; surgical patients

To investigate turnover intention among newly licensed registered nurses and to clarify the impact pathways of organisational justice, work engagement and nurses' perception of care quality on turnover intention. Nurse shortage is an ongoing and urgent issue worldwide, in which nurse turnover could exacerbate the situation. Newly licensed registered nurses will become the main nursing workforce in the future; however, previous studies have not revealed the specific reasons underlying their turnover intentions. A descriptive cross-sectional design. A total of 569 newly licensed registered nurses undertaking direct care were recruited from thirteen hospitals from October to November 2018 across Beijing, China. Based on the job demands-resources model, we advanced a hypothetical model, linking the paths between organisational justice, work engagement, nurses' perception of care quality and turnover intention. Structural equation modelling was used to examine the hypothetical model. The study adhered to the STROBE statement for observational studies. In total, 22.3% of newly licensed registered nurses had a high turnover intention. The final model had an acceptable fit and could explain 58% of the variance in turnover intention. The organisational justice was directly related to high work engagement, great nurses' perception of care quality and low turnover intention. Additionally, organisational justice also had indirect effects on great nurses' perception of care quality and low turnover intention, which were partially mediated by work engagement. However, the effect of nurses' perception of care quality on turnover intention was not significant. The improvement of organisational justice could enhance work engagement, and nurses' perception of care quality, and reduce turnover intention, which is crucialto improving care quality and addressing the shortage of nurses. This study provides evidence for policymakers and hospital administrators to take targeted measures to enhance work engagement, foster high-quality care and create better defences against losing nurses.

BackgroundPatients’ perceptions of care quality within and across settings are important for the further development of palliative care. The aim was to investigate patients’ perceptions of palliative care quality within settings, including perceptions of care received and their subjective importance, and contrast palliative care quality across settings.MethodA cross-sectional study including 191 patients in late palliative phase (73 % response rate) admitted to hospice inpatient care, hospice day care, palliative units in nursing homes, and home care was conducted, using the Quality from the Patients’ Perspective instrument-palliative care (QPP-PC). QPP-PC comprises four dimensions and 12 factors; “medical–technical competence” (MT) (2 factors), “physical–technical conditions” (PT) (one factor), “identity–orientation approach” (ID) (4 factors), “sociocultural atmosphere” (SC) (5 factors), and three single items (S); medical care, personal hygiene and atmosphere. Data were analysed using paired-samples t-test and analysis of covariance while controlling for differences in patient characteristics.ResultsPatients’ perceptions of care received within settings showed high scores for the factors and single items “honesty” (ID) and “atmosphere” (S) in all settings and low scores for “exhaustion” (MT) in three out of four settings. Patients’ perceptions of importance scored high for “medical care” (S), “honesty” (ID), “respect and empathy” (ID) and “atmosphere” (S) in all settings. No aspects of care scored low in all settings. Importance scored higher than perceptions of care received, in particular for receiving information. Patients’ perceptions of care across settings differed, with highest scores in hospice inpatient care for the dimensions; ID, SC, and “medical care” (S), the SC and “atmosphere” (S) for hospice day care, and “medical care” (S) for palliative units in nursing homes. There were no differences in subjective importance across settings.ConclusionStrengths of services related to identity–orientation approach and a pleasant and safe atmosphere. Key areas for improvement related to receiving information. Perceptions of subjective importance did not differ across settings, but perceptions of care received scored higher in more care areas for hospice inpatient care, than in other settings. Further studies are needed to support these findings, to investigate why perceptions of care differ across settings and to highlight what can be learned from settings receiving high scores.

The COVID-19 pandemic led to a rapid expansion of telehealth utilization in medicine. However, the quality measures associated with telehealth use remain unclear, particularly among vulnerable populations. This study aims to investigate the impact of telehealth on individuals' perception of overall quality care among vulnerable patient populations. This cross-sectional study utilized Health Information National Trends Survey data. The individuals' overall perception of healthcare quality was compared between populations that had at least one telehealth visit and non-telehealth users, who all had the option of utilizing telehealth. This comparison focused on vulnerable populations, considering differences in race and ethnicity (non-Hispanic white vs. non-Hispanic black/Hispanic individuals) and socioeconomic status (high vs. low). Multivariable logistic regressions were employed to ascertain the association between individuals' overall perceptions of quality care with and without telehealth utilization. A total of 2920 participants, representing an unweighted population of 114,608,302, were analyzed. The adjusted odds ratio (AOR) for at least one telehealth visit associated with individuals' overall perception of quality care among the entire survey population was 0.76 with a 95% CI of 0.51-1.13 (p = 0.173). The AOR was 0.83 (95% CI 0.39-1.77, p = 0.618) among the non-White population, and the AOR was 0.71 (95% CI 0.29-1.78, p = 0.462) among individuals with low SES. Although telehealth utilization has both its limitations and advantages compared to traditional clinical visits, no statistically significant differences in individuals' overall perception of quality care were identified among telehealth and non-telehealth users. These findings were also consistent across various vulnerable populations.

The objective of this study was to assess the role of provider coordination on nurse manager and physician perceptions of care quality, while controlling for organizational factors. Findings indicated that nurse-nurse coordination was positively associated with nurse manager perceptions of care quality; neither physician-physician nor physician-nurse coordination was associated with physician perceptions. Organizational factors associated with positive perceptions of care quality included facility support of education for nurses and physicians, and the use of multidisciplinary rounding.

BackgroundLittle is known about the combination of person- and organization- related conditions and the relationships with patients’ perspectives of care quality. Such a combination could contribute knowledge reflecting the complexity of clinical practice, and enhance individualized care. The aim was to investigate the relationships between the combination of person- and organization-related conditions and patients’ perceptions of palliative care quality.MethodsA cross-sectional study, including 191 patients in the late palliative phase (73% response rate) admitted to hospice inpatient care (n = 72), hospice day care (n = 51), palliative units in nursing homes (n = 30) and home care (n = 38), was conducted between November 2013 and December 2014, using the instrument Quality from the Patients’ Perspective specific to palliative care (QPP-PC). Data were analysed, using analysis of covariance, to explore the amount of the variance in the dependent variables (QPP-PC) that could be explained by combination of the independent variables – Person- and organization-related conditions, − while controlling for differences in covariates.ResultsPatients scored the care received and the subjective importance as moderate to high. The combination of person- and organization - related conditions revealed that patients with a high sense of coherence, lower age (person – related conditions) and being in a ward with access to and availability of physicians (organization-related condition) might be associated with significantly higher scores for the quality of care received. Gender (women), daily contact with family and friends, and low health-related quality of life (person-related conditions) might be associated with higher scores for subjective importance of the aspects of care quality.ConclusionHealthcare personnel, leaders and policy makers need to pay attention to person- and organization-related conditions in order to provide person-centered palliative care of high quality. Further studies from palliative care contexts are needed to confirm the findings and to investigate additional organizational factors that might influence patients’ perceptions of care quality.

Background : Globally in all health care systems, major changes have taken place such as: cost effective care, early hospital discharge and high burden of patients with acute and chronic diseases. These escalating changes in health care systems influence quality of care, job satisfaction of nurses and patients perception of care. The aim of the study was to find the relationship between job satisfaction of nursing staff and patients 'perception of the quality of care. Methods : A co relational study was undertaken among 384 patients and 141 staff nurses in a tertiary teaching hospital Odisha, India within a 3 months period. RHCS questionnaire consists of 42-items was used to measure patients' perception of quality care and KUHJSS consist of 37-items was used to measure job satisfaction of nursing staff. Date was analysed to find out the related factors and relationship between job satisfaction of nursing staff and patients perception of quality care. Results : Patients' perception of overall quality care positively related to general job satisfaction of nursing staff. The highest job satisfaction levels of quality care were reported by older patients, patients who were in OPD units and patients from rural settings. Also the highest job satisfaction levels were reported by nurses over 51 years of age, nursing leaders, nurses with less than one year or more than 21 years of total work experience, and day shift workers. Conclusions : Generally job satisfaction of nursing staff is an important aspect for quality care, as evaluated by the patients. It is vital to support the well-being of staff because this has the potential to improve patients' perceptions of quality care.

PurposeTo (1) explore associations between paediatric nurses' perceptions of their own compassion, the practice environment, and quality of care, and (2) identify factors that influence perceived quality of care. Design and methodsCross-sectional survey of paediatric nurses (n = 113) from a hospital network in Melbourne, Australia. The survey included the Compassion Scale, Practice Environment Scale of the Nurse Work Index (PES-NWI), a single quality of care item, and demographic items. Hierarchical regression was used to explore factors that predicted perceived care quality. ResultsThere were moderate positive correlations between perceived care quality and both compassion (rho = 0.36, p < .001) and practice environment (i.e., total PES-NWI: rho = 0.45, p < .001). There were significant differences in perceived care quality based on nurses' work area (i.e., critical care vs medical/surgical wards). The final hierarchical regression analysis included compassion (Step 2) and four of five PES-NWI subscales (Step 3), controlling for work area (Step 1). The model was statistically significant and explained 44% of variance in perceived quality; compassion and PES-NWI subscale 2 (Nursing foundations for quality of care) were statistically significant predictors. ConclusionsPaediatric nurses' perceptions of quality were influenced by their own compassion for others and elements of the practice environment, particularly nursing foundations for care quality, which is characterised by a clear nursing philosophy and model of care, with programs and processes to support practice. Practice implicationsThe findings offer insights into potentially modifiable individual and workplace factors that contribute to paediatric nurses' perceptions of care quality.

This prospective study was designed to validate a questionnaire on patients’ perception of care quality during respiratory-gated radiotherapy for breast or lung cancer. Psychometric tests were performed on selected patients. Confirmatory factorial analyses and capacity to discriminate the responses were achieved to validate the best model on 297 patients. Factorial analyses identified the following three scales: (a) perception of quality, (b) global satisfaction, and (c) physical or emotional experience. The scales were able to differentiate patients’ responses according to radiotherapy modalities. The questionnaire presented adequate psychometric properties. This tool could be used for the assessment from the patient's point of view.

To monitor changes in providers' perceptions of health care quality and the importance of health reform, and in patients' satisfaction with services during and two years after restructuring, comparing the region of the province that was restructured (St John's) with those regions in which hospitals were not aggregated. The Employee Attitude Survey questionnaire was sent to acute care providers (n = 5353) to assess personal characteristics and perceptions of the impact of reform on workplace conditions, work-related attitudes and turnover intentions. The response rate for 2000 and 2002 was 42% (n = 1222 and 1034, respectively). Only respondents in both surveys (n = 589) were used in the analysis because study results were the same for both the repeat sample and total samples. A Patient Satisfaction Survey questionnaire was administered to patients discharged from acute care facilities in 2000 (n = 1741) and 2002 (n = 704). Response rates were 82.5% and 90.2%, respectively. Most providers felt, at both time periods, that restructuring of the health care system was a positive step, but felt that health care quality was low. In the St John's region, perceptions of quality and standards of care improved over time. Patients were extremely satisfied with the admission process and hospital stay at both time periods in St John's. However, satisfaction declined in 2002 in regions outside St John's. Aggregation of acute care hospitals is possible without adverse effects on providers' perceptions of health care quality or on patient satisfaction.

This study analyzes the relationship between patients’ understanding of online medical records and their perception of care quality. It also explores the mediating role of patients’ general health perception and mental health and the moderating role of age in this relationship. The study develops and tests an exploratory conceptual model by analyzing the 2020 US-based Health Information National Trends Survey (HINTS) collected during the COVID-19 pandemic. We checked the survey for multicollinearity and common method bias and adjusted for family-wise error. Using models 6 and 59 of the Hayes PROCESS macros, the study articulates a sequential mediation and a parallel moderated mediation model to capture the intended relationships. Patients’ understanding of online medical records had a significant positive association with the perception of care quality (Direct: ß=0.17; Indirect: ß=0.12). Additionally, the study captured the significant effect of age and perception of general health (self-health) on the perception of care quality. We also reported significant associations between mental health and general health perception (ß=0.26). These findings suggest that the patient portals' contents should be designed in a way to be easily understood by patients from various backgrounds to improve the overall care experience.

PurposePrevious studies show that the hospital environment and the behavior of health care personnel may predict patients’ perceptions of care quality. The aim of the study was to explore changes in perceived care quality from the patients’ perspective (QPP) when hospital services are relocated from an old to a new high-tech hospital and to describe what is important for patients in the high-tech hospital.Patients and methodsA comparative cross-sectional design was used. The questionnaire QPP, which is based on a theoretical model of the quality of care comprising four quality dimensions, was used. Data were collected in 2015 (old hospital) and 2016 (new hospital), with 253 and 324 respondents, respectively, by consecutive sampling. Comparative statistics was used to test differences between patients’ care quality perceptions (perceived reality [PR] and subjective importance [SI]) (P≤0.05).ResultsThe patients rated PR of all four quality dimensions (the care organization’s physical-technical conditions and sociocultural approach and the caregivers’ medical-technical competence and identity-oriented approach) higher in the new hospital. However, only the two quality dimensions concerning the care organization were rated significantly more highly. On an item level, five of the 27 items scored significantly higher on patients’ SI than on patients’ PR of the care in the new hospital, indicating a quality deficiency from the patients’ perspective. This comprised receiving effective pain relief, receiving examination and treatment within an acceptable waiting time, receiving useful information on self-care, receiving useful information on which doctors were responsible for their medical care, and having a comfortable bed.ConclusionThe increase in care QPP was associated with improved environmental conditions, and no significant improvement in care quality was associated with the health care personnel. The results indicate that being in a high-tech environment does not improve patients’ perceptions of care quality provided by health care personnel. The results gave valuable information for quality improvement in clinical practice, based on the patients’ perspective.

Introduction: Evaluating physician perceptions of telemedicine use and its impact on care quality among physician providers is critical to sustaining telemedicine programs, given the uncertainty of reimbursement policy, preferences, inadequate training, and technical difficulties. Physicians reported technical barriers to effectively practicing integrated medicine using telemedicine as patient volumes increased during the pandemic. The objective of this work was to examine whether perceived practice barriers and facilitators were associated with physician respondents' perceptions of telemedicine care quality compared with in-person care. Methods: This cross-sectional study analyzed the 2021 National Electronic Health Record Survey. The sample comprised 1,857 nonfederally employed physicians (weighted n = 403,013) delivering integrated patient care. Of those physicians, 1,630 (weighted n = 346,646) reported providing care through telemedicine. We reported frequencies and percentages of reported practice characteristics. Generalized ordinal logistic regressions examined relationships between practice factors and care quality for telemedicine care. Results: Most of the sample (n = 1,630) were male (66.1%), >50 years of age (66.1%), and worked in a single location (73.5%). A total of 70% of respondents reported that patients had difficulty using telemedicine platforms, and 64% reported limitations in patients' access to technology. Most respondents indicated having provided quality care to some extent (45%) and to a great extent (26%) during telemedicine visits compared to in-person visits. Associations between barriers, facilitators, and care quality perceptions were positive, underscoring resiliency in telemedicine programs among practices. Conclusion: Care modalities and the organizational, environmental, and personal facilitators drive quality perceptions among physicians. Perceived fit and usability determine perceptions of care quality for providers integrating telemedicine into their practice.

Background: The STROKE Perception Report is a valid and reliable instrument for assessment of patients’ and family members’ perceptions of the quality of acute stroke services. We examined differences in perceptions of acute stroke hospital care quality in relation to responder characteristics. Methods: As part of a psychometric analysis, data were collected from June 2010-July 2011 at 35 Stroke Centers in the continental U.S. and Hawaii. A special family instrument was used for patients with cognitive, level of consciousness, or communication issues that prevented direct patient response. Data collection occurred at the time of hospital discharge following completion of all interactions with hospital staff in a private area; surveys were sealed in de-identified envelopes once complete and submitted to independent investigators blinded to hospital sites for entry/analyses by Chi-square, Student’s t-test and logistic regression with SAS. RESULTS: A total of 1029 surveys were returned (761 [74%] patient, 268 [26%] family) with an overall complete response rate of 99.8%. Racial characteristics and ethnicity for the overall sample showed 72% white, 19% African American, 6% Asian, 2% Native Hawaiian/Pacific Islander and 1% American Indian/Alaska Native with 7% responding as Hispanic ethnicity. Education for the overall sample showed 87% of the participants graduated high school with 28% having a 4-year college degree or higher; higher educated family members were more likely to complete the survey (OR 1.178, 95% CI 1.045-1.328, p=0.0074). Length of stay (LOS) averaged 5%/-4.3 (range=1-59 days); the odds of family members acting as survey respondees was significantly associated with an increased LOS (OR 1.14, 95%CI 1.098-1.192, p&lt;0.0001). There was no difference in the perception of care quality by race, ethnicity, or LOS. Lowest rated quality items overall were in the 'Education to Prevent and Respond to Stroke' scale, while the highest rated quality items were in the 'Caring' scale. Patients were more likely to express displeasure over the way nurses treated their family members (p&lt;0.0001), and were more likely to state that their nurses (p=0.015) and physicians (p=0.0009) did not teach them about the warning signs for a stroke as compared to family member perceptions. Recall of educational content pertinent to stroke between patients and family members was different for facial droop (16% vs.8%; p= 0.001) and sudden onset of speech difficulty (11% vs. 5%; p= 0.016), with more patients stating these were not signs of stroke. People with a higher education were more likely to state that the nurses (p= 0.0014) and doctors (0.012) did not educate them about post-hospitalization care. Conclusions: The STROKE Perception Report provides insight into how patients and family members perceive the quality of acute stroke service, enabling ongoing performance improvement.

AimTo examine parents' perceptions of care quality at child health centres. Specific objectives were to examine parents' perceptions of the care received and the subjective importance of such care. Furthermore, to examine the relationship between parents' sociodemographic characteristics and the perceptions of care quality.DesignA cross‐sectional study.MethodsA random sample of parents of children born in Sweden in 2021 participated. Data were collected by the QPP‐CHC questionnaire and analysed using descriptive and analytical statistics.ResultsThe response rate was 19.4%. The targeted sample size of 210 participants was reached as 584 parents responded to the questionnaire. Parents' overall ratings of care quality at child health centres indicated optimal quality with mean values >3. However, various potential improvements areas were identified as needing additional information. These included dental care (m = 2.82), allergy prevention (m = 2.25), breastfeeding (m = 2.97), sleep (m = 2.83), the child's behaviour (m = 2.47) and the child's crying (m = 2.47). Also, parents rated suboptimal quality regarding that the care was based on healthcare routines rather than parental preferences and needs (m = 2.86). Parents born outside of the Nordic countries rated higher care quality than those born in the Nordic countries, as well as parents with a non‐academic education.ConclusionParents want information based on their preferences and needs. Parent's perceptions of areas for improvement are new and important knowledge for registered nurses at child health centres.Implications for the Profession and/or Patient CareThe findings indicate that parents feel that insufficient attention is given to areas of care that they perceive as important. Parents' perspectives on the care quality at child health centres is an important component of quality work and might lead to improvements in the care quality at child health centres.Reporting MethodThe Strengthening the Reporting of Observational Studies (STROBE) checklist for cross‐sectional studies was used to guide reporting.Implications for policy and practiceThe findings of this study suggests that parents feel that insufficient attention is given to areas of care that they perceive as important. Parents' perspectives on the care quality at child health centres provides important knowledge which can guide further development of care quality at child health centres. The findings indicate that a family‐centred approach that integrates relational and routine‐oriented nursing can be a way to ensure that the care is based on parents' preferences and needs.No patient or public contribution.