Abstract
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.
Highlights
Little is known about the combination of person- and organization- related conditions and the relationships with patients’ perspectives of care quality
Combination of person- and organization-related conditions When investigating the combination of person- and organization-related conditions, person-related conditions has been shown to be the strongest predictor whereas organization-related conditions to a smaller degree were associated with the patients’ perceptions of Setting Participants were recruited from settings representing densely and sparsely populated locations in the eastern part of Norway: two inpatient hospices (HICs), two hospice day-care centres (HDs), two palliative units in nursing homes that specialized in palliative care (PUNHs) and two home-care districts (HCs)
There were no significant differences between the patients included in the study and those who did not respond (n = 71), with regard to age (P = 0.569) and gender (P = 0.117)
Summary
Little is known about the combination of person- and organization- related conditions and the relationships with patients’ perspectives of care quality. The aim was to investigate the relationships between the combination of person- and organization-related conditions and patients’ perceptions of palliative care quality. In the palliative care setting, recruitment of patients and obtaining feedback from patients may be difficult [4, 5], because patients have life-threatening illnesses and often have severe physical, psychosocial and existential problems [6], and it may be difficult to locate patients in a palliative phase of illness [7] Despite these difficulties, it is still important to acquire knowledge about patients’ perceptions of palliative care quality. Conditions that influence patients’ perceptions of care quality can be classified into two areas: person-related conditions and organizationrelated conditions
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