Home Healthcare Nurses' Job Satisfaction Scale: refinement and psychometric testing

AIMS: This paper describes a study to further develop and test the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale, including reliability and construct and criterion validity. BACKGROUND: Numerous scales have been developed to measure nurses' job satisfaction. Only one, the Home Healthcare Nurses' Job Satisfaction Scale, has been designed specifically to measure job satisfaction of home healthcare nurses. The Home Healthcare Nurses' Job Satisfaction Scale is based on a theoretical model that integrates the findings of empirical research related to job satisfaction. METHODS: A convenience sample of 340 home healthcare nurses completed the Home Healthcare Nurses' Job Satisfaction Scale and the Mueller and McCloskey Satisfaction Scale, which was used to test criterion validity. Factor analysis was used for testing and refinement of the theory-based assignment of items to constructs. Reliability was assessed by Cronbach's alpha internal consistency reliability coefficients. The data were collected in 2003. RESULTS: Nine factors contributing to home healthcare nurses' job satisfaction emerged from the factor analysis and were strongly supported by the underlying theory. Factor loadings were all above 0.4. Cronbach's alpha coefficients for each of the nine subscales ranged from 0.64 to 0.83; the alpha for the global scale was 0.89. The correlations between the Home Healthcare Nurses' Job Satisfaction Scale and Mueller and McCloskey Satisfaction Scale was 0.79, indicating good criterion-related validity. CONCLUSIONS: The Home Healthcare Nurses' Job Satisfaction Scale has potential as a reliable and valid scale for measurement of job satisfaction of home healthcare nurses.     

Home healthcare practice environment: predictors of RN satisfaction

Since 2000, Medicare-certified home healthcare agencies have undergone significant regulatory changes that directly affect registered nurses. The satisfaction of 201 nurses from 19 home healthcare agencies was examined. Home healthcare nurses reported slightly lower satisfaction than hospital nurses and were approximately 50% less satisfied than they were in 2000. Satisfaction had a negative relationship with years worked as a home healthcare nurse (r= -.25, p< .01). Controlling for years of home healthcare experience, control over practice decisions and practice setting decisions were significant predictors of satisfaction. With the demand for home healthcare nurses expected to increase 109% by 2020, development of a National Database of Nursing Quality Indicators for home healthcare that includes satisfaction as a nurse-sensitive outcome might be helpful.     

Work Setting, Community Attachment, and Satisfaction Among Rural and Remote Nurses

ABSTRACT Objectives: To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada.
Design and Sample: Cross-sectional survey of rural and remote RNs in Canada as part of a multimethod study.The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long-term care, community health, home care, and primary care comprised the sample.
Measures: The home community satisfaction scale measured community satisfaction, whereas single-item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open-ended questions.
Results: Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open-ended responses that describe community satisfaction and community attachment.
Conclusions: Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.     

Patient satisfaction with nursing care: a concept analysis within a nursing framework

Title.  Patient satisfaction with nursing care: a concept analysis within a nursing framework.
Background.  Patient satisfaction is an important indicator of quality of care, and healthcare facilities are interested in maintaining high levels of satisfaction in order to stay competitive in the healthcare market. Nursing care has a prominent role in patient satisfaction. Using a nursing model to measure patient satisfaction with nursing care helps define and clarify this concept.
Data sources.  Rodgers' evolutionary method of concept analysis provided the framework for this analysis. Data were retrieved from the Cumulative Index of Nursing and Allied Health Literature and MEDLINE databases and the ABI/INFORM global business database. The literature search used the keywords patient satisfaction, nursing care and hospital. The sample included 44 papers published in English, between 1998 and 2007.
Results.  Cox's Interaction Model of Client Health Behavior was used to analyse the concept of patient satisfaction with nursing care. The attributes leading to the health outcome of patient satisfaction with nursing care were categorized as affective support, health information, decisional control and professional/technical competencies. Antecedents embodied the uniqueness of the patient in terms of demographic data, social influence, previous healthcare experiences, environmental resources, intrinsic motivation, cognitive appraisal and affective response. Consequences of achieving patient satisfaction with nursing care included greater market share of healthcare finances, compliance with healthcare regimens and better health outcomes.
Conclusion.  The meaning of patient satisfaction continues to evolve. Using a nursing model to measure patient satisfaction with nursing care delineates the concept from other measures of patient satisfaction.     

Further psychometric testing of the home healthcare nurse job satisfaction scale

The purpose of this study was to refine the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale (HHNJS). A theoretical model of job satisfaction had been used to develop the 30-item HHNJS, representing nine components of job satisfaction. Psychometric properties suggested the need for further refinement. Revised items and construct definitions were subjected to psychometric testing with 2,274 home healthcare nurses. Eight independent subscales consistent with the theoretical model were validated by factor analysis. Estimated internal consistency reliability of six of the eight subscales was improved. Results suggest that the refined HHNJS has potential for improving retention through accurate measurement of job satisfaction of home health care nurses.     

Measuring patient assessments of the quality of outpatient care: a systematic review

Rationale, aims and objectives The aim of the study was to answer three questions: first, what methods have been used to measure patient assessments of the quality of care? Second, how do outpatients rate their care? And third, what needs to be taken into account in measuring patient assessments of the quality of care? Methods Systematic review of the literature. Electronic searches were conducted on Medline, CINAHL and the Cochrane Database of Systematic Reviews. To be included, articles were to deal with patients’ assessments of health care in ambulatory units for somatic adult patients. They were to have been published between January 2000 and May 2005, written in English, Swedish or Finnish with an English abstract, and the research was to have been conducted in Europe. The search terms used were: ambulatory care, ambulatory care facilities, outpatient, outpatients, patient satisfaction and quality of health care. The articles were screened by two independent reviewers in three phases. Results Thirty‐five articles were included. The quality of care was measured using both quantitative and qualitative methods. Only a few studies relied on the single criterion of patient satisfaction for quality measurements. It is easy to identify common sources of dissatisfaction in different studies. Sources of satisfaction are more closely dependent on the target population, the context and research design. Conclusion Patient satisfaction is widely used as one indicator among others in assessing the quality of outpatient care. However, there is no single, universally accepted method for measuring this.     

Home Delivery: Transfusion Services When and Where They Are Needed

Home blood product transfusion has been utilized around the world in various forms over the past few decades. There is current interest in decentralizing hospital care to improve patient independence and convenience, minimize cost to the health service, and to prevent nosocomial infection, especially with the recent COVID-19 pandemic. The transition to “hospital in the home” is occurring across the healthcare sector driven by aims to improve patient outcomes and patient satisfaction, capacity pressures in the acute care sector, and most recently due to concerns regarding infectious disease transmission in hospital settings. This review explores the published literature on home red cell and platelet transfusions, and where the literature is limited, also considered data from subcutaneous immunoglobulin studies. Current published experience on red cell and platelet transfusion at home has identified benefits to the patient and health service, with further studies needed to quantify improvement in quality of life and health-related outcomes. Safety concerns may be a perceived barrier to implementation of home transfusion, however current published data suggests serious adverse reactions are rare. Cost-effectiveness data for home transfusion are very limited and a key area for future research. Home transfusion has the potential to benefit from newer technologies, such as portable/remote monitoring and electronic patient identifiers.     

Development of an instrument to measure patient perception of the quality of nursing care.

Although patient satisfaction has been given considerable attention in health care, analysis of the conceptual and measurement limitations of existing measures indicates that a more elemental approach to obtaining patients' perspectives is warranted. In this investigation we developed and evaluated the psychometric properties of an instrument designed to measure patients' perceptions of the degree to which their needs were met while hospitalized. This 15-item instrument, Patient Perception of Hospital Experience with Nursing (PPHEN), based on Swanson-Kauffman's framework of caring, is internally consistent and represents a single construct best described as feeling cared for. The relationship of PPHEN to other measures demonstrates concurrent validity; moreover, the scale is responsive to differences in care provided, as shown by differences in means for different hospitals. PPHEN offers a brief, theoretically oriented, internally consistent, and valid patient self-report measure of nursing care. It does not require patients to compare their expectations of care with the care received but only to evaluate whether their needs were met. It promises to be useful to clinical and health services researchers.     

User involvement in mental health care: the role of nurses. A literature review

This literature review was carried out to examine the effects of user involvement in shared decision-making processes and the methods/tools available to psychiatric nurses to measure and encourage user involvement. A systematic literature review was then used in this study. Many studies indicate that an increased involvement of service users leads to better care, better treatment compliance, improved health outcomes and higher levels of patient satisfaction. The tools and methods described are designed to measure the ability to participate, the process of implementation and the evaluation of healthcare services. An adequate instrument to measure user involvement will be necessary to underpin the positive effects. Although care providers have a statutory duty to help shape user involvement, and the tools required are available, care providers are still insufficiently inclined to take up this duty.     

Development of the Home Care Client Satisfaction Instrument

Abstract Client (patient) satisfaction has been studied extensively in the health care sector, yet those receiving home health care services have been the focus of few studies. The purpose of this study was to test the reliability and validity of the Home Care Client Satisfaction Instrument (HCCSI). A total of 400 clients, randomly selected from 20 randomly chosen home care agencies in one state, completed the HCCSI and demographic form. Most respondents were older adults with multiple health problems and their families or informal support systems. Since data were skewed, item analysis was used. The revised instrument (HCCSI-R) is unidimensional and includes 12 items rated on a 5-point Likert scale measuring specific aspects of care. In addition, there are three global measures of satisfaction rated on a 10-point scale. All items except one had significant item-total correlations greater than .59. The total score correlates with likeliness to recommend the agency to others (.37, p = .0001), showing some evidence for criterion-related validity.     

New challenges in ageing: Home care

Most nations are undergoing two fundamental demographic changes: concentration of their population in cities and accelerated pace of population ageing. The fastest-growing population is that 85 years and over. Morbidity increases with advancing age, functional capacities decrease; this results in decreased performance of activities of daily liver and need for services. The challenge is particularly strong in urban areas. Modern societies seek solutions in maintaining the elderly in their homes through home care programmes for those who are functionally impaired, homebound, and need support in home-making and home nursing. Home care is firmly established in programmes for the elderly. In order to become a scientific discipline home care has to define its boundaries, identify clients by careful multidisciplinary assessment, provide answers regarding its cost-effectiveness, evaluate outcomes of home caring, develop indicators of high-quality care and advise appropriate home care technology, which is affordable and accessible. Home care for the elderly population living in remote rural areas is one of the future challenges.     

Validation and test–retest reliability of the Risser patient satisfaction scale in Cyprus

charalambous a. (2010) Journal of Nursing Management   18 ,61–69
Validation and test–retest reliability of the Risser patient satisfaction scale in Cyprus
Aim  To describe the translation, adaptation and validation of the Risser Patient Satisfaction Scale (RPSS) questionnaire into Greek language and discuss possibilities of its use in cancer care settings.
Background  The translation and cultural adaptation of a widely accepted, psychometrically tested tool is regarded as an essential component of effective human resource management or quality monitoring and improvement in the healthcare arena.
Methods  The original version of the English self-administered questionnaire consisting of 25 items was translated and validated using the internationally accepted and recommended methodology. The validation process included: assessment of the item internal consistency, using the alpha coefficient of Cronbach. Reproducibility (test–retest reliability) was tested by the Kappa correlation coefficient.
Results  The psychometric properties of the Greek version of the PSS were good. The internal consistency of the instrument was very good, Cronbach's alpha was found to be 0.89 ( P  < 0.001) and Kappa coefficient for reproducibility was found to be 0.84 (95% CI: 0.83–0.85, P  < 0.0001).
Conclusions  The translated and adapted Greek version is comparable with the original instrument in terms of validity and reliability.
Implications for nursing management  Managers should use validated patient satisfaction scales such as the RPSS in order to evaluate the quality of care in cancer care departments. The findings should be also compared using a bench mark on national and international levels.     

Patients' satisfaction with the care given by district nurses at home and at primary health care centres

The main purpose of this study was to investigate patients' satisfaction with the care given by the district nurses at home and at the primary health care centres in one area of Greater Stockholm. The questionnaire entitled 'Quality of Care from the Patient's Perspective' (QPP) was used. A total of 168 adult, home-care (HC) and 264 outpatient clinic (OC) patients answered this questionnaire. Maximum median scores were reported for most items designed to measure the four following dimensions: 'medical-technical' competence of the district nurses; 'physical-technical' conditions of the care organization; 'identity orientation' in the attitudes and actions of the district nurses and the 'socio-cultural' atmosphere of the care organization; and the perceived accessibility of nursing care. Some areas were identified as being in need of improvement, for example, pain alleviation, safety of the patients' home environment, the possibility of the patients participating in the decision-making process, the feeling that the care is not based on the patients' desires and needs, and the possibility of always meeting the same district nurse. Differences between HC and OC patients and between sub-groups were found regarding demographic characteristics and self-rated, physical health and psychological well-being. HC and OC patients with poor, self-rated, physical health were identified as being likely to be dissatisfied with the care.     

住院患者满意和体验监测量表的研制

目的:编制住院患者满意和体验监测量表,并对其进行信度、效度检验,为研究住院患者对护理工作满意度提供测评工具。方法:参考《护理结局分类》中患者满意度结局,自行设计患者满意度调查表,采用专家咨询法进行内容效度检验,向江苏省某"三甲"医院舒心病房患者发放调查表209份,进行内部一致性信度、结构效度检验。结果:调查表总的Cronbach’sα系数为0.95,内容效度指数为0.76。采用主成分分析法提取了5个公因子,累积贡献率为75.516%。经最大正交旋转方法提取因子,共提取出因子37个。结论:初步形成了信度、效度较好的住院患者满意和体验监测量表,为评价临床护理工作质量提供依据。     

Measuring patient satisfaction with nursing care: experience of using the Newcastle Satisfaction with Nursing Scale

Patient satisfaction with care has frequently been used as a measurement of quality, especially in attempts to demonstrate the benefits of changes in nursing practice. Unfortunately such attempts have frequently failed as patient satisfaction ratings have lacked sensitivity, consistently achieving very high scores. They have also failed to isolate the nursing component from the whole health care experience. The Newcastle Satisfaction with Nursing Scale (NSNS) has been developed after extensive research work as an attempt to establish reliable and valid measures of patients' experiences of and satisfaction with nursing care. This study evaluated the use of the NSNS in practice and found that it was readily understood by patients and easily administered by clinical staff. However, several lessons were learnt which could help its administration. The results demonstrated a very high degree of satisfaction with nursing care which left the discriminatory ability of the scale open to question, although its potential benefits in standard setting were demonstrated. Further evaluative studies are needed if the potential benefits of the NSNS are to be fully realised.