The Effects of Patient and Nursing Unit Characteristics on Outcomes among Hospitalized Patients with Chronic Illness in Thailand

Persistent Link:
http://hdl.handle.net/10150/194037
Title:
The Effects of Patient and Nursing Unit Characteristics on Outcomes among Hospitalized Patients with Chronic Illness in Thailand
Author:
Meeboon, Sriwan
Issue Date:
2006
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The purpose of this cross-sectional correlational study was to examine the effects of patient and nursing unit characteristics on nursing-sensitive patient outcomes. The conceptual framework for this study is generated from the Quality Health Outcomes Model. The patient characteristics were patient age, gender, education, duration of illness, severity of illness, and illness representation. The nursing unit characteristics were nurse experience, nurse staffing, nursing unit competency, and group cohesion. Nursing-sensitive patient outcomes were patient’s confidence in self-care and patient’s perception of being well-cared for. Stratified sampling was employed to recruit a sample of 130 hospitalized chronically ill patients in 8 medical care units of 4 hospitals in Thailand. A face-to-face questionnaire interview was used to collect data from patients. A self-administered questionnaire was used to collect data from 90. Nurse staffing data were obtained from nursing administrative data for each unit. Multiple regression analyses were used to examine the relationships, test a mediator, and analyze the contextual effect of the study variables. Severity of illness (β = -.315, p <.01) and illness representation (β = -.234, p < .05) were significant predictors of patient’s confidence in self-care, when controlling for nursing unit characteristics. Illness representation partially mediated the relationship between severity of illness and patient’s confidence in self-care. Nursing unit characteristics were not significant predictors of patient’s confidence in self-care, when controlling for patient characteristics. There was a significant individual effect on patient’s confidence in self-care. Severity of illness (r = -.199, p < .05) and group cohesion (r = -.195, p < .05) were correlated with patient’s perception of being well-cared for. The findings of this study reinforce the need for acute care nurses to be aware of how chronically ill patients perceive health threats since illness representation directly affects patient’s confidence in self-care. Through understanding the role of illness representation as a mediator between severity of illness and confidence in self-care, it is suggested that nurses can improve patient’s confidence in self-care in severely ill patients by providing nursing interventions that promote positive illness representation.
Type:
text; Electronic Dissertation
Keywords:
patient characteristics; nursing unit characteristics; confidence in self-care; perception of being well-cared for
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Nursing; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Insel, Kathleen C.
Committee Chair:
Insel, Kathleen C.

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleThe Effects of Patient and Nursing Unit Characteristics on Outcomes among Hospitalized Patients with Chronic Illness in Thailanden_US
dc.creatorMeeboon, Sriwanen_US
dc.contributor.authorMeeboon, Sriwanen_US
dc.date.issued2006en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe purpose of this cross-sectional correlational study was to examine the effects of patient and nursing unit characteristics on nursing-sensitive patient outcomes. The conceptual framework for this study is generated from the Quality Health Outcomes Model. The patient characteristics were patient age, gender, education, duration of illness, severity of illness, and illness representation. The nursing unit characteristics were nurse experience, nurse staffing, nursing unit competency, and group cohesion. Nursing-sensitive patient outcomes were patient’s confidence in self-care and patient’s perception of being well-cared for. Stratified sampling was employed to recruit a sample of 130 hospitalized chronically ill patients in 8 medical care units of 4 hospitals in Thailand. A face-to-face questionnaire interview was used to collect data from patients. A self-administered questionnaire was used to collect data from 90. Nurse staffing data were obtained from nursing administrative data for each unit. Multiple regression analyses were used to examine the relationships, test a mediator, and analyze the contextual effect of the study variables. Severity of illness (β = -.315, p <.01) and illness representation (β = -.234, p < .05) were significant predictors of patient’s confidence in self-care, when controlling for nursing unit characteristics. Illness representation partially mediated the relationship between severity of illness and patient’s confidence in self-care. Nursing unit characteristics were not significant predictors of patient’s confidence in self-care, when controlling for patient characteristics. There was a significant individual effect on patient’s confidence in self-care. Severity of illness (r = -.199, p < .05) and group cohesion (r = -.195, p < .05) were correlated with patient’s perception of being well-cared for. The findings of this study reinforce the need for acute care nurses to be aware of how chronically ill patients perceive health threats since illness representation directly affects patient’s confidence in self-care. Through understanding the role of illness representation as a mediator between severity of illness and confidence in self-care, it is suggested that nurses can improve patient’s confidence in self-care in severely ill patients by providing nursing interventions that promote positive illness representation.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectpatient characteristicsen_US
dc.subjectnursing unit characteristicsen_US
dc.subjectconfidence in self-careen_US
dc.subjectperception of being well-cared foren_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineNursingen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorInsel, Kathleen C.en_US
dc.contributor.chairInsel, Kathleen C.en_US
dc.contributor.committeememberVerran, Joyce A.en_US
dc.contributor.committeememberJones, Elaineen_US
dc.identifier.proquest1867en_US
dc.identifier.oclc659746422en_US
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