title: Care-as-service, care-as-relating, care-as-comfort: understanding nursing home residents' definitions of quality.
abstract: OBJECTIVE
  This study explored how nursing home residents define quality of care.
  
  
  METHODS
  Data were collected through in-depth interviews and were analyzed using grounded dimensional analysis.
  
  
  RESULTS
  Residents defined quality in three ways: (a) Care-as-service residents focused on instrumental aspects of care. They assessed quality using the parameters of efficiency, competence, and value. (b) Care-as-relating residents emphasized the affective aspects of care, defining quality as care that demonstrated friendship and allowed them to show reciprocity with their caregivers. (c) Care-as-comfort residents defined quality as care that allowed them to maintain their physical comfort, a state that required minute and often repetitive adjustments in response to their bodily cues.
  
  
  CONCLUSIONS
  Residents' perceptions of care quality have implications for long-term care practice. The integration of these perceptions into quality assurance instruments could improve the usefulness of tools designed to obtain resident input.
authors.affiliation: School of Nursing, University of Wisconsin-Madison, K6/328 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA. bjbowers@facstaff.wisc.edu
authors.forename: B J
authors.initials: BJ
authors.lastname: Bowers
authors.forename: B
authors.initials: B
authors.lastname: Fibich
authors.forename: N
authors.initials: N
authors.lastname: Jacobson
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing* / Q000523:psychology; D003258:Consumer Behavior; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D009735:Nursing Homes; D019984:Quality Indicators, Health Care