Perception gap in quality-of-life ratings: an empirical investigation of nursing home residents and caregivers.
OBJECTIVE
Several studies have previously documented the existence of a perception gap-the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual factors.


METHODS
We calculated the perception gap for 11 quality-of-life domains. Caregivers rated both job satisfaction and their perception of quality of life of residents in the unit where they provided service. Concurrently, residents from these units completed quality-of-life interviews. We computed the perception gap by subtracting the residents' ratings from the caregivers' ratings for each quality-of-life domain. We conducted a hierarchical linear model using 3,850 observations to predict the perception gap.


RESULTS
Caregivers perceive quality of life to be lower than residents do across all domains fairly consistently. Caregiver demographics do not directly predict the perception gap. However, satisfaction with work, pay, and promotion were significant predictors (p <.05), and satisfaction with supervisor was a marginally significant predictor (p <.10), of the perception gap. As satisfaction with these job dimensions increased, the perception gap decreased. Additional models show that several caregiver demographics directly influence job-satisfaction dimensions, though they did not influence the perception gap.


CONCLUSIONS
Job-satisfaction dimensions, rather than caregiver characteristics, are the appropriate predictors of the perception gap. However, caregiver demographics exert their influence indirectly by means of job satisfaction. A key finding is that higher job satisfaction leads to a smaller perception gap. Helson's adaptation-level theory appears to be a useful approach for understanding the antecedents of the perception gap.
Mittal
Vikas
V
Katz Graduate School of Business, University of Pittsburgh, PA, USA.
Rosen
Jules
J
Govind
Rahul
R
Degenholtz
Howard
H
Shingala
Sunil
S
Hulland
Shelley
S
Rhee
Yongjoo
Y
Kastango
Kari B
KB
Mulsant
Benoit H
BH
Castle
Nick
N
Rubin
Fred H
FH
Nace
David
D
D000328:Adult; D017028:Caregivers / Q000523:psychology*; D036262:Empirical Research; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007588:Job Satisfaction; D008297:Male; D009735:Nursing Homes; D017060:Patient Satisfaction; D011788:Quality of Life; D014481:United States