title: Perception gap in quality-of-life ratings: an empirical investigation of nursing home residents and caregivers.
abstract: 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.
authors: Katz Graduate School of Business, University of Pittsburgh, PA, USA.
authors: Vikas
authors: V
authors: Mittal
authors: Jules
authors: J
authors: Rosen
authors: Rahul
authors: R
authors: Govind
authors: Howard
authors: H
authors: Degenholtz
authors: Sunil
authors: S
authors: Shingala
authors: Shelley
authors: S
authors: Hulland
authors: Yongjoo
authors: Y
authors: Rhee
authors: Kari B
authors: KB
authors: Kastango
authors: Benoit H
authors: BH
authors: Mulsant
authors: Nick
authors: N
authors: Castle
authors: Fred H
authors: FH
authors: Rubin
authors: David
authors: D
authors: Nace
mesh_terms: 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