Hospital environment, nurse-physician relationships and quality of care: questionnaire survey.
OBJECTIVE
This paper is a report of a study conducted to (a) to compare hospitalized patients' and nurses' perceptions of the hospital environment, nurse-physician relationships and quality of care; (b) to determine which factors best predict the quality of care from hospitalized patients' and nurses' perspectives; and (c) to assess the relationships among all variables.


BACKGROUND
Quality of care is a function of many factors and includes elements of the hospital environment and nurse-physician relationships. However, comparisons between patients' and nurses' perceptions are relatively limited.


METHODS
This was a cross-sectional study, and 575 patients and 220 nurses across 13 units completed questionnaires. Data were collected in 2009 and analysed using descriptive statistics, independent t-tests, stepwise regression and path analysis.


RESULTS
Overall, patients' mean scores were statistically significantly higher than those of nurses on perception of hospital environment (3·05 vs. 2·65 points), nurse-physician relationships (7·88 vs. 6·53 points) and quality of care (7·91 vs. 6·63 points) (P < 0·001). Both the hospital environment and nurse-physician relationships were statistically significant predictors of quality of care. Path analysis showed that quality of care was affected by the hospital environment, nurse-physician relationships and years of education for patients (P < 0·05). However, for nurses, quality of care was only directly affected by the hospital environment and nurse-physician relationships (P < 0·05).


CONCLUSIONS
These findings may help nursing leaders to ensure future excellent patient care by helping them to see which areas need improvement. They may also help nursing leaders to develop strategies to meet patients' and nurses' expectations.
Taipei County Hospital, Taiwan.
Hsi-Che
HC
Shen
Hsiao-Ting
HT
Chiu
Pi-Hsia
PH
Lee
Yi-Chun
YC
Hu
Wen-Yin
WY
Chang
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D004522:Educational Status; D005260:Female; D006272:Health Facility Environment / Q000592:standards*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019555:Physician-Nurse Relations; D011787:Quality of Health Care; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013624:Taiwan; D017132:Workplace / Q000592:standards; D055815:Young Adult