title: A Donabedian Model of the Quality of Nursing Care From Nurses' Perspectives in a Portuguese Hospital: A Pilot Study.
abstract: OBJECTIVE
  To test a Donabedian model in a pilot study of nurses' perceptions of the quality of nursing care.
  
  
  METHODS
  Four methods for detecting the tridimensionality of perception are compared: Cronbach's alpha, Steenbergen's similarity coefficients, the box and whiskers plot (B&W), and the Friedman test.
  
  
  RESULTS
  Low alphas suggested multidimensionality; the similarity coefficients indicated confounding between two factors but B&W and the Friedman test (p < .001) suggest nurses perceive more quality in outcome than in process.
  
  
  CONCLUSIONS
  The similarity coefficients are preferable to Cronbach's alpha for estimating internal consistency and for detecting multidimensionality. B&W suggests the factors confounded using Steenbergen's method occupy different levels of perception, suggesting tridimensionality. The homogeneous social group is largely responsible for the apparently contradictory results obtained from statistical analysis.
authors.affiliation: University of Algarve, School of Health, Portugal.
authors.forename: John
authors.initials: J
authors.lastname: Voyce
authors.forename: Maria J B
authors.initials: MJ
authors.lastname: Gouveia
authors.forename: Maria A
authors.initials: MA
authors.lastname: Medinas
authors.forename: Andreia S
authors.initials: AS
authors.lastname: Santos
authors.forename: Rogério F
authors.initials: RF
authors.lastname: Ferreira
mesh_terms: D006801:Humans; D016294:Models, Nursing; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010865:Pilot Projects; D011174:Portugal; D011787:Quality of Health Care