title: Advancing the Big Five of user-oriented care and accounting for its variations.
abstract: OBJECTIVE
  Care process quality (i.e. how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The purpose of this paper is to describe the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care.
  
  
  METHODS
  Two municipalities were selected for in-depth field studies. First, in each municipality, the authors interviewed and observed care workers' interactions with the older persons in both home care and nursing homes during two weeks (Study 1). Second, in an attempt to gain a deeper understanding of why process quality in terms of user-oriented care varies, the authors conducted interviews with care workers and care unit managers (Study 2).
  
  
  RESULTS
  A new taxonomy for categorizing process quality variation, the Big Five of user-oriented care (task-focus, person-focus, affect, cooperation, and time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality level).
  
  
  CONCLUSIONS
  The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.
authors.affiliation: Department of Psychology, University of Gothenburg, Göteborg, Sweden.
authors.forename: Petri
authors.initials: P
authors.lastname: Kajonius
authors.forename: Ali
authors.initials: A
authors.lastname: Kazemi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002965:Classification; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care / Q000458:organization & administration*; D057285:Precision Medicine; D011787:Quality of Health Care; D018570:Risk Assessment; D013548:Sweden
keywords: Elderly care; Individualized care; Person-centred care; Service quality; User satisfaction; User-oriented care