Research Problem/Purpose
The authors indicated the research problem in the introduction section of the study. They highlighted the presence of inconsistencies in existing studies on the contribution and association between gender difference and patient satisfaction (Chumbler, Otani, Desai, Herrmann, & Kurz, 2016). Additionally, the authors highlighted a lack of information on specific hospital care delivery attributes, which mostly influence patient satisfaction amongst elderly patients.
The authors placed the research problem within the existing knowledge by indicating that there is unclear and inconsistent information on the contribution of healthcare attributes and gender on patient satisfaction. The study is important in assessing the factors that significantly contribute to patient satisfaction in a hospital setting. The findings provide relevant information for the improvement of the quality of care. In the study, the purpose of the study was to determine if the care experiences and satisfaction varied according to gender and hospital dimensions.
Review of the Literature
In the research article, the literature review section is missing. However, the authors have used relevant and existing studies in introducing the study to support and provide detailed background for the research. The concepts explored by the authors in the literature review involve the associated contribution of the various hospital care attributes on patient satisfaction, which influence patient compliance and continued use of health services.
Moreover, Chumbler et al. (2016) discussed various experiences associated with hospital admission and care delivery. In this context, they have highlighted the significant benefits of evaluation of care quality, healthcare providers, and the hospital settings. Most references used by the authors are current and relevant to modern-day health issues. The authors’ use of current references is in line with the choice of a standardized modern research tool, the Hospital Consumer Assessment of Healthcare Providers and Systems questionnaire (HCAHPS). Therefore, the use of the latest research evidence significantly enhances the importance of the need for the research.
Theoretical Framework
The article does not highlight theoretical concepts associated with the study of patient satisfaction among old patients aged 65 and above. Moreover, the research does not explicitly indicate the theory from which it draws its concepts and principles. As the article does not have both theoretical concepts and nursing theory, it has no theoretical framework stated. However, the Primary Provider Theory is the appropriate nursing theory and theoretical framework for the study.
According to the Primary Provider Theory, the patient-centeredness of healthcare services determines the health outcomes of patients and consequently patient satisfaction (Aragon, Richardson, Lawrence, & Gesell, 2013). In this view, the ability of healthcare providers to manipulate hospital dimensions reflects the experience, outcomes, and satisfaction of patients.
Variables/Hypotheses/Questions/Assumptions
In the article, the independent variables comprise the factors surrounding the healthcare facility and the human element. These variables include facility conditions, demographic features, and composite measures. The conditions of the facility referred to hospital cleanliness and sound effect in the surrounding. Demographic features are age, education, gender, perceived health, and race. On composite variables, the study components include doctor-patient communication, nurse communication, instructions on drugs, and subordinate staff responsiveness. These variables provided a basis for the evaluation of the dependent variable of patient satisfaction.
The questionnaire used has concrete and measurable responses. HCAHPS has standardized response options containing arithmetic calculations for all items in the questionnaire making it measurable while significantly enhancing the validity of the results.
The authors did not state the research questions clearly, but they inferred two research questions.
- Which HCAHPS dimensions significantly predict the overall patient satisfaction in a hospital setting?
- What gender difference exists in inpatient satisfaction given the same HCAHPS dimensions?
The authors’ hypothesized there are no gendered difference in patient satisfaction based on hospital healthcare experience. Additionally, the authors’ second hypothesis is that all HCAHPS dimensions do not predict patient satisfaction in hospitalized patients.
Methodology
The study used the quantitative approach, which facilitated measurement of variations in HCAHPS dimensions and utilized a cross-sectional research design in data collection. The researchers employed a prospective randomized selection of participants in the selected hospitals. In cross-sectional research design, the researchers used deductive reasoning essentially to test the validity of the existing theory on factors influencing patient satisfaction in care delivery. The authors employed used a simple random sampling technique in selecting 6,021 older hospitalized patients. The age category included patients 65 years of age and those older.
The participants were selected from 70 hospitals from the nonprofit member hospitals of the American health care system. The large geographical coverage and sample size adequately represent the American old patient population. Additionally, the research utilized a probability sampling approach in selecting the participants from the different hospitals. The random sampling helped to reduce selection bias among the participants, ensure the equal chance of selection of eligible patients, and enhance the representation of the population.
The type of reliability used is internal consistency reliability and the type of validity is construct validity for the research tool contains the essentially significant elements of medical practices that predict patient satisfaction in healthcare delivery. These elements are regulated by the Centers for Medicare and Medicaid Services (CMS) tasked with the responsibility of ensuring incorporation of all dimensions associated with patient care.
Moreover, standardized data responses and the continuous update of HCAHPS by well recognized and scientific bodies that include Harvard Medical School and American institute for research through systematic and advanced scientific process enhances the reliability and validity of the HCAHPS instrument. The researchers observed ethical considerations in conducting the study by following the stipulated protocol facilitated by CMS in ensuring observation of proper research ethics.
Data Analysis
The study used Statistical Package for Social Sciences (version 22) in performing data analysis. The study utilized descriptive statistics the analysis of demographic variables and regression analysis in determining the degree of relationship between hospital dimensions and satisfaction of patients. The article presents descriptive statistics and outcomes of regression analyses using tables. The notable finding of the study is that all hospital dimensions are statistically significant predictors of satisfaction among patients aged 65 and above. Another finding is that with the adjustment of education, age, self-rated health status, and race, older male patients had a lower satisfaction level than older female patients.
Summary/Conclusions, Implications, and Recommendations
The research utilized a worldwide-recognized survey instrument. The HCAHPS instrument has higher reliability and validity due to the continuous update of the measurable elements of patient experiences through the scientific processes by the noble scientific institutions. Pomey, Hihat, Khalifa, Lebel, and Neron (2015) hold that patient experiences are essential factors important in the improvement of care the process.
The HCAHPS instrument is regulated by CMS to ensure observation of research ethics. Moreover, the study involved a large sampling of 6,021 participants from diverse geographical locations of the United States, and thus, enhancing its generalizability. However, the study was conducted only in the United States and did not consider patients from other regions around the world. In this view, the findings may only be relevant to developed countries.
Therefore, the generalization of the findings to other populations especially in developing nations is limited due to the fact the health care systems and human considerations of these nations are still underdeveloped. The findings of the study are significantly important in nursing as the results can be applied to the improvement of nursing care for older patients and enhancing the quality of life.
References
Aragon, S., Richardson, L., Lawrence, W., & Gesell, S. (2013). Nurses’ patient-centeredness and perceptions of care among Medicaid patients in hospital obstetrical units. Nursing Research and Practice, 2013(563282), 1-7. Web.
Chumbler, N., Otani, K., Desai, S., Herrmann, P., & Kurz, R. (2016). Hospitalized older adults’ patient satisfaction: Inpatient care experiences. SAGE Open, 1(1), 1-7. Web.
Pomey, M., Hihat, H., Khalifa, M., Lebel, P., & Neron, A. (2015). Patient partnership in quality improvement of healthcare services: Patient inputs and challenges faced. Patient Experience Journal, 2(1), 29-42.