Master of Science (Hons.)
Department of Nursing
Chuang, Hsun-Ying (Amanda), Satisfaction with care in aged care facilities, Master of Science (Hons.) thesis, Department of Nursing, University of Wollongong, 2002. http://ro.uow.edu.au/theses/2855
This research was undertaken to survey the residents and families of residents living in aged care facilities. The aim was to identify their levels of satisfaction with the quality of care received. The target population was 461 aged care facility residents in 5 nursing homes and 4 hostels belonging to a private company providing aged care. The resulting sample of 328 comprised 222 residents and 106 relatives/guardians of residents. Nearly half of the participating residents were in the age group 81 to 90 years (49.6%). The mean age of those living in nursing homes was 79.7 years (females: 81.7 years; males: 77.7 years), while the mean age of those in hostels was 82.3 years (females: 83.4 years; males: 81.2 years). The researcher met individually with each resident during his/her free time. Initially questionnaires for relatives or guardians were left in each facility, however, when the return rate was low, the questionnaires for relatives were mailed directly to them with a reply paid envelope. Ethical approval to conduct the survey was given by the University of Wollongong Human Experimentation Ethics Committee.
The questionnaires were developed using a combination of two satisfaction instruments: the Satisfaction with the Nursing Home Instrument (SNHI), and the Resident Satisfaction Schedule (RSS). Responses to the satisfaction tools might be affected by other factors than level of satisfaction with the aged care facility. Therefore, two additional instruments were used: the Life Satisfaction Index (LSI), and Schwabb's Depression Scale (SDS). Four instruments were used in the questionnaires for residents, whilst the questionnaires for relatives or guardians did not use the LSI and SDS instruments. Four extra questions were added to the relatives or guardians survey, two to the SHNI section and two to the RSS section. Two open-ended qualitative questions wear added for all participants.
The results indicate that the average satisfaction rate was 80.9% for SNHI and 70.4% for RSS. The approximate10% difference between the two satisfaction instruments is mainly due to the different questions in the two tools. There are many areas of similarity in the questionnaires, but the two instruments by no means parallel each other. Using the six subscales of the SNHI and matching corresponding items on the RSS it was possible to show a degree of correspondence between the two instruments. Satisfaction ratings on both instruments of some of the items in each of the subscales of the SNHI except one were below average. The items in the subscale "Involvement of the Family" were all rated highly by both residents and relatives/guardians. The findings also showed that the mean score in the SNHI for hostel residents was higher than for nursing home residents. The mean scores in the RSS were similar for both nursing home and hostel residents. However, mean satisfaction ratings for each facility were different and the mean satisfaction ratings on both SNHI and RSS in one nursing home were significantly lower than in the other facilities.
Life Satisfaction scores were somewhat lower than might have been expected (mean 44%). Life Satisfaction and Satisfaction scores were significantly correlated (r =0.39) but there was a negative correlation (r = -0.49) between Life Satisfaction and Depression. Higher depression scores may well have influenced the lower satisfaction rating of some nursing home residents. Residents in three of the nursing homes had significantly higher depression scores than residents in the other facilities. Depression scores in female residents were slightly higher than in male residents but not significantly different. Interestingly, divorced residents had lower depression scores and higher life satisfaction scores, while single residents had higher depression scores and lower life satisfaction scores.
The participants were also given the opportunity to make comments on the care provided and the staff giving care. The comments lend further support to the quantitative data. In general both relatives and residents commented positively on the care given although there were a few adverse comments from relatives/guardians about physical care. Both residents and relatives/guardians made negative comments about staff shortage, and a number of both residents and relatives/guardians made comments about the quality of the staff. Most of these latter comments were positive but there were also a few negative comments. These comments demonstrate that the residents were able to assess the care they were receiving.
In making recommendations based on the data the assumptions are made that items rated at or above average are aspects of care with which residents and relatives are reasonably satisfied; and that items rated below average are aspects of care which need attention. Many of the recommendations will require some staff education to assist in bringing them about. This can be achieved by the provision of on-going in-service education as well as by sponsoring staff to attend appropriate educational activities provided elsewhere.