Nursing Patient-Centeredness Improves African-American Female Medicare Patients' Experience-of-Care.

Abstract

Background: Along with clinical technical competence, nurses' interpersonal ability influences patient outcomes. Patient-centeredness, "[p]roviding care that is respectful of, and responsive to, individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions" (IOM, 2001, p. 3), is especially important in assuring that African-American Medicare patients achieve the desired outcomes.

Purposes: This study was designed to measure the effects of nursing patient-centeredness on African-American female Medicare hospital inpatients across national random test and cross-validation samples; specifically, on their experience-of-care, likelihood of recommending the hospital, and ratings of care. The stability of effects was assessed across samples and a competing model challenge further tested the hypothesis.

Hypothesis: Nursing patient-centeredness improves African-American female Medicare hospital patients' experience-of-care and increases the likelihood that they will recommend and highly rate their care.

Results: Supporting the hypothesis, the model fit. Nursing patient-centeredness significantly influenced African-American female Medicare hospital patients' experience-of-care, likelihood of recommending the hospital, and ratings of care (χ² = 39.35, df = 42, p = .588; RMSEA = .000, p =.982 CL90% = .000-.043; CFI = 1.000), explaining 71% of the variance of patients' experience-of-care (p < .001). A unit increase in nursing patient-centeredness increased patients' experience-of-care, likelihood of recommending the hospital, and ratings of hospital care by .842, .778, and .798 standardized units, respectively. These results were stable across both the test and cross-validation samples, and the hypothesized model was sustained when compared to the hypothesized competing model (χ²Δ = 10.974, df = 16, p = .811).

Discussion: Nursing performance is often chiefly associated with clinical or technical competence. Patient-centeredness concerns nurses' ability that affects the quality of their interaction with patients and concomitant outcomes. This study provided empirical evidence that nursing patient-centeredness significantly improves African-American female Medicare hospital patients' experience-of-care and increases the likelihood that they will recommend and highly rate their care.