NURSE-PATIENT CONGRUENCE IN PROBLEM IDENTIFICATION IN THE HOME HEALTH SETTING.
Contributors: University Of Illinois At Chicago, Health Sciences Center.
Published: 1991
Number of pages: 148
Subjects: Health Sciences, Public Health.; Health Sciences, Nursing.; Business Administration, Management.
Description: Nurses practicing in the dynamic and growing field of home health care will be held increasingly accountable for well defined patient care outcomes of their services. One outcome that is viewed in the literature as a component of quality care is provider-patient congruence in problem identification. The purpose of this study was to develop a measure of nurse-patient congruence in problem identification and then to examine the relationship between this congruence and individual, job, and case characteristics.

Seventy-one (71) nurse-patient dyads were interviewed using a combination of an investigator developed interview guide (POPI) and the Symptom Distress Scale (SDS) in order to assess congruence in the following areas: symptoms, severity of symptoms, main and secondary problems, outcome(s), and satisfaction with the case. The obtained responses were coded and used to calculate an overall congruence score. Individual providers demonstrated consistent patterns of congruence in problem identification (p $<$.032). This provides support for this congruence measure's ability to discriminate among providers. The measure had a high Kappa (.875) when tested for interrater reliability.

Support was also found for the theoretical assumption that individual provider characteristics as well as contextual (job and case) characteristics affect congruence levels. Higher congruence scores were significantly associated with higher autonomy perceptions, full time employment status, and satisfaction with case outcome. High agency mean congruence scores were associated with high percentages of BSN prepared staff nurses. Stepwise regression was used to identify the best set of predictor variables for the outcome measure of congruence. This exploratory analysis produced a model that accounted for over 42% of the variance in the congruence score. The variables in this model include: agency, autonomy$\sp*□ □$growth need strength, satisfaction and professional commitment.
Notes: Source: Dissertation Abstracts International, Volume: 53-02, Section: B, page: 0797.

Thesis (PH.D.)--UNIVERSITY OF ILLINOIS AT CHICAGO, HEALTH SCIENCES CENTER, 1991.

School code: 0806.