An investigation of the relationship of nurses’ perceptions of human resource practices and autonomy in practice and patients’ perceptions of satisfaction with nursing care and organizational climate for service

Abstract

<p>This study developed and tested theory to better understand the marketing construct of service quality, in a hospital setting. Marketing theory proposed that positive relationships exist between patients' perceptions of service quality and the following independent variables (a) nurses' perceptions of human resource practices, (b) nurses' perceptions of autonomy in practice, (c) patient satisfaction with nursing care, and (d) patients' perceptions of organizational climate for service. The sample was comprised of 102 nurse-patient dyads who were recruited at a metropolitan university hospital. The patient sample was primarily made up of white (86.2%), married (80.4%), men (61.8%) whose ages ranged from 24 to 83 years. The nurse sample was comprised of predominantly white (64.7%), staff nurses (94.1%) who were mostly women (93.1%). Hypotheses testing employed correlational and regression statistical techniques. No statistically significant relationships were found between patients' perceptions of service quality and (a) nurses' perceptions of human resource practices (r =.11, p =.13), or (b) nurses' perceptions of autonomy in practice (r =.08, p =.22). Strong positive relationships were found between patients' perceptions of service quality and (a) patient satisfaction with nursing care (r =.74, p $&lt;$.0001) and (b) patients' perceptions of organizational climate for service (r =.71, p $&lt;$.0001). The multiple regression hypothesis testing did not support a four-variable model; however, a two-variable model explained 66% of the variance in service quality (F (2,99) = 32.91, p $&lt;$.01). Two nurse variables, human resource practices and autonomy in practice, although theoretically related to service quality, failed to explain variance in service quality. Based on alternate theoretical and methodological explanations it can be concluded that selected marketing propositions concerning service quality may not be generalizable to acute care hospitals. The patient variables of patient satisfaction with nursing care and patients' perceptions of organizational climate for service both demonstrated considerable power in explaining variance in service quality. Therefore, it can be concluded that patients' perceptions of selected variables are important components of marketing theory that have meaningful application in acute care hospitals because of their strong bearing on service quality.</p>