The Influence of Nursing Patient-Centered Behaviors on African-American and Black Female Medicare Patient Satisfaction

Desired outcomes for female African-American and Black Medicare patients requires more than technical nursing knowledge alone because providing nursing care requires interpersonal interaction with patients. This element of healthcare, called patient-centeredness, is the underlying ability of nurses that affects the quality of their interaction with patients and consequently outcomes. PURPOSES: The aims of this study were first to determine the effects of nursing patient-centeredness on female African-American and Black Medicare hospital patients’ satisfaction, likelihood to recommend, and ratings of care, and secondly, to determine if the effects were stable (invariant) across national random samples. METHODS: A two-factor multigroup structural equation modeling design was used with randomly selected national test (N₁=101) and cross-validation (N₂=109) samples of patients. Experiments conducted to test the model’s trustworthiness included: model goodness of fit, parameter measurement invariance, and a post hoc competing model challenge. RESULTS: The model fit. Nursing patient-centered behaviors consistently influenced female African-American and Black Medicare hospital patients’ satisfaction, likelihood to recommend, and ratings of care. Nursing patient-centeredness accounted for 71% of female African-American and Black Medicare hospital patients’ satisfaction. A standardized increase in nursing patient-centeredness concomitantly increased patients’ satisfaction, likelihood to recommend, and ratings of care by .842, .778, and .798 units respectively. The magnitude of nurses’ patient-centeredness predicted patients’ ratings. These effects were stable (invariant) across both the test and cross-validation samples of patients. When the competing model was when compared to the hypothesized model, the latter was sustained. CONCLUSIONS: This study demonstrated that nursing patient-centeredness increased female African-American and Black Medicare hospital patients’ satisfaction, likelihood to recommend, and ratings of care. The Primary Provider Theory and this study offer evidence-based models for future research with implications for the measurement and improvement of female African-American and Black Medicare hospital patients’ satisfaction, likelihood to recommend, ratings of care, nursing patient-centeredness, and disparities prevention.