Paper
Friday, July 13, 2007
The Influence of Nurse Practitioner Patient-Centeredness on Pediatric, Internal Medicine and Family Practice Patient's Satisfaction
Stephen J. Aragon, PhD, MHA, BS1, Sheigethia Edwards, MSN, BSN2, and Stephanie Pickett, MSN, BSN2. (1) School of Health Sciences- Department of Nursing, Winston-Salem State University, Winston-Salem, NC, USA, (2) The School of Health Sciences, Department of Nursing, Winston-Salem State University, Winston-Salem, NC, USA
PURPOSE: The purpose of this study was to determine the effects of patient-centered care on the satisfaction and trust with, confidence in, and likelihood of recommending nurse practitioners across three national random samples of pediatric, internal medicine, and family practice patients, and secondly, to determine if the effects were robust across these samples. METHODS: A two-factor multigroup structural equation modeling design was used, with cross-group equality constraints to test the robustness of the model and equality of its effects across groups. The model was compared with a competing model to further test its plausibility. RESULTS: The two-factor model fit the data well. The patient-centeredness of nurse practitioners explained 86 percent of the variability of satisfaction with nurse practitioners. When patient-centered care increased by one unit, satisfaction with the nurse practitioner increased by 1.069 units (.928 standardized), confidence in nurse practitioner increased by 1.069 units (.891 standardized), and the likelihood of recommending the nurse practitioner by 1.075 units (.869 standardized). Practitioners’ patient-centered concern for their patient’s questions and worries, efforts to include them in treatment decisions, and follow-up care instructions increased satisfaction with care and the practitioners. This pattern of effects held across the pediatric, internal medicine, and family practice patients. The model’s plausibility was sustained when compared with the competing model. DISCUSSION: This investigation illuminated the positive influence of patient-centered care on the satisfaction with, confidence in, and likelihood of recommending nurse practitioners across for pediatric, internal medicine, and family practice patients. The results offer a plausible two-factor model for the measurement and improvement of satisfaction with nurse practitioners. It has implications for evidence-based outcome measurement and nursing education.