Organizational influences on patient perceptions of symptom management

Authors

  • Cynthia Thornton Bacon,

    Corresponding author
    1. School of Nursing, University of North Carolina at Chapel Hill, Campus Box 7460, c/o Dr. Barbara Mark, Room 508, Carrington Hall, Chapel Hill, NC
    • School of Nursing, University of North Carolina at Chapel Hill, Campus Box 7460, c/o Dr. Barbara Mark, Room 508, Carrington Hall, Chapel Hill, NC.
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    • Doctoral Student.

  • Linda C. Hughes,

    1. Virginia Commonwealth University, Richmond, VA
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    • Assistant Professor.

  • Barbara A. Mark

    1. School of Nursing, University of North Carolina at Chapel Hill, Campus Box 7460, c/o Dr. Barbara Mark, Room 508, Carrington Hall, Chapel Hill, NC
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    • Sarah Frances Russell Distinguished Professor.


  • This work was supported by grant number 5R01NR003149 from the National Institute of Nursing Research (National Institutes of Health) “A Model of Patient and Nursing Administration Outcomes” and by grant number 5T32NR008856 “Research Training in Health Care Quality and Patient Outcomes,” also from the National Institute of Nursing Research.

Abstract

We tested a theoretical model of the relationships of hospital context, nursing unit structure, and patient characteristics to patients' perceptions of the extent to which nurses met their expectations for management of troubling symptoms. In our sample of 2,720 patients randomly selected from 278 nursing units in 143 hospitals, we found that patient age was positively associated with patients' perceptions of symptom management. The proportion of registered nurses as caregivers on the unit was not a significant predictor of symptom management, but better work conditions on the unit (nurses' autonomy, participation in decision-making, and collaboration with other disciplines [relational coordination]) significantly contributed to patients' perceptions of better symptom management. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:321–334, 2009

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