Provision of individualised care improves hospital patient outcomes: An explanatory model using LISREL

Background: Previous studies propose the efficacy of individualised care for hospital patients. Individualised care and proposed correlates have not been tested by means of a single multivariate analyses simultaneously. Objectives: The aim of this study is to examine predicted relationships between individualised care and patient satisfaction, patient autonomy and health-related quality of life. Design: A cross-sectional correlational survey. Settings: This study was carried out in six acute hospitals in Southern Finland. Participants: A sample of 861 (response rate 84%) pre-discharged hospitalised adult patients were recruited from surgical, gynaecological and internal medicine units. Methods: A correlational survey design was used to investigate to complete a battery of instruments measuring individualised care (the ICS), patient satisfaction with nursing care (the PSS), patient autonomy and perceived health-related quality of life (the 15D). The data from these instruments were used to test the proposed model using LISREL implementing the Maximum Likelihood estimation procedure. Results: The findings support the proposed model linking individualised nursing care directly to the positive patient outcomes defined. The initial model, permitting all possible covariances, showed a good fit between the variables. Independent variables, supported individuality through nursing interventions (ICS-A) and perception of individuality in their own care (ICS-B) accounted for 58% of the variance in the frequency of individualised care. Individualised care explained the variance on the dependent variables patient satisfaction and patient autonomy. A low but significant association was also found between individualised care and perceived health-related quality of life. Conclusions: The results of this study highlight the contribution of individualised nursing care to positive patient outcomes, such as patient satisfaction, patient autonomy and perceived health-related quality of life. Not only clinically important, this model also has implications for further research into individualised care and its relationship with positive patient outcomes.