QUALITY OF CARE FROM THE ELDERLY PERSONS PERSPECTIVE - SUBJECTIVE IMPORTANCE AND PERCEIVED REALITY

The aim of this study was to carry out a theoretically-based survey of elderly persons' perceptions of quality of care, in terms of their ev aluations of actual care conditions, as well as the subjective importa nce they ascribe to these. The sample consisted of 428 elderly (greate r than or equal to 60 years) persons, in four different care environme nts: a geriatric department (N=51); persons receiving home nursing (N= 111); nursing homes (N=111); and service homes (N=154) in two Swedish cities. Data were collected by way of personal interviews, structured from the questionnaire, Quality from the Patients' Perspective (QPP), The QPP is theory-based and consists of 40 items covering 17 factors. Each item was evaluated in two ways by the respondent: assessment of p erceived reality, and evaluation of subjective importance (Likert scal es). The results show that personal characteristics, such as age, sex, and self-rated health, had a limited effect on reports of what were r egarded as highly important care characteristics, as well as on rating s of actual care conditions. Psychological well-being was strongly rel ated to perceived reality ratings; a favorable well-being covaried wit h favorable ratings and vice versa. Considerable differences were note d in both types of ratings when the four types of cave environments we re compared. On the subjective importance scales, persons living in se rvice homes reported lower scores, particularly on the scales designed to measure the medical-technical competence of the caregivers. On the perceived reality scales, the participants in service homes and the g eriatric department scored lower, Thus, different types of care enviro nments may be connected with different kinds of expectations and needs , which through selective perception and socialization processes, may be strengthened during a person's stay in a particular cave environmen t, In contrast to previous studies, highest scores on subjective impor tance were noted on the scales designed to measure care equipment and care room characteristics; this could be due to the fact that physical -technical conditions often have a direct impact on the daily lives of elderly people.