A Donabedian Model of the Quality ofNursing Care From Nurses' Perspectivesin a Portuguese Hospital: A Pilot Study

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Background and Purpose:

To test a Donabedian model in a pilot study of nurses' perceptions of the quality of nursing care.


Four methods for detecting the tridimensionality of perception are compared: Cronbach's alpha, Steenbergen's similarity coefficients, the box and whiskers plot (B&W), and the Friedman test.


Low alphas suggested multidimensionality; the similarity coefficients indicated confounding between two factors but B&W and the Friedman test (p < .001) suggest nurses perceive more quality in outcome than in process.


The similarity coefficients are preferable to Cronbach's alpha for estimating internal consistency and for detecting multidimensionality. B&W suggests the factors confounded using Steenbergen's method occupy different levels of perception, suggesting tridimensionality. The homogeneous social group is largely responsible for the apparently contradictory results obtained from statistical analysis.

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