Date of Award


Document Type


Degree Name

Master of Science (MS)



Research Advisor

June H. Larrabee, Ph. D., R. N.


Margaret Hartig, Ph. D., R. N.


Nursing, Patient perception, Quality of care


The influence of patient values and patient perception of benefits on patient perceptions of quality have not been extensively investigated, even though patient and provider perceptions of quality have been widely studied. Refocusing quality assessment and improvement to include factors that influence patient perceptions of quality is necessary for humanitarian and economic reasons. The health care patient has certain expectations of health care. These expectations are based on the value the patient places on the services. Value is a predictor of patient-perception of quality. The relative worth of patient goals may also be related to patient perceptions of quality. If so, providers need to consider this when giving care and assessing quality. This study was a secondary analysis of a study by Larrabee, “Hospital Patients’ and Nurses’ Perception of Quality". The sample consisted of 199 patients. The purpose of this study was to examine the relationships between quality and value as relative worth and quality and beneficence from the patient’s perspective. There were four key findings. First, a close relationship was found between patient-perceived quality and value and patient-perceived quality and beneficence. These findings supported the proposition that value and beneficence are related to quality. Second, this study provided partial support for the proposition that value as relative worth is related to quality. This finding identifies the need for further research into the qualitative nature of patient goals and their different rankings. Third, patients appeared to value all their goals equally even when pain relief was one of their goals. However, when pain relief was identified as goal one, the achievement of this goal was related to increased patient-perceived quality. Finally, a strongly positive relationship was found among all three patient goals. This indicated that patient goals may be interrelated and interdependent on each other, and that the achievement of one leads to the achievement of the others. The implications for nursing include nurses having patients identify their own health goals. By validating the worth of the patient’s goals, by acknowledging them and assisting in their achievement, the nurse will demonstrate beneficence. As the patient perceives benefits from care, their perceptions of quality should increase. In conclusion, the findings in this study suggest that assisting patients in meeting all their health goals is an important strategy for improving patient outcomes and patient satisfaction. It also may help an agency maintain market share, since satisfied patients are more likely to return for future care.