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

Int J Nurs Stud. 2007 Feb;44(2):197-207. doi: 10.1016/j.ijnurstu.2005.11.030. Epub 2006 Jan 19.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Communication
  • Cross-Sectional Studies
  • Female
  • Finland
  • Humans
  • Likelihood Functions
  • Linear Models*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nurse-Patient Relations
  • Nursing Evaluation Research
  • Nursing Methodology Research
  • Nursing Theory
  • Outcome Assessment, Health Care
  • Patient Care Planning / organization & administration*
  • Patient Participation / psychology
  • Patient Satisfaction*
  • Patient-Centered Care / organization & administration*
  • Quality of Life / psychology
  • Surveys and Questionnaires