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Measures of Nursing Environment Multidimensionality and Patient Centricity Using Importance-Performance Map Analysis

*Andy Andy  -  Department of Hospital Administration, Graduate School of Management, Universitas Pelita Harapan, Indonesia
Salsabilla Maula Zalfa El-Hamzah  -  Department of Hospital Administration, Graduate School of Management, Universitas Pelita Harapan, Indonesia
Ferdi Antonio  -  Department of Hospital Administration, Graduate School of Management, Universitas Pelita Harapan, Indonesia
Open Access Copyright (c) 2022 Nurse Media Journal of Nursing
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Background: The nursing environment has become a consideration for an organization in improving service quality, especially in the implementation of patient-centred care. The various dimensions make it necessary to know which sectors need to be prioritized. However, there is still limited research that is more specific in linking the dimensions to become more operational.  

Purpose: This study aimed to analyze the relationship between nursing environment dimensions and patient centricity through the Importance-Performance Map Analysis (IPMA).

Methods: A quantitative survey with a cross-sectional approach was conducted in June 2022 to test the conceptual framework on the population obtained from non-managerial inpatient nurses who worked for above two years in a general hospital in East Java, Indonesia. The constructs were measured using a set of indicators in The Practice Environment Scale of the Nursing Work Index (PES-NWI) and Patient Centricity. During the data collection, a total sampling technique was performed, resulting in 89 respondents being acquired. The data were analyzed through partial least squared structural equation modelling (PLS-SEM).

Results:  At the construct level, the mean total effect and performance were 0.192 and 56.302, respectively. From the IPMA chart, it was found that the construct in the right lower quadrant with the largest total effect value but not having adequate performance was nursing manager ability (total effect: 0.294, performance: 34.563), making it a construct with the highest importance and requiring priority for improvement among all dimensions.

Conclusion: The nursing environment dimensions have to get attention to achieve patient centricity in inpatient ward nurses, where nursing manager ability is the dimension that has the most vulnerable performance. Leadership development is needed for the head nurse of the inpatient unit to strengthen the ability to lead and change the culture in nurturing subordinates so that kinship between nursing professionals can be established.
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Keywords: Importance-performance map analysis; inpatient nurses; nursing environment; patient centricity

Article Metrics:

  1. Abualrub, R. F., & Alghamdi, M. G. (2012). The impact of leadership styles on nurses’ satisfaction and intention to stay among Saudi nurses. Journal of Nursing Management, 20(5), 668–678.
  2. Adriansyah, A. A., Setianto, B., Sa'adah, N., Arindis, P. A. M., Kurniawan, W. E., & Lestari, I. (2021). Analisis insiden keselamatan pasien di rumah sakit berdasarkan pendekatan beban kerja dan komunikasi [Analysis of patient safety incidents in hospitals based on the workload and communication approach]. Jurnal Manajemen Kesehatan Indonesia, 9(3), 183-190.
  3. Ali, B. R. M., & Wajidi, F. A. (2013). Factors influencing job satisfaction in public healthcare sector of Pakistan. Global Journal of Management and Business Research Administration and Management, 13(8), 61–66
  4. Andy, A., & Antonio, F. (2022). Linking work engagement of emergency physicians to patient centricity in underdeveloped regions. SA Journal of Human Resource Management, 20, 1–14.
  5. Arsat, N., Chua, B. S., Wider, W., & Dasan, N. (2022). The impact of working environment on nurses’ caring behavior in Sabah, Malaysia. Frontiers in Public Health, 10(4), 1–14.
  6. Bougie, R., & Sekaran, U. (2020). Research methods for business: A skill-building approach (8th ed.). John Wiley & Sons, Inc
  7. Crown, W. (1998). Statistical model for the social and behavioral sciences: Multiple regression and limited-dependent variable models. Praeger
  8. DeVellis, R. (2012). Scale development theory and applications. SAGE Publications
  9. Ditlopo, P., Blaauw, D., Penn-Kekana, L., & Rispel, L. C. (2015). Contestations and complexities of nurses’ participation in policy-making in South Africa. Global Health Action, 8(19), 26–34.
  10. Gaalan, K., Kunaviktikul, W., Akkadechanunt, T., Wichaikhum, O. A., & Turale, S. (2019). Factors predicting quality of nursing care among nurses in tertiary care hospitals in Mongolia. International Nursing Review, 66(2), 176–182.
  11. Gad, R. A. E.-F. S. A. A. (2018). The influence of nurse managers’ leadership practices and organizational characteristics on staff nurses’ innovation: A comparative study. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 7(5), 73–86.
  12. Hair, J., Risher, J., Sarstedt, M., & Ringle, C. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31(1), 2–24.
  13. Hartati, H., Lolok, N. H., Fudholi, A., & Satibi, S. (2014). Analysis of incidence medication error in ICU patients. Journal of Management and Pharmacy Practice, 4(2), 125-132.
  14. Henseler, J., Ringle, C., & Sarstedt, M. (2014). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115–135.
  15. Jafree, S. R., Zakar, R., Zakar, M. Z., & Fischer, F. (2016). Nurse perceptions of organizational culture and its association with the culture of error reporting: A case of public sector hospitals in Pakistan health systems and services in low and middle income settings. BMC Health Services Research, 16(1), 1–13.
  16. Jennifa, J., Sari, D. A., Anugraheni, E. (2021). Correlation knowledge and attitude of nurse behaviour in medical waste disposal in inpatient ward of the JIH Hospital Yogyakarta. D'Nursing and Health Journal, 2(2), 99-108
  17. Kieft, R. A., de Brouwer, B. B., Francke, A. L., & Delnoij, D. M. (2014). How nurses and their work environment affect patient experiences of the quality of care: A qualitative study. BMC Health Services Research, 14, 249.
  18. Lamberti, M. J., & Awatin, J. (2017). Mapping the landscape of patient-centric activities within clinical research. Clinical Therapeutics, 39(11), 2196–2202.
  19. Mahendradhata, Y., Trisnantoro, L., Listyadewi, S., Soewondo, P., Marthias, T., Harimurti, P., & Prawira, J. (2017). The Republic of Indonesia health system review. Health Systems in Transition, 7 (‎1)‎, WHO Regional Office for South-East Asia.
  20. Manning, J. (2016). The influence of nurse manager leadership style on staff nurse work engagement. Journal of Nursing Administration, 46(9), 438–443.
  21. Mehrad, A., Fernández-Castro, J., de Olmedo, M. P. G. G., & García-Sierra, R. (2022). Mediation role of perceived organizational support on nurses’ work engagement and leadership Styles. Nurse Media Journal of Nursing, 12(2), 208–222.
  22. Memon, M. A., Ting, H., Cheah, J. H., Thurasamy, R., Chuah, F., Cham, T. H. (2020). Sample size for survey research: Review and recommendations. Journal of Applied Structural Equation Modeling, 4(2), 1-20.
  23. Molina‐mula, J., & Gallo‐estrada, J. (2020). Impact of nurse‐patient relationship on quality of care and patient autonomy in decision‐making. International Journal of Environmental Research and Public Health, 17(3).
  24. Muchsin, T., & Syahrial, E. (2013). Gambaran perilaku perawat dalam membuang limbah medis dan non medis di Rumah Sakit Umum Daerah Kabupaten Aceh Tamiang tahun 2013 [Description of the behavior of nurses in throwing away medical waste and non-medical waste in General Hospital District of Aceh Tamiang in 2013]. Kebijakan, Promosi Kesehatan dan Biostatistika, 2(2), 1-9
  25. Nartey, E., Aboagye-Otchere, F. K., & Yaw Simpson, S. N. (2020). The contingency effects of supply chain integration on management control system design and operational performance of hospitals in Ghana. Journal of Accounting in Emerging Economies, 10(2), 207–241.
  26. Numminen, O., Ruoppa, E., Leino-Kilpi, H., Isoaho, H., Hupli, M., & Meretoja, R. (2016). Practice environment and its association with professional competence and work-related factors: Perception of newly graduated nurses. Journal of Nursing Management, 24(1), E1–E11.
  27. Peeler, M. L. (2015). Exploration of work environmental factors that affect nurse job satisfaction in a hospital setting [Master's thesis, Gardner-Webb University]. Nursing Theses and Capstone Projects.
  28. Rawah, R., & Banakhar, M. (2022). The relationship between empowerment and organizational commitment from nurse’s perspective in the ministry of health hospitals. Healthcare (Switzerland), 10(4), 664.
  29. Ringle, C. M., & Sarstedt, M. (2016). Gain more insight from your PLS-SEM results the importance-performance map analysis. Industrial Management and Data Systems, 116(9), 1865–1886.
  30. Salleh, M. I. M., Abdullah, R., & Zakaria, N. (2017). Extending health information system evaluation with an importance‐performance map analysis. Advances in Health Management, 3(8), 33–55.
  31. Sarstedt, M., Hair, J., Pick, M., Liengaard, B., Radomir, L., & Ringle, C. (2022). Progress in partial least squares structural equation modeling use in marketing research in the last decade. Psychology & Marketing, 1–30.
  32. Sarstedt, M., Ringle, C., & Hair, J. (2017). Partial least squares structural equation modeling. Handbook of market research. Springer International Publishing
  33. Senek, M., Robertson, S., Ryan, T., King, R., Wood, E., Taylor, B., & Tod, A. (2020). Determinants of nurse job dissatisfaction - Findings from a cross-sectional survey analysis in the UK. BMC Nursing, 19(1), 1–10.
  34. Shmueli, G., Sarstedt, M., Hair, J., Cheah, J., Ting, H., Vaithilingam, S., & Ringle, C. (2019). Predictive model assessment in PLS-SEM: Guidelines for using PLS predict. European Journal of Marketing, 53(11), 2322–2347
  35. Srivastava, S., & Singh, S. (2020). Linking personal growth initiative and organizational identification to employee engagement: Testing the mediating-moderating effects in Indian hotel industry. Journal of Hospitality and Tourism Management, 45, 79–89.
  36. Suhadi, S., & Siyoto, S. (2020). Analysis of nursing performance and performance system in implementing nursing assessment in inaporal installation Bhayangkara Hospital Pusdik Brimob Gempol Pasuruan. Journal for Research in Public Health, 2(1), 9–14.
  37. Swiger, P. A., Patrician, P. A., Miltner, R. S. (Susie)., Raju, D., Breckenridge-Sproat, S., & Loan, L. A. (2017). The practice environment scale of the nursing work index: An updated review and recommendations for use. International Journal of Nursing Studies, 74(6), 76–84.
  38. World Health Organization. (2022). Process of translation and adaptation of instruments. WHO guidelines on translation and adaptation of instruments. 2.0 Translation guidelines.pdf
  39. Yeoman, G., Furlong, P., Seres, M., Binder, H., Chung, H., Garzya, V., & Jones, R. R. M. (2017). Defining patient centricity with patients for patients and caregivers: A collaborative endeavour. BMJ Innovations, 3(2), 76–83.
  40. Yu, W., Chavez, R., Jacobs, M., Wong, C. Y., & Yuan, C. (2019). Environmental scanning, supply chain integration, responsiveness, and operational performance: An integrative framework from an organizational information processing theory perspective. International Journal of Operations and Production Management, 39(5), 787–814.
  41. Zhao, X., Huo, B., Flynn, B. B., & Yeung, J. H. Y. (2008). The impact of power and relationship commitment on the integration between manufacturers and customers in a supply chain. Journal of Operations Management, 26(3), 368–388.

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