Perception of quality of hospital care of patients with Heart Failure in Thailand

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Pornsiri Phipatanapanit
Kanaungnit Pongthavornkamol
Doungrut Wattakitkrileart
Chukiat Viwatwongkasem
Prin Vathesatogkit


               Understanding patients’ perception of quality of care is a crucial step in improving healthcare service, but understanding patients’ experiences of quality of care is limited, including those with heart failure. This predictive descriptive study aimed to: describe perceptions of quality of care among people with heart failure and determine factors influencing their perception of quality of care including preferences for participation in care, symptom distress, and patient-related factors of age, gender and education. Convenience sampling was used to recruit 92 participants with heart failure at one tertiary university hospital in Bangkok, Thailand. The measures used were Personal Characteristics Questionnaire, Control Preference Scale, Memorial Symptom Assessment Scale-Heart Failure and the Quality of Care from Patients’ Perspectives Questionnaire.

            The results revealed that most participants reported balanced-high quality of care. The most distressing symptom was difficulty when lying flat, and symptom distress and preference for participation in care were significant predictors of patients’ perception of quality of care. Participants with high preference for participation (passive-shared, collaborative) perceived quality of care lower than participants with low preference for participation (passive). The findings of this study can be used to design nursing intervention programs for managing symptom distress and promoting patient participation in care to improve perceived quality of care among patients with heart failure during hospitalization.

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How to Cite
Phipatanapanit P, Pongthavornkamol K, Wattakitkrileart D, Viwatwongkasem C, Vathesatogkit P. Perception of quality of hospital care of patients with Heart Failure in Thailand. PRIJNR [Internet]. 2018 Dec. 19 [cited 2023 Jan. 29];23(1):87-99. Available from:
Original paper


1. Savarese G, Lund LH. Global public health of heart failure. Card Fail Rev. 2017;3(1):7-11.

2. Reyes EB, Ha J, Firdaus I, Ghazi AM, Phrommintikul A, Sim D, et al. Heart failure across Asia: same healthcare burden but differences in organization of care. Int J Cardiol. 2016;223:163-7.

3. Roger VL. Epidemiology of heart failure. Circ Res. 2013; 113:646-59.

4. Carter J, Ward C, Wexler D, Donelan K. The association between patient experience factors and likelihood of 30-day readmission: a prospective cohort study. BMJ Qual Saf. 2018.

5. World Health Organization. Quality of care: a process for making strategic choices in health systems. Geneva: WHO; 2006.

6. Siriwardena AN, Gillam S. Patient perspectives on quality. Qual Prim Care. 2014;22(1):11-5.

7. Donabedian A. Evaluating the quality of medical care. Milbank Q. 1966;44(3):166-206.

8. Wilde B, Starrin B, Larsson G, Larsson M. Quality of care from a patient perspective : a grounded theory study. Scand J Caring Sci. 1993;7(2):113-20.

9. Stein SM, Day M, Karia R, Hutzler L, Bosco III JA. Patients’ perceptions of care are associated with quality of hospital care:a survey of 4605 hospitals. Am J Med Qual. 2015; 30(4):382-8.

10. Borghans I, Kleefstra SM, Kool RB, Westert GP. Is the length of stay in hospital correlated with patient satisfaction? Int J Qual Health Care. 2012;24(5):443-51.

11. Dy SM, Chan KS, Chang HY, Zhang A, Zhu J, Mylod D. Patient perspectives of care and process and outcome quality measures for heart failure admissions in US hospitals: how are they related in the era of public reporting? Int J Qual Health Care. 2016;28(4):522-8.

12. Pongthavornkamol K, Lekdamrongkul P, Siritanara N, Siripum S. Relationship between patients’ preference for participation in care, gender, age, symptom burden, and perceived quality of care of hematological cancer patients during hospitalization. J Nurs Sci. 2016;34(2):45-57. [in Thai].

13. Kanrat K, Pongthavornkamol K, Wattanakitkrilleart D. Factors associated with perception of quality of care in cancer patients during hospitalization. Chula Med J. 2016; 60(5):523-34. [in Thai].

14. Mehica L, Gershater MA, Roijer CA. Diabetes and infected foot ulcer: a survey of patients’ perceptions of care during the preoperative and postoperative periods. Eur Diabetes Nursing. 2013;10(3):91-5.

15. Hozel LP, Kriston L, Harter M. Patient preference for involvement, experienced involvement, decisional conflict, and satisfaction with physician: a structural equation model test. BMC Health Serv Res. 2013;13:231.

16. Feyer P, Kleeberg UR, Steingraber M, Gunther W, Behrens M. Frequency of side effects in outpatient cancer care and their influence on patient satisfaction-a prospective survey using the PASQOC questionnaire. Support Care Cancer. 2008;16(6):567-75.

17. Chen H, Li M, Wang J, Xue C, Ding T, Nong X, et al. Factors influencing inpatients’ satisfaction with hospitalization service in public hospitals in Shanghai, People’s Republic of China. Patient Prefer Adherence. 2016;10:469-77.

18. Beattie M, Murphy DJ, Atherton I, Lauder W. Instruments to measure patient experience of healthcare quality in hospitals: a systematic review. Systematic Reviews. 2015;4:97.

19. Weingart SN, Zhu J, Chiappetta L, Stuver SO, Schneider EC, Epstein AM, et al. Hospitalized patients’ participation and its impact on quality of care and patient safety. J Qual Health Care. 2011;23(3):269-77.

20. Laal M. Inpatient’ s perspective on nursing care; affecting factors Procedia Soc Behav Sci. 2013;84:243-7.

21. Grondahl VA, Karlsson I, Hall- Lord ML, Appelgren J, Wilde-Larsson B. Quality of care from patients’ perspective: impact of the combination of person-related and external objective care conditions. J Clin Nurs. 2011;20:2540-51.

22. Koberich S, Feuchtinger J, Farin E. Factors influencing hospitalized patients’ perception of individualized nursing care: a cross-sectional study. BMC Nursing. 2016; 15(14).

23. Sandsdalen T, Hoye S, Rystedt I, Grondahl VA, Hov R, Wilde-Larsson B. The relationships between the combination of person- and organization-related conditions and patients’ perceptions of palliative care quality. BMC Palliat Care. 2017;16(1):17-24.

24. Forsberg A, Vikmam I, Walivaara B, Engstrom A. Patients’ perceptions of quality of care during the perioperative procedure. J Perianesth Nurs. 2015;30(4):280-9.

25. Näsström L, Jaarsma T, Idvall E, Årestedt K, Strömberg A. Patient participation in patients with heart failure receiving structured home care - a prospective longitudinal study. BMC Health Serv Res. 2014;14(1):633.

26. Wilde-Larsson B. Patients’ view on quality of care: age effects and identifications of patient profile. J Clin Nurs. 1999;8:693-700.

27. Degner LF, Sloan JA, Venkatesh P. The control preferences scale. Can J Nurs Res. 1997;29(3):21-43.

28. Zambroski CH, Lennie T, Chung ML, Heo S, Smoot T, Ziegler C. Use of the Memorial Symptom Assessment Scale-Heart Failure in heart failure patients. Circ. 2004; 25(4):110.

29. Suwanratsamee W, Pinyopasakul W, Charoenkitkarn V, Dumavibhat C. Symptom experiences, symptom management, and functional status in patients with heart failure. Thai Journal of Cardio-Thoracic Nursing 2013;24(1 ):1-16. [in Thai].

30. Wilde-Larsson B, Larsson G. Development of a short form of the Quality form the Patient’ s Perspective (QPP) questionnaire J Clin Nurs. 2002;11(5):681-7.

31. ImproveIT. Revised quality index. 2015 [cited 2015]; Available from:

32. Wilde-Larsson B, Larsson G, Starrin B. Patients’ view on quality of care: a comparison of men and women. J Nurs Manag. 1999;7:133-9.

33. Hosmer DW, Lemeshow S. Applied logistic regression. 2nd, editor: Wiley- Interscience, NY: John Wiley & Sons; 2000.

34. Alkan S, Nural N. Evaluation of symptoms and predictors in patients with heart failure in Turkey. J Hosp Palliat Nurs. 2017;19(5):404 -12.

35. Xu J, Abshire M, Han H. Decision-making among persons living with heart failure. J Cardiovasc Nurs. 2016;31(5).

36. Cowie MR, Anker SD, Cleland J, Felker GM, Filippatos G, Jaarsma T, et al. Improving care for patients with acute hart failure: before, during and after hospitaization. ESC Heart Fail. 2014; 1(2):110-45.

37. Chiaranai C, Salyer J, Best A. Self-care and quality of life in patients with heart failure. Thai J Nurs Res. 2009;13(4): 302-17.

38. FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Medical Ethics. 2017;18.