Discussion
This descriptive study is the ®rst of its kind in Thailand. The
results from the ®rst phase of this study showed that the
de®nitions of quality of nursing care had some similarities
and some differences. Nurses proposed that quality of
nursing care should included both physical, psychological,
emotional, and spiritual dimensions, and the satisfaction of
patients. Hospital administrators perceived quality of nursing
care as including standards, ef®ciency of work and the
satisfaction of the patient. Patients described the good service
from nursing personnel as quality of nursing care. They
believed that the professional quali®cations of nursing
personnel assured patients of quality.
These ®ndings imply that each group of participants,
hospital directors, nurses, and clients de®ned quality of care
based on their own perspectives. These ®ndings support the
work of Donabedian (1982) who proposed three de®nitions.
The absolutist de®nition from the practitioner's perspective
considers the possibility of bene®t and harm to health while
the individualized de®nition focus on patient's expectation of
bene®t and/or harm and other undesired consequences. The
third de®nition for the concept social includes the cost of
care, the bene®t/harm continuum, and the distribution of
health care as valued by the population in general
(Donabedian, cited in Katz & Green 1997).