An examination of case management nurses' role strain, participative decision making, and their relationships to patient satisfaction : utilization of King's Theory of Goal Attainment in a managed care environment

One way of accommodating quality and cost contained health care in a managed care environment has been to incorporate a case management process. Producing Healthcare in this manner required the development of a new role, the Case ManagementNurse (CMN). Restructuring organizational communication processes, provides CMNs opportunities to collaborate with physicians to provide quality care. CMNs role strain,participation in decision making, and collaboration is examined in this study for their relationship with patient satisfaction.King's Theory of Goal Attainment guides this study using a model of transactions which includes feedback, perception, reaction, interaction, and transaction. This study expands King's Theory including physicians as die isomorphic equivalent of the client in the model of transactions. A descriptive correlational design was used to analyze responses from survey instruments sent to a group of CMNs and to patients who had been under the CMNs care, Pearson's correlation coefficients were calculated resulting infindings that identify CMN role conflict and role ambiguity being positively related to participation in decision making and collaboration. Serendipitously, Baccalaureate or higher education CMN preparation was found to be positively related to role conflict, role ambiguity, participation in decision making, and patient satisfaction.