Assessment of Nursing Service Quality Based on Patients' Expectations and Perceptions in the Dialysis Ward of a Hospital Complex

Mastanah, Z; Yazdani, S; Ghanbarnejad, A; Mosuli, َA

Assessment of Nursing Service Quality Based on Patients' Expectations and Perceptions in the Dialysis Ward of a Hospital Complex

Document Type : Original Article

Authors

z Mastanah ¹

S Yazdani ²

A Ghanbarnejad ³

َA Mosuli ⁴

¹ Associate Professor, Department of Health Information Technology, Faculty of Paramedical Sciences, Social Factors in Health Promotion Research Center, Hormozgan Health Research Institute, Hormozgan University of Medical Sciences, Iran

² Master of Health Information Technology, Student Research Committee, Hormozgan University of Medical Sciences, Iran

³ Assistant Professor, Department of Statistics and Epidemiology, Faculty of Health, Social Factors in Health Promotion Research Center, Hormozgan Health Research Institute, Hormozgan University of Medical Sciences, Iran

⁴ Associate Professor, Department of Health Services Management, Faculty of Health, Social Factors in Health Promotion Research Center, Hormozgan Health Research Institute, Hormozgan University of Medical Sciences, Iran

Abstract

Background and Objective: The quality of nursing services is crucial for improving health outcomes and enhancing patient satisfaction. For patients undergoing hemodialysis, the chronic nature of their condition and their long-term dependence on healthcare necessitate an assessment of the gaps between their expectations and perceptions of nursing services. Such an evaluation can highlight areas requiring improvement in service delivery. This study aims to assess the quality of nursing services in the hemodialysis unit from the patients' perspectives, focusing on their expectations and perceptions, utilizing the SERVQUAL model.
Materials & Methods: This cross-sectional descriptive-analytical study was conducted in 2022 and involved 180 hemodialysis patients from the Dialysis Ward of the Prophet Muhammad Educational, Therapeutic, and Research Complex in Bandar Abbas. Using a census methodology, data were collected through a standardized SERVQUAL questionnaire, which included demographic information and 44 items divided into two sections: expectations and perceptions, across five dimensions of service quality. Eligible participants completed the questionnaire either through self-administration or with assistance from researchers after providing informed consent. Data analysis was performed using SPSS version 25, employing both descriptive and inferential statistical tests with a significance level set at 0.05.
Results: The overall quality gap in nursing services was calculated as -1.58, indicating a shortfall in meeting patients' expectations. The most significant gap was observed in the tangibility dimension, while the assurance dimension exhibited the smallest gap. Statistically significant differences were detected in the dimensions of tangibility, reliability, responsiveness, and empathy (P < 0.001); however, no significant difference was observed in the assurance dimension (P = 0.386). Furthermore, significant differences were found in the assurance (P = 0.007 and P = 0.008) and empathy (P = 0.002 and P = 0.005) dimensions in correlation with the duration of patients' hemodialysis treatment, whereas no significant associations were identified concerning gender, work shift, or type of disease.
Conclusion: The findings of this study demonstrate that hemodialysis patients consistently have expectations that exceed their perceptions across most dimensions of nursing service quality. These systematic discrepancies underscore the inadequacies in the perceived quality of care relative to patients' desired standards. Therefore, it is imperative to enhance the quality of nursing services in the dialysis ward by upgrading physical infrastructure, improving empathetic communication and responsiveness among nursing staff, and adopting a more patient-centered approach to care.

Keywords

Patient Satisfaction

Hemodialysis Units

Hospital

Nursing Services

Patient-Centered Care

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