INTRODUCTION:

BACKGROUND:

Health is a fundamental human right, and healthcare agencies play a critical role in delivering essential services to individuals in need. The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being, extending beyond the mere absence of disease. This holistic perspective underscores the need to address all dimensions of well-being to achieve optimal health outcomes¹. Achieving the goal of health requires attention to all aspects of physical, mental, and social well-being. Hospitals, as primary healthcare units, play a central role in the treatment and care of individuals, addressing their health needs and overall welfare. Patient satisfaction is a critical element in healthcare, especially when assessing or improving the quality of services provided. Factors such as patient expectations, attitudes, and prior experiences significantly influence their perception of care, highlighting the importance of understanding these elements in enhancing healthcare outcomes². One does not always come to hospital with pain and illness but hospitals also provides joy, hope and confidence e.g. the joy of a pregnant women who gets her child after a difficult operation and similarly the confidence of a person who has a successful heart surgery. One cannot achieve this mission without a spirit of caring and compassion. The core principle and aim of any health care agency should be caring and compassion along with professional excellence and advancement.

Professional excellence in healthcare encompasses various professionals, with nurses forming a significant part of the workforce.⁵ Leininger (1995) emphasized the importance of "caring" in nursing, a concept that has been integral to human history.⁶ The idea of caring for others became more formalized during the Nightingale era, where Florence Nightingale, regarded as the founder of modern nursing, advocated for essential aspects of care such as ventilation, warmth, and cleanliness.⁷These principles laid the foundation for nursing as a caring science. Nursing care plays a critical role in patient outcomes during hospitalization, making patient satisfaction an essential measure of nursing care quality and a key dimension of overall healthcare quality.^8,9

A descriptive study was conducted to assess the nursing care from the patient’s perspective admitted in medical and surgical wards of tertiary care hospital of Chandigarh.

RESEARCH METHODOLOGY:

For current study, descriptive research design was used. Total enumeration technique was used and total 60 patients were taken for study after taking written consent from them. In inclusion criteria focus was on male and female patients of medical and surgical units who were going to discharge from the unit. An interview schedule was used to collect the data. Data collection tools were consisted of socio-demographic profile and Caring Behaviour Measurement tool. Caring Behaviour Measurement tool was standardized tool with 28 items. In this nursing care was assessed from patient’s perspectives that were going to be discharged from medical and surgical wards.

DATA COLLECTION PROCEDURE:

Ethical approval was obtained from the institutional ethical committee prior to conducting the study. Written permission was secured from the relevant authorities. Informed consent was acquired from each participant after clearly explaining the study's objectives, procedures, and the expected duration of their involvement. Participants were assured of the confidentiality of their information. Data were analysed using SPSS version 16.0.

RESULTS:

The study included 60 participants, with a diverse range of socio-demographic characteristics. Regarding age, the majority of subjects were in the 41–60-year age group (48.3%), followed by those aged 21-40 years (26.7%), 61 years and above (17.3%), and under 20 years (5%). A slight majority of participants were male (53.3%), with females comprising 46.7%.

In terms of education, most subjects had completed secondary or higher education, with 28% being graduates or postgraduates, 21.7% having high secondary education, and 21.7% being illiterate. The marital status was predominantly married (76.7%), with fewer single (16.7%) or widowed individuals (6.7%).

In occupation, a large portion of participants were unemployed (48.3%), while others were engaged in professional work (23.3%), clerical (3.3%), shop-owner (6.7%), and other types of work. Regarding monthly income, the majority earned between Rs. 10,000-20,000 (41%), with a smaller number falling into other income groups.

Most participants lived in nuclear families (55%), while 45% belonged to joint families. The study also showed a higher proportion of urban residents (61.7%) compared to rural residents (38%).

Table 1: Socio-Demographic Profile of the study subjects N =60

Variables	n (%)
Age*(in years)
<20	03 (5)
21-40	16 (26.7)
41-60	29 (48.3)
>61	12 (17.3)
Sex
Male	32 (53.3)
Female	28 (46.7)
Education
Professional	4(6.7%)
Graduate or postgraduate	17(28%)
High secondary	13(21.7%)
Middle school	9(15.0%)
Primary school	4(6.7%)
Illiterate	13(21.7%)
Marital status
Single	10(16.7)
Married	46 (76.7)
Widowed	4 (6.7)
Occupation
Profession	14 (23.3)
Clerical	2 (3.3)
Shop owner	4 (6.7)
Farmer	3 (5.0)
Skilled worker	1 (1.7)
Unskilled worker	4 (6.70)
Unemployed	29 (48.33)
Student	3 (5.0)
Income(in Rs.)/month**
<5000	9 (15.0)
10,000-20,000	25(41)
20,000-30,000	12(20.0)
30,000-40,000	7 (11.7)
40,000-50,000	3 (5.0)
50,000>	4 (6.70)
Type of Family
Nuclear	33 (55.0)
Joint	27 (45.0)
Locality
Urban	37 (61.7)
Rural	23 (38)

*Age: Mean ± S.D = 45.25± 5.9, Range =12-82

**Income: Mean± S.D. = 24223.33 ± 5.6, Range= 5000-150000.00

Table 2 depicts the clinical data of the study subjects revealed that a majority were admitted for medical conditions (55%), while the remaining 45% were admitted for surgical conditions. Regarding the duration of hospitalization, the majority of patients (51.7%) were hospitalized for 5-10 days, followed by 25% who stayed for 10-15 days. Fewer patients were hospitalized for longer durations: 13.3% for 15-20 days, 3.3% for 20-25 days, 1.7% for 25-30 days, and 5% for 30-35 days.

Table 2. Clinical Data of the subjects N=60

Diagnosis
Medical	33 (55.0)
Surgical	27 (45)
*Duration of hospitalization (in days**)
5-10	31(51.7)
10-15	15 (25.0)
15-20	8 (13.3)
20-25	2 (3.3)
25-30	1 (1.7)
30-35	3 (5.0)

*Mean±S.D. = 11.63±5.77, Range = 5-30.00

Table 3. Level of satisfaction of subjects as per C.B.M. Tool N=60

S. N.	Items	Fully Satisfied =4 n (%)	Moderately Satisfied =3 n (%)	Not Satisfied =2 n (%)	Not Sure =1 n (%)
1.	Did nurses communicate in simple clear language or use of medical terminology?	36(60)	21(35)	3(5)	-
2.	Did nurse explain your situation to you and your family?	33(55)	25(41.7)	2(3.3)	-
3.	Did nurses understand your condition by your behaviour?	24(40)	30(50)	6(10)	-
4.	Did she realize you that you are having caring nurse?	32(53.3)	27(45)	1(1.7)	-
5.	Did she address u properly and make you feel respected?	35(58.3)	25(41.7)	-	-
6.	Did she respect your privacy?	32(53.3)	28(46.7)	-	-
7.	Did she treat you like a family?	22(36.7)	37(61.7)	1(1.7)	-
8.	Did she keep promises and explain why she broke them?	12(20)	29(48.3)	6(10)	13(21)
9.	Did she praise you, e.g. Yes, you are doing well?	19(31.7)	34(56.7)	3(5)	4(6.7)
10.	Did she take immediate action to comfort you?	21(35)	38(63.3)	1(1.7)	-
11.	Did she help you take medicine and therapy when supposed to?	40(66.7)	20(33.3)	-	-
12.	When she is busy or her shift time to be finished does she inform you?	7(11.7)	23(38.3)	20(33.3)	10(16.7)
13.	Did she regularly examine the speed of IV fluid and checks insertion site?	37(61.7)	23(38.3)	-	-
14.	Did she explain you procedures (before and after)?	29(48.3)	28(46.7)	3(5)	-
15.	Did she explain you about effects and side effects of medicine?	16(26.7)	25(41.7)	17(28.3)	2(3.3)
16.	Did she teach or demonstrate the skill how to take care of yourself?	21(35)	35(58.3)	4(6.7)	-
17.	Did she contact your concerned health personnel to solve your problem?	29(48.3)	29(48.3)	1(1.7)	1(1.7)
18.	Did nurses introduce herself/ himself and let you know their responsibility for you?	12(20)	27(45)	12(20)	9(15)
19.	Did she make you more comfortable?	22(36.7)	36(60)	1(1.7)	1(1.7)
20.	Did she pay attention to your safety?	29(48.3)	29(48.3)	2(3.3)	-
21.	Did she inform you her daily examination and nursing care plan to prepare you psychologically?	21(35)	34(56.7)	5(8.3)	-
22.	Did she listen to you and your family patiently?	34(56.7)	26(43.3)	-	-
23.	Did she wear genuine smile?	9(15)	9(15)	15(25)	27(45)
24.	Did she provide support when you was going through difficulty?	24(40)	33(55)	2(3.3)	1(1.7)
25.	Were her actions gentle?	33(55)	26(43.3)	-	1(1.7)
26.	On necessary examination and therapy, did she check you on time to time and concern with you?	32(53.3)	28(46.7)	-	-
27.	Did she provide you a quiet and comfortable environment?	20(33.3)	35(58.3)	3(5)	2(3.3)
28.	Did she give you enough time to speak?	25(41.7)	32(53.3)	3(5)	-

Table 4: Relationship between socio-demographic variables and items of C.B.M. tool. N=60

Variables	Fully satisfied n (%)	Moderately satisfied n (%)
Age (years)
<20	2(66.7)	1(33.3)
21-40	13(81.3)	3(18.8)
41-60	19(65.5)	10(34.5)
>60	10(83.3)	2(16.7)
Sex
Male	29(90.6)	3(9.4)
Female	15(53.6)	13(46.4)
Education
Profession	3(75)	1(25)
Graduate/postgraduate	14(82.4)	3(17.6)
High school certificate	10(76.9)	3(23.1)
Middle school certificate	6(66.7)	3(33.3)
Primary school certificate	4(100)	-
Illiterate	7(53.8)	6(46.2)
Marital status
Unmarried	9(90)	1(10)
Married	32(69.6)	14(30.4)
Widowed	3(75)	1(25)
Occupation
Profession	13(92.9)	1(7.1)
Clerical	2(100)	-
Shop owner	3(75)	1(25.)
Farmer	2(66.7)	1(33.3)
Skilled workers	1(100)	-
Unskilled workers	3(75)	1(25)
Unemployed	17(58.6)	12(41.4)
Students	3(100)	-

Table 5: Relationship between socio-demographic profile and C.B.M. items. N=60

Variables	Fully satisfied	Moderately satisfied
Family type
Nuclear	24(54.54)	9(56.25)
Joint	20(95.45)	7(43.75)
Income
<5000	3(6.81)	6(37.5)
10000-20000	21(47.72)	4(25)
20000-30000	11(25)	1(6.25)
30000-40000	6(13.63)	1(6.25)
40000-50000	1(33.3)	2(66.7)
>50000	2(4.54)	2(12.5)
Locality
Urban	29(65.90)	8(50)
Rural	15(34.09)	8(50)
Duration of hospitalization (days)
5-10	20(45.45)	11(68.75)
10-15	12(27.27)	3(18.75)
15-20	8(9.09)	-
20-25	2(4.54)	-
25-30	-	1(6.25)
30-35	2(4.54)	1(6.25)
Diagnosis
Medical	26(59.09)	7(43.75)
Surgical	18(40.90)	9(56.25)

DISCUSSION:

Nursing involves the collaborative care of individuals across all age groups, families, communities, and populations, whether they are healthy or ill. It encompasses health promotion, illness prevention, and the care of those who are ill, disabled, or nearing the end of life (W.H.O.). At the heart of nursing is the concept of caring. Understanding a patient's perception of the care they are receiving is crucial to assessing the quality and effectiveness of that care.

There is no universal tool used in satisfaction studies and comparisons are difficult to make but still by looking at different research studies one can know the overall satisfaction score and patient satisfaction rating.

A study conducted at the Iran University of Medical Sciences in 2007, involving 250 hospitalized patients in medical and surgical wards, found a statistically significant relationship between patients' perceptions of nurse caring and their satisfaction with nursing care (r = 0.72, p = 0.000, CI 95%: 178.18-189.99 for the CBI and 82.81-86.71 for the PSI). The results revealed that male patients reported higher satisfaction with nursing care compared to female patients. Similarly, the findings of the current study also demonstrated that male patients were more satisfied with the nursing care they received than female patients.

A study conducted in Saudi Arabia found a higher level of satisfaction with nursing care among female patients (n=55) compared to male patients (n=45). These findings were in contrast to the results of the present study. Similarly, a study at the International Medical University in Kuala Lumpur, involving 100 patients, revealed that while patients were generally moderately satisfied with nursing care, the majority expressed high satisfaction with the emotional support provided by nurses, such as respect, smiles, and care. The study found no significant differences in patient satisfaction based on age, gender, or marital status. In the present study, 35(58.3%) patients reported high satisfaction with the domain of respect, while only 9(15.5%) were highly satisfied with the domain of smiles.

Also, socio-demographic variable were compared with the mean satisfaction score to observe any variation in the level of satisfaction but statistically there was no significant difference observed in their level of satisfaction related to those selected socio-demographic variables. Maximum results falls between the categories of fully satisfied and moderately satisfied which shows that the patients were satisfied with the nursing care provided to them.

Achieving patient satisfaction is a challenging task, as it is an abstract and highly subjective concept. Even with the most standardized tools, assessing the level of satisfaction can be difficult. Additionally, patient satisfaction may be influenced by various factors, such as the nature of their illness (chronic or acute), their personal expectations, and their prior experiences with nursing care.

Finding of present study suggest that out of 60 patients 16(26.6%) were moderately satisfied and 44(74.3) were fully satisfied as evaluated with Caring Behaviour Measurement (C.B.M.) tool.

Although the findings indicate that most subjects were fully satisfied, it is possible that their responses were influenced by their current state of mind. As the participants were about to be discharged from the hospital at the time of the interview, they may have felt a sense of relief or joy at returning home. Additionally, it is important to consider that some patients may have hesitated to express dissatisfaction with the nursing care they received.

CONCLUSION:

In nursing care perspective, it is essential to maintain satisfaction and contentment within the patient for quality nursing care. It is necessary for nurses to ensure how they behave and act with patients. It is important to know what the patient feels about the care which he is experiencing. This study results may be of interest to the nurse administrators in the hospital setting so that nurses can improve their communication as well as caring skills for patient care.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding in current study.

ACKNOWLEDGMENTS:

The authors would like to thank all the participants who given their consent to be part in the study.

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Received on 21.12.2024 Revised on 13.03.2025

Accepted on 24.04.2025 Published on 21.05.2025

Available online from May 23, 2025

Int. J. of Advances in Nursing Management. 2025;13(2):76-80.

DOI: 10.52711/2454-2652.2025.00016

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