doi: 10.56294/hl202326

ORIGINAL

Perceived satisfaction with nursing care in relation to users/subjects of care and their companions in the Medical Clinic Service of the Hospital Zonal de Comodoro

Satisfacción percibida respecto del cuidado enfermero con relación a usuarios/sujetos de atención y sus acompañantes en el Servicio de Clínica Médica del Hospital Zonal de Comodoro Rivadavia

Horacio Alen¹ *, Daniel Ernesto Gutiérrez Raina² *

¹Hospital Zonal de Comodoro Rivadavia. Chubut, Argentina.

²Universidad Adventista del Plata. Argentina.

Cite as: Alen H, Gutiérrez Raina DE. Perceived satisfaction with nursing care in relation to users/subjects of care and their companions in the Medical Clinic Service of the Hospital Zonal de Comodoro Rivadavia. Health Leadership and Quality of Life. 2023; 2:26. https://doi.org/10.56294/hl202326

Submitted: 30-08-2023                         Revised: 24-10-2023                         Accepted: 30-11-2023                        Published: 01-12-2023

Editor: Dra. Mileydis Cruz Quevedo

ABSTRACT

The present study focuses on the evaluation of the satisfaction of users and subjects of care in a hospital service. A simple cross-sectional descriptive research design was used and data were collected through a questionnaire with 15 questions addressing dimensions such as empathy, responsibility, technical capacity, communication and tangible goods. The results show that the majority of respondents are satisfied with the service, with no significant differences according to sociodemographic variables. However, lower satisfaction is observed among accompanying persons in the dimensions of responsibility and tangible goods. It is concluded that satisfaction is high in several dimensions of nursing care, but a lack of tangible resources is noted due to the shortage of personnel during data collection. It is recommended that similar studies be conducted in other hospitals to obtain a more complete representation of the perception of nursing care in different hospital settings.

Keywords: User Satisfaction; Nursing Care; Quality of Care; Care Evaluation.

RESUMEN

El presente estudio se centra en la evaluación de la satisfacción de usuarios y sujetos de atención en un servicio hospitalario. Se utiliza un diseño de investigación descriptiva transversal simple y se recopilan datos a través de un cuestionario con 15 preguntas que abordan dimensiones como empatía, responsabilidad, capacidad técnica, comunicación y bienes tangibles. Los resultados muestran que la mayoría de los encuestados están satisfechos con la atención, sin diferencias significativas según variables sociodemográficas. Sin embargo, se observa una menor satisfacción entre los acompañantes en las dimensiones de responsabilidad y bienes tangibles. Se concluye que la satisfacción es alta en varias dimensiones de la atención enfermera, pero se señala una falta de recursos tangibles debido a la escasez de personal durante la recolección de datos. Se recomienda llevar a cabo estudios similares en otros hospitales para obtener una representación más completa de la percepción sobre la atención de enfermería en diferentes entornos hospitalarios.

Palabras clave: Satisfacción del Usuario; Atención de Enfermería; Calidad de la Atención; Evaluación de la Atención.

INTRODUCTION

The satisfaction of the user/subject of care and those accompanying him/her is an indicator of the quality of care provided by the nursing team, hence the importance of evaluating it and detecting opportunities for improvement. Studies on this subject with nursing care in hospitalized users have recently presented a boom motivated, among other things, by considering it as an indicator of compliance with the care provided by this staff and of the quality of the service provided. The satisfaction of the user/subject of care is measured through different indicators, one of which considers the evaluation through dimensions.^(1,2)

The concept of "User" in the context of health services refers to the person who seeks and chooses to use these services to address their health care needs. It is crucial to understand that health care must be designed in a way that is tailored and responsive to the needs and expectations of these users.⁽³⁾ Satisfaction of people receiving health care has become a key element in assessing the performance of healthcare institutions. This approach highlights the importance of providing quality care that is sensitive to patient's individual preferences and concerns.⁽⁴⁾

On the other hand, the term "Subject of Care" refers to the person who will be the object of care and attention in the Medical Clinic Service of the Comodoro Rivadavia Zonal Hospital. This subject of care, which may be a hospitalized patient, depends to a great extent on the quality of nursing care and medical attention he/she receives during his/her stay in the hospital. Nursing care is a set of care provided by nurses that goes beyond purely technical aspects. It implies a committed attitude on the part of the nursing team, which should be oriented towards monitoring and preserving the health of the subject of care, regardless of his or her condition or severity.⁽⁵⁾

The "Level of Satisfaction" refers to the degree of positive or negative perception that users have regarding the care provided by the nursing team in the medical clinic service of the Regional Hospital of Comodoro Rivadavia in Chubut. Measuring this level of satisfaction is essential to evaluate the quality of medical care and the user's experience in the hospital.^(6,7,8)

Nowadays, hospitals offering inpatient services face internal challenges, and the nursing team plays a crucial role as an intermediary between medical staff and patients.^(9,10) The satisfaction of users and their companions is an increasingly relevant issue in health care and health services management.⁽¹¹⁾ This importance is due to significant changes in the relationship between patients and health professionals resulting from the evaluation of the quality of health services.

The satisfaction of users and subjects of care is a complex process influenced by various factors and has become a key focus in the improvement of hospital practices. User feedback plays an essential role in assessing the quality of care, and factors such as communication, empathy, and the technical ability of nursing professionals are significant predictors of the evaluation of the care received.^(12,13,14)

To ensure the quality of nursing care, the healthcare team must healthcare ethical, humane, and effective relationships with patients and their families. In addition, precise and agile mechanisms are required to measure and evaluate the quality of nursing care and to establish improvement plans according to the findings.⁽¹⁵⁾ Ongoing evaluation is essential to identify areas that need attention and to work toward continuous improvement of nursing practice.^(16,17)

The present study aims to determine whether there is a difference in the level of satisfaction with regard to nursing care perceived by the users/subjects of care and the level of satisfaction perceived by those accompanying them.

METHODS

The design corresponds to a simple cross-sectional descriptive research.

The sample was non-probabilistic by convenience and corresponded to all users/subjects of care and companions who were hospitalized in the Medical Clinic Service with 48 hours or more of hospitalization in the service in August 2021 and who met the inclusion criteria at the time of data collection.

The results obtained through the statistical analysis carried out with SPSS, to measure the reliability of the instrument and verify that it has internal consistency, the Cronbach's Alpha coefficient was used, obtaining a value greater than 0,8, which is considered good.

Inclusion Criteria

· All users/subjects of care and accompanying persons of the Medical Clinic Service who stay 48 hours or more in the inpatient service.

· Users/subjects of care oriented in time, space, and person.

· Accompanying persons oriented in time, space, and person.

· Having signed the informed consent form.

Exclusion Criteria

· Illiterate users/subjects of care.

· Users/subjects of care who are not in the service at the time of the data collection.

· Users/subjects of care not oriented in time, space, and person.

· Illiterate companions.

· Accompanying persons who are not in the service at the time of the information survey.

· Accompanying persons not oriented in time and space.

· Not having signed the informed consent form.

The technique used is the survey. When the data collection instrument was prepared (see appendix), it was presented to a group of experts for evaluation, and it was also tested in the inpatient surgical clinic service of the Regional Hospital of Comodoro Rivadavia. This service has the same characteristics as the service selected to develop this research. The observations of the experts (members of the Training and Teaching Committee of the Regional Hospital Dr. Manuel Sanguinetti Comodoro Rivadavia) were taken into account to survey definitively in order to carry out this research.

The Likert scale was used, with a weighting from 1 to 5, where:

1- corresponds to "Not satisfied."

2- corresponds to "Not very satisfied."

3- corresponds to "Satisfied".

4- corresponds to "Very satisfied."

5- corresponds to "Extremely satisfied."

This scale was used to measure the 15 questions that were developed in accordance with the variables to be studied. In order to carry out the questionnaire, a note requesting authorization (see appendix) was sent to the head of the Nursing Service of the Medical Clinic, the head of the Nursing Department of the Regional Hospital, and the Director of Nursing of the hospital.

Once the users/subjects of care and accompanying persons who met the inclusion criteria had been identified, they were asked to participate by means of the informed consent form (see appendix).

It was explained to the user/subject of care and companion that they were free to withdraw from the study at any time they wished, and the instrument was applied by means of an interview.

To assess the location of the user/care subject and companion in person, place, and time, as well as to verify their ability to communicate verbally, they were asked their name, where they were, and how many days they had been hospitalized, and then the instrument was applied.

First of all, the informed consent form was given to the patient to read, understand, and complete personal data. To measure the satisfaction of the user/subject of attention and companion with the nursing care, the Questionnaire Satisfaction of users and companions with the nursing care received in the Medical Clinic Service of the Comodoro Rivadavia Regional Hospital was used.

This instrument is made up of 15 open questions that make it possible to evaluate the level of satisfaction of the users/subjects of attention and companions of the nursing care they received during their hospitalization period in the Medical Clinic Service of the Regional Hospital of Comodoro Rivadavia, by means of a rating from 1 to 5.

Data collection through the survey was carried out on a total of 133 people, of whom 69 were users/subjects of care and 63 companions, who stayed more than 48 hours of hospitalization in the medical clinic service of the regional hospital of Comodoro Rivadavia.

Initially, the users/subjects of care and accompanying persons were asked to participate, considering the inclusion criteria for the study. They were presented with the informed consent form detailing the objective of the research, and their signature was requested in order to confirm their participation.

RESULTS

A total of 133 surveys were carried out on users/subjects of attention and companions of the nursing care received in the Medical Clinic service of the Hospital Zona de Comodoro Rivadavia, all of which were answered anonymously with the prior signature of the informed consent form.

Reliability analysis of the instrument used

To measure the reliability of the instrument and verify that it has internal consistency, Cronbach's Alpha coefficient was used, obtaining a value greater than 0,8, which is considered good.

Table 1. Cronbach's Alpha Coefficient test
Cronbach's alpha	Cronbach's alpha based on standardized items	Number of elements
0,861	0,864	15

Level of satisfaction of users/subjects of care and accompanying persons

Figure 1 shows the level of satisfaction obtained in the survey. In general, as shown in the graph, the majority of respondents generally classify their level of satisfaction as satisfied or very satisfied.

Figure 1. Distribution of satisfaction levels

Statistical tests for each variable studied

The Chi-Square test with the Monte Carlo test, both with values of p>0,05, indicates that there is no relationship between the level of satisfaction obtained and the sex of the respondents. There is also no relationship between the level of satisfaction obtained and the age range of the respondents.

As for the relationship between the level of satisfaction and the level of education, it was shown that there is no relationship between the level of satisfaction obtained and the level of education of the respondents.

Analyzed the response according to the empathy dimension, there is no statistically significant difference in the level of satisfaction between users and companions. However, in the responsibility dimension, there is a statistically significant difference between the level of satisfaction of users and accompanying persons. According to the chi-square statistical test, the level of satisfaction of the accompanying persons was lower. p = 0,016.

Table 2. Chi-square tests for the responsibility dimension
	Value	df	Asymptotic significance (bilateral)
Pearson's Chi-square	10,365^a	3	0,016
Likelihood ratio	0,394	2	0,016
Linear by linear association	1,059	1	0,303
N of valid cases	130
Legend: a. 4 boxes (50,0 %) expected a count of less than 5. The minimum expected count is 2,54.

In the technical capacity dimension, there is no statistically significant difference in the level of satisfaction between users and accompanying persons, as well as in the communication dimension.

The tangible goods dimension shows a statistically significant difference in the level of satisfaction between users and accompanying persons. According to the chi-square statistical test, the level of satisfaction of accompanying persons was lower p = 0,024.

Table 3. Chi-square tests for the tangible goods dimension
	Value	df	Asymptotic significance (bilateral)
Pearson's Chi-square	9,475^a	3	0,024
Likelihood ratio	9,443	2	0,024
Linear by linear association	2,922	1	0,087
N of valid cases	130
Legend: a. 4 boxes (12,5 %) expected a count lower than 5. The minimum expected count is 3,81.

To compare the dimensions and determine the lowest level of satisfaction among users and accompanying persons, the Kruskal-Wallis test was applied to compare the dimensions:

Table 4. Lowest level of satisfaction in all dimensions
	Ranges
	Visiting condition	N	Average range
Satisfaction level for Dimension A-Empathy	User	75	67,87
	Companion	55	62,26
	Total	130
Satisfaction level for Dimension B-Responsibility	User	75	69,29
	Companion	55	60,34
	Total	130
Nivel de satisfacción para la Dimensión C-Capacidad Técnica	User	75	66,27
	Companion	55	64,65
	Total	130
Nivel de satisfacción para la Dimensión D-Comunicación	User	75	66,50
	Companion	55	64,14
	Total	130
Nivel de satisfacción para la Dimensión E-Bienes Tangibles	User	75	70,84
	Companion	55	58,22
	Total	130

Table 5. Test statistics for comparison of Dimensions^a,b
	Satisfaction level for Dimension A-Empathy	Satisfaction level for Dimension B-Responsibility	Satisfaction level for Dimension C-Technical Capacity	Satisfaction level for the D-Communication Dimension	Satisfaction level for the E-Tangible Assets Dimension
Chi-square	0,949	2,314	0,099	0,186	4,514
GI	1	1	1	1	1
Asymptotic Sig.	0,330	0,128	0,753	0,666	0,034
Legend: a. Kruskal Wallis test; b. Grouping variable: Visiting condition.

Those who present the lowest level of satisfaction are the accompanying persons in the dimension E-Tangible Goods with a, as tested by the Kruskal Wallis statistical test p=0,34.

For the visit condition variable, there is no relationship between the level of satisfaction obtained and this dimension.

DISCUSSION

Based on the findings, we accept the tentative hypothesis that users/subjects of care and accompanying persons hospitalized for 48 hours or more in the medical clinic service of the regional hospital of Comodoro Rivadavia express a high level of satisfaction with the nursing care provided.

There is also a strong and essential correlation with the level of satisfaction perceived among users/subjects of care and their respective companions in the Medical Clinic Service of the Comodoro Rivadavia Regional Hospital.

In this study, the level of satisfaction with the nursing care provided by the nursing staff of the medical clinic service was investigated; the findings reveal that 46 % of the users expressed "very satisfied" with the level of satisfaction with the nursing care; these results are related to the study by Collantes Delgado.⁽¹⁸⁾

In general, knowing the level of satisfaction with the nursing care perceived by those accompanying the hospitalized user allows us to find solutions and increase our quality of service. The results found are in line with what Ramos Frausto states; these authors express that 58,84 % of the accompanying family members rate the perceived level of nursing care as very good, which is in line with what is found in this study. However, what does not agree with the authors referred to in this study is that 41,2 % of those surveyed had incomplete primary schooling, and in this study, these results have yet to be found.⁽¹⁹⁾

Other studies have shown that there is no statistical relationship between sex, age, age group, and satisfaction.^{(18,20,21,22,23,24)}

CONCLUSIONS 

Despite considering several sociodemographic variables, no significant influence on satisfaction was found. The results indicated a high level of satisfaction in several dimensions, such as empathy, responsibility, technical capacity, communication, and tangible goods. The main difficulty identified was the need for tangible resources, such as room conditioning and hygiene, attributed to the shortage of personnel during data collection.

RECOMMENDATIONS

Based on the findings, it is recommended to conduct other studies in which the study sample includes other hospitals in the health sector, which will allow a better representation of the population, as well as the perception of nursing care in different hospitals.

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FINANCING

The authors did not receive funding for the development of this research.

CONFLICT OF INTEREST

The authors declare that there is no conflict of interest.

AUTHORSHIP CONTRIBUTION

Conceptualization: Horacio Alen, Daniel Ernesto Gutiérrez Raina.

Research: Horacio Alen, Daniel Ernesto Gutiérrez Raina.

Methodology: Horacio Alen, Daniel Ernesto Gutiérrez Raina.

Writing - original draft: Horacio Alen, Daniel Ernesto Gutiérrez Raina.

Writing - revision and editing: Horacio Alen, Horacio Alen, Daniel Ernesto Gutiérrez Raina.

APPENDIX 1

Survey

Satisfaction of users and accompanying persons with the nursing care received at the Medical Clinic Service of the Comodoro Rivadavia Zonal Hospital.

Dear User/Companion, we are interested in knowing your opinion about the quality of the nursing care you received at the Medical Clinic Service of the Regional Hospital of Comodoro Rivadavia. Your answers are completely confidential. Thank you in advance for your participation

Please answer as appropriate:

1. Age: ____ Years old

2. Sex: ____M ____F

3. Educational level:

____Alliterate

____Complete primary school

____Incomplete primary school

____Secondary school complete

____Incomplete high school

____Complete technical high school

____Incomplete technical high school

____Complete university degree

____Incomplete university degree

4. You are on the service as a ____User ____Ccompanion

The experience of the days of hospitalization in the medical clinic service is useful for us to improve the care that nursing provides to each user and his companion, we ask you to mark us according to your experience:

1-Not satisfied

2-Slightly satisfied

3-Satisfied

4-Very satisfied

5-Extremely satisfied

		1-Not satisfied	2-Little satisfied	3-Satisfied	4-Very satisfied	5-Extremely satisfied
1	Did the care provided by the nurses meet your needs?
2	Did the nursing staff maintain smooth communication when you explained what was going to be done?
3	Do the nursing staff treat you with respect?
4	How do you perceive the commitment of the nursing team to your care?
5	Was your privacy respected during your period of hospitalization?
6	Did you understand the explanation provided by the nursing staff about the procedures/techniques that were to be performed on you?
7	Was your treatment by the nursing staff adequate?
8	Is the room where you are hospitalized in a hygienic and well-maintained condition?
9	When you required the nurse's attention, were you assisted promptly?
10	In your opinion, is the nursing staff that attends you skilled in performing the procedures?
11	Did the nursing staff inform you of each procedure to be performed?
12	Did the nursing team inform you about your pathology and the relevant care?
13	Does the nursing team work according to biosafety standards?
14	Were you oriented according to service and hospital standards?
15	Prior to meal and rest times; did the infirmary set up the room?

APPENDIX 2

Informed consent form for Users / Accompanying Persons

Satisfaction of users and companions with the nursing care received at the Medical Clinic Service of the Comodoro Rivadavia Zonal Hospital.

We would like your opinion on the level of satisfaction received or perceived with the nursing care provided by the nursing team in the medical clinic service during your days of hospitalization, with the aim of conducting a study. The main objective of this study is to evaluate the level of satisfaction of users and accompanying persons with the nursing care provided by the nursing staff in the medical clinic service. The study does not involve any risk for the patient; participation is voluntary, and the patient can withdraw from the study at any time he/she wishes. The personal data of the user and the accompanying person will be used exclusively for this study in a confidential manner, and the only person who will have access to this data will be the principal investigator.

I, _____________________ DNI __________ as USER agree to participate in the study.

I, _____________________ DNI __________ as an ACCOMPANYING PERSON agree to participate in the study.

Responsible researcher ___________________________________

____ as of August 2021.