Adult Patient Satisfaction with Nursing Care
Services and Associated Factors Among Admitted
Patients at Saint Paul’s Hospital, Millennium
Medical College, Addis Ababa, Ethiopia, 2022: A
Cross-Sectional Study
Bantalem Amanu Bogale1, Sindew Mahmud Ahmed2, Aynie Birhane Gebrekidan3, Getachew Amanu Bogale4
1 Department of Nursing, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
² School of Nursing, Kotebe University of Education, Addis Ababa, Ethiopia
3 Department of Nursing, Kea-Med College, Addis Ababa, Ethiopia
4 Department of Public Health, Kutaber City Heath Oce, Dessie, Ethiopia
GMJ.2023;12:e2906
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Correspondence to:
Bantalem Amanu, Swaziland Street, Addis Ababa, Ethi-
opia, PO Box: 1271.
Telephone Number: +251917293068
Email Address: bantalem.amanu@sphmmc.edu.et
Received 2023-01-05
Revised 2023-02-04
Accepted 2023-02-07
Abstract
Background: Providing comprehensive nursing care and ensuring patient satisfaction are es-
sential health performance indicators worldwide. Despite some eorts to improve patient sat-
isfaction with nursing care, the approach in developing countries, including Ethiopia, remains
insucient. This study aimed to assess the level of adult patient satisfaction and identify the
factors aecting satisfaction. Materials and Methods: This cross-sectional study included 407
participants selected using a simple randomization technique. The samples were distributed
using proportional allocation to each selected adult inpatient department. The participants were
interviewed using a modied structured Amharic version of the Newcastle Satisfaction with
Nursing Scale. Bivariate and multivariable logistic regression analyses were also performed.
Results: The overall level of patient satisfaction with nursing care services was 54.3%.
Respondents without formal education (P=0.010), male sex (P=0.041), free ser-
vice consumers (P<0.001), and health insurance users (P<0.001) were signicantly as-
sociated with satisfaction with nursing care. In addition, previously hospitalized pa-
tients (P=0.001), governmental workers (P<0.001), and patients admitted to the med-
ical ward (P=0.010) were associated with patient dissatisfaction with nursing care services.
Conclusion: This study revealed that adult patient satisfaction with nursing care ser-
vices is low. A previous admission history, higher education level, paying cash for ser-
vices, and private and governmental workers were signicant predisposing factors for
dissatisfaction with nursing care. On the other hand, patients without formal education,
free-service consumers, and male sex were signicant predictors of satisfaction with
nursing care services. Therefore, hospital administrators are encouraged to focus on pa-
tients’ needs and expectations. [GMJ.2023;12:e2906]DOI:10.31661/gmj.v12i0.2906
Keywords: Patient Satisfaction; Adult; Inpatients; Nursing Care; Healthcare Service
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Copyright© 2021, Galen Medical Journal.
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Email:info@gmj.ir
Bogale BA, et al. Adult Patient Satisfaction with Nursing Care
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Introduction
Patient satisfaction is dened as people’s
expectations of healthcare services based on
their health, disease, quality of life, and other
requirements [1]. The American Nurses Asso-
ciation denes patient satisfaction with nur-
sing care as patients' perceptions of the care
they receive from the nursing sta during hos-
pitalization [2]. Many researchers describe it
as an individual's assessment of how well the
healthcare service provided meets their expe-
ctations, preferences, beliefs, and needs from
their unique perspective, resulting in patient
satisfaction [3].
Patient satisfaction is a key determinant of the
quality of care delivery, and as an indicator
accepted worldwide, it must continuously be
part of institutional standards [4]. Thus, the
healthcare sector has strived to transform and
expand globally to meet patient needs, and
quality healthcare is now seen as a right rather
than a privilege [5]. The World Health Orga-
nization (WHO) and International Council of
Nurses (ICN) have set the crucial goal of pro-
viding the best possible healthcare services
for all people and maintaining high patient
satisfaction [6, 7].
Nurses are the rst-line professionals for pa-
tient care and spend most of their time in the
hospital with patients. Overall, nursing care
plays a signicant role in patient satisfaction
during hospitalization [1]. The assessment of
patient satisfaction level is important for iden-
tifying factors that inuence patients' needs
and quality of care [8]. Unfortunately, deve-
loping countries, including Ethiopia, have not
conducted patient satisfaction surveys to mo-
nitor and assess the quality of care delivery
compared to developed countries [9].
The Ethiopian Federal Ministry of Health
(FMOH) has been working on reforms to
improve the quality of nursing care for better
patient satisfaction across the country over the
past 10 years [10].
These include the launch of the Compassio-
nate, Respectful, and Caring (CRC) project
and introducing national standards for quality
improvement in nursing care services; and au-
dit tools. [10].
However, in Ethiopia, the quality of heal-
thcare services is inadequate to improve and
maintain patient satisfaction with nursing
care. Furthermore, patient dissatisfaction can
lead to poor adherence to treatment and poor
health outcomes [11].
Materials and Methods
Study Design and Setting
This descriptive cross-sectional study was
conducted at the Saint Paul’s Hospital, Mil-
lennium Medical College, Addis Ababa, Ethi-
opia. According to the hospital's human re-
sources report, Saint Paul’s Hospital Millenni-
um Medical College is a 700-bed specialized
hospital providing care to the underserved
population on the outskirts of Addis Ababa.
The hospital serves an average of 200,000 pa-
tients and clients daily and has a catchment
population of over 5 million.
There are over 3,162 clinical and non-clinical
sta in over 13 departments. Data collection
started on July 1 and ended on July 30, 2022,
G.C.
The study included patients who were admit-
ted to Saint Paul's Hospital, Millennium Med-
ical College's medical, surgical, ENT/maxil-
lofacial, and obstetrics-gynecology depart-
ments; had a hospital stay of >2 days; were
>18 years old; were conscious, coherent, and
mentally stable; and were willing to partici-
pate in the study.
Study Sample and Sampling Procedure
The sample size (n) was calculated using the
single population proportion formula (p) with
an adult patient satisfaction with nursing care
magnitude of 49.2% [12], a degree of preci-
sion (d) of 0.05, and a 95% condence inter-
val (Zα/2). After adding a 10% non-response
rate, the nal sample size was 422. The nal
sample size (422) was allocated proportion-
ally to each selected department to select a
representative sample of patients, considering
the number of hospitalizations in each depart-
ment over the last 12 months. Then, a simple
random sampling method was employed to
select eligible respondents for the face-to-face
interviews. A lottery selection process was
used to select participants who met the inclu-
sion criteria from each department. This was
achieved by asking the participants to choose
from a roll of paper that had the words "Yes"
Adult Patient Satisfaction with Nursing Care Bogale BA, et al.
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3
and "No" written on it. Those who picked
"Yes" were entered into the study, whereas
those who picked "No" were excluded.This
led to the inclusion of 268 patients from the
Obstetrics and Gynecology Department, 101
patients from the surgical department, 33
patients from the ENT/maxillofacial depart-
ment, and 20 patients from the internal medi-
cine department.
Data Collection Tool
The modied Amharic version of the "New-
castle Satisfaction with Nursing Scale"
(NSNS) tool, adapted from a similar study
conducted in Ethiopia, was used to measure
patients satisfaction with nursing care [13].
The questionnaire for the current study was
divided into three sections: Part I, which pro-
vides a guide on socio-demographic data;
Part II, which provides a guide on patient sat-
isfaction with nursing care and includes 19
items on a 5-point Likert scale (1=not at all
satised, 2=barely satised, 3=quite satised,
4=very satised, and 5=completely satised)
[13,14]; and Part III, which provides a guide
on organization and patient admission-related
issues.
Data Collection Process and Personnel
Two diploma nurses and one BSc nurse par-
ticipated actively in the data collection. The-
investigators provided one day of training
session on research instruments and data col-
lection techniques to the data collectors. The
investigators and supervisor collected the
completed questionnaires daily and reviewed
them for completeness and missing values.
The quality of the data was checked before,
during, and after collection. At Saint Peter's
Hospital, 5% of the study participants were
pretested before data collection, and questions
that were dicult for them to understand were
restated in a way that was clear to the partic-
ipants. All study participants were assured of
their condentiality and anonymity. Informa-
tion was collected through face-to-face inter-
views.
Operational Denition
Satisfaction was classied into two catego-
ries: satised and dissatised. On this basis,
"Satised" refers to participants who scored
greater than or equal to the mean value for
NSNS satisfaction questions, and "Dissatis-
ed" refers to participants who scored below
the mean value for NSNS satisfaction ques-
tions [13,14].
Statistical Analysis
Before exporting the data to IBM SPSS Statis-
tics version 26 (SPSS Inc., Chicago, IL, USA)
for analysis, the data were modied, coded,
and entered into EpiData version 4.6 (EpiData
Association, Odense, Denmark). Descriptive
statistics were used to present the results of
the data analysis.
Bivariate and multivariable logistic regression
models were used to identify the association
between adult patient satisfaction and its as-
sociated factors. Bivariate analysis was pri-
marily used to t the multiple logistic regres-
sion models, and variables with P<0.25 were
selected and entered into the multivariable
logistic regression model. Finally, variables
with a statistically signicant association with
the outcome variable were identied using
P<0.05, with a 95% condence interval.
Ethics Approval and Consent to Participate
Ethical clearance was secured from the Insti-
tutional Review Board (IRB) of Saint Paul’s
Hospital Millennium Medical College (ap-
proval identication PM23/54), and permis-
sion and support letters were secured from the
Research and Ethical Review Board of Kea-
Med College (OF02/KMC/5470/14) to the
respective hospital administrators before data
collection. Informed consent was obtained
from the volunteer participants. Each respon-
dent was informed by the data collectors of
the purpose and expected benets of the study.
The respondents were also given the right to
refuse to participate in the study and to with-
draw at any time during the study. Condence
and anonymity were ensured throughout the
study. In addition, the study was conducted in
conformity with all applicable rules and reg-
ulations.
Results
Socio-demographic Characteristics of Study
Participants
A total of 407 patients participated in this
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Bogale BA, et al. Adult Patient Satisfaction with Nursing Care
study, with a response rate of 96.4%. Most
of the study participants, 181 (44.5%), were
aged between 18 and 30 years. More than
three-fourths (311, 76.7%) of the participants
were female. Regarding the educational status
of patients, 262 (64%) had a college/univer-
sity and secondary education, while the re-
maining 145 (36%) could not read and write
and had only primary education. Regarding
income level, 118 (29%) earned a monthly in-
come of Birr >5000, while the remaining 113
(21.5) and 173 (42.5%) had a monthly income
of Birr 1000-5000 and Birr <1000, respective-
ly (Table-1).
Organization and Patient Admission Related
Characteristics
Regarding the units of admission, 257 (63.1%)
participants were from the obstetrics and gy-
necologic department, 99 (24.3%) were from
the surgical department, and 19 (4.7%) were
from the medical department, while the re-
maining 32 (7.9%) were from the ENT/max-
illofacial department. In terms of previous
admission history, nearly all 349 (85.7%) par-
ticipants had no prior patient hospitalization,
while the remaining 58 (14.3%) had at least
one admission history (Table-2).
Level of Adult Patient Satisfaction with Inpa-
tient Nursing Care
Patient satisfaction with inpatient nursing care
was 54.3% (95% CI=49.6-59.2) with a mean
score of 4.106 (SD± 0.81). The “nurse's man-
ner of going about their work” (216, 53.1%)
and “there always being a nurse around when
needed” (216, 53.1%) were the highest param-
eters for nursing care satisfaction, followed
by the “willingness of nurses to respond to
patients' requests” (210, 51.6%). On the con-
trary, “Nurse’s awareness of patients' needs”
(127, 31.2%), and “how nurses helped put
patients' relatives’ or friends' minds at rest”
(129, 31.7%) were found to be the lowest pa-
rameters for patient satisfaction (Table-3).
Factors Associated with Patient Satisfaction
in Nursing Care
In the bivariate analysis, 15 predictor variables
were used, and those with a P-value of less
than 0.25 were entered into the multivariate
logistic regression model. The outcome vari-
able was signicantly associated with only six
predictor variables. The variables that had a
signicant association with adult patient sat-
isfaction with nursing care services were the
respondents' gender, educational level, occu-
pation, admission ward, prior hospitalization,
and method of service charge. Respondents
without formal education (Adjusted odds ra-
tio (AOR)=8.482; 95% CI=1.678–42.873)
(P=0.01), male sex (AOR=2.487; 95%
CI=1.038–5.959) (P=0.041), patients who
were free service consumers (AOR=6.650;
95% CI=2.677–16.517) (P<0.001), and those
using health insurance (AOR=7.309; 95%
CI=3.122–17.110) (P<0.001) were associat-
ed with patient satisfaction with nursing care
services. Patients with a previous admission
history (AOR=0.261; 95% CI=0.122-0.560)
(P=0.001), as well as governmental work-
ers (AOR=0.090; 95% CI=0.026-0.310)
(P<0.001), private workers (AOR=0.148;
95% CI=0.048-0.453) (P=0.001), and patients
admitted to the medical ward (AOR=0.160;
95% CI=0.039-0.649) (P=0.010) were associ-
ated with patient dissatisfaction with nursing
care services (Table-4).
Discussion
Nursing care is a key element of healthcare
services. Thus, patients have the right to ex-
pect and receive high-quality nursing care ser-
vice. Nursing sta are the most professional
group and have the most contact with physi-
cians and other health care professionals. As
a result, nurses are more likely to inuence
patients' attitudes and behaviors toward re-
ceiving care, rehabilitation, and recovery pro-
cesses [15,16].
This study revealed that overall satisfaction
with nursing care was 54.3% (95% CI=49.6-
59.2). Thus, the nding of this study were
higher than a study done in Nepal (39%) [17].
This dierence could be due to the variation in
the level of nursing care services needed and
expectations. However, the ndings of this
study are less signicant than those conduct-
ed in England (60%) [18] and Pawie General
Hospital in West Ethiopia (68.8%) [19]. This
discrepancy may result from the subjective
character of satisfaction and/or study, which
might be due to the dierence in operational-
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Adult Patient Satisfaction with Nursing Care Bogale BA, et al.
Table 1. Socio-demographic Characteristics of the Respondents at SPHMMC (n=407) of Addis Ababa,
Ethiopia, 2022
Variable Category Frequency Percent %
Sex Male 96 23.6
Female 311 76.4
Age
18-30 181 44.5
31-40 156 38.3
41-50 19 4.7
51-60 30 7.4
>60 21 5.2
Level of education
Unable to read and write 12 2.9
Able to read and write 22 5.4
Primary education 111 27.3
Secondary education 95 23.3
College/University 167 41.0
Marital status
Single 62 15.2
Married 327 80.3
Divorced 12 2.9
Widowed 6 1.5
Occupation
Private work/NGO 148 36.3
Governmental 81 19.9
Housewife 138 33.9
Farmer 40 9.8
Income: birr/month
<1000 ETB 173 42.5
1000-2500 ETB 47 11.5
2501-5000 ETB 66 16.2
>5000 ETB 118 29.0
Place of residency Urban 330 81.0
Rural 77 19.0
ETB: Ethiopian birr; SPHMMC: Saint Paul’s Hospital Millennium Medical College
ization and techniques used to measure satis-
faction. Additionally, the dierences might be
inuenced by the services that hospitals pro-
vide, community expectations for healthcare
services, and cultural views and values.
Patients’ educational status was a signicant
predictor of patient satisfaction with nursing
care services. Patients with no formal educa-
tion were eight times (AOR = 8.482; 95% CI =
1.678–42.873) more likely to be satised than
patients with a higher educational status. This
nding is supported by other studies conduct-
ed in Ghana [20] and Debre Berhan, Amhara
Region, Ethiopia [12]. A possible explanation
is that patients without formal education had
lower expectations, were less aware of health-
care services, and had less knowledge of nurs-
ing care than the educated patients. Structured
education enables patients to compare their
needs and expectations of care and services
with the services they receive.
The present study also revealed that male pa-
tients were two times (AOR=2.487; 95% CI
=1.038–5.959, P-value=0.041) more likely
to be satised than female patients, which
was similar to a study conducted in Ethiopia
at Butajira General Hospital [21]. The pos-
sible justication could be the similarities in
the operationalization of satisfaction, tech-
niques used to determine satisfaction status,
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Bogale BA, et al. Adult Patient Satisfaction with Nursing Care
and the satisfaction scale tool. In contrast, a
study conducted in Ethiopia at public hospi-
tals in Addis Ababa reported higher satisfac-
tion among female patients than among male
patients [8]. Explanations for this dierence
include cultural and geographical factors. Ad-
ditionally, compared with male wards, female
wards reported increased patient turnover
during the study. It aects nursing care ser-
vices and leads to burnout and exhaustion in
the provision of nursing care.
People using health insurance were
(AOR=5.621; 95% CI=1.489–11.213)
(P<0.001) more likely to be satised with
nursing care than those who paid cash for
services. This nding is supported by stud-
ies conducted in the Eastern Amhara Region,
northeastern Ethiopia, and China [13, 22].
This could be due to the detrimental eect of
high medical expenses on patient satisfaction
with nursing care and other healthcare ser-
vices.
In terms of occupation, 91% of governmen-
tal workers (AOR=0.090; 95% CI=0.026-
0.310) (P<0.001) and 85% of private em-
ployees (AOR=0.148; 95% CI=0.048-0.453)
(P=0.001) were less likely to be satised than
their farmer counterparts. This nding is con-
sistent with that of a study conducted in public
hospitals in the Amhara region of Northwest
Table 2. Organization and Patient Admission Related Characteristics of the Study Participants at SPHMMC
(n=407) of Addis Ababa, Ethiopia, 2022
Variable Category Frequency Percent Satisfaction Level
Satised Dissatised
Departments
Medical 19 4.7 11 (57.9%) 8( 42.1%)
Surgical 99 24.3 33 (33.3%) 66 (66.7%)
Gynecology-
obstetrics
257 63.1 162 (63.0%) 95 (67.0%)
ENT/Maxillofacial 32 7.9 15 (46.9%) 17 (53.1%)
Previous
admission history
Yes 58 14.3 23 (39.65%) 35 (60.34%)
No 349 85.7 198 (56.7%) 151 (43.3%)
Length of stay
2-7 days 218 53.6 81 (37.2%) 137 (62.8%)
8-15 days 106 26.0 62 (58.5%) 44 (41.5%)
16-30 days 59 14.5 37 (62.7%) 22 (37.3%)
31-60 days 23 5.7 17 (73.9%) 6 (26.1%)
>60 days 23 5.7 6 (26.0%) 17 (74.0%)
Comorbidity
Yes 20 4.9 8 (44.0%) 12 (66.0%)
No 379 93.1 208 (54.9%) 171 (45.1%)
I do not know 8 2.0 5 (62.5%) 3 (37.5%)
Availability of
assigned nurse
Yes 378 92.9 203 (53.7%) 175 (46.3%)
No 4 1.0 2 (50.0%) 2 (50.0%)
I do not know 25 6.1 16 (64.0%) 9 (36.0%)
Involving with
treatment and
care decision
making
Yes 389 95.6 221 (56.8%) 168 (43.2%)
No 18 4.4 0 (0%) 18 (100%)
Method of service
charge
Free 214 52.6 135 (63.0%) 79 (37.0%)
Health insurance 115 28.3 67 (58.3%) 48 (41.7%)
Pay with cash 78 19.2 19 (24.4%) 59 (75.6%)
Number of beds
per room
Single bed 2 0.5 0 (0%) 2 (100%)
Two beds 4 1.0 2 (50.0%) 2 (50.0%)
More than two bed 401 98.5 219( 54.6%) 182 (45.4%)
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Adult Patient Satisfaction with Nursing Care Bogale BA, et al.
Table 3. Frequency of Adult Patient Satisfaction with Nursing Care (N=407)
Items SatisedN(%) DissatisedN
(%)
The amount of time nurses spent 172 (42.3%) 235 (57.7%)
How capable nurses were at their job 191 (46.9%) 216 (53.1%)
There always being a nurse around when needed 216 (53.1%) 191 (46.9%)
The amount nurses knew about patients care 202 (49.6%) 205 (50.4%)
How quickly nurses came when patients called for them 204 (50.1%) 203 (49.9%)
The way the nurses made patients feel at home 181 (44.5%) 226 (55.5%)
The amount of information nurses gave to patients about
their condition and treatment 165 (40.5%) 242 (59.5%)
How often nurses checked to see if patients were okay 182 (44.7%) 225 (55.3%)
Nurses’ helpfulness 210 (51.6%) 197 (48.4%)
The way nurses explained things to patients 199 (48.9%) 208 (51.1%)
How nurses helped put patients’ relatives’ or friends’ minds
at rest 129 (31.7%) 278 (68.3%)
Nurses’ manner in going about their work 216 (53.1%) 191 (46.9%)
The type of information nurses gave to patients
about their condition and treatment 195 (47.9%) 212 (52.1%)
Nurses’ treatment of patients as an individual 202 (49.6%) 205 (50.4%)
The willingness of nurses to listen to patients worries and
concerns 162 (39.8%) 245 (60.2%)
The amount of freedom patients were given on the ward 202 (49.6%) 205 (50.4%)
The willingness of nurses to respond to patients’ requests 210 (51.6%) 197 (48.4%)
The amount of privacy nurses gave to patients 207 (50.9%) 200 (49.1%)
Nurses’ awareness of patients’ needs 127 (31.2%) 280 (68.8%)
Ethiopia [23]. A possible explanation is that
most government employees’ education is
higher than their counterparts’, so structured
education could inuence the expectations of
their rights, needs, and nursing care. In addi-
tion, most private employees were not free
service consumers or health insurance users,
therefore, they might be dissatised because
of the unequal service they receive.
Hospitalization was also signicantly associ-
ated with satisfaction with nursing care ser-
vices, with those who had a hospitalization
history of 74% (AOR=0.261; 95% CI:0.122-
0.560) (P=0.001) less likely to be satised
than their counterparts. This result is consis-
tent with the ndings of a meta-analysis con-
ducted in Addis Ababa, Ethiopia [24]. This
could be due to antecedent dissatisfaction and
stressful events, including organization-relat-
ed factors, therapeutic procedures, the service
fees they incur, and the inadequate quality of
services they receive. There was a signicant
relationship between admitting department
and patient satisfaction; 84% of those admit-
ted to the medical ward (AOR=0.160; 95%
CI=0.039-0.649) (P=0.010) were more likely
to be dissatised with nursing care than their
counterparts. This nding was consistent with
that of a study conducted in Ethiopia at public
hospitals in Addis Ababa [25]. A possible ex-
planation is that patients admitted to the med-
ical ward typically have more serious condi-
tions with worse prognosis and are confronted
with stressful and uncomfortable situations.
Additionally, the majority of patients admit-
ted to the medical ward had experienced pre-
vious admissions and traumatic events such as
therapeutic procedures and expensive service
charges.
According to the ndings of this study, pa-
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Bogale BA, et al. Adult Patient Satisfaction with Nursing Care
Table 4. Association between Patient Satisfaction and Dierent Determinant Factors at SPHMMC, Addis
Ababa 2022
Variables Satisfaction Level COR(95%CI) AOR(95%CI)
Satised Dissatised
Sex
Male 44 (45.83%) 52(54.17%) 1.561 (0.986-2.473) 2.487(1.038-5.959)
*
Female 177 (56.9%) 134 (43.1%) 1.00 1.00
Level of education
Unable to read and
write 10 (83.3%) 2 (16.7%) 7.846(1.666-36.957) 1.729(0.296-
10.087)
Able to read and write 19 (86.4%) 3 (13.6%) 9.938(2.828-34.924) 8.482(1.678-
42.873)*
Primary education 53 (47.7%) 58 (52.3%) 1.434 (0.883-2.330) 1.051(0.566-1.951)
Secondary education 74 (77.9%) 21 (22.1%) 5.53 (3.109-9.835) 6.409(0.103-
13.237)
College/ University 65 (38.9%) 102 (61.1%) 1.00 1.00
Place of residency
Urban 156 (47.3%) 174 (52.7%) 1.405 (0.846-2.331) 0.929(0.453-1.905)
Rural 30 (39%) 47 (61%) 1.00 1.00
Occupation
Private work/NGO 69 (46.6%) 79 (53.4%) 0.254 (0.113-0.570) 0.148(0.048-0.453)
**
Governmental 28 (34.6%) 53 (65.4%) 0.153 (0.064-0.367) 0.090(0.026-0.310)
***
Housewife 93 (67.4%) 45 (32.6%) 0.6 (0.263-1.366) 0.176 (0.053-3.585)
Farmer 31 (77.5%) 9 (22.5%) 1.00 1.00
Departments
Medical 11 (57.9%) 8 (42.1%) 0.364 (0.134-0.990) 0.160(0.039-0.649)
**
Surgical 33 (33.4%) 66 (66.6%) 1.24 (0.482-3.192) 0.854(0.223-
3.2690)
Gynecology/obstetrics 162 (63.0%) 95 (37.0%) 0.642 (0.204-2.017) 0.259(0.048-1.389)
ENT/Maxillofacial 15 (46.9%) 17 (53.1%) 1.00 1.00
Admission history
Yes 23 (39.7%) 35 (60.3%) 0.501 (0.284-0.884) 0.261(0.122-0.560)
**
No 198 (56.7%) 151(43.3%) 1.00 1.00
Method of service
charge
Free 135 (63.1%) 79 (36.9%) 5.306 (2.951-9.543) 6.650(2.677-
16.517)***
Health insurance 67 (58.3%) 48 (41.7%) 4.334 (2.294-8.188) 7.309(3.122-
17.110)***
Pay with cash 19 (24.4%) 59 (75.6%) 1.00 1.00
NB: Variables having a P≤0.25 in bivariate analysis included in the multivariable analysis; *: Statistically
signicant at P<0.05, **: signicant at P<0.01, ***: signicant at P<0.001, 1.00 Reference, AOR: Adjusted
odds ratio; CI: Condence interval; COR: Crude odds ratio; ENT: Ear, nose, and throat
tient satisfaction with inpatient nursing care is
low. Educational status, previous hospitaliza-
tion, sex, admitting department, and method
of service charge were predictors of admitted
adult patients' satisfaction with nursing care
services. Among the NSNS satisfaction items,
"the nurses' awareness of patients’ needs"
(127, 31.2%), "nurse’s help for patients’ rel-
atives or friends’ minds at rest" (129, 31.7%),
"the nurses' willingness to listen to patients'
worries and concerns" (162, 39.8%), "nurse’s
awareness of patients’ needs" (43, 17.6%),
and the amount of information nurses provid-
ed to patients about their condition and treat-
ment were found to be the lowest parameters
regarding patient satisfaction.
Conclusion
Approximately half of the study participants
were dissatised with nursing care among pa-
tients admitted to Saint Paul’s Hospital, Mil-
lennium Medical College, Addis Ababa, in
the surgical, medical, obstetric-gynecological,
and ENT/maxillofacial departments. Com-
pared with many published national and in-
ternational studies, the current study revealed
that admitted adult patients had a low level
of satisfaction with nursing care services.
Among the educational level, being male, not
having formal education, and health insurance
usage were found to be signicant factors in
patient satisfaction with nursing care. On the
other hand, admission ward (medical), being
a government worker, and having a history of
admission were found to be signicant factors
of patient dissatisfaction with nursing care.
Therefore, hospital administration should em-
phasize the needs and expectations of patients.
Acknowledgments
We are incredibly grateful to all data collec-
tors and study participants for their voluntary
participation in the interview process. We also
extend our acknowledgment to Saint Paul’s
Hospital millennium Medical College admin-
istrators who gave their time and information
to make this study possible. Additionally, we
would like to express our sincere thanks to the
University of Newcastle's NSNS team for en-
abling us to use their NSNS questionnaire in
this research. Finally, we would like to thank
Research Square for posting our paper as a
preprint and allowing us to improve our paper
with feedback from the community prior to
peer review in the journal.
ConictofInterest
The authors declare that they have no compet-
ing interests.
Adult Patient Satisfaction with Nursing Care Bogale BA, et al.
GMJ.2023;12:e2906
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9
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