INTRODUCTION

Patient satisfaction has become increasingly popular, as a critical component

in the measurement of quality of care. Satisfaction is one of the cares out come for

healthcare. Satisfaction with health care is measure with a long history in the social

science. Nursing service is one of the most important components of hospital

service. Understanding how things are looking through the patient‟s eye should be

central part of quality improvement. The level of patient satisfaction with nursing

care is an important indicator of quality of care provided in hospitals .

Patient satisfaction is a term that can be interpreted differently by patients

and it meaning can also differ for one patient at different times. Patient‟s satisfaction

some time treated as an outcome measure of healthcare providers. A satisfied patient

is more willing to recommend the hospital to provide his or her care to others.

Patient‟s satisfaction is defined as patient‟s subjective evaluation of their

cognitive and emotional reaction as a result of interaction between their expectation

regarding ideal nursing care and their perceptions of actual nursing care.

Definition of nursing care is to promote health and to help support, educate

and develop patient by liberating his or her own resources. The nursing care

provided by nurse is regarded as most important factor in patient assessment of their

satisfaction with health care. If patient is satisfied with health care received,this is

positive not only for individual but also for nurse and entire health care organization

(Johansson et al; 2002)

1
BACKGROUND OF THE STUDY

Nursing is a career, which calls for certain special qualities. Florence

Nightingale is considered as the founder of modern nursing. She mentioned in her

notes on nursing about the characteristics of a nurse. She says “A nurse must be no

gossip, no vain talker is strictly sober and honest; but more than this, she must be

devoted woman, she must have respect for her calling, she must be a sound, a close

and a quick observer, and she must be a woman of delicate and decent feeling”.

According to the American Nurses Association, “Nursing practice is a direct

service, goal directed and adaptable to the needs of the individual, the family and

community during health and illness. The nurse‟s primary responsibility is to those

people who require nursing care.

Instruments measuring patient‟s satisfaction have often been focused on in

patient treatment [Muntlin et al., 2006]. Nursing care has a prominent role in patient

satisfaction, patient satisfaction is an important indicator of quality of care and

healthcare facilities are interested in maintaining high levels of satisfaction in order

to stay competitive in healthcare market [Wagner et al., 2009].The main indication

for measuring patient satisfaction with nursing care is to identify area for

improvement.

During hospitalization patient’s satisfaction represents a balance between

patient’s perception and exceptions of their nursing care. Patient’s satisfaction is

important patient-centred out come to measure, is accepted as standard measure of

quality of care and it is steadily gaining in popularity.

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 Today’s nurse engages in approximately eight inter related roles: -care giver,

advocate, critical thinker, teacher, communicator, manager, researcher &

rehabilitator [Hark reader and Hogan2004]. Patient satisfaction with nursing care has

consistently been found to be correlated with overall satisfaction care and has

been defined as the patient subjective evaluation of 3the cognitive and emotional

response that result from interaction the patient‟s expectation of nursing care and

their perception of actual nurse behavior and characteristics [Erickson.,1987].

Nursing is a process of recognizing; understanding and meeting health needs

of any person or society and is based on constantly changing the body of scientific

knowledge. Nurses and physicians perceptions about good quality of care do not

always agree with patient’s perceptions. Nursing is an accountable profession

guided by science, theory, code of ethics and the art of care and comfort to treat

human responses to health and ill Patient’s satisfaction with nursing care is

considered as an important factor in explaining patient’s perception of service

quality.

The nurse work environment has being found to be both directly and

indirectly related to patient‟s satisfaction [Vahey. 2004]. Patient‟s satisfaction has

been advocated as an outcome measure of quality nursing care. Determinants quality

of nursing care include: adequate skill, caring attitudes, effective communication,

efficient organizational and management systems, and effective participation.

3
NEED OF THE STUDY

Nursing care is recognized as an area subjected to competition, where the

patient is seen both as a client and consumer of health care. To improve quality of

nursing care, nurses need to know what factors influence patient satisfaction.

Nursing care plays the key role in providing satisfaction in this arena.

Quality of nursing care is vital to patient outcomes and safety. Patient

satisfaction with nursing care is strongly associated with patients overall satisfaction

with hospital experience. To ensure service improvement initiatives at appropriative

levels in hospital is a prerequisite to understand factors which influence patient

satisfaction with nursing care. The measurement of patient satisfaction with nursing

care is important to determine and meet patient‟s need in terms of care and to

evaluate quality of care provided.

Patients in the ICU needs prolonged hospital stay. Prolonged hospital stay

itself can cause health care associated infections, psychological stress and

complication like bed sore, hydrostatic pneumonia etc. So nurse should focus giving

in holistic care to the patient in order to prevent or limit the complication and for

easy recovery. So assessing patient satisfaction can bring new changes in approach

or modification in nursing care.

4
OBJECTIVES OF THE STUDY

1. To assess the patient satisfaction with quality of nursing care.

2. To identify relationship between satisfaction of patient with respect to age,

sex, marital status variables

3. To identify relationship between satisfaction of patient with respect to

previous admission and education variables

4. To identify services provided by the hospitals.

5. To suggest nurses regarding the patient satisfaction towards their care on

them.

OPERATIONAL DEFINITIONS

Patient satisfaction - The degree to which the individual perceives health

care service provided by nurses in selected department as useful, effective or

beneficial as measured by using Patient Satisfaction With Nursing Care Quality

Questionnaire.

Quality of nursing care - It refers to meeting the health care needs of patients

with regards to caring attitude of nurses, effective communication, proper

explanations before procedures and treatment, adequate skill and competence,

effective participation, organizational and management systems and involvement of

patient and significant others in care.

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RESEARCH METHODOLOGY

Introduction

Research methodology is the systematic way to solve research problem. It

include the step that researcher adopt to study this problem with the logic behind. It

indicates the general pattern of organizing the procedure of gathering valid and

reliable data for an investigation.

This chapter provides a brief description of method adopted by the

investigator to conduct the study. This chapter includes research approach, research

design, and setting of the study, sample and sampling technique. It further deals with

development of tool, procedure for data collection, and for data analysis.

Research approach

Survey approach is used for the present study. Survey approach is more

useful in educational fact finding, in relatively small samples.

Research design

The descriptive study design was used to fulfill the objective of the study.

Setting of the study

This study was conducted in ICU Andhra hospitals, Vijayawada in Andhra

Pradesh State

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Study population

The target population of the study was both male and female patients

admitted in AHS.

Sample size

The sample size consists of 50 patients. 10 patients were selected for pilotstudy.

Criteria for sample selection

Inclusion criteria:

- Patients who are willing to participate

- Patients who can read and understand Telugu

- Patients who are for discharge on the day of data collection.

- Patients who have age above 18 years.

Exclusion criteria

- Patients on ventilator

- Patients who do not respond/ disoriented/altered mental status

Sampling technique

Patients who are in ICU during data collection period and who fulfilled

inclusion criteria were collected as samples by convenient sampling technique.

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 Data collection tool

Data collection tool refers to instrument which was used by investigator to

obtain relevant data. A modified questionnaire was prepared by investigator from

Dr. Laschingers. The questionnaire was translated to regional language Telugu with

some modifications. The tool was examined by experts of ANDHRA HOSPITALS.

The research tool was finalized according to experts’ opinion.

Description of the tool

The rating scales were - excellent, very good, good, fair, and poor

The questionnaire was translated to regional language Telugu with some modification.

 The structured questionnaire consists of two sections.

General information or demographic data, it includes Name, age, sex, marital

status, education, category, date of admission, number of previous admission, way

of admission and diagnosis

20 questions regarding patient satisfaction with nursing care. The options given

for rating were: excellent, very good, good, fair and poor.

Data collection procedure

There was no problem faced during pilot study, the same method of data

collection was used for the final study. The researcher first introduced herself to the

patient and explained the need and purpose of the study. Informed consent was taken

from the patient before data collection. It took 20 minutes for the patient to

answering the questions

8
 INDUSTRY PROFILE

INTRODUCTION

Healthcare has become one of India’s largest sectors - both in terms of revenue and

employment. Healthcare comprises hospitals, medical devices, clinical trials, outsourcing,

telemedicine, medical tourism, health insurance and medical equipment. The Indian

healthcare sector is growing at a brisk pace due to its strengthening coverage, services and

increasing expenditure by public as well private players.

Indian healthcare delivery system is categorised into two major components - public and

private. The Government, i.e. public healthcare system comprises limited secondary and

tertiary care institutions in key cities and focuses on providing basic healthcare facilities in

the form of primary healthcare centres (PHCs) in rural areas. The private sector provides

majority of secondary, tertiary and quaternary care institutions with a major concentration in

metros, tier I and tier II cities.

India's competitive advantage lies in its large pool of well-trained medical professionals.

India is also cost competitive compared to its peers in Asia and Western countries. The cost

of surgery in India is about one-tenth of that in the US or Western Europe.

Market Size

Deloitte Touche Tohmatsu India has predicted that with increased digital adoption,

the Indian healthcare market, which is worth around US$ 100 billion, will likely grow at a

CAGR of 23 per cent to US$ 280 billion by 2020.

The revenue of India’s corporate healthcare sector is estimated to grow at 15 per cent

in FY 2017-18.*

India is experiencing 22-25 per cent growth in medical tourism and the industry is

expected to double its size from present (April 2017) US$ 3 billion to US$ 6 billion by 2018.

9
Medical tourist arrivals in India increased more than 50 per cent to 200,000 in 2016 from

130,000 in 2015.

The Healthcare Information Technology (IT) market is valued at US$ 1 billion

currently (April 2016) and is expected to grow 1.5 times by 2020.

Over 80 per cent of the antiretroviral drugs used globally to combat AIDS (Acquired

Immuno Deficiency Syndrome) are supplied by Indian pharmaceutical firms^.

There is a significant scope for enhancing healthcare services considering that healthcare

spending as a percentage of Gross Domestic Product (GDP) is rising. Rural India, which

accounts for over 70 per cent of the population, is set to emerge as a potential demand source.

A total of 3,598 hospitals and 25,723 dispensaries across the country offer AYUSH

(Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) treatment, thus ensuring

availability of alternative medicine and treatment to the people.

Investments

The hospital and diagnostic centres attracted Foreign Direct Investment (FDI) worth US$

4.34 billion between April 2000 and March 2017, according to data released by the

Department of Industrial Policy and Promotion (DIPP). Some of the major investments in the

Indian healthcare industry are as follows:

 Kerala Institute of Medical Sciences (KIMS) has raised US$ 200 million from True

North, a private equity fund, for a 40 per cent stake in the company, which will be

utilised towards funding its growth plans.

 Syngene, a subsidiary of Biocon Ltd, has acquired a contract from HerbalLife

Nutrition, a nutrition company, to develop nutrition based products that can be sold by

Herbalife in India.

 CureFit, a healthcare and fitness start-up, has acquired Kristys Kitchen, an online

health-food delivery company, in a cash and stock deal.

10
 STEER Engineering has announced research collaboration with Merck, a German

healthcare and life sciences firm, for creating a technology useful for processing

special effect pigments for the plastic industry.

 Max Healthcare, a healthcare institute based in New Delhi, has plans to invest Rs 320

crore (US$ 48 million) to build a cancer care hospital in Delhi, being a part of Max's

larger plan to develop its hospital in Saket.

 Thyrocare Technologies, a diagnostic laboratory chain, plans to expand its lab centres

from 7 to 25 and franchisees from 1,200 to 5,000 to achieve a target revenue of Rs

1,000 crore (US$ 150 million) by 2020.

 OrbiMed, a healthcare-dedicated investment firm, plans to invest around US$ 40

million in Kolkata-based pathology and radiology services chain Suraksha

Diagnostics for expanding the diagnostics chain's laboratory network across India and

enhancing its equipment technology backbone.

 International Finance Corporation (IFC), the investment arm of World Bank, has

invested around Rs 450 crore (US$ 67.5 million) for a 29 per cent stake in Healthcare

major Apollo Group’s subsidiary Apollo Health and Lifestyle Ltd for funding

Apollo's expansion activities.

 Abraaj Group, a Dubai-based private equity investment firm, is in advanced

discussions to acquire a controlling stake in south India’s leading diagnostics services

provider Medall Healthcare Pvt Ltd, at an enterprise value of around Rs 1,500 crore

(US$ 225 million).

 Practo Technologies Pvt Ltd, a digital healthcare start-up, has raised US$ 55 million

in series D round of funding led by Chinese investment holding company, Tencent

Holdings Ltd, which will be used for expanding its product portfolio.

 Japanese financial services firm Orix Corp. is in talks to buy a minority stake in

Bengaluru-based fertility clinic chain Nova IVI Fertility, from the company’s

11
 promoters and existing private equity investors for Rs 250-300 crore (US$ 37.5-45

million).

 UAE-based Gamma Group has outlined plans of investing around Rs 3,000 crore

(US$ 449.68 million) in the infrastructure, health and education sectors of Kerala,

which is expected to generate around 2,000 indirect and direct jobs in the state.

Government Initiatives

Some of the major initiatives taken by the Government of India to promote Indian healthcare

industry are as follows:

 In the Union Budget 2017-18, the overall health budget increased from INR 39,879

crore (US$ 5.96 billion) (1.97% of total Union Budget) to INR 48,878 crore (US$ 7.3

billion) (2.27% of total Union Budget). In addition, the Government of India made

following announcements in the Union Budget 2017-18:

 Harmonise policies and rules for the medical devices industry to encourage local

manufacturing and move towards improving affordability for patients.

 Modify the Drugs and Cosmetics Act to promote generics and reduce the cost of

medicines.

 Set up two new All India Institute of Medical Sciences (AIIMS) in Gujarat and

Jharkhand.

 Convert 1.5 lakh sub centres in Indian villages to health and wellness centres

 Set short and medium term targets for key health indicators and bring down the

Maternal Mortality Rate to 100 by 2018-2020 and Infant Mortality Rate to 28 by

2019.

 Prepare action plans to eliminate Kala Azar and Filariasis by 2017, leprosy by 2018,

measles by 2020 and tuberculosis (TB) by 2025.

12
  The Union Cabinet, Government of India, has approved the National Health Policy

2017, which will provide the policy framework for achieving universal health

coverage and delivering quality health care services to all at an affordable cost.

 The Government of India plans to set up a single window approval system for

innovation in medical research, in order to grant permission/approvals within 30 days

from the date of application to Indian innovation projects who have applied for global

patent.

 Mr Shripad Naik, Minister of State with Independent Charge for AYUSH, has

verified that the AYUSH Ministry is working with various agencies, institutions and

Ayurveda researchers and practitioners across the globe to turn India into a global hub

for knowledge, research, practice and developmental projects on traditional

medicines.

 The Government of Assam has launched the Atal-Amrit Abhiyan health insurance

scheme, which would offer comprehensive coverage for six disease groups to below-

poverty line (BPL) and above-poverty line (APL) families, with annual income below

Rs 500,000 (US$ 7,500).

 The Government of India and the Government of the State of Nagaland signed

financing agreement and project agreement respectively with The World Bank, for the

‘Nagaland Health Project’ for US$ 48 million, which aims to improve health services

and increase their utilisation by communities in targeted locations in the state.

Road Ahead

India is a land full of opportunities for players in the medical devices industry. The country

has also become one of the leading destinations for high-end diagnostic services with

tremendous capital investment for advanced diagnostic facilities, thus catering to a greater

proportion of population. Besides, Indian medical service consumers have become more

conscious towards their healthcare upkeep.

13
India's competitive advantage also lies in the increased success rate of Indian companies in

getting Abbreviated New Drug Application (ANDA) approvals. India also offers vast

opportunities in R&D as well as medical tourism. To sum up, there are vast opportunities for

investment in healthcare infrastructure in both urban and rural India.

TOP 10 HOSPITALS IN INDIA

10. APOLLO MUNICH

Victor of Insurer of the Year grant, Apollo Munich Health Insurance Company is a

main organization in medicinal services area. The organization offers an extensive variety of

medical coverage arranges, which gives cashless hospitalization.The organization is a joint

endeavor between the Apollo Hospitals Group and Munich Health and offer treatment in

more than 50 clinics in the nation.

9. FORTIS HEALTHCARE LIMITED

Fortis Healthcare Limited is a major player in this section and possessed ninth spot in

the rundown of main 10 medicinal services organizations in India. Joined in the year 2001,

Fortis Healthcare Limited is a main medicinal services administration supplier and offer

administrations through doctor’s facilities and symptomatic offices. Fortis Healthcare

Limited works a chain of super claim to fame doctor’s facilities in the nation, which offer

world class medicinal services offices. These doctor’s facilities offer social insurance

administrations in various areas like Cardiology, Dermatology, Hematology, Hepatology,

Gastroenterology, and so on.

14
8. APOLLO HOSPITALS ENTERPRISE LIMITED.

Apollo is name that needs no presentation in the medicinal services industry as it is

known for offering head quality human services administrations. It works 64 world class

clinics in the nation, which offer unmatched medicinal services administrations.

7. RELIGARE HEALTH INSURANCE COMPANY LIMITED

This is a main medical coverage supplier in the nation, which offer medical coverage

items. The organization offers a complete scope of medical coverage arranges, which covers

cashless hospitalization and treatment for ailment and ailments.The organization offers

cashless treatment in more than 4,500 clinics and works a substantial number of

demonstrative labs. The organization is advanced by huge names like Fortis Hospitals and

SRL Diagnostics, which makes it equipped for giving better administrations than clients.

6. WOCKHARDT LIMITED

Wockhardt Limited is a chief social insurance organization occupied with the matter

of pharmaceuticals, biotechnology and doctor’s facilities. The organization has 12 fabricating

units and a workforce of more than 8,500 individuals.The organization offers an extensive

variety of pharmaceutical items for restorative ranges like Cardiology, Neurology,

Respiratory, Dermatology, and so forth. Wockhardt likewise has a chain of cutting edge super

forte doctor’s facilities in the nation, which offer world class wellbeing administrations.

15
5. PIRAMAL ENTERPRISES LIMITED

Fused in the year 1988, Piramal Enterprises Limited is positioned fifth in the rundown

of main 10 human services organizations in India. The business verticals of the organization

are medicinal services and money related administrations and it remains among the main

players in inward breath soporifics.Social insurance Division produces real part of the

organization’s income, which is around 90% of the aggregate income. The organization has

fabricating units in India, USA, Canada, UK and Scotland and its items are accessible in

more than 100 nations over the globe. This is one amongst Top 10 Healthcare Companies in

India 2017.

4. CIPLA

Established in the year 1935, Cipla is a main pharmaceutical organization with a

turnover of more than $1.75 Billion. The organization has a workforce of more than 20,000

individuals and offer pharmaceutical items for restorative territories like Dermatology,

Respiratory, Cosmetology, and so forth.Headquartered in Mumbai, Cipla has nearness in

more than 150 nations and offer more than 1,500 items. Cipla has more than 35 fabricating

units with a creation limit of 23 Billion units of tablets and containers.

3. DR.REDDY’S LABORATORIES

This is the following on this rundown, which is a multinational pharmaceutical

organization joined in the year 1984. The organization has 4 fabricating units and nearness in

more than 25 nations on the planet.The organization offers an extensive variety of items for

restorative territories like cardiovascular care dermatological care, gastroenterological care,

paediatrics, and so forth.

16
2. LUPIN PHARMACEUTICALS

Lupin Pharmaeuticals is among the main pharmaceutical makers and stand at second

place in the rundown of main 10 social insurance organizations in India. The organization has

11 fabricating focuses, which delivers an extensive variety of pharmaceutical items.

1. SUN PHARMA

Sun Pharma has a nearness in more than 100 nations on the planet and utilizes more

than 32,000. Joined in the year 1961, Sun Pharma is a main maker and dealer of

pharmaceuticals in the nation.It is the biggest pharma organization in the nation and makes

pharmaceutical items for remedial ranges like diabetology, cardiology, neurology, and so

forth. The organization has 48 fabricating destinations and a group of 2000 examination

researchers working in R&D focuses.

17
 COMPANY PROFILE ---ANDHRA HOSPITALS

Andhra Hospitals (Formerly Ramana Gastro, Laparoscopy & Multi Speciality

Hospital) is located in one of the most serene residential areas of the Vijayawada city. This

Hospital has spacious and well ventilated rooms with neatly maintained floors. It is a five

storied building with each floor having a carpet area of 9000 sft totaling to 45000 sft in all.

The location is well connected to all the prime areas in the city. and is away from Bus Station

or Railway Station by 2 kms. All modes of transportation are available to the hospital from

various parts of city. All these facilities ensure easy access of the Hospital for the patients.

The imported equipment is procured from reputed manufacturers who apart from providing

Performance Guarantee are also providing periodical maintenance and training of Hospital's

technicians in upkeep/routine maintenance of equipment.

The administration is looked after by the Chief Executive and Chief Surgical Gastro

Enterologist Dr.P.V. Ramana Murthy, M.S., FRCS. (UK), who has a rich experience in the

field of hospital management.

Andhra Hospitals was formed in 2004. It has 250 beds at main hospital site in

Vijayawada.Other Andhra Hospitals centres at Bhavanipuram(Vijayawada),Eluru and

Machilipatnam which will accommodate 150,100 and 100beds respectively,will start

functioning shortly.We have one satellite centre functioning at Hanuman Junction.Andhra

Hospitals is a centre of excellence in child healthcare in addition to other specialties and

superspecialties What we do.Most of the patients we care for are referred from other hospitals

throughout the coastal Andhra and beyond. There are more than 20 different clinical

specialties at Andhra Hospitals.we pride ourselves on being the hospital of choice for

18
hundreds of expectant mothers.In everything we do, we work hard to live up to our three core

values: pioneering, world-class and collaborative.

Our highly-skilled team of consultants, obstetricians and midwives are here to support

and guide you, from the time you find out you are pregnant to the moment you hold your baby

for the first time, and on into the first few hours, days and weeks of parenthood. Above all, our

aim is to offer a sensitive and flexible service to meet the specific needs of every woman and

her family. And we encourage you to be partners in the planning of your care. We are able to

offer you an extensive range of antenatal screening tests and investigations. The safety and

wellbeing of every woman in our care is our number one priority making us a safe pair of hands

at this exciting time in life.

Healthcare services we provide are among the safest and most advanced in the

state.Whatever your reasons for visiting us, we’ll take the very best care of you. Our aim is

not just to deliver clinically advanced healthcare, but also to meet the wider, individual needs

of all our patients, so you receive personal care at all times, from every member of our

team.We have five values that are part of everything we do as an organisation. We will:

 Put patients first

 Take pride in what we do
 Respect others
 Strive to be the best
 Act with integrity

We are committed to providing patient-centred, family-focused care to everyone who

attends the Andhra Hospitals. We provide 24-hour, Consultant-led care for emergency

admissions, ensuring patients are seen as quickly as possible and we also deliver

comprehensive Outpatient and Ward services for more routine cases.We deliver services

across the whole of the coastal Andhra region, and receive referrals from many other

hospitals, locally and regionally, who do not have the necessary expertise to treat complex

conditions service.

19
TYPES OF SERVICES

MATERNITY

Rooms are available that are all-inclusive where mothers can give birth, nurse their babies

and spend a day two recovering from the delivery. Other hospitals utilize operating rooms for

deliveries and nurseries for the newborns. Newborn intensive care facilities are available at

most hospitals for babies born prematurely or with other serious medical conditions.

Maternity hospitals also prepare for emergency deliveries and those with complications that

require special care.

NURSING

Hospitals are the largest employers of nurses, who staff all sections in hospitals. Nurses carry

out the orders provided by doctors and see to the daily needs of patients who are staying in

rooms at the hospital. Nurses assist physicians in surgery and staff various services in

hospitals 24 hours a day.

SURGERY

Hospitals stock and staff surgical suites that can be used for outpatient services or in-depth

procedures, such as transplants, heart surgery and repairing broken bones. While many

hospitals employ surgeons full-time on staff, others make their surgical services available to

affiliated doctors. Surgical services include anesthesiology services, nursing care, pre- and

post-operative rooms, and lab and x-ray technicians.

PHARMACY

Hospitals provide pharmacy services that supply patients with medications as prescribed. In

addition to providing inpatients with medicine, many hospital pharmacies can fill

prescriptions for patients as they leave.

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SPECIALTIES

Various hospitals provide specialty services such as cardiology wards, cancer centers,

pediatric services and rehabilitation units. Nurses and technicians who work in specialty units

receive additional training to serve that population. Patients may receive ongoing treatment as

outpatients through a hospital-run clinic as well as surgical and rehabilitation services in the

same facility. Specialty units at hospitals typically provide social services in addition to

medical treatments in the form of specialized referrals or in-house counselors.

21
 CUSTOMER SATISFACTION

INTRODUCTION

The modern age can be called as the “Age of Consumers”. In today’s cut-throat

competition the consumer is considered as the king. Many policies of various organizations

are aimed at keeping the consumer happy and satisfied. It is very important for each and

every organization to keep its consumers satisfied in order to maintain its competitiveness in

the market. Not only does this help the organization to maintain the size of its share in the

market, it might even help it to increase the size of its share. It might also be instrumental in

increasing the overall market size. This helps in increasing the overall profitability of the

organization. It also helps the long-term survival prospects of the organization. Consumers

when viewed on the macro level exhibit similar traits. However when we take a closer look

and come down to the micro level, we find that the consumers vary as compared to one

another on one aspect or the other based on a variety of attributes (Kotler, 2003).

In the present business scenario of cutthroat competition, customer satisfaction has

become the prime concern of each and every kind of industry. Companies are increasingly

becoming customer focused. Companies can win customers and surge ahead of competitors

by meeting and satisfying the needs of the customers. World over businesses have realized

that marketing is not the only factor in attracting and retaining customers. Other major factors

responsible for the same are satisfaction through service quality and value. Even the best

marketing companies in the world fail to sell products and services that fail to satisfy the

customers’ needs. So customer satisfaction is the keyword in today’s fiercely competitive

business environment.

22
CUSTOMER SATISFACTION

Whether the buyer is satisfied after purchase depends on the product’s performance in

relation to the buyer’s expectations. In general, satisfaction is a person’s feelings of pleasure

or disappointment resulting from comparing a product’s perceived performance in relation to

his or her expectations. If the performance falls short of expectations, the customer is

dissatisfied. If the performance matches the expectations, the customer is satisfied. If the

performance exceeds expectations, the customer is highly satisfied or delighted.

The link between customer satisfaction and customer loyalty is not proportional.

Suppose customer satisfaction is rated on a scale from one to five. At a very low level of

customer satisfaction (level one), customers are likely to abandon the company and even bad

mouth it. At levels two to four customers are fairly satisfied but still find it easy to switch

when a better offer comes along. At level five, the customer is very likely to repurchase and

even spread good word out of mouth about the company. High satisfaction creates an

emotional bond with the brand or company, not just a rational preference.

CUSTOMER EXPECTATIONS

How do buyers form their expectations? From past buying experiences, friends’ and

associates’ advice, and marketers’ and competitors’ information and promises. If marketers

raise expectations too high, the buyer is likely to be disappointed. However, if the company

sets expectations too low, it won’t attract enough customers. Some of today’s most successful

companies are raising expectations and delivering performances to match. These companies

are aiming for TCS- total customer satisfaction.

A customers’ decision to be loyal or to defect is the sum of many small encounters with the

company. The key to generating high customer loyalty is to deliver high customer value. So a

company must design a competitively superior value proposition aimed at a specific market

segment, backed by a superior value-delivery system.

23
 The value proposition consists of the whole cluster of benefits the company

promises to deliver; it is more than the core positioning of the offering. Whether the

promise is kept depends on the company’s ability to manage its value delivery system.

The value delivery system includes all the experiences the customer will have on the

way to obtaining and using the offering.

Customer satisfaction is a feeling of pleasure or disappointment on the offers perceived

performance in relation to buyers’ expectations. Expectation is defined as what the customer

wants/requires from the product/service and perceived performance is the perception of the

customer about the product/service i.e. evaluation of the product/service after using it. So

perception is what the customer actually receives/gets from the product/service. The

evaluation is done by comparing the expectations with the perceived performance of the

product/service. Therefore customer satisfaction is a function of perceived performance and

customer expectations. Customers who are just satisfied find it easy to switch over when a

better offer comes than those who are highly satisfied. For customer focused companies

satisfaction is both a goal as well as a marketing tool. What a consumer thinks about the

product or services offered by a firm can have a marked effect on the purchase of its products

or services. So one of the tasks before the management is to know what the consumer expect

and what they are getting in return.

Satisfaction is a judgment that a product or service feature, or the product or service

itself, provided (or is providing) a pleasurable level of consumption-related fulfillment,

including levels of under- or over fulfillment. However, and as is occasionally noted, if a

customer experiences disconfirmation after consuming a product, future expectations

regarding the product should be revised toward the performance perceived by the customer. If

expectations do not change in the face of disconfirmation, the implication would be that the

customer did not learn from their consumption experience (Oliver, 1997).

24
MEASURING SATISFACTION

Although the customer oriented companies seek to create high customer satisfaction

that is not is main goal. If the company increases customer satisfaction by lowering its price

or increasing its services, the result may be lower profits. The company might be able to

increase its profitability by means other than increased satisfaction. Also, company has many

stakeholders, including employees, dealers, suppliers, and stockholders. Spending more to

increase customer satisfaction might diverts funds from increasing the satisfaction of

other partners. Ultimately, the company must operate on the philosophy that it is trying to

deliver a high level of customer satisfaction subject to delivering acceptable levels of

satisfaction to the other stakeholders, given its total resources.

Table describes four methods companies use to track and measuring customer satisfaction:

Complaint and A customer-centered organization makes it easy for

suggestion system customers to register suggestion and complaints.

Customer Satisfaction Responsive companies measure customer satisfaction

Surveys directly by conducting periodic surveys. While

collecting customer satisfaction data, it is also useful

to ask additional questions to measures repurchase

intention and to measure the likelihood or willingness

to recommend the brand to others.

Ghost Shopping Companies can hire people to pose as potential buyers

to report on strong and weak points experienced in

buying company’s and competitors’ products.

Lost Customer Analysis Companies should contact customers who have

stopped buying or who have switched to another

supplier to learn why this happened.

25
 The measurement of customer satisfaction has become very important for the health

care sector also. The concept of customer satisfaction has encouraged the adoption of a

marketing culture in the health care sector in both developed and developing countries. As

large numbers of hospitals are opening up and the people are becoming more aware and

conscious of health, great competition has emerged in this industry. So to retain their patients

hospitals have to provide better facilities/services to its customers. Various factors that can

affect the patients’ satisfaction include behaviour of doctors, availability of specialised

doctors, behaviour of medical assistants, quality of administration, quality of atmosphere,

availability of modern facilities etc.

As grew the competition, so grew the trend of providing better facilities to the

customers by the hospitals. In last few years, a plethora of hospitals have mushroomed in and

around the city. These hospitals are advertising heavily about the specialized treatments

provided by tthese hospitals. There are various hospitals that provide specialized treatments

for various diseases. Because of neck to neck competition between hospitals customers run to

these hospitals for specialized treatments. Interestiongly all hospitals claim to have a high

success rate. They claim to provide the best treatment and other essential facilities at

reasonable cost and in easy way to their customers. But how much of this is true and how

many of their claims are myth are not known to vast majority of customers.

As competition is increasing, the hospitals are making their best efforts to provide

quality health care services to its customers. They have begun practicing a patient satisfaction

strategy comprising consumer-oriented plans, policies and practices to genuinely meet the

needs of customers. Also, with increased awareness and high expectations of the customers’

hospitals have to provide them better facilities. Patients have begun to demand high quality of

services i.e. a consumer oriented approach.

26
These days patients have become more aware about their rights so they want they should be

better facilities like responding to their queries promptly, friendly environment,

understanding their problems, availability of specialized doctors, maintaining cleanliness,

regular repots etc. i.e. providing them every type of essential facilities. So, if the hospitals

want that their customers must be satisfied, they have to provide not only better treatment

but other facilities also.

THEORIES OF CUSTOMER SATISFACTION

A number of theoretical approaches have been utilized to explain the relationship

between disconfirmation and satisfaction. Still again there are a number of theories

surrounding the satisfaction and service paradigm

Four theoretical approaches have been advanced under the umbrella of consistency theory:

(1) Assimilation theory

(2) Contrast theory; and

(3) Negativity theory.

1. Assimilation Theory

Assimilation theory is based on Festinger’s (1957) dissonance theory. Dissonance theory

posits that consumers make some kind of cognitive comparison between expectations about the

product and the perceived product performance.This view of the consumer post-usage evaluation

was introduced into the satisfaction literature in the form of assimilation theory According to

Anderson (1973), consumers seek to avoid dissonance by adjusting perceptions about a given

product to bring it more in line with expectations.

Consumers can also reduce the tension resulting from a discrepancy between expectations and

product performance either by distorting expectations so that they coincide with perceived

product performance or by raising the level of satisfaction by minimizing the relative importance

of the disconfirmation experienced.

27
Assimilation Theory –Criticism

Payton et al (2003) argues that Assimilation theory has a number of shortcomings.

 First, the approach assumes that there is a relationship between expectation and

satisfaction but does notspecify how disconfirmation of an expectation leads to either

satisfaction or dissatisfaction.

 Second, the theory also assumes that consumers are motivated enough to adjust either

their expectations or their perceptions about the performance of the product.A number of

researchers have found that controlling for actual product performance can lead to a

positive relationship between expectation and satisfaction. Therefore, it would appear that

dissatisfaction could never occur unless the evaluative processes were to begin with

negative consumer expectations.

2.Contrast Theory Contrast

Theory was first introduced by Hovland, Harvey and Sherif (1987).Dawes et al (1972)

define contrast theory as the tendency to magnify the discrepancy between one’s own

attitudes and the attitudes represented by opinion statements.Contrast theory presents an

alternative view of the consumer post-usage evaluation process than was presented in

assimilation theory in that post-usage evaluations lead to results in opposite predictions for

the effects of expectations on satisfaction.

According to the contrast theory, any discrepancy of experience from expectations

will be exaggerated in the direction of discrepancy. If the firm raises expectations in his

advertising, and then a customer’s experience is only slightly less than that promised, the

product/service would be rejected as totally un-satisfactory.

Conversely, under-promising in advertising and over-delivering will cause positive

disconfirmation also to be exaggerated.

28
Contrast Theory Criticism

Several studies in the marketing literature have offered some support for this

theory. The contrast theory of customer satisfaction predicts customer reaction instead of

reducing dissonance; the consumer will magnify the difference between expectation and the

performance of the product/service.

3. Negativity Theory

This theory developed by Carlsmith and Aronson (1963) suggests that any

discrepancy of performance from expectations will disrupt the individual, producing

‘negative energy’.

Negative theory has its foundations in the disconfirmation process. Negative theory states

that when expectations are strongly held, consumers will respond negatively to any

disconfirmation.

“Accordingly dissatisfaction will occur if perceived performance is less than expectations or

if perceived performance exceeds expectations”.

Patients’ Experiences with Healthcare Service-

One significant dependent variable in the study of patients’ satisfaction is the patients’ own

experiences of the real service performances. This vital factor later also creates ones’ hopes

of receiving the same or a better quality of services than they get used to. People normally

base their judgment of the services on seeing, touching, listening, smelling and tasting than

the elements included in a set of quality service. For healthcare service, particularly patients

will decide whether they are low or highly satisfied with service through feeling the direct

elements of the services such as physical facility, physicians’ consultation and treatment skill,

nurses’ consoling skill, pharmacy service, registering service, and so on. Patients’ opinion

about qualify services would be instantly changed if the patient continuously experiences

29
same services with different ways of serving. Self involvement really matters in

determination of one’s’ way of perceiving quality of satisfaction regarding waiting time,

cleanliness, and the setting of infrastructure around.

Pasaribu(1996) stated that he found the causes of patients’ satisfaction, to be a low level of

quality of care and less amount drugs provided.

Physicians’ and Nurses’ Services-

Robert and Coale Redman (1987) found that physicians’ and nurses’ communication skills

with patients are the key components to a high level of patients’ satisfaction. In a research

done in Switzerland, physician-patient interaction has been suggested as the vital factor in

predicting patients’ satisfaction.

Afridi (2002) argue that likewise, way of raising voice, physical feeling, communication and

Personal behaviours of physicians really contribute in bringing a higher level of users’

satisfaction.

Barry(2001) mentioned in a study in Ireland that good interaction between physicians and

their patients is the milestone to reach clients’ satisfaction and continuous improvement of

quality of care Likun (1996).

Pharmacy, Registration and, Service Principles-

Additional services like pharmacy, registration and service flow are particularly mentioned to

significantly influence the level of patients’ satisfaction.

Phyunyathikum (1994) clarified in his research that the quality of pharmacy service including

numbers of personnel, rates of prescribing medicines and waiting time to receiving medicines

determine the result of patients’ satisfaction.

30
Accessibility to Healthcare Service-

Accessibility means physician-visiting structure, first-line reception, and availability of

different physicians, personal house visitation, and the follow-up visits. Many factors are

leading patients to feel frustrated when they are admitted to a hospital usually indicated as an

embarrassing aspect, is the absence of clinical staffs in any working shifts, especially at

night-time. Emergency cases can happen anytime without warning; therefore, punctual and

critical presence of necessary personnel must be under close monitoring.

Aday (1983) mentioned the trend of moving from public healthcare body to private one is

increasing day to day as the result of such neglect. Good communication and capability to

understand and share the feeling of others are now being perceived as the main aspects to

patients’ satisfaction. The activity of removing a person’s doubt or fear, capability to

understand and share the feeling of others, are among other significant factors to extend the

value of physician-patient interaction. However, a straight relationship between them and

satisfaction was not assured. Patients tend to give value to their physicians and nurses in term

of respects and friendly attitudes rather than technical matters. Removing a person’s doubt or

fear and capability to understand and share the feeling of others reflect the value of health

profession and are well recognized in treating patients with cancer.

Cockerham (1982) argued that demand for health care service is always there. Therefore,

healthcare service providers should be ready to serve anytime. Ease of accessing to health

care facilities has become a potential goal for policy makers throughout the world.

Nonetheless, attempt in conceptualize and assess the accessibility still vary based on people’s

perception.

31
Ross et al ;( 1993) findings provide evidences that most of the respondents decided to

prioritize clinical quality of care followed by physicians/nurses’ communication skills, and

ended up by the accessibility to healthcare facilities as their preferences. Likewise, the

respondents who prioritized the accessibility were from older-age group with a low

Educational background and low income.

Components of Patients’ Satisfaction-

The main elements of satisfaction proposed by the researcher in the Khmer-Soviet

Friendship Autonomous Hospital comprise of convenience, courtesy, and quality of care.

Convenience-

Convenience is defined as the comfort in approaching a set of standard quality of care such as

chances of seeing wanted physicians, adequate waiting time, ease of meeting the required

expectation and qualified services.

Kunarantnapruek and Boonpadoong (1989) mentioned that Users usually will come back to

receive services from where they used to be satisfied. Researchers can use this characteristic

to differentiate the quality of services provided. Furthermore, one main factor that should be

considered for predicting the level of convenience is waiting time.

Sriratanabul and Pimpakovit (1993) in a study of patients’ satisfaction in the Outpatient

Department of Chulalongkorn Hospital, argue that a significant factor led the majority of the

respondents to feel uncomfortable with the services provided was long waiting time. 83% of

the respondents showed positive feeling towards services provided in the department while

disappointed with very long waiting time to receiving services.

32
Likun(1996) mentioned waiting time services in a study of “Ways and Means to

Reduce the Waiting Time and Improve Patient Satisfaction”. He revealed that there was a

significant relationship between waiting time to receive service, and patients’ satisfaction

level. The majority of his respondents, 61% complained that waiting was not good for them.

Tessler et al ;( 1976) in a research in Ramathibodi Hospital, long waiting time was indicated

as the significant factor for a low level of satisfaction. There is a report that the Respondents

who were highly educated showed a low level of satisfaction in the Registration section while

similar effect also happened in the Pharmacy section.

Quality of Care-

Bashir and Armstrong (1991) argue that nowadays, hot issues like qualified health care

service and patients’ satisfaction are being crucially discussed throughout the world. Many

different institutions have adopted a means to reflect on their service providing. Hi-tech,

humanistic approach, educational backgrounds, communication, and means of transferring

qualified service quality to the patients constitute the vitality of patients’ satisfaction.

Donabedian(1993) suggests that Efficacy, effectiveness, efficiency, optimality, acceptability,

legitimacy, and equity are the seven main factors for patient satisfaction..

Williams and Calnan (1991) states significant changes in health care service evaluating and

enhancement are opening a new health care portrait for the service user. Formally accepted

principles and apparatus to assessing and improving of health care service users are dated to

the American College of Surgeon’s 1971, Hospital Standardization Program when it evolved

into the Joint Commission on Accreditation of Healthcare Organization Accreditation

Process.

33
Piyathida Sumtraprapoot (1997) mentions that a new trend in combining quality assurance

from other commercial industries with health care delivery strategies is the main indicator for

quality of care. Generally accepted and hi-tech methods of health care services have led the

industry to the contemporary way of qualified healthcare management.

Quality of hospital care was created by The American College of Surgeons as a fundamental

formula in 1933 and gradually this principle in 1917 became its hospital standardization

program. Furthermore, The Canadian Hospital Association with American College of

Physicians, The American Hospital Association, and American Medical Association has

established a Joint Commission on Accreditation of Hospital (JACHO) that originated the

criteria based audit method.

Garpenby (1999), Sweden written an article regarding Resource Dependency mainly

indicated the relationship between the aspect of national-level clinical profession and patient

satisfaction level. It also suggested that service quality advancement should be the main focus

in order not to lose the public expectation. He also mentioned that the health care framework

should be regarded as in other industries by characterizing its quality profession. An accepted

set of qualified standards of care such as accessibility, availability, personnel’s qualifications,

and mutual understanding are not only the significant factors considered by the management

level, but also by the users of the healthcare services who are normally called clients.

Courtesy-

Courtesy is usually defined by respect, attentiveness, and care shown by the clinical

personnel.

34
Assessment of Patient Satisfaction in Healthcare Service

Assessment of users’ satisfaction in healthcare services is a means of evaluating the

healthcare service performances by clinical personnel. In addition, it also indicates the

success and failure of service implementation and development in a way of perceived

services.

Barry et al; (2001) states that Patient satisfaction is a very complicated principle, which is

usually affected by some significant factors such as socio-demographic factors, personal

characters, physical and mental aspects, cause and effect of the services, and patients’

expectations

In spite of these complexes, ways of assessing patients’ satisfaction have been proposed as:

 An accurate merging of consumers’ opinions about healthcare service for the sake of

quality improvement and assurance.

 Marketing strategies regarding consumers’ satisfaction that have been introduced in

the health care industry.

 Increasing the level of complying with treatment, originated from the vital study of

patients’ behaviours toward services.

By quality improvement, assessment of the patients’ satisfaction becomes a significant

educational process to find the developments that are inexpensive to make, have better

service performance and sets of qualified standards.

Theoretical Model for Constructing Conceptual Framework-

Aday and Anderson (1978) in the study of people’s satisfaction with health care delivery in

the United States of America from 1970 to 1975 pointed out six principles focusing on

patient satisfaction, and three of them are presented below:

1. Satisfaction in term of convenience:

- Waiting time to obtain service

- Available care when required

35
- Base of receiving care

2. Satisfaction in term of courtesy:

- Friendly and polite attitude of the service providers

- Provision of what is necessary for the welfare of a patient

3. Satisfaction in term of quality of care:

- The patients’ perception of the service performance.

In 1974, they also mentioned that patient satisfaction is the attitude of people who were

involved in the health care system that is different from the elements of the predisposing

variables, as it measures the people’s satisfaction against the amount of care and its quality.

Aday and Anderson (1983) Furthermore, also suggested that evaluation of the patient

satisfaction might be best performed in the form of relevant medical service seeking

behaviour, which is clear, up-to-date, and classifiable, in order to elicit the subjective

perception about access which points out the satisfaction with the convenience of service, its

correspondence and cost, courtesy of the servers, information the patients obtained about the

treatment, and the patients’ opinion based on the quality of care. Patients’ satisfaction is the

indicator of the outcome in a theoretical model of access, which indicated the use of the

services.

36
 DATA ANALYSIS AND INTERPRETATION

Introduction

Analysis is categorizing, ordering manipulating and summarizing the data to

an intelligible and interpretable form so that the research problem can be studied and

tested including relationship between variables.

Interpretation is the process of making the sense of results and the examining

the implication of the findings with in a broad context.

The data‟s in this study analyzed and arranged under following sections

 Distribution of samples according to demographic variables.

 Distribution of samples according to information given by nurses.

 Distribution of samples according to quality of nursing care.

 Distribution of sample based on association of overall satisfaction with nursing

care and selected variables.

37
1. Distribution of samples according to demographic variable

Distribution of sample by age

Age Group Frequency Percentage (%)

<20 3 6
21-30 10 20
31-40 7 14
41-50 12 24
51-60 6 12
61-70 8 16
71-80 4 8
Total 50 100

14
12
12
10
10
8
8 7
6
6
4
4 3

0
<20 21-30 31-40 41-50 51-60 61-70 71-80

Frequency

INTERPRETATION:
Table shows distribution of sample by age. The age of sample ranges
from18-78 with a mean age of 44.7, standard deviation 16.88, majority of samples
were from age group 41-50 and only 6% were from age group <20

38
2. Distribution of sample according to sex

Table shows distribution of sample according to sex.

Gender Frequency Percentage

Male 33 66
Female 17 34
Total 50 100

35 33

30

25

20 17
15

10

0
Male Female

Frequency

INTERPRETATION:

Table shows distribution of sample according to sex. There majority of

sample were male (66%) and only (34%) in female sample.

39
3. Distribution of sample according to marital status

Table shows Distribution of sample by marital status

Marital status Frequency Percentage

Single 9 18
Married 41 82
Total 50 100

45 41
40
35
30
25
20
15
9
10
5
0
Single Married

Frequency

INTERPRETATION:

Table shows that distribution of sample by marital status. Majority of sample

were married (82%). 41(82%) were married and 9 (18%) were single.

40
4. Distribution of sample according to education

Table shows Distribution of sample according to education

Education Frequency Percentage

School 25 50
Plus two 12 24
Graduate 10 20
Post graduate 3 6
Total 50 100

30
25
25

20

15
12
10
10

5 3

0
School Plus two Graduate Post graduate

Frequency

INTERPRETATION:

Table shows that the majority of sample had school education (50%), only
6% percentage had post graduate education.

41
5. Distribution of sample according to income category

Table shows distribution of sample according to category

Category Frequency Percentage

A 3 6
B1 9 18
B 8 16
C 3 6
D 27 54
Total 50 100

30
27

25

20

15

10 9
8

5 3 3

0
A B1 B C D

Frequency

INTERPRETATION:

Table shows that majority of samples (54%) were D category, only (6%)
were A category and (6%) were C category.

42
 6. Distribution of sample according to length of hospital stay

Table shows Distribution of sample according to length of hospital stay

Length of stay in days Frequency Percentage

≤10 days 38 76
>10 days 12 24
Total 50 100

40 38

35
30
25
20
15 12
10
5
0
≤10 days >10 days

Frequency

INTERPRETATION:
Table shows that majority of sample 41(82%) stay <=10 day, only 9(18%)
were more than 10 days.

43
 7. Distribution of sample according to previous admission

Table Distribution of sample according to previous admission

Previous admission Frequency Percentage

Yes 36 72
No 14 28
Total 50 100

40 36
35
30
25
20
14
15
10
5
0
Yes No

Frequency

INTERPRETATION:

Distribution of sample according to previous admission.36 (72%) patients were

previously admitted and 14(28%) patients not previously admitted.

44
8. Distribution of sample according to diagnosis

Table shows Distribution of sample according to diagnosis

Diagnosis Frequency Percentage

Myasthenia gravis 9 18
Vasculitis 2 4
Multiple sclerosis 6 12
Tb meningitis 2 4
Encephalitis 31 62
Total 50 100

35
31
30

25

20

15
9
10
6
5 2 2
0
Myasthenia Vasculitis Multiple Tb meningitis Encephalitis
gravis sclerosis

Frequency

INTERPRETATION:

The diagnosis of sample made by 5 types. There were 31(62%) patients

with encephalitis.

45
9. Distribution of sample based on patients’ satisfaction about criteria
information given by nurses.

Table shows patient‟s satisfaction about information given by nurses.

Patient’s satisfaction Frequency Percentage

Poor 1 2
Good 38 76
Excellent 11 22
Total 50 100

40 38

35
30
25
20
15
11
10
5
1
0
Poor Good Excellent

Frequency

INTERPRETATION:

Table shows that patient‟s satisfaction about information given by nurses.

Only 2% samples rated poor. 38(76%) samples rated good and 11(22%) rated
excellent.

46
10. Distribution of sample based on patients’ satisfaction about information
given by nurses and age group.

Distribution of sample based on patients‟ satisfaction about information

given by nurses and age group.
The age of sample ranges from18-78 with a mean age of 44.7, standard
deviation 16.88.
Satisfaction of patient Age <45 Age ≥45 Total
by information given Frequency Frequency (%) Frequency (%)
by nurses (%)
Poor 1 (4%) 0 1 (2%)
Good 22 (88%) 16 (64%) 38 (76%)
Excellent 2 (8%) 9 (36%) 11 (22%)
Total 25 (50%) 25 (50%) 50 (100%)

30
27

25

20

15
11
10 9

5
2
1
0
0
Poor Good Excellent

School & plus2 Graduate & post graduate

INTERPRETATION:

The above Table show that patients with ≥45 years 64% rated good. Among that
36% rated excellent and no one reported poor. Among <45 yrs 88% were rated
good, 2(8%) were rated excellent and only 4% were rated poor.

47
11. Nurse listening to your health problem and explaining to you any treatment that you
need

Percentage
Nurse listening to patient Frequency
Completely Satisfied 36 72
Somewhat Satisfied 12 24
Neutral 1 2
Somewhat Dissatisfied 1 2
Completely Dissatisfied 0 0
Total 50 100

40 36
35
30
25
20
15 12
10
5 1 1 0
0
Completely Somewhat Neutral Somewhat Completely
Satisfied Satisfied Dissatisfied Dissatisfied

Frequency

INTERPRETATION:

From the above table, about the Nurses listening to your health problem and explaining
patient any treatment that needed out of 50 responses, 36 responded completely satisfied, 12
responded somewhat satisfied, 1 are neutral and 1 responded somewhat dissatisfied.

48
 12. Helpfulness of the nurses to you
Helpfulness of the nurses Percentage
Frequency
to you
Completely Satisfied 42 84
Somewhat Satisfied 4 8
Neutral 2 4
Somewhat Dissatisfied 2 4
Completely Dissatisfied 0 0
Total 50 100

45 42
40
35
30
25
20
15
10
4
5 2 2
0
0
Completely Somewhat Neutral Somewhat Completely
Satisfied Satisfied Dissatisfied Dissatisfied

Frequency

INTERPRETATION:

From the table it is clear that the Nurses are helpful. Patients out of 50 responses, 42
responded completely satisfied, 4 responded somewhat satisfied, 2 are neutral and 2
responded somewhat dissatisfied which shows their caring towards patient.

49
 13. Distribution of sample based patients’ satisfaction about information
given by nurses according to sex.

Satisfaction of the Female Male Total

patient

Frequency % Frequency % Frequency %

Poor 0 0 1 3.03 1 2
Good 13 76.47 25 75.76 38 76
Excellent 4 23.53 7 21.21 11 22
Total 17 100 33 100 50 100

30
25
25

20

15 13

10
7

5 4
1
0
0
Poor Good Excellent

Female Male

INTERPRETATION:

Table shows that majority of sample 38(76%) rated good, 22% rated excellent and only 2%
were rated poor. Among females 13(76.47%) rated good, 23.53%rated excellent and no one
reported poor. Among males and 25(75.76%) rated good, 21.21% were rated excellent and
3.03% rated poor.

50
 14. Distribution of sample based on patients’ satisfaction about information given by
nurses and marital status

Satisfaction of the Single Married Total

patient

Frequency % Frequency % Frequency %

Poor 0 0 1 2.44 1 2
Good 7 77.78 31 75.61 38 76
Excellent 2 22.22 9 21.95 11 22
Total 9 100 41 100 50 100

35
31
30

25

20

15
9
10 7
5 2
0 1
0
Poor Good Excellent

Single Married

INTERPRETATION:

Table shows that 22.22% rated excellent, 76% were rated good and 2% rated poor. Among
single 77.78%rated good, 22.22% were rated excellent. Among married 21.95% rated
excellent, 75.61% were rated good and only 2.44% rated poor. There is no relationship
between marital status and information given by nurses.

51
15. Distribution of sample based on patients’ satisfaction about information given by
nurses and educational status.

Satisfaction of the School & plus2 Graduate & post Total

patient graduate

Frequency % Frequency % Frequency %

Poor 1 2.7 0 0 1 2
Good 27 72.97 11 84.62 38 76
Excellent 9 24.32 2 15.38 11 22
Total 37 100 13 100 50 100

30
27

25

20

15
11
10 9

5
2
1
0
0
Poor Good Excellent

School & plus2 Graduate & post graduate

INTERPRETATION:

The above table shows that 22% were rated excellent.76% rated good and
2% rated poor. Among school &plus2 24.32% rated excellent, 72.97% rated good
and 2.70% were rated poor. Among graduate &post graduate 22% excellent, 76%
rated good and 2% poor. It means there is only a slight variation between
educational status and information given by nurses.

52
16. Distribution of sample based on patients’ satisfaction about information
given by nurses and to length of stay.

Satisfaction of the ≤10 days >10 days Total

patient

Frequency % Frequency % Frequency %

Poor 1 2.64 0 0 1 2
Good 31 73.68 7 83.33 38 76
Excellent 9 23.68 2 16.67 11 22
Total 41 100 9 100 50 100

35
31
30

25

20

15
9
10 7
5 2
1 0
0
Poor Good Excellent

≤10 days >10 days

INTERPRETATION:

The above table shows that majority of sample ≤10days (73.68%) & among
>10days (83.33%) were rated good. Among ≤ days 32.68% rated good and 2.64%
rated poor. Among 10 days 16.67% rated excellent and no one rated poor.

53
17. Distribution of sample based on quality of nursing care and previous admission

Satisfaction of the Yes No Total

patient

Frequency % Frequency % Frequency %

Poor 1 2.78 0 0 1 2
Good 26 72.22 12 85.71 38 76
Excellent 9 14.29 2 14.29 11 22
Total 36 100 14 100 50 100

30
26
25

20

15
12

10 9

5
2
1
0
0
Poor Good Excellent

Yes No

INTERPRETATION:

The above table shows that 10(71.43%) previously admitted samples and
24(66.67%) previously not admitted samples were rated good. 4 (28.57%)
previously admitted and 12(33.33%) previously not admitted were rated excellent.
There is only a slight variation between quality of nursing care and previous
admission.

54
18. Distribution of sample based on patients’ satisfaction about information
given by nurses and Income category.

Satisfaction A B1,B & C D Total

of the patient

Frequency % Frequency % Frequency % Frequency %

Poor 0 0 1 5 0 0 1 2
Good 2 66.67 17 85 19 70.37 38 76
Excellent 1 33.33 2 10 8 29.63 11 22
Total 3 100 20 100 27 100 50 100

20 19
18 17
16
14
12
10
8
8
6
4
2 2
2 1 1
0 0
0
Poor Good Excellent

A B1,B & C D

INTERPRETATION:

The above table shows that among A category 33.33% rated excellent,
among B1,B &C category 10 rated excellent and among D category 29.63% rated
excellent. Among income category only 1% rated poor. There is no marked variation
between income category and information given by nurses.

55
19. Distribution of sample according to overall patient satisfaction with quality
of nursing care.

overall patient satisfaction with quality of Percentage

Frequency
nursing care
Excellent 15 30
Good 35 70
Total 50 100

35 33

30

25

20 17
15

10

0
Male Female

Frequency

INTERPRETATION:

The above table shows that distribution of sample according to overall

patient satisfaction with nursing quality of care. 15 (30% were rated excellent,
35(70%) were rated good and no one rated poor.

56
FINDINGS:
 Total number of sample was 50. The mean age of patients was 44.7 yrs, standard
deviation 16.88.
 Patient satisfaction with quality nursing care <45 ranges from excellent 4(16%)
and good 21(84%),
 Patient satisfaction with quality of nursing care ≥45 ranges from excellent
11(44%) and 14(56%).
 Patient satisfaction with quality of nursing care under income A category 33.33%
rated excellent.
 As the length of stay of patient increasing the quality of nursing care also
increased.
 There is no relationship between marital status and information given by nurses.
 The quality of nursing care is unbiased with respect to gender.

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RECOMMENDATIONS:

The following recommendations were made for future research.

1. Similar study would be repeated in other intensive care units and
wards of this institute.
2. Similar study can be repeated by increasing the size of the sample.

58
 BIBLIOGRAPHY

 Abramowitz S, Berry E, Cott A A. „Analyzing patient satisfaction; A multi

analytic approach.‟ Quality review bulletin 1987; 13: 122-130.

 Andaleeb S „Service quality and patient satisfaction, A study of Hospitals in a

developing country.‟ Soc Sci Med 2011; 52:1359-70.
 Foss C. „Gender bias in nursing care? Gender – related in patient satisfaction with
quality of nursing care‟. Scandinavian journal of caring nurses 2002; 16 [1]: 19-26.

 Harkreader H & Hogan M A. „Fundamentals of nursing caring & clinical

judgement‟ . Elsiver science 2004;2: 45-51.
 http://www.healthcaresuccess.com/blog/medical-advertising-agency/swot.html
 http://andhrahospitals.org/
 https://www.ibef.org/industry/healthcare-india.aspx
 https://en.wikipedia.org/wiki/Healthcare_industry

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QUESTIONNAIRE

1. Name of the patient:.......................................................

2. Age of the patient

a) Below 20 b) 21-30 c)31-40 d) 41-50

e)51-60 f)61- 70 g) 71-80

3. Gender

a) Male b) Female

4. Marital Status

a) Married b) Single

5. Education

a)School b) Plus two c) Graduate d) Post Graduate

6. Income Category

a) A b) B1 c) B d) C e) D

7. Patient length of stay in hospital

a) Below 10 days b) above 10 days

8. Have you admitted previously in the present hospital

a) Yes b) No

9. Diagnosis of patient—

a) Myasthenia gravis b) Vasculitis c) Multiple sclerosis

d) Tb meningitis e) Encephalitis

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 10. Rate your satisfaction regarding information given by nurses

a) Poor b) Good c) Excellent

11. Satisfaction levels of patient towards nurse listening to your health problem and

explaining to you any treatment that you need

a) Completely Satisfied b) Somewhat Satisfied c) Neutral

d) Somewhat Dissatisfied e) Completely Dissatisfied

12. Satisfaction levels of patient towards Helpfulness of the nurses to you

a) Completely Satisfied b) Somewhat Satisfied c) Neutral

d) Somewhat Dissatisfied e) Completely Dissatisfied

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