Gap Analysis between Perceptions and Expectations of Medical-Surgical Patients in a Public Hospital in Saudi Arabia

OBJECTIVES To investigate patients' satisfaction with nursing care by measuring the gap between patients' expectations of care and perceptions of the actual care provided and to identify the areas of nursing care that need improvement. SUBJECTS AND METHODS A cross-sectional survey was conducted among patients who were admitted to the Departments of Medicine and Surgery at King Saud Medical City, Riyadh, Saudi Arabia. A modified Service Quality (SERVQUAL) instrument was adapted to collect information from a convenience sample of 432 patients from November 25, 2012, to February 3, 2013. The instrument comprised 22 pairs of questions assessing 5 dimensions of the nursing care provided to patients during hospitalizations. The mean patient expectations and perceptions as well as the gap score values for each dimension of nursing service were tested for differences between the mean scores of the sample at a level of significance of 0.05 using a t test. RESULTS The gap score for all of the 5 dimensions of nursing services were: responsiveness, -1.71; reliability, -1.48; tangibles, -1.36; assurance, -1.26, and empathy, -0.96. Service quality across the dimensions of responsiveness and reliability was statistically significant (p < 0.05). This result indicated that patients were not satisfied with the nursing service quality in relation to all dimensions. CONCLUSION Our study showed negative gaps for the 5 nursing service quality dimensions evaluated. This could provide nurses with information about the aspects of nursing care that promote more positive patient outcomes and satisfaction.