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Int J Nurs Stud. 2011 Oct;48(10):1188-98. doi: 10.1016/j.ijnurstu.2011.04.004. Epub 2011 May 17.

Organizational factors impacting on patient satisfaction: a cross sectional examination of service climate and linkages to nurses' effort and performance.

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The University of Queensland, School of Psychology, St Lucia, Australia.



Patient satisfaction is influenced by the setting in which patients are treated and the employees providing care. However, to date, limited research has explained how health care organizations or nurses influence patient satisfaction.


The purpose of this study was to test the model that service climate would increase the effort and performance of nursing groups and, in turn, increase patient satisfaction.


This study incorporated data from 156 nurses, 28 supervisors, and 171 patients. A cross-sectional design was utilized to examine the relationship between service climate, nurse effort, nurse performance and patient satisfaction. Structural equation modeling was conducted to test the proposed relationships.


Service climate was associated with the effort that nurses directed towards technical care and extra-role behaviors. In turn, the effort that nurses exerted predicted their performance, as rated by their supervisors. Finally, task performance was a significant predictor of patient satisfaction.


This study suggests that both hospital management and nurses play a role in promoting patient satisfaction. By focusing on creating a climate for service, health care managers can improve nursing performance and patient satisfaction with care.

[Indexed for MEDLINE]

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