Implementation of a Culturally Sensitive Caring-Based Nursing Service Model Increasing Patient Satisfaction in Hospitals


  • Aemilianus Mau Department of Nursing, Basics and Management Professional Education Study Program for Nurses Ministry of Health Polytechnic, Kupang, NTT Province, Indonesia
  • Tutik Sri Haryati Department of Nursing Management, Faculty of Nursing, University of Indonesia, Depok, West Java, Indonesia
  • Enie Novieastari Department of Nursing, Faculty of Nursing, University of Indonesia, Depok, West Java, Indonesia
  • Dewi Gayatri Department of Nursing, Faculty of Nursing, University of Indonesia, Depok, West Java, Indonesia



Nursing services, Culturally sensitive caring, Patient satisfaction, Hospitals


BACKGROUND: Culturally sensitive caring-based nursing services yield numerous benefits for patients, nurses, and hospitals. One of the advantages hospitals derive is enhanced patient satisfaction and loyalty, leading to financial benefits.

AIM: The aim of this study was to assess the impact of culturally sensitive caring-based nursing services on patient satisfaction in hospitals.

METHODS: Quasi-experimental pre-post-test control group design. The sample consisted of inpatients that were purposefully selected. The formula for the difference in proportions between the two groups was used to determine the sample size, yielding a total sample of 360 people, 180 in the intervention group and 180 in the control group. The intervention group received model socialization, module books, and 2 months of assistance with model implementation practices, while the control group only received module books without socialization and assistance. Data collection utilized a patient satisfaction questionnaire developed from the Swanson caring instrument, validated for reliability. Data analysis involved independent sample t-tests to ascertain differences in patient satisfaction between the intervention and control groups, and the general linear model repeated measure (GLM-RM) test to assess the development of patient satisfaction during the intervention and the model’s contribution to its increase.

RESULTS: The independent t-test yielded a p = 0.0001 <0.05, signifying a significant difference in patient satisfaction between the intervention and control groups. The GLM-RM test demonstrated a Partial Eta Squared value of 0.715, indicating that the model contributed to a 71.50% increase in patient satisfaction, with the remainder influenced by other variables.

CONCLUSION: Culturally sensitive caring-based nursing services enhance patient satisfaction in hospitals. Suggestion: This model can be implemented across hospitals.


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Author Biography

Tutik Sri Haryati, Department of Nursing Management, Faculty of Nursing, University of Indonesia, Depok, West Java, Indonesia

Department of Nursing Management, Faculty of Nursing,


Aagard M, Papadopoulos I, Biles J. Exploring compassion in U.S. Nurses: Results from an International research study. Online J Issues Nurs. 2018;23(1):1-7. DOI:

Afriliana L, Suryawati C, Dwiantoro L. Patient satisfaction with caring behavior of nurses in Indonesia: Literature review. J Nurs. 2022;14:931-40.

Alligood MR. Nursing theorists and their work (8th edn). Contemp Nurs. 2014;24(1):106. DOI:

Andews M, Boyle JS. Trunscultural Concepts in Nursing (LWW; Seven). St. Louis: Mosby; 2018.

Aty YM, Herwanti E, Mau A, Ayatullah MI, Asriwhardani F. Factors affecting nurse caring behavior. J Health Inf. 2020;18(2):171-81. DOI:

Batbaatar E, Dorjdagva J, Luvsannyam A, Savino MM, Amenta P. Determinants of patient satisfaction: A systematic review. Perspect Public Health. 2017;137(2):89-101. PMid:27004489 DOI:

Berry LL, Parasuraman A, Zeithaml VA. The service-quality puzzle. Bus Horiz. 1988;31(5):35-43. DOI:

Lestari MD, Sri Oktri Hastuti A, Maura Harjanti CB. The relationship between nurses’ caring behavior and patient satisfaction during the Covid-19 pandemic in the treatment room of a private hospital in Yogyakarta. I Care J Nurs STIKes Panti Rapih. 2021;2(2):170-83. DOI:

Ellina AD, Nursalam N, Yunitasari E, Rusmawati A. Patient satisfaction about nurse caring behavior: Based on Swanson’s theory of caring and transcultural nursing theory. Int J Psychosoc Rehabil. 2020;24(9):737-43.

Husni M, Indrayadi, Despiyadi. The relationship between nurses’ caring behavior and the anxiety response of coronary heart disease patients in the Alamanda ward at Ulin Hospital, Banjarmasin in 2020. Army Nurs J. 2020;1(2):37-46.

Jannah AA, Ardiana A, Purwandari R. Relationship between nurses’ caring behavior and the level of hope for recovery in cancer patients undergoing a chemotherapy program at Baladhika Husada Hospital, Jember. Health Syst Res Bull. 2020;23(3):169-77. DOI:

Khairani M, Salviana D, Bakar A. Patient satisfaction judging from nurse-patient communication. J Psychol Res. 2021;12:9- 17. DOI:

Kieft RA, de Brouwer BB, Francke AL, Delnoij DM. How nurses and their work environment affect patient experiences of the quality of care: A qualitative study. BMC Health Serv Res. 2014;14:249. PMid:24923663 DOI:

Librianty N. Factors that Influence BPJS Patient Satisfaction with Nursing Services in the Mawar Inpatient Room, Bangkinang Regional Hospital; 2017:13-4.

Lintresa L, Silalahi E, Purba S. Dominant factors affecting inpatient satisfaction at Bina Kasih General Hospital, Medan. J Manag Bus. 2021;21(1):113-27. DOI:

Nahrisah P, Khairina. Factors that influence inpatient satisfaction in the women’s internal medicine room (RPDW) at Sultan Abdul Aziz Syah Peureulak Hospital. . 2019;8(5):55.

Nurwianti I, Mita, Putri TH. Nurses’ caring behavior on patient satisfaction levels in hospitals: Literature review. Proners J. 2020;5(2):1-9. DOI:

Potter PA, Perry AG, Stockert PA, Hall A. Fundamentals of Nursing. 10th ed. Canada: Elsevier; 2020.

Pratiwi RD, Pertiwi DS. The relationship between therapeutic communication and caring at Multazam Medika General Hospital, East Bekasi. Edudharma J. 2018;2(2):3-22. DOI:

Purniawati W, Dewi PA, Kamaryati NP. An overview of nurses caring behavior toward patients in patient Ward At Rsud in Klungkung Regency. Natl J Health Res. 2018;1(1):17-27. DOI:

Putri DM. Transcultural nursing knowledge of culturally based practice. In: Transcultural Nursing. London: Intechopen; 2017.

p. 285-87. Available from: https://repository.akperykyjogja. transcultural nursing book [Last accessed on 2024 Jan 15].

Rina D. The influence of excellent service on patient satisfaction in hospitals: Literature review. AFAMEDIS. 2022;3:20-9.

Romero-Martín M, Gómez-Salgado J, Robles-Romero JM, Jiménez-Picón N, Gómez-Urquiza JL, Ponce-Blandón JA. Systematic review of the nature of nursing care described by using the Caring Behaviors Inventory. J Clin Nurs. 2019;28(21- 2):3734-46. PMid:31342576 DOI:

Sitorus R, Panjaitan R. Nursing Management: Nursing Management in the Ward. Jakarta: Sagung Seto; 2011.

Sukmalara D. Factors that influence the satisfaction of class III inpatients at RSUD X. Afiat. 2015;5(2):83-92. DOI:

Sulaiman, et al. Factors that Influence Outpatient Satisfaction at West Pasaman Regional Hospital. Vol. 3. Indonesia: Andalas University; 2021. p. 1-6.

Suparman, Islami V, Nelfianti F. Service Excellence. Yogyakarta: Graha Ilmu; 2019.

Supriatin E, Lindayani L. Factors Related to Behavior in Implementing Patient Safety in Nurses. Dunia Keperawatan: Jurnal Keperawatan dan Kesehatan. 2021;9(2):215-23. DOI:

Suweko H, Warsito BE. The relationship between nurses’ caring behavior and patient satisfaction in the inpatient room: Literature review. J Nurs Midwifery Sci. 2019;10(1):243. DOI:

Wahyuni E. Caring nurses influence patient satisfaction in inpatient installations. Sci J Altruistic Nurs. 2022;5(2):34-40. DOI:

Widyantari NL, Made N, Wati N, Lisnawati K, Dewi PT, Studi P, et al. Literature review: Implementation of nurses’ caring behavior on patient loyalty in hospitals. Enlightenment Health Sci J. 2021;10(1):1-8.

Witdiawati, Purnama D, Eriyani T. Socio-cultural life in breast cancer patients: Literature study. BSI Nurs J. 2017;5(2):148-54.

Yarnita Y, Gasril P. Application of nurse caring model in improving patient satisfaction in class 3 Room Arifin Achmad Hospital, Riau Province. Med Sci Health J. 2020;11(2): 141-149.

Yoost BL, Crawford LR. Fundamentals of Nursing Active Learning for Collaborative Practice. Canada: Elsevier; 2020.


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Mau A, Haryati TS, Novieastari E, Gayatri D. Implementation of a Culturally Sensitive Caring-Based Nursing Service Model Increasing Patient Satisfaction in Hospitals. Open Access Maced J Med Sci [Internet]. 2024 Jun. 15 [cited 2024 Jun. 17];12(2):330-4. Available from:



Nursing in Internal Medicine