Determinants of patient satisfaction in a tertiary hospital in Cross River State, Nigeria: Implications for integrative nursing and service delivery

Objective: The objective of this study was to assess patient satisfaction and its determinants among adult patients attending the University of Calabar Teaching Hospital (UCTH), Cross River State, Nigeria. Materials and Methods: A descriptive cross-sectional study was conducted among 424 adult patients across major outpatient clinics and selected inpatient wards. Participants were selected using a multi-stage, proportionate stratified sampling method. Data were collected via a structured interviewer-administered questionnaire adapted from the Patient Satisfaction Questionnaire Short-Form-18 and SERVQUAL instruments. Data were analyzed using SPSS version 25. Descriptive statistics summarized participant characteristics and satisfaction scores. Bivariate associations were assessed using Chi-square tests, and significant variables were included in a multivariable logistic regression to identify independent determinants of satisfaction. Results: The study population had a mean age of 37.8 ± 11.6 years, and 55.2% were female. Overall, 62.3% ( n = 264) of participants were satisfied with the services provided. Satisfaction was higher among outpatients (68.4%) and participants with tertiary education (69.8%). In multivariable analysis, significant independent predictors of satisfaction were: good communication (adjusted odds ratios [aOR] = 2.98; 95% confidence interval [CI]: 1.75–5.07), adequate staff availability (aOR = 2.45; 95% CI: 1.40–4.30), short waiting time <60 min (aOR = 1.87; 95% CI: 1.12–3.12), and tertiary education (aOR = 3.12; 95% CI: 1.48–6.56). Type of patient (inpatient vs. outpatient) was not statistically significant (aOR = 1.42; P = 0.150). The regression model demonstrated good fit (Hosmer–Lemeshow P = 0.61) and strong predictive ability (AUC = 0.81). Conclusion: Patient satisfaction at UCTH is moderate, with process-related factors, particularly communication, staffing, and waiting time, playing a more critical role than structural or demographic characteristics.