Nurse as patient: a qualitative study on nursing service quality gaps based on the SERVQUAL model

To explore nursing service quality gaps in a tertiary hospital via nurses’ dual perspective as care providers and patients, guided by the SERVQUAL model. A single-center qualitative study using framework analysis. 10 clinical nurses were recruited using purposive and maximum variation sampling. Data were collected through face-to-face semi-structured interviews and analyzed using framework analysis guided by the SERVQUAL model. Rigor was ensured via Lincoln and Guba’s trustworthiness criteria and the COREQ checklist. 5 core themes and 13 sub-themes were identified, mapping to the SERVQUAL model’s five gaps: (1) demand for optimization of medical service processes (knowledge gap); (2) shortcomings in hospitalization environment and service details (delivery gap); (3) insufficient nurse-patient communication and humanistic care (standards gap; its interpersonal communication component is an interpretive extension of the communication gap); (4) deviations in nursing professional competence and execution (delivery gap); and (5) limited awareness of the hospital’s advantageous disciplines (an interpretive, staff-facing extension of the knowledge gap). Cross-cutting analysis further revealed a phenomenon termed “being assumed to know”: because participants were hospital staff, providers withheld the information, explanations, and follow-up routinely offered to lay patients, manifesting as knowledge gaps and as failures of interpersonal communication at the level of individual care encounters. Nurses’ dual identity uncovers latent service gaps overlooked by traditional evaluations. The findings suggest context-specific strategies for optimizing patient-centered care that warrant further evaluation, aligning with the WHO’s vision of integrated people-centered health services.