Factors associated with patients’ satisfaction with quality of nursing care in Namibian public health facilities: a cross-sectional study

Patient satisfaction is a robust indicator of healthcare quality and the degree to which services are truly patient-centred. The evidence on which care domains most shape patient experience in Namibia is limited, leaving a critical gap in the quality improvement literature. To identify factors associated with patient satisfaction with the quality of nursing careat selected public health facilities in Namibia. A cross-sectional, descriptive quantitative design was used at two public health facilities in the Kavango-East Region. A total of 299 adult patients were recruited through convenience and sex quota-based sampling. Data were collected via an online modified Patient Satisfaction Questionnaire (PSQ); the final 30-item scale showed excellent internal consistency (Cronbach’s α = 0.975). Exploratory factor analysis, descriptive statistics, one-sample Wilcoxon tests against the neutral midpoint, non-parametric group comparisons, Spearman’s correlations and multiple linear regression with robust standard errors were performed in SPSS v27.0. Satisfaction was significantly below the neutral midpoint (median = 2.19, M = 2.50, SD = 0.87; p < 0.001), and 63.2% of participants were dissatisfied. The regression model explained 71.6% of the variance in quality of nursing care (R² = 0.716, F(8, 286) = 90.02, p < 0.001). Technical competencies was most strongly associated with quality of care (β = 0.369, p < 0.001). Access to health information was also significant (β = 0.208, p = 0.045), while involvement in decision-making was borderline (β = 0.214, p = 0.051). Nurses’ affective support and sociodemographic variables were not significant ( p > 0.05). Dissatisfaction with nursing care was widespread. Lower satisfaction was associated mainly with lower ratings of nurses’ technical competencies and, less strongly, with access to health information and involvement in decision-making. Although causality cannot be inferred, these domains are practical targets for improving care in resource-constrained public facilities, and intervention studies should test their effect. This study provides the first empirically validated assessment of nursing care satisfaction domains in Namibia.