CHAPTER ONE

INTRODUCTION

This chapter includes different historical aspects starting from the background of the study, followed with this is the problem statement, specific research questions and objectives, the justification for the study, the significance and the scope of the study.

1.1 Background

Healthcare systems across the world are increasingly focusing on improving the quality of care delivered to patients. One of the most important indicators used to measure quality in healthcare is patient satisfaction. Patient satisfaction refers to the extent to which patients feel that their expectations of care have been met during their interaction with healthcare providers. In recent years, there has been growing attention on patient-centered care, which emphasizes respect for patients’ preferences, needs, and values. Within this context, nursing care plays a central role because nurses are the healthcare professionals who spend the most time with patients in hospital settings. As a result, patients’ satisfaction with nursing care has become a key area of interest in healthcare research and practice.

Globally, patient satisfaction is widely recognized as a major indicator of healthcare quality and performance. It provides important information about how patients perceive the services they receive and helps healthcare institutions identify areas that need improvement. Studies have shown that patient satisfaction is closely linked to better health outcomes, increased trust in healthcare providers, and improved adherence to treatment (Obaidi, 2025) . When patients are satisfied with the care they receive, they are more likely to follow medical advice, attend follow-up appointments, and maintain a positive relationship with healthcare providers. On the other hand, dissatisfaction can lead to poor health outcomes, reduced use of healthcare services, and negative perceptions of the healthcare system.

Nursing care is particularly important in determining patient satisfaction because nurses are directly involved in the day-to-day care of patients. They are responsible for administering medications, monitoring patient conditions, providing emotional support, and communicating important information to patients and their families. Because of this close interaction, patients often judge the quality of healthcare services based on their experiences with nurses. Research has shown that the quality of nursing care is strongly associated with patient satisfaction, making it an essential component of healthcare delivery (Alharbi et al., 2022) . Nurses’ communication skills, responsiveness, empathy, and professional competence all influence how patients perceive their care.

In addition, several studies conducted in different countries have demonstrated that patient satisfaction with nursing care varies widely depending on multiple factors. These factors include the level of communication between nurses and patients, the availability of nurses, waiting time, respect for patient privacy, and the overall hospital environment. For example, a study found that effective communication and clear explanations by nurses significantly improve patient satisfaction levels (Alhussin, 2024) . Similarly, responsiveness to patient needs and timely delivery of care have been identified as key determinants of satisfaction. Where these factors are lacking, patients tend to report lower levels of satisfaction.

Furthermore, patient satisfaction with nursing care is not only influenced by healthcare providers but also by patient-related factors such as age, education level, cultural background, and previous hospital experiences. Research indicates that patient satisfaction is a complex concept that depends on individual expectations, personal values, and prior experiences with healthcare services (Obaidi, 2025) . For instance, patients who have had previous positive experiences in hospitals are more likely to report higher satisfaction levels compared to those with negative experiences. Similarly, patients with higher educational levels may have greater expectations, which can influence their level of satisfaction.

Despite the global recognition of the importance of patient satisfaction, many healthcare systems, especially in developing countries, continue to face challenges in providing high-quality nursing care. Studies conducted in Africa have shown that patient satisfaction levels are often moderate or low due to factors such as inadequate staffing, limited resources, and poor working conditions for nurses. For example, research in some African countries revealed that satisfaction levels ranged from very low to moderate, reflecting gaps in healthcare service delivery (Muthelo, 2025) . These challenges can negatively affect the quality of nursing care and, consequently, patient satisfaction.

Another important issue affecting patient satisfaction is nurse workload and burnout. When nurses are overworked and stressed, their ability to provide quality care may be reduced. This can lead to poor communication, delayed responses to patient needs, and decreased attention to patient comfort. A recent study found that nurse burnout is associated with lower patient satisfaction and reduced quality of care (JAMA Network Open, 2024) . This highlights the need for healthcare systems to ensure adequate staffing and support for nurses in order to improve patient outcomes.

In addition, the measurement of patient satisfaction has become an important tool for healthcare management and policy-making. Hospitals use patient satisfaction surveys to evaluate the performance of their services and to identify areas that require improvement. These surveys provide valuable feedback from patients and help healthcare providers understand their strengths and weaknesses. According to recent studies, continuous assessment of patient satisfaction is essential for improving the quality of nursing care and ensuring that healthcare services meet patient expectations (Rahman, 2025) . Without proper assessment, it becomes difficult to identify gaps in service delivery and implement effective interventions.

In the context of Cameroon, the healthcare system faces several challenges that may affect patient satisfaction with nursing care. These challenges include limited healthcare infrastructure, shortage of trained healthcare personnel, and inadequate medical equipment. In many public hospitals, nurses are required to care for a large number of patients, which can affect the quality of care provided. Additionally, issues such as long waiting times, poor communication, and lack of patient-centered care have been reported in some healthcare facilities. These challenges make it important to assess patient satisfaction in order to identify specific areas that need improvement.

The Buea Regional Hospital, being one of the major referral hospitals in the South West Region of Cameroon, provides a wide range of healthcare services to a large population. As a result, the quality of nursing care delivered in this hospital has a significant impact on patient outcomes and overall healthcare quality in the region. However, there is limited research focusing specifically on patients’ satisfaction with nursing care in this setting. Understanding patients’ experiences and perceptions of nursing care in this hospital is essential for improving service delivery and ensuring that patients receive high-quality care.

Moreover, assessing patient satisfaction with nursing care at the Buea Regional Hospital is important for several reasons. First, it will provide insight into how patients perceive the quality of care they receive from nurses. Second, it will help identify specific factors that influence patient satisfaction in this context. Third, it will guide hospital administrators and policymakers in developing strategies to improve nursing care and overall healthcare services. By addressing the identified gaps, the hospital can enhance patient satisfaction, improve health outcomes, and strengthen trust in the healthcare system.

1.2 STATEMENT OF THE PROBLEM

Despite the growing emphasis on quality healthcare delivery, patient satisfaction with nursing care remains a major concern in many healthcare systems, particularly in developing countries such as Cameroon. Nursing care is a key component of hospital services because nurses are in constant contact with patients and play a central role in meeting their physical, emotional, and informational needs. However, evidence from recent studies suggests that patients in many public hospitals continue to report dissatisfaction due to factors such as poor communication, long waiting times, inadequate attention, and limited nurse availability (Alharbi et al., 2022; Obaidi, 2025). These challenges are often linked to systemic issues such as understaffing, limited resources, and heavy workload among nurses, which can negatively affect the quality of care delivered.

In the context of Buea Regional Hospital, which serves as a major referral facility in the South West Region, patients rely heavily on nursing services for their care and recovery. However, increasing patient load, resource constraints, and possible gaps in patient-centered care may influence how patients perceive the nursing services they receive. While complaints related to delays, poor interaction, and unmet expectations are often informally expressed, there is limited empirical data that clearly assesses the level of patient satisfaction with nursing care in this hospital. This lack of documented evidence makes it difficult for hospital management and policymakers to identify specific problems and implement targeted improvements.

Therefore, the problem addressed by this study is the insufficient understanding of patients’ satisfaction with nursing care at the Buea Regional Hospital and the factors influencing it. Without proper assessment, gaps in nursing care may persist, leading to reduced quality of healthcare services, poor patient outcomes, and decreased trust in the healthcare system. This study seeks to fill this gap by providing evidence-based insights that can support improvements in nursing care and overall patient satisfaction.

1.3 Rationale

This study is carried out because patients’ satisfaction is an important measure of healthcare quality, especially in relation to nursing care. Nurses are in constant contact with patients and play a major role in their treatment, recovery, and overall hospital experience. However, in many public hospitals, including those in Cameroon, there are concerns about the quality of nursing care due to issues such as heavy workload, limited resources, and high patient numbers. These challenges may affect how patients perceive the care they receive, making it necessary to assess their level of satisfaction.

The study is also important because there is limited documented evidence on patients’ satisfaction with nursing care at the Buea Regional Hospital. Without such information, it is difficult for hospital management and health authorities to identify specific problems and make informed decisions to improve service delivery. By examining patients’ experiences and identifying factors that influence satisfaction, this study will provide useful information that can guide improvements in nursing care and enhance the overall quality of healthcare services.

1.4 Objectives of the Study

The objectives of this study are divided into the main research objective and specific research objectives.

1.4.1 Main Research Objective

The main objective of this study is to assess patients’ satisfaction with nursing care at the Buea Regional Hospital.

1.4.2 Specific Research Objectives

The specific objectives of this study are to:

·         Determine the level of patients’ satisfaction with nursing care at the Buea Regional Hospital.

·         Identify the factors influencing patients’ satisfaction with nursing care, such as communication, responsiveness, and professionalism of nurses.

·         Examine the challenges affecting the quality of nursing care and suggest ways to improve patient satisfaction.

1.5 Research Questions

The research questions are derived from the objectives of the study.

1.5.1 Main Research Question

What is the level of patients’ satisfaction with nursing care at the Buea Regional Hospital?

1.5.2 Specific Research Questions

·         What is the level of patients’ satisfaction with nursing care at the Buea Regional Hospital?

·         What factors influence patients’ satisfaction with nursing care in the hospital?

What challenges affect the quality of nursing care and how can patient satisfaction be improved?