Relationships Between Hospitalized Patients’ Expectations of Nursing Care, Hospitalization Experience, and Subjectively Assessed Health

Abstract

Introduction Patients’ expectations are a key factor shaping their perception of nursing care quality (1). They influence satisfaction, trust, and overall experience, and arise from previous encounters, personal beliefs, and sociocultural context (2). Clear communication, emotional support, and professional competence are central elements patients evaluate. Organizational factors such as workload, responsiveness, and ward environment also determine whether expectations are met (3,4). Aim To assess the relationships between hospitalized patients’ expectations of nursing care and selected hospitalization characteristics (number of hospitalizations, type of ward accommodation) as well as patients’ subjectively assessed health. Methods A cross-sectional study was conducted from April to September 2025 with 160 patients hospitalized in the Urology Department of the Hospital of the Lithuanian University of Health Sciences Kaunas Clinics. Patients’ expectations of nursing care were assessed using the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), Laschinger HKS et al, 2005, (22 items, 7 subscales), permission is freely available. It was adapted to evaluate patients’ expectations. Subjectively assessed health and hospitalization characteristics were collected using additional questions. Internal consistency was high (Cronbach’s α = 0.929). Mann– Whitney U and Kruskal–Wallis H tests were applied (p < 0.05). Ethical approval of LSMU Bioethics Center (BEC2-0532) was obtained to conduct the study. Results Patients in a single-bed ward expected better information provision (mean 4.25±0.56). Patients sharing a ward had the highest expectations for comfort and privacy (4.09±0.63); however, no statistically significant differences were found. Patients hospitalized for the first time had higher expectations for overall nursing care than those hospitalized more times (4.16±0.56 vs. 3.78±0.57). Patients hospitalized ≥3 times had the lowest expectations for preparation of discharge (3.85±0.85), comfort, and privacy (3.78±0.81). Worse subjective health assessment was associated with higher expectations for information (4.28±0.66), family involvement (4.40±0.99), respect and care (4.36±0.56), and preparation of discharge (4.35±0.85). Excellent subjective health was associated with higher expectations for overall nursing care (4.26±0.42, 4.08±0.57, 3.87±0.61). Conclusions Patients’ expectations of nursing care were strongly associated with hospitalization characteristics and subjective health. Higher expectations were observed among first-time hospitalized patients and those reporting poorer subjective health, particularly in relation to information provision, respect and care, and discharge preparation. These findings highlight the importance of recognizing patients’ expectations when planning and delivering nursing care in hospital settings.