Determinants of Parental Satisfaction on Health Care Services Provided to Children - A Tertiary Care Hospital Based Cross Sectional Study

 

Sneha Joy¹, Jibimol Reji², Lekshmi Priya², Liana James², Linnet Pauly²

¹Assistant Professor, M.O.S.C College of Nursing, Kolenchery, India.

²III B.Sc Nursing Students, M.O.S.C College of Nursing, Kolenchery, India.

 

ABSTRACT:

One of the most important goals of modern healthcare management systems is to provide high quality medical services. Parental satisfaction refers to the extent to which parents experience gratification regarding the health care services provided in the inpatient unit in relation to the hospitalization of their child. This study was aimed to assess the determinants of parental satisfaction on health care services provided to children. A quantitative cross-sectional design was undertaken for the study. The data collection was done among parents of hospitalized children by using Socio Demographic Profile, Self-structured Determinants of Parental Satisfaction tool and Modified Pediatric Quality of Life Inventory (PedsQL) health care satisfaction tool. The content validity of the tool was established by experts and the samples consisted of 165 parents of hospitalized children who satisfied the inclusion criteria and were selected by using convenience sampling technique.  The objectives of the study is to estimate the parental satisfaction on health care services provided to children in a tertiary care hospital and to determine the association of parental satisfaction with selected demographic variables. The selected data was tabulated and analysed by using descriptive and inferential statistics. The major findings of the study is 77.58% is having the highest level of satisfaction and 22.42% is having a moderate level of satisfaction. It also revealed that there is significant association of parental satisfaction with selected demographic variables such as primary caregiver, educational status, employment status and area of admission in hospital.

 

 

 

INTRODUCTION:

Satisfaction with medical care, including nursing care, is a multidimensional concept which is defined in various ways and depends on the degree of correspondence between meeting expectations of the patient and their family and the perception of care they are provided with. In case of a child, the satisfaction with care is also assessed by parents or guardians, who have the right to be present, participate and co-decide medical care issue¹.

 

A sense of parental satisfaction with care is determined by their individual needs, experiences of previous hospitalizations, changing external factors, including systemic factors, child’s health condition and its impact on family functioning, child’s maintaining continuity of care from hospital admission to discharge including preparing parents for continuing nursing care in home environment². Parents’ psychosocial functioning and attitudes during a child’s illness and hospitalization, may significantly influence the child’s adherence to the care and impact of diseases³. Patient’s satisfaction represents patient’s feeling about the degree of fulfilling their needs by healthcare providers. In recent years there is growing recognition of children’s rights and the need of listening to and taking their views in planning and delivery of health care to them⁴

 

 

METHODS:

Research Approach adopted for the study was Quantitative approach and the design was cross- sectional design. 165 parents of hospitalized children were selected using convenient sampling technique. Primary outcome variable in the study was parent satisfaction and the demographic variables were age, gender, religion, place of residence, type of family, educational status, employment status, socioeconomic status. Data was collected using Socio Demographic Profile, Self-structured Determinants of Parental Satisfaction tool and Modified Pediatric Quality of Life Inventory (PedsQL) health care satisfaction tool. The validity of the tool was assessed by giving the tool to experts in the nursing field. Obtained permission from the hospital and informed consent from the subjects were taken.  Pilot study was conducted among 30 parents of hospitalized children to check the feasibility and practicability of the study. The study was found to be feasible. The data was tabulated and analysed using descriptive and inferential statistics like percentage, frequency, mean, median and inter quartile range. The association was computed using chi-square test and fisher’s exact test.

 

RESULTS:

Section A: Description of demographic variables of parents of hospitalized children:

Table 1 shows that among the primary caregiver majority of subjects 82.42% belongs to mothers, 63.03% are within the age group of 28-37 years, 43.64% belong to Christians.

 

Figure 1 shows that 72.12% subjects are from rural area.

 

Figure 1: Frequency and percentage distribution based on Place of residence.          (n=165)

 

 

 

 

 

Table 1: Frequency and percentage distribution of demographic variables of parents of hospitalized children based on Primary caregiver, Age in years, Religion.                            (n=165)

 

Table 2: Frequency and percentage distribution of demographic variables of parents of hospitalized children based on Type of family, Educational status, Employment status, Socio-economic Status.                                                                                              (n=165)

 

Table 2 shows that 73.94% are from nuclear family, 60% were graduate and above and 7.88% are private employees, 62.42% are above poverty line.

 

Table 3 shows that 58.79% are males and 77.58% are between 0-6 years and 99.39% are vaccinated.

 

Table 3: Frequency and percentage distribution of demographic variables of hospitalized children based on Gender, Age in years, Immunization status.                                                             (n=165)

Demographic variables		Frequency (f)	Percentage (%)
Gender	Male Female Others	97 68 0	58.79 41.21 0
Age in years	0-6 7-12 13-18	128 30 7	77.58 18.18 4.24
Whether vaccinated appropriate to age?	Yes No	164 1	99.39 0.61

 

 

Section B: Description of Frequency and percentage distribution of determinants of parental satisfaction on health care services.

Figure 2 shows that 48.48% subjects have 2 children.

 

 

Figure 2: Percentage distribution based on number of children. (n=165)

 

 

Table 4 shows that 45.45% children admitted were first child of parents, 93.94% stayed    3-7 days in the hospital, 55.76% were admitted in general ward and 84.24% were admitted with acute illness.

 

 

Table 4: Frequency and percentage distribution of determinants of parental satisfaction on health care services based on Order of child, Days of hospital stay, Area of admission, Indication for admission.                                                                ( n=165)

 

Figure 3 shows that 70.3% of subjects are having elective admission.

 

Figure 3: Frequency and percentage distribution based on Mode of admitting child to hospital. (n=165)

 

Table 5 shows that 58.18% of children have previous history of hospitalization and 95.15% of subjects have availability of social support system.

 

Table 5: Frequency and percentage distribution of determinants of parental satisfaction on health care services based on Previous history of hospitalization, Availability of social support system.                     (n=165)

 

Section C: Description of parental satisfaction on health care services provided to children.

Table 6 shows that 77.58% of subjects are having highest level of parental satisfaction.

 

It was observed that the median value of parental satisfaction was 78(Q₁-66, Q₅-85). It was also observed that 77.58% of subjects are having highest level of parental satisfaction.

 

Table 6: Parental satisfaction on health care services provided to children.                                                                                                 ( n=165)

 

Section D: Association of parental satisfaction with selected demographic variables of children and parents of hospitalized children.

Table 7 shows that there is significant association of parental satisfaction with primary caregiver.

 

Table 7: Association of parental satisfaction with selected demographic variables of parents of hospitalized children based on Primary caregiver, Age in years, Religion.                                                                                                                                              (n=165)

 

Table 8 shows that there is significant association of parental satisfaction with educational status.

 

Table 8: Association of parental satisfaction with selected demographic variables of parents of hospitalized children based on Place of residence, Type of family, Educational status.                                                                                                                                       ( n=165)

 

Table 9 shows that there is significant association of parental satisfaction with employment status.

 

Table 9: Association of parental satisfaction with selected demographic variables of parents of hospitalized children based on Employment status, Socioeconomic status.                                                                                                                                               (n=165)

 

Table 10 shows that there is no significant association of parental satisfaction with gender, age in years and immunization status.

 

Table 10: Association of parental satisfaction with selected demographic variables of hospitalized children based on Gender, Age in years, Immunization status.                                                                                                                                                                         ( n=165)

 

 

 

 

Section E: Description of association of parental satisfaction with determinants of parental satisfaction on health care services.

 

Table 11 shows that there is significant association between parental satisfaction and area of admission in hospital

 

Table 11: Association of parental satisfaction with determinants of parental satisfaction on health care services based on Number of children, Order of child, Days of hospital stay, Area of admission.                                                                                                (n=165)

 

Table 12 shows that there is no association of parental satisfaction with indication for admission, mode of admission, previous hospitalization and availability of social support system.

 

Table 12: Association of parental satisfaction with determinants of parental satisfaction on healthcare services based on indication for admission, mode of admission, previous hospitalization, availability of social support system.                                                              (n=165)

 

DISCUSSION:

The result shows that out of 165 subjects, among the primary caregiver majority of subjects 82.42% belongs to mothers, 63.03% are within the age group of 28-37 years, 43.64% belong to Christians, 72.12% from rural areas, 73.94% from nuclear family, 60% were graduate and above, 47.88% belongs to private sector of employment and 62.42% belongs to above poverty line. Regarding the children 58.79% were males, 77.58% were under the age group of 0-6 years and 99.39% were vaccinated appropriate to age. The above findings were supported by a descriptive study that was conducted on Parent’s Satisfaction Regarding Nursing Care Services Among Parents of Children with Lower Respiratory Tract Infection in Paediatric Ward. The sample size is 50. An analysis of demographic data showed that 36% of subjects belong to the age group of above 29 years and nearly 34% were between 20-30 years. Among 50 children 60% of the females and 40% of them were male. Regarding educational status 4% were in the income group of below 3,000. Regarding overall parent satisfaction, about 92% of them were adequately satisfied with the nursing care services and 8% of them were moderately satisfied. None of them fell under the category of not satisfied. The study concluded that 92% of parents where adequate satisfied and 8% were moderately satisfied this shows that quality of nursing care are highly satisfactory by professional rendering of services.⁵

 

The results show that among the number of children, majority of subjects 48.48% had two children, 45.45% of them were first born child, 93.94% have stayed for 3-7 days, 55.76% were admitted in general ward, 84.24% admitted with acute illness, 70.3% of children had elective admission, 58.18% had previous history of hospitalization and 95.15% had availability of social support from family members. The findings of the study are supported by another study that was conducted in University Children’s hospital and the Provincial Specialist Children’s hospital in Krakow on Determinants of Parental Satisfaction with Nursing Care in Pediatric Wards in 2016-2017. It was done in a group of 336 parents of children hospitalized in general-pediatric and specialist departments (non-surgical) on the day of discharge from the hospital. The mean score of the overall parental satisfaction was high, amounting to 4.19 points. The lower level of satisfaction with nursing care was reported in parents of children under the age of 6 years, admitted in an emergency mode with a diagnosed post-trauma condition and those with higher education. The duration of hospitalization, sex and age of parents did not have an influence on the satisfaction with care. The age of the child, admission mode and education of respondents are determinants of parental satisfaction with nursing care.¹

 

The result shows that majority of subjects 77.58% had the highest level of satisfaction and 22.42% had a moderate level of satisfaction. The present finding was supported by another descriptive study that was conducted by Matziou on Parents satisfaction concerning their child's hospital care in 2011. The parents of 206 children participated in the study. The study demonstrated that the parents showed greater satisfaction with staff attitudes and medical treatment, whereas they were less satisfied with the information concerning routines and the staff work environment. The result reveal that adequacy of care, adequate pain management, parents involvement in care, a trusting relationship, and staff attitudes were the most important determinants of parental satisfaction.⁶

 

In this study, there is significant association of parental satisfaction with selected demographic variables such as primary caregiver, educational status of parents, employment status of parents and area of admission in hospital. The present finding was supported by another descriptive study that was conducted by Dipanjana Das and Ratna Biswas to assess the parent satisfaction level as an outcome of nursing care behavior for children admitted in pediatric ward in a selected hospital of Kolkata, West Bengal in 2022. The participants of the study were 100 parents of hospitalized children, and were included by using purposive sampling technique. The study concluded that 72% of parents were average satisfied, 16% parents were highly satisfied and 12% of parents were low satisfied with the care provided to the children admitted in the pediatric ward. The study also showed that there were significant association between parent satisfaction level and educational qualification of parent and occupation of parent.²

 

In this study, there is significant association of parental satisfaction with area of admission in hospital. The present finding was supported by another exploratory study that was conducted by Tamilselvi D on factors affecting the parental satisfaction regarding care of children admitted in the pediatric department at Sree Balaji medical college and hospital, Chromepet, Chennai in 2022. The objective of this study is to identify the factors affecting parental satisfaction regarding care of children and to find the association of factors affecting the parental satisfaction regarding care of children with selected socio demographic variables. Convenient sampling technique is adopted in this study. Result of this study reveals that communication/information had the highest mean percentage (68.33%) followed by admission criteria (66.77%), then patient care (62.22%) and at last hospital environment (59.66%). Overall satisfaction level among parents of children satisfied level 69(69.0%), more satisfied level 31(31.0%).⁷

 

CONCLUSION:

The conclusion drawn from the study has shown that the majority of parents are having the highest level of satisfaction on health care services provided to children. It also revealed that there is significant association of parental satisfaction with selected demographic variables such as primary caregiver, educational status, employment status and area of admission in hospital.

 

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2.      Das D, Biswas R. A study to assess the parent satisfaction level as an outcome of nursing care behavior for children admitted in a pediatric ward in a selected hospital of Kolkata, West Bengal.

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5.      S N Sherin, Parent’s Satisfaction Regarding Nursing Care Services Among Parents of Children with Lower Respiratory Tract Infection in Paediatric Ward, Puducherry. 2018; 18(4): e167-75.

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Received on 14.10.2025         Revised on 08.11.2025 Accepted on 29.11.2025         Published on 26.02.2026 Available online from March 03, 2026 A and V Pub J. of Nursing and Medical Res. 2026;5(1):9-14. DOI: 10.52711/jnmr.2026.03 ©A and V Publications All right reserved
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