Patient Trust and Service Quality Essential for Satisfaction in Long-Term Hemodialysis Care

Gloria Florensia Br Surbakti Selasa, Agustus 11, 2026
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FORMOSA NEWS

Service quality and patient trust serve as the primary drivers of patient satisfaction in specialized hemodialysis units, while direct emotional support alone is insufficient to raise overall satisfaction ratings. These findings were established in a study published in 2026 by researchers Thika Marliana, Dessi Mellisa Malik, and Alih Germas Kodyat from Universitas Respati Indonesia. The study was conducted in July 2025 at the Hemodialysis Unit of Karawang Islamic Hospital in West Java, Indonesia, addressing a documented multi-year decline in local patient satisfaction scores. Understanding these drivers provides essential insights into improving long-term care for individuals living with chronic kidney disease.

Background and Clinical Context

Hemodialysis is a life-sustaining renal replacement therapy required by individuals facing end-stage renal disease (ESRD). Because hemodialysis requires repetitive, long-term treatments, patients depend heavily on consistent healthcare delivery and reliable clinical procedures. In public and regional hospitals across Southeast Asia, high patient volumes, resource constraints, and workforce limits frequently challenge healthcare facilities striving to deliver patient-centered care.

At Karawang Islamic Hospital, administrative evaluations revealed a drop in the patient satisfaction index from 80.18% in early 2023 down to 77.68% by late 2023. Evaluating how service procedures, interpersonal trust, and psychosocial factors interact is critical for healthcare administrators seeking to reverse such declines and maintain long-term treatment adherence.

Research Methodology

The researchers utilized a quantitative, explanatory research design to evaluate direct and indirect influences on patient satisfaction.

  • Study Location and Date: The investigation was conducted in July 2025 at the Hemodialysis Unit of Karawang Islamic Hospital.
  • Sampling: The researchers used a saturated sampling technique involving 41 active hemodialysis patients.
  • Demographics: Female participants represented 65.9% of the sample, while 58.5% of respondents were over 50 years of age. Furthermore, 68.3% of participants had been undergoing hemodialysis treatment for more than three months.
  • Analytical Approach: Structured Likert-scale questionnaires were distributed to assess four main dimensions: service quality, psychosocial support, patient trust, and patient satisfaction. Data were processed through multiple linear regression, path analysis, and Sobel mediation testing using SPSS software.

Key Findings

The statistical analysis established that service quality, psychosocial support, and patient trust simultaneously explain 88.7% of the variance in patient satisfaction (Adjusted $R^2 = 0.887, F = 105.462, p < 0.001$). However, individual variables exhibited distinct effects: 

+---------------------+-------------------+---------------------+---------------------------+
| Variable           | Direct Effect (t) | Direct P-value      | Statistical Significance  |
+---------------------+-------------------+---------------------+---------------------------+
| Service Quality     | t = 2.819         | p = 0.008           | Positive & Significant    |
| Psychosocial Support| t = -0.229        | p = 0.820           | Negative & Not Significant|
| Patient Trust       | t = 5.023         | p = 0.000           | Positive & Significant    |
+---------------------+-------------------+---------------------+---------------------------+

  • Service Quality: Exerted a direct positive effect on patient trust ($\beta = 0.644, p < 0.001$) and patient satisfaction ($\beta = 0.323, p = 0.008$).
  • Patient Trust as a Mediator: Patient trust significantly mediated the relationship between service quality and patient satisfaction (Sobel test $z = 2.644, p = 0.008$), yielding a total indirect-and-direct effect score of 0.751.
  • Psychosocial Support: Significantly increased patient trust ($\beta = 0.336, p = 0.001$), but showed a negligible and statistically non-significant direct effect on patient satisfaction ($\beta = -0.020, p = 0.820$). Furthermore, patient trust did not act as a significant mediator for psychosocial support toward satisfaction (Sobel test $z = -0.238, p = 0.810$).

Real-World Impact and Industry Implications

The research underscores that while emotional and family support strengthens patient confidence, overall clinical satisfaction among chronic kidney disease patients is primarily determined by operational reliability, staff responsiveness, and clinical safety. Patients prioritizing technical accuracy and physical comfort view high service standards as non-negotiable foundations of care.

For hospital administrators, medical directors, and healthcare policy planners, these results demonstrate that improving satisfaction scores requires prioritizing professional development, transparent communication, and standardized care delivery. Healthcare facilities must build systematic trust-building practices into routine care to optimize the overall patient experience.

Expert Commentary

Highlighting the practical implications of the findings, the lead authors emphasized:

"Service quality significantly affects both patient trust and patient satisfaction, while patient trust serves as a critical mediator in healthcare delivery. Implementation of these findings suggests that hospitals should enhance technical service quality, maintain standardized procedures, and integrate structured psychosocial support to strengthen trust and the overall patient experience." — Thika Marliana, Dessi Mellisa Malik, and Alih Germas Kodyat, Universitas Respati Indonesia

Author Profiles

  • Thika Marliana, S.Kep., Ns., M.Kep. is an academic researcher and nursing expert at Universitas Respati Indonesia, specializing in clinical nursing management and hemodialysis patient care.
  • Dessi Mellisa Malik, M.Kep. serves as a healthcare researcher at Universitas Respati Indonesia, focusing on healthcare service quality and patient outcomes.
  • Alih Germas Kodyat, SKM., M.Kes. is a public health specialist and academic staff member at Universitas Respati Indonesia with expertise in health administration and community health systems.

Source Information

Gloria Florensia Br Surbakti

Diposting oleh Gloria Florensia Br Surbakti

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