Nurse-patients Communication and Its Relation to Inpatients
Satisfaction in Indonesia General Hospital
at RSU Bina Kasih
Wiyogo
1
, F. Kasim
2
and P. Eyanoer
3
1
Director of RSU Bina Kasih, Medan, Sumatera Utara, Indonesia North Sumatera
2
Institut Kesehatan Deli Husada, Medan, Sumatera Utara, Indonesia North Sumatera
3
Department of Community and Preventive Medicine, Faculty of Medicine, Universitas Sumatera Utara,
Jl. Dr. Mansur No. 5, Medan, Sumatera Utara, Indonesia
Keywords: Nurse, patients, communication, inpatients, satisfaction
Abstract: One of the things that affect patient satisfaction in hospital is nurse communication way. The purpose of this
study is to determine the association of nurse communication in inpatient installation with patient
satisfaction in Bina Kasih Hospital. This research conducted at Bina Kasih Hospital Inpatient Wards on
January – April in 2018. The research is a mixed method. The sample used in the first phase was 100
inpatients, and in the second phase were 16 nurses who were divided into 2 FGDs and an in-depth interview
with the Chairman of Bina Kasih Hospital Foundation. The results showed that the patient satisfaction at
interaction communication stage has the lowest percentage stages (65% - 68%). The basic problem is the
problem of assignment transfer between nurses, lack of knowledge about diagnosis, lack of local language
skills, low caring level to patients and patient's family who indifferent toward the nurses, the work
experience of nurses is still low which yielded to low self-confidence in giving services. It is recommended
to Bina Kasih Hospital to evaluate and continuously improve the quality of communication through
continuous communication training.
1 INTRODUCTION
Satisfaction is the feeling of pleasure or
disappointment of someone who emerges after
comparing perceptions or impressions of the
performance or outcome of a product and its
expectations [Kotler, 2002].
Therapeutic communication is an interpersonal
relationship between nurse and patient. It is then
necessary for nurses to learn the best communication
methods to reach the client's emotional experience
[Stuart, 1998]. The results of the nurse
communication survey of inpatients wards in RSU
Bina Kasih General Hospital from October to
December 2017 were 57% and the standard should
be above 90%. This general purpose of the study
aims is to determine the association of nurse
communication with patient satisfaction at inpatient
wards and specifically to identify the way of the
nurse's communication manner in a general hospital
RSU Bina Kasih, and to analyze the nurse
communication associated to patient satisfaction.
2 METHODS
This research study is a mixed method between
quantitative research design and qualitative research
designs with ultimately qualitative research design
becomes as this study research priority.
2.1 The First Phase of Research
The design of quantitative data is cross-sectional and
the data is to find the percentage of patient
satisfaction to nurse communication in inpatient
ward which will be presented in a frequency
distribution table. The populations are all patients at
RSU Bina Kasih inpatients ward around 150 patients
per day in March 2018. The incidental sampling
technique used is all patients who are being
194
Wiyogo, ., Kasim, F. and Eyanoer, P.
Nurse-patients Communication and Its Relation to Inpatients Satisfaction in Indonesia General Hospital at RSU Bina Kasih.
DOI: 10.5220/0009863201940197
In Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease (ICTROMI 2019), pages 194-197
ISBN: 978-989-758-469-5
Copyright
c
 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

hospitalized in RSU Bina Kasih at the time of
research and the research instrument is
questionnaires.
2.2 The Second Phase of Research
The design of this phase is sequential explanatory
that qualitative data is used to explain quantitative
data. The sample of FGDs is nurses from RSU Bina
Kasih inpatient ward with purposive sampling
technique and homogenous sampling, and the total
was 16 persons divided into 2 FGDs. The sample for
the in-depth interview was the chairman of the RSU
Bina Kasih Foundation. The main instrument
research for this phase is the researcher supported
with in-depth interview sheet and set topics for
FGDs.
3 RESULTS
3.1 Results of the First Phase
Table 1: The quality of the pre-interaction stage of nurse
communication
Nu. Statement Patient
satisfaction
Frequency %
1. Neatness and
cleanliness of
nurse appearance
not satisfied
less
satisfied
satisfied
very
satisfied
1
13
84
2
1
13
84
2
2 Nurses are calm
and able to
control their
feelings when
meeting patients
not satisfied
less
satisfied
satisfied
very
satisfied
2
23
73
2
2
23
73
2
3 The nurse in
completing the
tool will be used
to perform the
action
not satisfied
less
satisfied
satisfied
very
satisfied
2
23
73
2
2
23
73
2
Table 2: The quality of the interaction stage of nurse
communication
Nu. Statement
Patient
satisfaction
Frequency
%
1 The nurse
greets and
introduces
himself when
he first
interacts with
the
patient/family
not satisfied
less satisfied
satisfied
very
satisfied
4
27
68
1
4
27
68
1
2 Provide an
opportunity
for clients to
describe their
opinions
not satisfied
less satisfied
satisfied
very
satisfied
6
26
67
1
6
26
67
1
3 Nurse
attention
listening
not satisfied
less satisfied
satisfied
very
satisfied
4
29
65
2
4
29
65
2
4 The nurse asks
me about my
readiness
before taking
nursing action.
not satisfied
less satisfied
satisfied
very
satisfied
2
30
67
1
2
30
67
1
Table 3: The quality of the work stage of nurse
communication
Nu. Statement
Patient
satisfaction
Frequency
%
1. The nurse
explains
every action
to be
performed to
the patient
not satisfied
less satisfied
satisfied
very
satisfied
3
23
73
1
3
23
73
1
2 Nurses
explain and
educate the
patients and
families about
health
not satisfied
less satisfied
satisfied
very
satisfied
0
36
63
1
0
36
63
1
3 The nurse
offers help to
the patient
during
difficulty
not satisfied
less satisfied
satisfied
very
satisfied
3
24
72
1
3
24
72
1
Nurse-patients Communication and Its Relation to Inpatients Satisfaction in Indonesia General Hospital at RSU Bina Kasih
195

Table 4: The quality of the termination stage of nurse
communication
Nu. Statement
Patient
satisfaction
n
%
1. The nurse asks the
patient's
circumstances after
the nursing action
not satisfied
less satisfied
satisfied
very satisfied
2
24
72
2
2
24
72
2
2 The nurse reminds
and notifies the
patient if there is
any further
investigation
not satisfied
less satisfied
satisfied
very satisfied
0
17
81
2
0
17
81
2
3 The nurse makes an
agreement for the
next meeting with
the patient (the
place, time and
purpose already
discussed)
not satisfied
less satisfied
satisfied
very satisfied
1
22
75
2
1
22
75
2
4 The nurse greets the
patient and family
when leaving the
patient's room
not satisfied
less satisfied
satisfied
very satisfied
1
15
82
2
1
15
82
2
3.2 Result of the Second Phase
Table 5: Results of first FGDs (problems summed up)
Informant Keywords Category
Nurses  ...less mastering...
 …doctor
diagnosis...less
mastering…
Mastering the
knowledge
?????  …local language… Mastering the
local language
?????  …not all been told
during transfer…
Transfer
assignment
process
?????  ...patient’s family
indifferent…
The attitude of
the patient's
family
 ...low caring level… Nurse
behavior
Table 6: Results of second FGDs (problems summed up)
Informant Keywords Category
Nurses  …we less familiar
about…side effect…
 …not familiar with
the disease…
 …his
thrombocyte…has
been explained…not
satisfy…
Mastering the
knowledge
?????  …from ER…has not
been
explained…been
Transfer
assignment
process
transferred…
 …complained
abdominal
discomfort from
ER …at here become
hypertension…
?????

…there is a nurse
promise the doctor
will come
earlier…meanwhile,
the doctor comes
late…
Nurse
behavior
Table 7: Results of in-depth interview
Informant Keywords Category
The
chairman
of RSU
Bina Kasih
Foundation

…experience is
relatively low…
 …maybe fairly
educated …
 …must know some of
the medicines…
 …good mastery…she
will no doubt
communicate…
Mastering
the
knowledge
4 DISCUSSIONS
The nurses play an important role in the process of
caring for the patients because, in terms of service
time, the since nurses have the longest service time
to the patients compared to the medical doctors.
Medical doctors in charge of the patient who
generally visits the patient at least once a day and
the duration of the visit ranges from 5 to 10 minutes
per patient.
One of the processes of inpatient nursing is
communication. Good communication can improve
patient's compliance in terms of treatment and
nursing process. As well as having a significant role
in the satisfaction of patient who treated, otherwise
will reduce patient satisfaction [Hadi, 2013]
Based on the first phase research is showed that
patient satisfaction on interaction communication
stage has the lowest satisfaction percentage around
65% - 68%. And those result also the same with
other researchers that the implementation of
therapeutic communication of polyclinics nurses on
orientation (interaction) stage is around 35%
because of some of the nurses do the implementation
of therapeutic communication while some of them
none [Kusumo, 2016].
According to the books of Science Nurse
Communication for Nursing Students that the
orientation (interaction) stage is the beginning
ICTROMI 2019 - The 2nd International Conference on Tropical Medicine and Infectious Disease
196

meeting with the patient which aims to validate the
accuracy of the data and plans that have been made
in accordance with the current state of the patient. In
starting a relationship, the main task is to foster trust,
acceptance, understanding and opened
communication with patients [Nurhasanah, 2010].
Analysis result of nurse communication problems in
table 5 to table 7 also caused by the nurse violation
against the standards that have been determined by
RSU Bina Kasih internal regulations about effective
communication policy, giving information and
education policy, and the provisions of
communication standards by the National
Accreditation Standard of Hospital, the First Edition
2017 [Hospital Accreditation Commission,2017].
The orientation (interaction) stage is the
introductory stage between the nurse and the patient,
by introducing themselves to the patient means that
the nurse has been open to the patient and gives a
comfortable impression of the services provided to
the patient [Suryani, 2016]. With a good therapeutic
communication at the orientation (interaction) stage,
the nurse will find the easier way to dig outpatient
complaints (Reference).
Good attitudes and behaviors by nurses can often
cover deficiencies in terms of facilities and
infrastructure [4] it agrees with the statement from
the Chairman of RSU Bina Kasih Foundation “..in
management concept, human resources are a power,
include infrastructure, management system, yes but,
yaa that human resources. Yea if we sort between
hospital infrastructure, management, and human
resources, of course, human resources have the
greatest role, haaa..but, if we think more, among
human resources, so communication way of human
resources has the greatest role…”
5 CONCLUSIONS
Patient satisfaction of nurse communication in RSU
Bina Kasih inpatients ward is not in accordance with
the standard that has been determined by the Decree
of the Minister of Health of the Republic of
Indonesia number 129/Menkes/SK/II/2008 about
Minimal Standards Hospital Appendix II
Description Minimum Service Standards Inpatient
Services point 10 Inpatient Customer Satisfaction
where the specified standard is ≥ 90%.
Interaction stage of nurse communication is
becoming the main priority in this study as a source
of problems to patient satisfaction. There is a
relationship between the low quality of nurse
communication relates to the low level of patient
satisfaction and is often caused by:
 Less mastering and lack of knowledge of
diagnosis, medical treatments among nurses in
the hospital
 The assignment patient transfer done by nurses is
not in accordance with RSU Bina Kasih standard
operational procedure.
 Lack of nurses’ confidence while communicating
with patient or patient’s family that makes
hesitation during services
 Lack of experience or length of work, and nurse
communication training in the hospital
 The increased quality of nurses' communication
to patients will have an impact on the quality of
hospital services and increased patient safety at
in hospitals.
Based on conclusions above, it is advisable for
nurses and hospital management to improve the
attitudes and behavior of nurses, especially raising
the level of awareness for communication to patients
or families of patients in hospitals professionally,
care about the rule of law, hospital accreditation
standard about communication to patients, always
improve the knowledge of the mostly founded
diagnosis in hospital, and always make internal or
external trainings about nurse communication
regularly.
REFERENCES
Kotler P. Marketing Management. 9
th
Ed. Erlangga.
Jakarta Cetakan XV. 2002
Stuart, GW and Sundeen SJ. Pocket Guide to Psychiatric
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1998
Hadi PL, Prabowo T, Yulitasari BI. Therapeutic
Communication of Nurses Associated with Level
Patient Satisfaction at Puskesmas Dukun Magelang.
2013
Kusumo MP. Effect of Therapeutic Communication of
Nurses on Patient Satisfaction in Outpatient of Jogja
Hospital. Jogja. 2016
Nurhasanah N. Science Nurse Communication for Nursing
Students. Jakarta: Trans Info Media, 2010
Hospital Accreditation Commission. 1
st
Ed. Jakarta:
KARS, 2017
Suryani. Therapeutic Communication: Theory and
Practice. 2
nd
Ed. Jakarta: EGC, 2016
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