Beyond Clinical Care: The Influence of Psychosocial Support, Trust, and Service Quality on Patient Satisfaction

Thika Marliana; Dessi Mellisa Malik; Alih Germas Kodyat

doi:10.59890/ijnhs.v4i3.248

Authors

Thika Marliana Universitas Respati Indonesia
Dessi Mellisa Malik Universitas Respati Indonesia
Alih Germas Kodyat Universitas Respati Indonesia

DOI:

https://doi.org/10.59890/ijnhs.v4i3.248

Keywords:

Hemodialysis, Psychosocial Support, Patient Trust, Patient Satisfaction, Quality of Care

Abstract

Patient satisfaction represents a key indicator for assessing the quality of hemodialysis services and is shaped by multiple factors, particularly service quality, psychosocial support, and patients’ trust in healthcare providers. This study was conducted to examine the influence of service quality and psychosocial support on the satisfaction of hemodialysis patients, while also exploring the mediating role of patient trust. The research took place at Karawang Islamic Hospital, where a decline in the patient satisfaction index has been observed in recent years. A quantitative research design was employed to investigate the relationships among service quality, psychosocial support, trust, and patient satisfaction. The study was carried out in July 2025 in the Hemodialysis Unit of RSI Karawang and involved 41 respondents selected through a total sampling technique. The findings demonstrated that service quality had a positive and statistically significant effect on both patient trust and patient satisfaction. Furthermore, trust was found to significantly mediate the relationship between service quality and patient satisfaction. Conversely, psychosocial support showed a significant direct effect on patient trust, but its effect on patient satisfaction was negative and not statistically significant. These findings highlight the importance of improving service quality and strengthening patient trust as strategic approaches to enhance satisfaction among hemodialysis patients

References

Agnaty, R. A., & Jaksa, S. (n.d.). Analisis kepuasan pasien BPJS terhadap kualitas pelayanan rawat jalan di rumah sakit dengan pendekatan SERVQUAL. Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management), 28(02), 44–49. https://doi.org/10.22146/jmpk.v28i02.21340

Ahrabi, A., Poshtdar, S., Salimi, J., Ashouri, M., & Yaseri, M. (2025). Patient perspective and satisfaction with different types of vascular access in hemodialysis: A systematic review and meta-analysis. BMC Nephrology, 26, Article 457. https://doi.org/10.1186/s12882-025-04393-9

Al-Abdelmuhsin, L., Alammari, M., Babelghaith, S. D., Syed, W., Asiri, Y., Almetawazi, M. S., Alghadeer, S., & Al-Arifi, M. N. (2020). Pharmacist-led medication counseling for patients undergoing hemodialysis: A path to better adherence. International Journal of Environmental Research and Public Health, 17(7), 2399. https://doi.org/10.3390/ijerph17072399

Alatawi, A. A., Alaamri, M., & Almutary, H. (2024). Social support and adherence to treatment regimens among patients undergoing hemodialysis. Healthcare (Basel, Switzerland), 12(19). https://doi.org/10.3390/healthcare12191958

Al-Hilou, M., & Suifan, T. (2023). The mediating effect of patient trust on the relationship between service quality and patient satisfaction. International Journal of Health Care Quality Assurance. https://doi.org/10.1108/IJHCQA-05-2023-0028

Alikari, V., Matziou, V., Tsironi, M., Theofilou, P., Giannakopoulou, N., Tzavella, F., Fradelos, E. C., & Zyga, S. (2021). Patient knowledge, adherence to the therapeutic regimen, and quality of life in hemodialysis. Advances in Experimental Medicine and Biology, 1337, 259–272. https://doi.org/10.1007/978-3-030-78771-4_29

Almeida, R., Silva, A., & Rodrigues, P. (2023). Patient adherence and psychosocial factors in chronic kidney disease: Evidence from hemodialysis units. Journal of Renal Care, 49(2), 145–155. https://doi.org/10.1111/jrc.12488

Al-Qalah, T. A. H., Alrubaiee, G. G., & Alkubati, S. A. (2025). Factors associated with the quality of life and needs of hemodialysis patients in Saudi Arabia: A basis for improved care. Medicina, 61(2), 180. https://doi.org/10.3390/medicina61020180

Bahri, M. Y., & Patimah, S. (2023). Pengaruh kualitas layanan terhadap kepuasan dan kepercayaan pasien di unit rawat inap rumah sakit umum daerah Arifin Nu’mang. Journal of Muslim Community Health, 4(4), 180–191. https://doi.org/10.52103/jmch.v4i4.1406

Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice-Hall.

Barello, S., Anderson, G., Acampora, M., Bosio, C., Guida, E., Irace, V., Guastoni, C. M., Bertani, B., & Graffigna, G. (2023). The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: A systematic review and a meta-analysis. International Urology and Nephrology, 55(4), 897–912. https://doi.org/10.1007/s11255-022-03374-3

Creswell, J. W., & Creswell, J. D. (2023). Research design: Qualitative, quantitative, and mixed methods approaches (6th ed.). Sage Publications.

Hartanti, L. K., & Antonio, F. (2022). The effect of service quality dimensions on hemodialysis patient satisfaction in Indonesia. Jurnal Administrasi Kesehatan Indonesia, 10(1), 50–59. https://doi.org/10.20473/jaki.v10i1.2022.50-59

Hasanah, U., Syarifur Rahman, I., Tsalitsah, I. M., & Fauzia, F. A. (2023). Pendampingan psikososial pada pasien dengan penyakit kronis di Yayasan Kanker Indonesia. Aksiologiya: Jurnal Pengabdian Kepada Masyarakat, 7(1). https://doi.org/10.30651/aks.v7i1.17247

Hasnidar, Aswadi, M. W., & Putra, W. U. C. J. (2022). Family support and quality of life for chronic kidney disease (CKD) patients hemodialysis therapy at Undata Hospital. Journal of Health and Nutrition Research, 1(1), 6–10. https://doi.org/10.56303/jhnr.v1i1.3

Inayati, A., Hasanah, U., & Maryuni, S. (2021). Dukungan keluarga dengan kualitas hidup pasien gagal ginjal kronik yang menjalani hemodialisa di RSUD Ahmad Yani Metro. Jurnal Wacana Kesehatan, 5(2), 588–595. https://doi.org/10.52822/jwk.v5i2.153

Iqbal, M. S., Iqbal, Q.-A., Iqbal, S., & Ashraf, S. (2021). Hemodialysis as long term treatment: Patients satisfaction and its impact on quality of life. Pakistan Journal of Medical Sciences, 37(2). https://doi.org/10.12669/pjms.37.2.2747

Karim, F., Hussain, M., & Ahmed, S. (2021). Reliability and validity assessment of patient satisfaction questionnaires in chronic care. Health Services Research, 56(4), 732–745. https://doi.org/10.1111/1475-6773.13712

Khan, M. I., Rahman, Z. U., Saleh, M. A., & Khan, S. U. Z. (2022). Social media and social support: A framework for patient satisfaction in healthcare. Informatics, 9(1), 22. https://doi.org/10.3390/informatics9010022

Koon, J. (2020). Staff nurses’ perception of the hemodialysis unit as practice environment and patients’ perception of nurse caring behaviors and their level of satisfaction. Journal of Health and Caring Sciences, 2(1), 4–18. https://doi.org/10.37719/jhcs.2020.v2i1.oa001

Mansoor, L. A., & Muhammad, T. R. (2023). Impact of nurse’s job satisfaction upon quality of nursing care for patients undergoing hemodialysis. Journal of Contemporary Medical Sciences, 9(6). https://doi.org/10.22317/jcms.v9i6.1458

Meiliana, R., Kusbandrijo, B., & Rochim, A. I. (2024). Pengaruh pelayanan dan kepercayaan terhadap kepuasan pasien gawat darurat badan layanan umum daerah RSUD Balangan Provinsi Kalimantan Selatan. SENTRI: Jurnal Riset Ilmiah, 3(4), 2113–2125. https://doi.org/10.55681/sentri.v3i4.2607

Morgan, R. M., & Hunt, S. D. (1994). The commitment-trust theory of relationship marketing. Journal of Marketing, 58(3), 20–38. https://doi.org/10.1177/002224299405800302

Muchlis, N. (2021). Kualitas pelayanan terhadap kepuasan dan kepercayaan pasien rawat inap di rumah sakit DR Sumantri Pare-Pare. Journal of Muslim Community Health, 2(3), 154–164. https://doi.org/10.52103/jmch.v2i3.552

Notoatmodjo, S. (2014). Metodologi penelitian kesehatan. PT Rineka Cipta.

Ommen, O., Janssen, C., Neugebauer, E., Bouillon, B., Rehm, K., Rangger, C., Erli, H. J., & Pfaff, H. (2008). Trust, social support and patient type—Associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients. Patient Education and Counseling, 73(2), 196–204. https://doi.org/10.1016/j.pec.2008.03.016

Parasuraman, A., Zeithaml, V. A., & Berry, L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40. https://www.marketeurexpert.fr/wp-content/uploads/2023/12/servqual.pdf

Patil, S., Kumar, R., & Singh, A. (2022). Explanatory research design in healthcare studies: Applications and best practices. International Journal of Research Methodology, 9(3), 55–63. https://doi.org/10.1016/j.ijrm.2022.04.005

Rahayu, S. P., & Surwanti, A. (2022). Pengaruh kualitas pelayanan terhadap kepercayaan dan kepuasan pasien BPJS. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 5(1), 65–72. https://doi.org/10.52643/marsi.v6i2.2582

Ramadia, A., Rahmaniza, R., & Maulidi, A. (2022). Hubungan komunikasi terapeutik perawat dengan tingkat kepuasan pasien di ruang rawat inap. Jurnal Keperawatan Jiwa, 10, 393–402. https://doi.org/10.26714/jkj.10.2.2022.393-402

Rondhianto, R., Murtaqib, M., & Yonda, N. N. (2024). Psychosocial factors affecting the adherence of chronic kidney disease patients to undergo a hemodialysis program: A cross-sectional study. Jurnal Ners, 19(3 SE-Original Article), 314–325. https://doi.org/10.20473/jn.v19i3.48195

Saanin, A. P., Rumengan, G., Ulfa, L., & Rustandy, J. (2022). Hubungan kepercayaan, kualitas pelayanan, kewajaran harga, dan lingkungan fisik terhadap kepuasan pasien pada unit rawat inap RS Azra Kota Bogor Provinsi Jawa Barat. Jurnal Manajemen Dan Administrasi Rumah Sakit Indonesia (MARSI), 6(2), 182–186. https://doi.org/10.52643/marsi.v6i2.2582

Siregar, H. S., Lubis, Y., & Sofiyan, S. (2023). The influence of hospital facilities and services on patient satisfaction with hospital image as an intervening variable at Haji Abdul Manan Simatupang General Hospital. Jurnal Bintang Manajemen, 1(3), 97–112. https://doi.org/10.55606/jubima.v1i3.1848

Sugiyono. (2020). Metode penelitian kuantitatif, kualitatif, dan R&D. Alfabeta.

Sułkowski, L., Matyja, A., & Matyja, M. (2024). Social support and quality of life in hemodialysis patients: A comparative study with healthy controls. Medicina, 60(11), 1732. https://doi.org/10.3390/medicina60111732

Tran, B., Nguyen, H., & Le, T. (2022). Validity and reliability of structured questionnaires in healthcare research: A systematic review. Journal of Health Research, 36(5), 407–415. https://doi.org/10.1108/JHR-06-2022-0087

Wahyudi, E., Rahayu, Y. N., & Kartikasari, D. (2025). Outpatient patient satisfaction with service quality, hospital image: Mediated by patient trust. Journal of Community Health Management, 12(1), 19–26. https://doi.org/10.18231/j.jchm.2025.004

Zeng, B., Wang, L., Wu, S., Lin, S., Li, Y., Jiang, W., Guo, R., Zhou, F., & Lin, K. (2021). Cognitive dysfunction and health-related quality of life in patients with end-stage renal disease undergoing hemodialysis in comparison with patients undergoing peritoneal dialysis: A cross-sectional study. Medical Science Monitor, 28, e934282. https://doi.org/10.12659/msm.934282

Zhang, Y., & Li, J. (2021). Quantitative research methodologies for evaluating patient satisfaction: A critical review. Journal of Healthcare Research, 35(2), 201–214. https://doi.org/10.1016/j.jhr.2021.01.012