INSTRUMENTS MEASURING NURSING CARE RESPONSIVENESS: A SYSTEMATIC REVIEW

Abstract

Introduction: Responsiveness in nursing care is a crucial quality indicator, particularly in outpatient settings where nurse-patient interactions are brief but significantly impact patient satisfaction and safety. Responsiveness refers to the timeliness, accuracy, empathy, and effectiveness of nurses' responses to patient needs. As patient-centered care continues to gain importance, various instruments have been developed to measure responsiveness in nursing care systematically. However, the availability of responsiveness instruments in nursing care remains limited. This study aims to review the existing instruments used to assess nursing care responsiveness in healthcare settings.

Methods: A systematic search was conducted across major databases, including PubMed, ScienceDirect, ProQuest, and Google Scholar, for articles published between January 2020 and December 2025. Out of 58.700 identified articles, 58 were reviewed in full text, and six met the final criteria based on a critical appraisal method. The analyzed studies focused on various instruments used to measure responsiveness in general and specialized outpatient nursing care contexts. Inclusion criteria included quantitative, qualitative, or mixed-methods studies that discussed responsiveness measurement instruments and full-text articles published in English.

Results: The review identified several instruments designed to measure responsiveness in nursing care, such as the Patient Satisfaction Questionnaire (PSQ), Outpatient Nursing Responsiveness Index (ONRI), Nursing Services Responsiveness Tool (NSRT), and adaptations of the SERVQUAL instrument tailored to nursing contexts.The PSQ contains 30 items, assessing dimensions like timeliness, communication, and empathy. The validity of this instrument was confirmed through expert review and factor analysis, yielding a Cronbach's alpha of 0.85. The ONRI consists of 18 items, evaluating aspects such as clarity of communication, response time, and nurse availability. This instrument demonstrated strong construct validity and achieved a Cronbach's alpha of 0.88 in various settings.The NSRT includes 20 items, measuring responsiveness through dimensions like attention to emotional needs, empathy, and personalized care. Its validity was affirmed with content validity index (CVI) of 0.90 and reliability confirmed by Cronbach's alpha of 0.90.The SERVQUAL adaptation for nursing contexts measures five key dimensions: tangibles, reliability, responsiveness, assurance, and empathy, with 22 items. Validity and reliability tests showed a Cronbach's alpha of 0.87.

These instruments assess different dimensions of responsiveness such as timeliness, communication clarity, empathy, individualized attention, and continuity of communication. The studies highlighted that measuring responsiveness improves patient satisfaction, nursing professionalism, and overall service quality. Additionally, integrating digital feedback tools has increased the efficiency of service evaluations. Despite these advancements, challenges such as limited resources and inadequate training in using these instruments remain persistent.

Conclusion: Instruments for measuring responsiveness in outpatient nursing care have proven effective in evaluating and enhancing service quality, patient satisfaction, and nurse-patient relationships. The systematic use of validated tools provides a data-driven foundation for clinical decision-making and nursing service improvement, ensuring more humane and efficient care. Institutional support through continuous training, integration into quality assurance systems, and policy development is essential for the widespread adoption of these tools. Further research is recommended to explore the long-term effects of these instruments across diverse healthcare settings.