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The mediating role of the nurse–patient dyad bonding in bringing about patient satisfaction


L.M.S. Tejero: e-mail:


tejero l.m.s.(2011) The mediating role of the nurse–patient dyad bonding in bringing about patient satisfaction. Journal of Advanced Nursing 68(5), 994–1002.


Aim.  This article is a report on a Synergy Model-guided correlational study of the direct and indirect relations of nurse-characteristics and patient characteristics to patient satisfaction, as mediated by nurse–patient dyad bonding.

Background.  Findings from previous studies have revealed that interventions alone do not fully account for patient outcomes, and that the effect of interventions on outcomes is mediated by factors such as interpersonal communication. The characteristics of the nurse and the patient synergize during their interaction, forming nurse–patient dyad bonding that affects patient satisfaction. Patient satisfaction is regarded as a critical part of the quality outcomes in healthcare.

Method.  A total of 210 nurse–patient dyadic interactions were observed using the Nurse–Patient Bonding Instrument. Nurse characteristics and patient characteristics were gathered through observation, interview and chart review. Data were collected in 2008 from four hospitals in the Philippines.

Results.  Path analysis revealed that the patient characteristic of predictability had both direct effect and indirect effects on patient satisfaction, and that the nurse characteristic of facilitation of learning had an indirect effect on patient satisfaction. Nurse–patient dyad bonding mediated the relations between patient predictability and patient satisfaction, and nurse facilitation of learning and patient satisfaction.

Conclusion.  The nurse and the patient both have a role to play in forming a therapeutic dyadic relationship that brings about the desired outcome. Further research on the formation and development of nurse–patient dyads in other settings and with other patient outcomes is recommended.