Introduction:

The simultaneous test demonstrated that effective communication and patient safety collectively had a significant effect on patient satisfaction, confirming the robustness of the regression model.

Discussion

This study demonstrates that effective communication has a significant influence on patient satisfaction at HoREX Baucau Hospital. Patients reported greater comfort and trust when healthcare providers delivered clear, understandable information and demonstrated empathy during care interactions. Effective communication reduces patient anxiety, improves understanding of medical procedures, and strengthens therapeutic relationships, which ultimately contributes to higher satisfaction levels (Meikayanti et al., 2021; Nurfitriani et al., 2025). From a psychological perspective, communication clarity helps patients feel valued and respected, which enhances emotional security and promotes positive perceptions of healthcare services (Kulinska et al., 2022).

These findings are consistent with previous studies indicating that nurse–patient communication plays a crucial role in shaping patient satisfaction in inpatient settings. Studies in hospital environments have shown that patients who perceive communication as clear, timely, and respectful tend to evaluate healthcare services more positively (Ramadia et al., 2022; Masmumah et al., 2024). Communication extends beyond information transfer and includes emotional support, active listening, and interpersonal engagement, which are central components of patient-centered care and contribute to improved patient experiences (Firdausi, 2022).

From a professional nursing perspective, effective communication enables patients to better understand their health conditions, treatment plans, and expected outcomes. This understanding promotes patient cooperation, adherence to treatment, and shared decision-making, which ultimately improves clinical and experiential outcomes (Tarigan & Ginting, 2019). Continuous communication training for healthcare providers is therefore essential to maintain service quality, enhance therapeutic interactions, and improve patient satisfaction, particularly in inpatient care settings where prolonged interaction occurs (Wandira et al., 2022).

In addition to communication, patient safety was found to exert a strong influence on patient satisfaction. Patients who perceived that safety standards were consistently implemented reported greater confidence, trust, and comfort during hospitalization. This finding supports previous studies that identify patient safety as a core dimension of healthcare quality and a primary determinant of patient satisfaction (Azizah et al., 2023; Oktarina et al., 2024). From a quality-of-care perspective, safety serves as a foundational requirement that shapes patients’ overall perception of healthcare reliability and professionalism (World Health Organization, 2019).

Earlier research has highlighted that prevention of medical errors, accurate patient identification, medication safety, and infection control significantly enhance patients’ perception of care quality. When patients feel protected from harm, they are more likely to trust healthcare providers and report higher satisfaction with hospital services (Juniarti & Mudayana, 2018; Raynaldi et al., 2024). The psychological sense of security plays a central role in shaping patient satisfaction, as safety perception directly influences emotional comfort and trust toward healthcare systems (Kulinska et al., 2022).

The stronger influence of patient safety compared to communication in this study may reflect patients’ prioritization of physical security and protection from harm during hospitalization. In clinical environments where patients depend heavily on healthcare providers, visible safety practices such as safe medication administration, monitoring, and infection prevention become critical determinants of trust and perceived service quality. Safety, as a structural dimension of healthcare quality, may therefore carry greater weight in shaping patient satisfaction compared to communication alone (World Health Organization, 2019; Raynaldi et al., 2024).

The combined influence of effective communication and patient safety on patient satisfaction represents a key contribution of this study. Effective communication facilitates the correct implementation of safety procedures, while strong safety practices reinforce patient trust and satisfaction. Previous studies have demonstrated that teamwork, communication, and safety culture interact synergistically to improve patient outcomes, service quality, and satisfaction levels (Hastuti, 2020; Junita et al., 2021). This synergy indicates that communication and safety should be addressed simultaneously rather than independently in healthcare quality improvement strategies.

The findings of this study are particularly relevant in the context of HoREX Baucau, where multilingual communication and diverse educational backgrounds may influence patient understanding and perception of safety. The use of multiple languages such as Tetum, Portuguese, and English may create variability in message clarity and patient comprehension. Misinterpretation or incomplete communication may cause patients to perceive safety implementation as inconsistent, even when clinical procedures are correctly followed (Wang et al., 2022). This multilingual context represents a unique characteristic of the study setting and highlights the importance of culturally and linguistically adaptive communication strategies.

The implications of these findings suggest that healthcare institutions should prioritize strengthening communication competencies alongside reinforcing patient safety culture. Regular communication and safety training, open and non-punitive communication environments, improved teamwork, and continuous quality improvement initiatives are essential to enhance patient satisfaction and healthcare service quality. Strengthening these aspects can support patient-centered care and improve trust, safety perception, and overall patient experience (O’Neill et al., 2021; World Health Organization, 2019).

Study Limitations

This study has several limitations that should be acknowledged to ensure a balanced interpretation of the findings. First, the cross-sectional design limits the ability to establish causal relationships between effective communication, patient safety, and patient satisfaction. The observed associations reflect conditions at a single point in time and may not capture changes in perceptions over longer periods. Future studies employing longitudinal or experimental designs are recommended to better explore causal pathways.

Second, the use of self-reported questionnaires may introduce response bias, as participants’ answers could be influenced by personal perceptions, recall limitations, or social desirability. Although confidentiality was assured, respondents might have provided favorable responses toward healthcare services. Incorporating objective indicators, such as incident reports or observational assessments, may strengthen future research.

Third, this study was conducted in a single hospital setting, which may limit the generalizability of the results to other healthcare institutions with different organizational cultures, patient characteristics, or resource availability. Expanding the study to multiple hospitals or regions would enhance external validity and provide broader insights into the relationship between communication, patient safety, and satisfaction.

Conclusion

This study concludes that effective communication and patient safety play important roles in determining patient satisfaction among inpatients at HoREX Baucau Hospital. Patient safety emerged as a more influential factor, while effective communication contributed by strengthening patient trust, comfort, and understanding during care. The findings emphasize that communication and safety are interconnected elements that jointly shape patient experiences and perceptions of healthcare quality.

The results highlight the importance of integrating communication skills development with consistent implementation of patient safety practices. Strengthening these aspects may improve service quality, support patient-centered care, and enhance patient satisfaction. Future research is encouraged to explore intervention-based strategies and broader settings to further develop evidence in this area.

Acknowledgment

The authors would like to express their gratitude to the management and healthcare staff of HoREX Baucau Hospital for their cooperation and support during the data collection process. Sincere appreciation is also extended to all patients who voluntarily participated in this study.

Conflict of Interest

The authors declare that they have no competing interests.

Credit Author Statement

Saturnina Fernandes Belo: Conceptualization, methodology, investigation, data curation, formal analysis, writing–original draft.
Ratna Wardani: Supervision, validation, methodology review, writing–review and editing.

Novita Ana A: Supervision, validation, writing–review and editing, project administration.