{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:00:27Z","timestamp":1790427627137,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the context of patient\u2010centered healthcare, VIP wards are becoming increasingly common due to their commitment to an excellent service experience. This study aimed to investigate the associations between nursing service quality, patient\u2010reported health status, and patient satisfaction in VIP wards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010center retrospective cross\u2010sectional secondary analysis was conducted from January 2025 to March 2026, involving 266 discharged patients from the VIP general ward of a tertiary hospital in China. All primary study outcomes were patient\u2010reported. The five\u2010dimensional service quality (SERVQUAL) scale was used to assess nursing service quality gaps, the patient\u2010reported outcomes measurement information system 29\u2010item profile (PROMIS\u201029) scale was used to evaluate patient\u2010reported outcomes (PROs), and overall satisfaction, along with socio\u2010demographic information, was collected. Data were analyzed using descriptive statistics, analysis of variance, correlation analysis, and multiple linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 266 participants, a significant gap existed between patients' expectations and perceptions of nursing service (overall gap score: \u22120.45\u2009\u00b1\u20090.61), with the largest gap found in assurance (\u22120.63\u2009\u00b1\u20090.85; paired Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      _\n                      <jats:italic>z<\/jats:italic>\n                      \u2009=\u2009\u22120.74), indicating a moderate\u2010to\u2010large standardized discrepancy. Patients reported lower physical function and higher anxiety, fatigue, and sleep disturbance than the general population reference. Patients who opted for the VIP payment package reported significantly smaller gaps in reliability, responsiveness, and assurance than patients using other payment methods, but no significant differences were found among the three payment groups across the seven PROMIS\u201029 domains or pain intensity. Multiple regression analysis revealed that the empathy deficit (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.447, 95% CI \u22120.562 to \u22120.333,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and anxiety level (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.299, 95% CI \u22120.424 to \u22120.174,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) had the largest standardized coefficients; the reliability deficit (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.226, 95% CI \u22120.347 to \u22120.106,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and sleep disturbance (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.124, 95% CI \u22120.223 to \u22120.024,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) were also significant, whereas the remaining candidate variables were not. Importance\u2010performance analysis (IPA) identified four high\u2010importance, low\u2010performance items including \u2018Individualized attention\u2019, \u2018Sufficient nursing knowledge\u2019, \u2018Nurses willingness to help\u2019, and \u2018Patient safety\u2019, as priority areas for improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In VIP wards, there is significant room for improvement in nursing service quality, particularly in the empathy and assurance dimensions. Use of the VIP payment package was associated with a more favorable service\u2010process experience in selected dimensions but was not associated with better patient\u2010reported health status in this cross\u2010sectional study. Targeted improvement should focus on individualized communication and anxiety management, supported by appropriate nursing training and organizational resources. Because this was a single\u2010center cross\u2010sectional study, these findings should not be interpreted causally and should be generalized cautiously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70599","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:36:32Z","timestamp":1789497392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of Nursing Service Quality Gaps and Improvement Strategies in VIP General Wards Based on Patient\u2010Reported Outcomes"],"prefix":"10.1111","volume":"32","author":[{"given":"Xueyan","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Shuxin General Practice School of Medicine, the Sixth Affiliated Hospital of South China University of Technology (Nanhai District People's Hospital of Foshan) Guangdong 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