The Quantitative Analysis of Patients' Dignity and Privacy Needs in Anesthesia Nursing Services Based on the Kano and SERVQUAL Models.

BACKGROUND: Patients undergoing pulmonary anesthesia face dignity and privacy threats due to intraoperative positioning, unconsciousness, and postoperative discomfort. Existing studies focus mainly on technical safety, lacking systematic investigation from the patient's perspective. This neglect may lead to patient dissatisfaction and ethical concerns. OBJECTIVE: To identify patients' dignity and privacy needs, evaluate service quality gaps, and prioritize improvement targets in pulmonary anesthesia nursing using an integrated Kano-SERVQUAL framework. METHODS: A cross-sectional survey was conducted between March and September 2025 among patients undergoing pulmonary resection under general anesthesia in five tertiary hospitals in China. A 25-item questionnaire based on the Kano and SERVQUAL models was developed to assess dignity- and privacy-related service needs. Kano attribute classification, Better-Worse coefficient analysis, SERVQUAL gap analysis, and integrated quadrant analysis were performed. RESULTS: A total of 423 valid questionnaires were analyzed. Patients' dignity- and privacy-related needs showed a clear hierarchical structure, with informed consent, confidentiality protection, professional competence, and body privacy identified as fundamental requirements. Significant gaps were observed between patients' expectations and perceived service experiences, particularly in the domains of assurance and empathy. The integrated Kano-SERVQUAL analysis identified informed consent, privacy protection, responsiveness to patient concerns, professional competence, and respectful communication as the highest-priority areas for improvement. CONCLUSION: Patients undergoing pulmonary anesthesia place substantial importance on dignity and privacy protection, yet important service gaps remain. This study is among the first to integrate Kano-based need hierarchy analysis with SERVQUAL service quality assessment in pulmonary anesthesia nursing, enabling simultaneous evaluation of patient priorities and service deficiencies. The proposed framework offers a practical and evidence-based strategy for prioritizing patient-centered quality improvement and resource allocation in perioperative anesthesia care.