Patient Awareness, Satisfaction and Associated Factors Related to Preoperative Nursing Care among Adults Undergoing Major Surgeries at Selected Tertiary Care Hospitals in Sri Lanka

Background: The preoperative phase is a critical period during which nursing care significantly influences surgical outcomes. Despite growing global interest in patient-centered perioperative care, no published evidence exists examining patient awareness and satisfaction with preoperative nursing care in Sri Lanka. This study aimed to assess the level of awareness and satisfaction regarding preoperative nursing care among adult patients undergoing major surgery and to identify factors associated with these outcomes in selected tertiary care hospitals in the Colombo District of Sri Lanka.
Methods: A descriptive cross-sectional study was conducted among 430 postoperative adult patients at the surgical wards of the National Hospital of Sri Lanka and Colombo South Teaching Hospital from May 2024 to February 2025 using consecutive sampling. Data were collected on postoperative day two using a pre-tested, content-validated, interviewer-administered questionnaire. Awareness was assessed using 32 items on surgical preparation, procedural knowledge, and postoperative expectations. Patient satisfaction was measured using a five-point Likert scale with ten items. Data were analyzed using descriptive statistics and Chi-square tests.
Results: Among participants, 244 (56.7%) were male, and most were aged 50–65 years (36.5%). Mean awareness was 57.62% (SD: 17.77), with 224 (52.1%) demonstrating low awareness. Major awareness gaps included jewelry removal (83.3% unaware), nail polish removal (94.2%), and underwear removal (77.4%). Mean satisfaction was 80.79 (SD: 10.85), with 318 (74%) reporting high satisfaction. Highest satisfaction scores were identified for nocturnal nursing care (mean: 4.25) and nurse–patient communication (mean: 4.21). Awareness was significantly associated with gender, marital status, income, surgery type, illness duration, patient expectations, current health status, healthcare workers in the family, and caregiver availability (p < 0.05). Satisfaction was significantly associated with gender, illness duration, and patient expectations (p < 0.05).
Conclusions: Although most patients reported high satisfaction with preoperative nursing care, important awareness gaps regarding personal preparation procedures remain. Targeted educational interventions, standardized preoperative education protocols, and improved nurse–patient communication are needed to enhance preoperative care quality in Sri Lankan hospitals.