Satisfaction with hospital meal service and associated factors among adult patients admitted to public hospitals in Addis Ababa, Ethiopia, 2024

Satisfaction with hospital meal service and associated factors among adult patients admitted to public hospitals in Addis Ababa, Ethiopia, 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Satisfaction with hospital meal service and associated factors among adult patients admitted to public hospitals in Addis Ababa, Ethiopia, 2024 Mulugeta Taybele, MPH, Chala Getaneh, MPH, Elazar Tadesse,PHD, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6128623/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Background A sound healthcare system is indispensable for fast and better recovery of patients which involves best medication along with adequate and balanced diet. In public hospitals, hospital meal is the source of nutrition for most patients. Despite the critical role of appropriate hospital feeding in the recovery process of hospitalized patients, there is little understanding of satisfaction with food service in regular hospital settings among adult patients admitted to public hospitals. Objective To assess satisfaction levels with hospital meal service and associated factors among adult patients admitted to public hospitals in Addis Ababa, Ethiopia, 2024. Methods An Institution-based cross sectional study was conducted from June to July, 2024. Representative samples of 567 adult patients admitted to public hospitals in Addis Ababa, Ethiopia were included in the survey. Result The overall satisfaction towards hospital meal services was 32.5% (95% CI: [29, 36]). Multivariable logistic regression shows Meal flavour (AOR = 4.65; 95%CI: [2.26-10.97]), meal type (AOR = 2.35; 95%CI:[1.912-4.49]), provision of well cooked meals for easily chewing (AOR=0.483; 95%CI:[0.294-0.792]), meal provider’s behaviour (AOR = 2.20;95%CI:[1.252-3.195]), and nutritional status (AOR = 0.389; 95%CI: [0.271-0.558]) of respondents were identified as influencing factors of patient satisfaction on meal service at hospitals. Regarding nutritional status 343 (60.5%) of admitted patients were well nourished and 224 (39.5%) were malnourished. Conclusion and recommendation This research revealed low patient’s satisfaction with hospital meal service among adult patients admitted at public hospitals so health managers and health care providers need to work on how to maintain the good aspects of hospital meal services. Satisfaction hospital meal service associated factors Figures Figure 1 Figure 2 Figure 3 Introduction 1.1 Background Food intake and the systems that control appetite, satiety, and hunger are complex physiological processes. These processes significantly impact nutritional status, which is determined by food intake, balanced supply of macro - and micro-nutrients, and water intake( 1 ). A good healthcare system is indispensable for fast and better recovery of patients which involves best medication along with adequate and balanced diet. The quality of food served to patients during hospital treatment regulates their physical and mental health( 2 ).The provision of dietary services to patients by hospitals is an important aspect of comprehensive patient care and improves patient health outcomes( 3 ). Comprehensive care includes communication from health professionals, attention to social, spiritual, and psychological needs, but it also has to be tailored to the individual and prioritize those needs( 4 ). Most hospitalized patients often rely on hospital meals and oral nutritional intake as their main sources of sustenance. Therefore, planning hospital meals that may accommodate various dietary needs is essential. This involves considering nutritional needs, medical issues, and personal preferences. When prepared with care, hospital meals are the first line of defense against malnutrition in the hospital, particularly for those patients for whom obtaining their dietary requirements from regular hospital meal is both feasible and safe( 5 ). Consequently, hospital food provision should be flexible enough to cover several requirements. Maintaining the highest standards in raw material selection, cleanliness, and preparation techniques is imperative in order to guarantee patients receive the best possible nutrition. A meal that is both nutritious and aesthetically pleasing is mostly dependent on the quality of the ingredients, with a particular focus on obtaining complete, fresh foods( 6 ). Ensuring patient safety during food preparation necessitates strict adherence to cleanliness protocols. The attention to flavor and presentation is equally important, as these elements are crucial in getting patients to eat their meals voluntarily. To further improve the entire eating experience, it is ideal to acknowledge and include patient preferences into meal planning wherever feasible. This approach is important for promoting health and helping persons during times of sickness, since it acknowledges that food consumption is not only a physiological need but also a key predictor of quality of life and well-being. To maximize patients' entire quality of life, a comprehensive dedication to the highest standards of nutrition, flavor, and presentation is essential( 5 ). Doctors, nurses, medical and nursing students, volunteers, and meal service personnel contribute substantially to the fight against malnutrition. Unfortunately, this priceless instrument is frequently overlooked and misused. However it has a significant potential influence, not only in avoiding many chronic diseases but also in lowering rates of death and morbidity and promoting a more complete recovery. To fully realize the promise of nutrition in improving patient outcomes and general well-being, a multidisciplinary strategy comprising a range of healthcare experts and support personnel is required( 7 ). Inadequate nourishment during hospitalfiguC.T2n is associated with heightened vulnerability to hospital-acquired infections, weakened immunity, postponed wound healing, and prolonged hospital stay. Furthermore, poor nutritional status raises healthcare expenses, which puts a financial strain on individuals and healthcare systems. Poor nutrition during hospital stays can also increase the risk of morbidity and death, underscoring the necessity of monitoring and addressing food needs as a crucial part of total patient care. Not only may nutritional support techniques help recovery, but they can also increase patient well-being and overall healthcare efficiency when included into protocols. Disease related malnutrition (DRM) is a significant problem, affecting 20–60% of hospitalized patients( 5 ). This problem is often exacerbated during hospitalization, as hospital procedures may necessitate fasting or skipping meals( 5 ). Nutrition need differs with age, gender and physiological changes such as illness, pregnancy, trauma, weight gain, changes in blood composition, metabolic changes and adaptive responses. The importance of patient satisfaction with hospital meal cannot be overstated as it directly impacts adherence to prescribed nutritional plans, overall recovery rates, and overall quality of care. As primary health care providers to a diverse population, public hospitals provide a unique context for investigating the dynamics of patient satisfaction with nutrition services( 6 ). Not only is the provision of meal services important, but patient satisfaction with these services is equally important( 3 ). Patient satisfaction has become an important measure in evaluating the quality of healthcare services. Providing delicious meals for patients must be considered an element of hospital treatment that has the potential to promote recovery( 8 ). Methods and Materials Study Area & Period The study was conducted in public hospitals of Addis Ababa, Ethiopia. There are 5 hospitals under Ministry of health, 6 Hospitals under Addis Ababa Health Bureau, 1 Hospital under Ministry of Defense, 1 Hospital under Police Force and more than 40 Private Hospitals. The city also has more than 96 functional governmental health centers and more than 760 private clinics in 11 sub cities. The study was conducted at randomly selected 4 public hospitals in Addis Ababa from June to July, 2024. Figure 2 Map of study area, showing the location of hospitals in Addis Ababa, adapted from Ethiopia Addis Ababa health facility location map, Addis Ababa, Ethiopia, 2024. Study design An institution based cross sectional study was conducted from May 13 to July 4, 2024. Source population All adult patients admitted to public hospital in Addis Ababa, Ethiopia. Study population All adult patients admitted to selected public hospital in Addis Ababa, Ethiopia. Inclusion criteria Adult patients who admitted to each ward three nights before the time of data collection were included. This time frame is believed to allow patients to share their experiences with hospital meals( 8 ). Exclusion criteria Patients who are unable to communicate, or unconscious, and are not receiving food from the hospital throughout their hospital stay, and patients who are admitted to mental wards were excluded from the study. Sample size determination Sample size was determined by using single population proportion formula n = z (a/2) 2 p(1-p)/d 2 by considering the following assumptions: margin of error (d = 0.05), confidence interval of 95%, non-response rate of 10%, and considering the prevalence of satisfaction of adult patients with regular hospital diet as 33.6% taken from similar study conducted in Wolayita zone, Ethiopia( 8 ).i.e. 95% confidence level z = 1.96, margin of error d = 5%, p = 0.336, q = 0.664 N = z 2 .pq/d 2 Sample size (n) = (1.96) 2 × 0.336(1-0.336)/(0.05) 2 = 3.8416 × 0.223104/0.0025 = 342.8 Sample = 343 Then, Adding design effect Add design effect = sample × design effect (1.5) 343 ×1.5 = 514.5 = 515 Then considering 10% non-response rate 515 × 0.1 = 51.5 = 515 + 52 = 567 I.e. the total sample size was = 567 4.5.1. Sample size determination by using factors For factor analysis double population proportion formula was used N = (Z α/2 +Z β ) 2 * (p 1 (1-p 1 ) + p 2 (1-p 2 )) / (p 1 -p 2 ) 2 Table 1 sample size determination by using factors for the study No Factors Assumptions Ratio power CI Proportion of satisfaction with meal service in (%) Non response (10%) Sample size Reference 1 Flavour of meal 1:1 80 95% P1 = 5.7 56 62 ( 31 ) P2 = 94.3 2 Provision of meal for easy chewing 1:1 80 95% P1 = 91.3 2 3 ( 8 ) P2 = 8.7 3 Meal service provider's behavior 1:1 80 95% P1 = 68.1 3 4 ( 8 ) P2 = 31.9 From the above sample size comparing its prevalence and factors sample size calculation the largest sample size which is calculated is 567, calculated from prevalence of satisfaction with hospital meal service. 4.6 Sampling technique Participants in the study were chosen by multistage cluster sampling, from 13 public hospitals in Addis Ababa; 4 public hospitals were assigned by simple random sampling by lottery method. Following departmental clustering, each hospital's computed sample size was distributed using proportion-to-size allocation. A precise sample size was then determined from each selected hospital based on client load after assessing available beds and each selected hospital's quarterly report. The available beds of each selected hospitals is as follows. St. Petro’s specialized hospital is 316, ALERT hospital 513, Yekatit 12 medical college hospital 456, Tikur Anbessa specialized hospital 630( 28 ). Data Collection Tools and Procedure Data was collected using interviewer administered structured questionnaires with questions about demographic characteristics such as age, sex, marital status, residence, educational status, occupation, and income level, diet components, portion size, and other variables for that questionnaire adapted from similar studies in Wolaita& east Malaysia was used. And questionnaires adopted from Subjective Global Assessment Form were used to determine nutritional status of adult patients admitted to public hospital. The questionnaires were prepared originally in English and then translated into the local language Amharic for the purpose of data collection, then translated back to English again for consistency of the variables under question and for analysis purpose. Data collectors For administering the questionnaire three clinical nurses who have data collection experience were recruited to conduct an interview. 1 health officer supervisor was assigned and training on data collection was given for two secessions. And training also given regarding the SGA tool for two secessions. Operational definitions Satisfaction with Hospital meal; the patient's subjective evaluation, of the nutritional value, flavor, and overall experience of the meals served during their hospital stay and a client were regarded as satisfied if scored mean of > 50% and considered as dissatisfied if scored mean of < 50%( 8 ). Nutritional status; Measured using SGA Rating and score and malnutrition criteria were determined based on the results of the SGA scores, which were categorized into three groups: those scored 0–3 (non-malnourished /well nourished), 4–8 (moderate malnutrition), and ≥ 9 (severe malnutrition)( 29 ), then for analysis moderate malnutrition and severe malnutrition were considered as malnourished. Standard hospital meal; nutritionally balanced meal that is served to patients which consists of a protein source, vegetables, carbohydrate, and drinks and is created to satisfy dietary recommendations as well as the needs of general patients. 4.11 Data analysis Data obtained from institution-based survey using Google docs was checked for completeness &inconsistencies, and then coded, entered, cleaned and transferred to Statistical package for Social Sciences (SPSS) version 27. Descriptive statistics, such as mean, standard deviation, and frequencies were primarily used to summarize and describe the dataset and Odds ratio with 95% confidence interval and level of significance p value of 0.05 used to analyze data and to assess the strength of associations for variables in the study. Binomial logistic regression analysis techniques was used to see the crude association between the independent variables and the dependent variable and the strength of association between each independent variable regarding satisfaction with hospital meal expressed in an odds ratio (OR) and P values < 0.05. Binomial logistic regression with p value of < 0.25 was included in multinomial logistic regression to control possible confounders. Multivariable logistic regression analysis was applied to identify significant predictors of satisfaction. Result 5.1 Socio-demography characteristics The study conducted at 4 selected public hospitals in Addis Ababa, Ethiopia from the selected hospitals 567 individuals were participated in this study. Regarding the study participants, 331(58.4%) were males and 236 (41.6%) were females, 334 (58.9%) were married, 22 (3.9%) were divorced. The mean age of the study participants was 39.5 ± 15.2 years with this 192 (33.9%) were 18–30 years & 33 (5.8%) were greater than 65 years old. Regarding religion of respondents 418 (73.7%) orthodox and 10 (1.8%) were catholic religion followers. From those 433 (76.4%) were urban residents, 294 (51.9%) attended higher education, 7(1.2%) read & write only. Regarding the employment status of the participants, 247(43.6%) were government employees, 24 (4.2%) were pensioned and 79 (13.9%) were house wife’s, and 314 (55.4%) of the study participants earn more (Table 2 ) Table 2 Sociodemographic characteristics of admitted adult patients at public hospitals in Addis Ababa, 2024. Characteristics Categories Frequency Percentage Gender Male 331 58.4 Female 236 41.6 Age 18–30 years 192 33.9 31–43 years 183 32.3 44–56 years 115 20.3 57–65 years 44 7.8 > 65 years 33 5.8 Marital status Single 183 32.3 Married 334 58.9 Divorced 22 3.9 Widowed 28 4.9 Residency Urban 433 76.4 Rural 134 23.6 Religion Orthodox 418 73.7 Muslim 78 13.8 Catholic 10 1.8 Protestant 61 10.8 Educational level No school 14 2.5 Read & write 7 1.2 Primary 59 10.4 Secondary 99 17.5 Technical/vocational 94 16.6 Higher 294 51.9 Employment status Government employed 247 43.6 Merchant 129 22.8 House wife 79 13.9 Pensioned 24 4.2 Private employed 88 15.5 Average Monthly income 5500ETB 314 55.4 5.2 Nutritional status of respondents The nutritional status of the respondents were evaluated using SGA tool and their nutritional status was classified as well nourished and malnourished 343 (60.5%) of admitted patients were well nourished and 224 (39.5%) were malnourished (Fig. 2 ). 5.3 Characteristics of meal service of respondents Among the study participants 442(78.0%) had three meals per day for their hospital stay, 6(1.1%) had single meal per day due to different reasons, from all respondents489 (86.2%) states as meal was delivered on time but 59 (10.4%) reported that meal was not delivered timely and majority of meal delay time was 15–30 minutes, 503(88.7) of the participants has another food source other than hospital meal. Only 52 (9.2%)skip meal due to new type of meal/ meal aversion. 5.4 Overall facility experience of respondents The mean hospital stay was 12.95 ± 10.03 days with 285(50.3%) of the respondents stay 8–14 days and 130(22.9%) of them stay in hospital for longer than 14 days. 510 (89.9%) of the participants states that toilets are easily accessible and comfortable whereas 57 (10.1%) says it was not comfortable, 509 (89.9%) of respondents tells hospitals has access to clean water and hand washing facilities, the type of meal which the study participants eat for the majority of their hospital stay was 457 (80.6%) standard meal, 11 (1.9%) pureed diet, and 8 (1.4%) fluid diet,493 (86.9%) of respondents agreed that there is provision of easily chewable meal but 74 (13.6%) disagreed with the provision of chewable meal in hospitals (Table 3 ). Table 3 Overall characteristics of meal service and facility experience of adult admitted patients at public hospitals in Addis Ababa, 2024. Characteristics Categories Frequency Percentage Length of hospital stay 3–7 days 152 26.8 8–14 days 285 50.3 > 14 days 130 22.9 Frequency of daily meal One & Two 60 10.6 Three 442 78.0 >Three 65 11.5 Timeliness of meal delivery No 59 10.4 Yes 489 86.2 Not sure 19 3.4 Delaying time in minutes < 15 minutes 5 8.3 15–30 minutes 46 76.7 30–45 minutes 9 15.0 Food source other than hospital meal Yes 503 88.7 No 64 11.3 Skipping meal due to new type Yes 52 9.2 No 515 90.8 Hospital`s toilet easily accessible & comfortable Yes 510 89.9 No 57 10.1 Hospital`s access to clean water & hand washing facility Yes 509 89.8 No 58 10.2 Type/sort of meal have you been for the majority of your hospital stay for this time standard meal 457 80.6 diabetic menu 20 3.5 high protein/ high energy menu 36 6.3 restricted diet for medical reasons 14 2.5 minced or pureed diet 11 1.9 HTN 21 3.7 fluid diets 8 1.4 Provision of easily chewable meal Yes 493 86.9 No 74 13.1 5.5 Patient`s Satisfaction level with hospital meal services Patients were asked for their degree of agreement on meal services items and level of satisfaction. They were assigned either as satisfied or not satisfied based on the mean score. The overall satisfaction towards hospital meal services among the 567 study participants was 32.5% (95% CI: [29, 36]). Regarding the items assessing satisfaction level most of patients disagreed on flavor of meal (94.4%), taste of meal (92.5%), flexibility of beds (92.1%), temperature of cold drinks (91.4%), amount of meal (84.5%), rooms privacy to eat (76.9%), room cleanness (73.5%), the way vegetables cooked (71.6%), meal providers behavior (71.1%), variety of foods (70.7%), cleanness of meal providers (66.8%), temperature of hot drinks (64.1%), and cleanness of cups & plates to eat (58.4%). However, patients agreed on time of meal delivery (86.2%), provision of well cooked meal for easily chewing (86.9%), availability of clean water and hand washing facility (89.8%), toilet`s easily accessibility & comfortableness (89.9%) (Fig. 3 ). 5.6 Factors associated with the patient’s satisfaction level During the binomial logistic regression analysis variables like education level, age, religion, daily meal frequency (three meals a day), availability of food source other than hospital meal, type/sort of meal used in the hospital, nutritional status, provision of easily chewable food, flavour of meal, and behavior of meal providers were significantly associated with patient satisfaction towards hospital meal services. However, residences, sex, monthly income, marital status, and occupation, were not associated. In Multivariable logistic regression analysis, meal flavour, nutritional status, type/sort of meal used in the hospital, provision of easily chewable food and behavior of meal providers were statistically significant whereas religion, level of education, age, food source other than hospital meal, daily meal frequency (three meals a day), were not statistically significant with satisfaction towards hospital meal service (Table 4 ). Table 4 Binomial and multivariate logistic regression of patient satisfaction with hospital meal service among adult patients admitted to public hospitals in Addis Ababa, 2024. Variables Satisfaction in (%) COR (95%CI) AOR (95%CI) Satisfied Dissatisfied Meal flavour Good 48(64.0%) 27(36.0%) 4.65(2.26–10.97) 4.65(2.26–10.97) Not good 136(27.6%) 356(72.4%) 1 1 Meal type Standard 331(72.4%) 126(27.6%) 1.210(1.072–1.365) 2.35(1.912–4.490) Other meals (cardiac, HTN, fluid meals) 58(52.7%) 52(47.3%) 1 1 Well cooked meals for easily chewing Yes 149(30.2%) 344(69.8%) 0.483(0.294–0.792) 0.483(0.294–0.792) No 35(47.3%) 39(52.7%) 1 1 Meal providers behavior Good 96(43.2%) 126(56.8%) 1.517(1.290–1.786) 2.20(1.252–3.195) Bad 88(25.5%) 257(74.5%) 1 1 Nutritional status Well nourished 83(24.2%) 260(75.8%) 1 1 Malnourished 101(45.1%) 123(54.9%) 0.389(0.271–0.558) 0.389(0.271–0.558) N.B Statistically significant in multivariable logistic regression (AOR) at p < 0.05 Participants who states that the meals flavour as good were 4.65 times more satisfied than those who perceived meal flavour as not good (AOR = 4.65, 95%CI:[2.26, 10.97]). Participants who receive meal from providers with good behavior were 2 times more satisfied than those who get their meal from providers with poor behavior (AOR = 2.2, 95%CI:[1.25,3.20]). Participants who use standard meals in their hospital stay were 2.35 times more satisfied than those who use other meals (cardiac, HTN, fluid meals) (AOR = 2.35, 95%CI:[1.91,4.49]). Study participants who claimed the provision of meal for easily chewing are more satisfied than those who didn`t (AOR = 0.483, 95%CI: [0.294–0.792]). Participants whose nutritional status was well nourished are less satisfied than those of malnourished (AOR = 0.389, 95%CI: [0.271–0.558]. Discussion This study evaluates patients’ satisfaction and potential factors regarding hospital meal service in Addis Ababa, Ethiopia. The result showed that 32.5% (95% CI: [29, 36]) of patients satisfied with overall hospital meal service provision. This result was lower than findings of studies conducted in other countries like 80% in Swedish study using the Acute Care Hospital Foodservice, 67.3% in Lusaka province, Zambia, 60.8% Mashhad University of Medical Sciences, Iran, 53.3% in East Malaysia, but it is similar with the previous study conducted in Wolaita zone, Ethiopia which shows 33.6% (95%CI: [29.1, 38.3]) [( 24 )( 21 )( 27 )( 19 )( 8 )]. This result shows patient’s satisfaction with hospital meal service is low in Ethiopia and possible explanations for the discrepancy between our country and those countries might be due to differences in socio-economical, cultural, and infrastructure aspects. According to the study findings, socio-demographic variables like age, gender, religion, marital status, educational level, monthly income, length of hospital stay and residency had no impact on the patients' general level of satisfaction. Regarding age, gender, education level, length of hospital stay similar studies also showed as they were insignificant variables with overall meal service satisfaction [( 3 )( 8 )].However, the results for residency and monthly income are in contrast of previous study ( 8 ), which revealed that patients from rural areas and those receiving 500 Ethiopian Birr or less per month were more likely to be satisfied with hospital meal service than patients from urban areas and patients receiving more than 500 Ethiopian Birr, respectively. Patients in hospitals have reported varying experiences with different components of meal services. Accordingly 94.4% of patients disagreed on flavor of meal, 92.5% with taste of meal, and 92.1% about flexibility of beds whereas 86.2% agreed on timeliness of meal, 86.9% with provision of easily chewable meal, 71.1% with meal providers’ behavior. Previous researches’ that was done provided support for these results [( 30 )( 19 )( 21 )( 8 )]. This might be explained by the fact that patient satisfaction was being influenced by many hospital meal service dimensions and characteristics and this suggests that in order toaddress the contributing elements, interventions must be done while taking into account every dimension and aspects of meal service. In relation to the predictive variables, patients who thought the hospital meal flavour as nice were more likely to be satisfied than those who thought it didn't. These result is in accordance with earlier studies and it was also suggested that improving the flavour of hospital meals with different enhancers is important to meet expectation of patients towards the meal services [( 31 )( 8 )( 22 )( 24 )]. The current as well as previous studies suggested that in order toimprove patient satisfaction with meal, hospitals could incorporate more flavor into their meals using fresh products. Furthermore, eating tasty food made correctly may make you feel better psychologically and raise the value of the meal, which supports the link between participant satisfaction and meal flavor that has been shown. Participants who receive meal from providers with good behavior (friendly & polite) were more satisfied than those who get their meal from providers with poor behavior. This result is in line with previous studies [( 19 )( 21 )( 22 )( 8 )( 24 )( 31 )]. This could be due to friendly and polite approach of providers can make participants feel valued and respected, leading to a greater sense of comfort and appreciation for the service. This emotional and psychological boost can elevate the perceived quality of the meal and the service, resulting in higher satisfaction compared to those who experience poor behavior from providers. Participants who use standard meals in their hospital stay were more satisfied than those who use other meals (cardiac, HTN, fluid meals), this result is similar with a study in Hospitals of Lahore, Pakistan which shows the patients who were consuming standard diabetic or cardiac menu were not satisfied with foodservice as compared to the patients who were on restricted or textured modified diet ( 3 ) but it is in contrast with study about Food Services in the Teaching Hospitals of Tabriz, Iran which shows food type (special hospital diet or regular) did not significantly influence overall satisfaction with hospital meals and meal services, which found no correlation between food type and meal satisfaction( 22 ). The possible reason for this might be due to the low salt and low fat containing meal that is provided for hypertension and cardiac patients. Study participants who claimed the provision of meal for easily chewing are more satisfied than those who didn`t this result is in accordance with previous studies [( 8 )( 32 )]. A plausible interpretation for this finding might be that having meal that is well-cooked enhances the dining experience, hence elevating the degree of pleasure with the meal served. The current study showed that from all (567) study participants 224 (30.5%) was well nourished this result is in line with a study by Ogada Irene Mount Saint Vincent University, Department of Applied Human Nutrition, which shows 35.4% well nourished status ( 33 ) and participants whose nutritional status was well nourished are less satisfied than those of malnourished but further studies to assess the association between nutritional status and satisfaction with hospital meal service is required. Strength and limitation of the study The study offers up-to-date reflections on patient satisfaction and the factors influencing it at the center. This study may have been limited by its exclusive focus on overall patient satisfaction as perceived by the patients themselves. It did not evaluate the organizational viewpoints, such as the abilities of the team that distributes meals, the cooks, or the medical specialists. The data collectors of this study were partially selected from the study hospitals and this may lead to social desirability bias. Conclusion The findings of this research revealed low patient’s satisfaction with hospital meal service among adult patients admitted at public hospitals. In this study, a significant proportion of participants were agreed on time of meal delivery, provision of well cooked meal for easily chewing, and availability of clean water and hand washing facility while the majority of them had reported unacceptable experiences on aspect of meal flavor & taste, flexibility of beds, and temperature of cold drinks. Meal flavour, meal type, provision of well cooked meals for easily chewing, meal providers behaviour, nutritional status of respondents were identified as statistically associated factors with patient satisfaction on meal service at hospitals. The results also insight the interventions need to be made to address the influencing factors considering each meal service aspects and dimensions. Recommendation Health managers and health care providers need to work with nutritionists and specialized dieticians should work together to develop meals that take patients' medical circumstances and nutritional needs into account while maintaining a balance of vital nutrients. Abbreviations AAPHREM Addis Ababa public health research & emergency management ACHFPSQ The Acute Care Hospital Foodservice Patient Satisfaction questioners ALERT All Africa Leprosy Rehabilitation and Training Center DRM Disease related malnutrition MUAC Mid Upper Arm Circumference SGAF Subjective Global Assessment Form SPSS Statistical package for Social Sciences TASH Tikur Anbessa Specialized hospital Declarations Ethical approval and consent to participate ; the ethical clearance was obtained from Institutional Review Board of menlik II Medical and Health Sciences college and official letters was submitted to each respective health facility.After explaining the objectives of the study, informed written consent was obtained from all mothers and caregivers, and anonymity and confidentiality of the data were kept. Respondents have the right not to participate or withdraw from the study at any stage, and all study methods were performed in accordance with the Declaration of Helsinki. Consent for publication ; Not applicable. Availability of data and materials; The data used to support the findings of this study are available from the corresponding author upon request Competing interests; The authors declare that they have no conflicts of interest Funding ; Not applicable. Author contributions; Version 2: This paper is the original work of me(Mulugeta Taybele), main author & current corresponding Author. previously one of the Co authors was trying to proceed for publication process eventhough his contribution was significant for our work he doesn't know the details of this research work as a result he missed, one of the co author, main supervisor of the research(Elazar Tadesse,Phd) and had also multiple spelling error as well as email address was missed in the previous version of preprint and also due to personal reasons and work overload the corresponding author is changed. C.G; Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Visualization, Writing – original draft M.T; Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Visualization, Writing – original draft O.k; Conceptualization, Formal analysis, Methodology, Resources, Software, Visualization, Writing and original draft J.K,Conceptualization, Formal analysis, Methodology, Software, Supervision, Writing, review & editing G. B; Conceptualization, Formal analysis, Methodology, Software, Supervision, Writing, review & editing A.N; Conceptualization, Formal analysis, Methodology, Software, Supervision, Writing, review & editing Acknowledgements ; The authors would like to express their gratitude to respective health facility, data collectors, supervisors and study participants for their diligence and dedication in the collecting and inputting high quality data used in the study. References Ismail NH, Masman AH, Kamarul Zaman M, Putriana D (2023) Nutritional Status and Factors affecting Food Intake among Hospitalised Patients in Hospital Al-Sultan Abdullah. Environ Proc J [Internet]. ;8(24):229–35. Available from: http://dx.doi.org/10.21834/ebpj.v8i24.4674 Arora M, Thakur S, Gupta R (2022) Assessment of patients’ satisfaction through dietary services in government and private hospitals in India. 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J Environ Public Health. ;2020 Belay Bizuneh Y, Fitiwi Lema G, Yilkal Fentie D, Woldegerima Berhe Y, Enyew Ashagrie H (2020) Assessment of Patient’s Satisfaction and Associated Factors regarding Postoperative Pain Management at the University of Gondar Compressive Specialized Hospital, Northwest Ethiopia. Pain Res Manag. ;2020 Glegziabher R, Biks GA, Dellie E, Worku N, Endalew B (2022) Patient-Centered Care and Associated Factors among Adult Admitted Patients in South Wollo Public Hospitals, Northeast Ethiopia. Patient Prefer Adherence 16:333–342 Weldearegay ZW, Yehualahet SS, Sinkie SO, Debela TF (2020) Patient satisfaction and associated factors among in-patients in primary hospitals of north shoa zone, amhara regional state, Ethiopia. Int J Public Heal Sci 9(2):76–81 Kibru EA, Mogessie YG, Regassa AA, Hailu KT (2023) Patient satisfaction with post-operative surgical services and associated factors at Addis Ababa City government tertiary hospitals’ surgical ward, cross-sectional study, 2022. Pan Afr Med J. ;45 Aga TB, Ferede YM, Mekonen EG (2021) Satisfaction and associated factors towards inpatient health care services among adult patients at Pawie General Hospital, West Ethiopia. PLoS One [Internet]. ;16(4 April):1–11. Available from: http://dx.doi.org/10.1371/journal.pone.0249168 Sabo KG, Mare KU, Berhe H, Berhe H (2023) Factors Affecting Satisfaction With Inpatient Services Among Adult Patients Admitted to Arba Minch General Hospital, Southern Ethiopia: A Mixed Method Study. Heal Serv Insights. ;16 Abdissa G, Asegidew A, Bekele S (2023) Assessment of Postoperative Patient Satisfaction towards Services Provision in Zewditu Memorial Hospital Addis Ababa Ethiopia. A Cross-Sectional Study. General Surgery and Clinical Medicine [revista en Internet] 2023 [acceso 20 de mayo de 2023]; 1(1): 1–4. Gen Surg Clin Med [Internet]. ;1(1). Available from: https://www.opastpublishers.com/peer-review/assessment-of-postoperative-patient-satisfaction-towards-services-provision-in-zewditu-memorial-hospital-addis-ababa-eth-5121.html Rajkumari B, Nula P (2017) Patient’s satisfaction with care in a government health facility in North East India: A cross-sectional study. JMS - J Med Soc 31(2):94–98 Aminuddin NF, Kumari Vijayakumaran R, Abdul Razak S (2018) Patient Satisfaction With Hospital Food service and its Impact on Plate Waste in Public Hospitals in East Malaysia. Hosp Pract Res 3(3):90–97 Osman NS, Nor NM, Sharif MSM, Hamid SBA, Rahamat S (2021) Hospital food service strategies to improve food intakes among inpatients: A systematic review. Nutrients 13(10):1–26 Miyoba N, Ogada I (2019) Diet satisfaction and associated factors among adult surgical orthopaedic inpatients at a teaching hospital in Lusaka province, Zambia; A hospital-based cross-sectional study. BMC Nutr 5(1):1–7 Rasouli A, Ebrahimi V, Hamedi Behtash H, Panjeshahin A, Kazemi M, Tarighat-Esfanjani A (2021) Comparison of Patient Satisfaction with Self-operating Food Services and Food Service Contractors in the Teaching Hospitals of Tabriz, Iran. J Human, Environ Heal Promot. ;7(1):54–9 Çelik Z, Başoğlu İ, Yiğit A, Güneş F (2019) Evaluation of the Level of Food Consumption and Satisfaction with Hospital Food Services in Elderly Inpatients. J Geriatr Sci 2(3):78–85 Rapo S, Mattson Sydner Y, Kautto E, Hörnell A (2021) Exploring patient satisfaction with hospital foodservice: A Swedish study using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire. Nutr Diet 78(5):487–495 Saus C, Sucheran R (2021) Patient satisfaction with foodservice in private hospitals in South Africa. J Crit Rev 8(02):302–311 MacKenzie-Shalders K, Maunder K, So D, Norris R, McCray S (2020) Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, plate waste and costs: A systematic literature review. Nutr Diet 77(1):103–111 Safarian M, Alinezhad-Nameghi M, Vafisani F, Asadi Z, Sh S (2018) Patient satisfaction with hospital food in the hospitals affiliated to Mashhad University of Medical Sciences. Iran J Nutr Fasting Heal 6(4):191–197 Firissa YB, Sultan M, Abdelwahab M, Kifle Belachew F (2023) Disaster response readiness assessment of public hospitals in Addis Ababa City, Addis Ababa, Ethiopia. African J Emerg Med [Internet]. ;13(3):210–6. Available from: https://doi.org/10.1016/j.afjem.2023.06.004 Duerksen DR, Laporte M (2020) Evaluation of Nutrition Status Using the Subjective Global Assessment: Malnutrition, Cachexia, and Sarcopenia. ;0(0) Saus C, FOODSERVICE SATISFACTION LEVELS AMONG PATIENTS IN PRIVATE HOSPITALS IN KWAZULU-NATAL Master of Management Sciences Specialising in Hospitality and Tourism. 2020;(November) Biosci IJ, Abdalgadir M, Abuagla A (2024) Evaluating patient satisfaction with food services provided in Khartoum teaching hospitals. Int J Biosci 6655:32–39 Trinca V (2020) Putting Quality Food on the Tray: Assessing Patients’ Expectations and Experiences of Meals Served in Sixteen Ontario Hospital. Univ Waterloo Irene O, Murambiwa N Nutritional Status and Associated Factors among Hospitalised Zambian Adult Patients Receiving Hospital Prepared Total Nasogastric Tube Feeds Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6128623","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":423849066,"identity":"1e8d7a56-51a7-4934-9dcb-a53d004cfbe3","order_by":0,"name":"Mulugeta Taybele, 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Hospital","correspondingAuthor":false,"prefix":"","firstName":"Gedfaw","middleName":"","lastName":"birhan","suffix":""}],"badges":[],"createdAt":"2025-02-28 12:29:30","currentVersionCode":2,"declarations":{"humanSubjects":false,"vertebrateSubjects":true,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":true},"doi":"10.21203/rs.3.rs-6128623/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-6128623/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":81988003,"identity":"a78b5325-de85-4afe-9360-e661911a3ea1","added_by":"auto","created_at":"2025-05-05 16:07:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":30775,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic approach for sampling procedure and proportional allocation of samples for data collection in study participants (n = 567) for the study satisfaction with regular hospital meal service and associated factors among adult patients admitted to public hospitals, Addis Ababa, Ethiopia, 2024(28).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6128623/v2/f9972449f6d5ea0334fd5b9e.png"},{"id":81988006,"identity":"a9561ae6-acb8-431c-b371-fd768ba3f571","added_by":"auto","created_at":"2025-05-05 16:07:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":24550,"visible":true,"origin":"","legend":"\u003cp\u003eNutritional status of adult patients admitted at public hospitals in Addis Ababa, Ethiopia, 2024.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6128623/v2/f4f1d7d80d8f2435d8c77af3.png"},{"id":81988016,"identity":"7b6c7a11-4dd9-4e16-8bb9-56c9ccb67478","added_by":"auto","created_at":"2025-05-05 16:07:23","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":66034,"visible":true,"origin":"","legend":"\u003cp\u003ePatient`s Satisfaction level with regular hospital meal services of admitted adult patients at public hospitals in Addis Ababa, 2024.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6128623/v2/c1e804433d38b98e4d3b92af.png"},{"id":81989280,"identity":"0c7023b8-a467-4a3b-81cb-23c553d3df02","added_by":"auto","created_at":"2025-05-05 16:15:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1229420,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6128623/v2/514a0297-9d0d-456e-9012-19601424beed.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"Satisfaction with hospital meal service and associated factors among adult patients admitted to public hospitals in Addis Ababa, Ethiopia, 2024","fulltext":[{"header":"Introduction","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Background\u003c/h2\u003e \u003cp\u003eFood intake and the systems that control appetite, satiety, and hunger are complex physiological processes. These processes significantly impact nutritional status, which is determined by food intake, balanced supply of macro\u003cb\u003e-\u003c/b\u003e and micro-nutrients, and water intake(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA good healthcare system is indispensable for fast and better recovery of patients which involves best medication along with adequate and balanced diet. The quality of food served to patients during hospital treatment regulates their physical and mental health(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).The provision of dietary services to patients by hospitals is an important aspect of comprehensive patient care and improves patient health outcomes(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Comprehensive care includes communication from health professionals, attention to social, spiritual, and psychological needs, but it also has to be tailored to the individual and prioritize those needs(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMost hospitalized patients often rely on hospital meals and oral nutritional intake as their main sources of sustenance. Therefore, planning hospital meals that may accommodate various dietary needs is essential. This involves considering nutritional needs, medical issues, and personal preferences. When prepared with care, hospital meals are the first line of defense against malnutrition in the hospital, particularly for those patients for whom obtaining their dietary requirements from regular hospital meal is both feasible and safe(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Consequently, hospital food provision should be flexible enough to cover several requirements. Maintaining the highest standards in raw material selection, cleanliness, and preparation techniques is imperative in order to guarantee patients receive the best possible nutrition. A meal that is both nutritious and aesthetically pleasing is mostly dependent on the quality of the ingredients, with a particular focus on obtaining complete, fresh foods(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Ensuring patient safety during food preparation necessitates strict adherence to cleanliness protocols. The attention to flavor and presentation is equally important, as these elements are crucial in getting patients to eat their meals voluntarily. To further improve the entire eating experience, it is ideal to acknowledge and include patient preferences into meal planning wherever feasible. This approach is important for promoting health and helping persons during times of sickness, since it acknowledges that food consumption is not only a physiological need but also a key predictor of quality of life and well-being. To maximize patients' entire quality of life, a comprehensive dedication to the highest standards of nutrition, flavor, and presentation is essential(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDoctors, nurses, medical and nursing students, volunteers, and meal service personnel contribute substantially to the fight against malnutrition. Unfortunately, this priceless instrument is frequently overlooked and misused. However it has a significant potential influence, not only in avoiding many chronic diseases but also in lowering rates of death and morbidity and promoting a more complete recovery. To fully realize the promise of nutrition in improving patient outcomes and general well-being, a multidisciplinary strategy comprising a range of healthcare experts and support personnel is required(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInadequate nourishment during hospitalfiguC.T2n is associated with heightened vulnerability to hospital-acquired infections, weakened immunity, postponed wound healing, and prolonged hospital stay. Furthermore, poor nutritional status raises healthcare expenses, which puts a financial strain on individuals and healthcare systems. Poor nutrition during hospital stays can also increase the risk of morbidity and death, underscoring the necessity of monitoring and addressing food needs as a crucial part of total patient care. Not only may nutritional support techniques help recovery, but they can also increase patient well-being and overall healthcare efficiency when included into protocols. Disease related malnutrition (DRM) is a significant problem, affecting 20\u0026ndash;60% of hospitalized patients(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). This problem is often exacerbated during hospitalization, as hospital procedures may necessitate fasting or skipping meals(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNutrition need differs with age, gender and physiological changes such as illness, pregnancy, trauma, weight gain, changes in blood composition, metabolic changes and adaptive responses. The importance of patient satisfaction with hospital meal cannot be overstated as it directly impacts adherence to prescribed nutritional plans, overall recovery rates, and overall quality of care. As primary health care providers to a diverse population, public hospitals provide a unique context for investigating the dynamics of patient satisfaction with nutrition services(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNot only is the provision of meal services important, but patient satisfaction with these services is equally important(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Patient satisfaction has become an important measure in evaluating the quality of healthcare services. Providing delicious meals for patients must be considered an element of hospital treatment that has the potential to promote recovery(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e "},{"header":"Methods and Materials","content":"\u003cp\u003e \u003cb\u003eStudy Area \u0026amp; Period\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe study was conducted in public hospitals of Addis Ababa, Ethiopia. There are 5 hospitals under Ministry of health, 6 Hospitals under Addis Ababa Health Bureau, 1 Hospital under Ministry of Defense, 1 Hospital under Police Force and more than 40 Private Hospitals. The city also has more than 96 functional governmental health centers and more than 760 private clinics in 11 sub cities. The study was conducted at randomly selected 4 public hospitals in Addis Ababa from June to July, 2024.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e Map of study area, showing the location of hospitals in Addis Ababa, adapted from Ethiopia Addis Ababa health facility location map, Addis Ababa, Ethiopia, 2024.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy design\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAn institution based cross sectional study was conducted from May 13 to July 4, 2024.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSource population\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAll adult patients admitted to public hospital in Addis Ababa, Ethiopia.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy population\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAll adult patients admitted to selected public hospital in Addis Ababa, Ethiopia.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInclusion criteria\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAdult patients who admitted to each ward three nights before the time of data collection were included. This time frame is believed to allow patients to share their experiences with hospital meals(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eExclusion criteria\u003c/b\u003e \u003c/p\u003e \u003cp\u003ePatients who are unable to communicate, or unconscious, and are not receiving food from the hospital throughout their hospital stay, and patients who are admitted to mental wards were excluded from the study.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSample size determination\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSample size was determined by using single population proportion formula n\u0026thinsp;=\u0026thinsp;z (a/2)\u003csup\u003e2\u003c/sup\u003ep(1-p)/d\u003csup\u003e2\u003c/sup\u003e by considering the following assumptions: margin of error (d\u0026thinsp;=\u0026thinsp;0.05), confidence interval of 95%, non-response rate of 10%, and considering the prevalence of satisfaction of adult patients with regular hospital diet as 33.6% taken from similar study conducted in Wolayita zone, Ethiopia(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).i.e. 95% confidence level z\u0026thinsp;=\u0026thinsp;1.96, margin of error d\u0026thinsp;=\u0026thinsp;5%, p\u0026thinsp;=\u0026thinsp;0.336, q\u0026thinsp;=\u0026thinsp;0.664\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;z\u003csup\u003e2\u003c/sup\u003e.pq/d\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eSample size (n) = (1.96)\u003csup\u003e2\u003c/sup\u003e \u0026times; 0.336(1-0.336)/(0.05)\u003csup\u003e2\u003c/sup\u003e= 3.8416 \u0026times; 0.223104/0.0025\u0026thinsp;=\u0026thinsp;342.8\u003c/p\u003e \u003cp\u003eSample\u0026thinsp;=\u0026thinsp;343\u003c/p\u003e \u003cp\u003eThen, Adding design effect\u003c/p\u003e \u003cp\u003eAdd design effect\u0026thinsp;=\u0026thinsp;sample \u0026times; design effect (1.5)\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e343 ×1.5 = 514.5 = 515\u003c/h3\u003e\n\u003cp\u003eThen considering 10% non-response rate 515 \u0026times; 0.1\u0026thinsp;=\u0026thinsp;51.5\u003c/p\u003e \u003cp\u003e=\u0026thinsp;515\u0026thinsp;+\u0026thinsp;52\u0026thinsp;=\u0026thinsp;567\u003c/p\u003e \u003cp\u003eI.e. the total sample size was =\u0026thinsp;567\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e4.5.1. Sample size determination by using factors\u003c/h2\u003e \u003cp\u003eFor factor analysis double population proportion formula was used\u003c/p\u003e \u003cp\u003eN = (Z\u003csub\u003eα/2\u003c/sub\u003e+Z\u003csub\u003eβ\u003c/sub\u003e)\u003csup\u003e2\u003c/sup\u003e * (p\u003csub\u003e1\u003c/sub\u003e(1-p\u003csub\u003e1\u003c/sub\u003e)\u0026thinsp;+\u0026thinsp;p\u003csub\u003e2\u003c/sub\u003e(1-p\u003csub\u003e2\u003c/sub\u003e)) / (p\u003csub\u003e1\u003c/sub\u003e-p\u003csub\u003e2\u003c/sub\u003e)\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003esample size determination by using factors for the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFactors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c9\" namest=\"c3\"\u003e \u003cp\u003eAssumptions\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRatio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003epower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eProportion of satisfaction with meal service in (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNon response (10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSample size\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFlavour of meal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1:1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e95%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;94.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProvision of meal for easy chewing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1:1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e95%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;91.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;8.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMeal service provider's behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1:1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e95%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;68.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;31.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFrom the above sample size comparing its prevalence and factors sample size calculation the largest sample size which is calculated is 567, calculated from prevalence of satisfaction with hospital meal service.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e4.6 Sampling technique\u003c/h2\u003e \u003cp\u003eParticipants in the study were chosen by multistage cluster sampling, from 13 public hospitals in Addis Ababa; 4 public hospitals were assigned by simple random sampling by lottery method. Following departmental clustering, each hospital's computed sample size was distributed using proportion-to-size allocation. A precise sample size was then determined from each selected hospital based on client load after assessing available beds and each selected hospital's quarterly report. The available beds of each selected hospitals is as follows. St. Petro\u0026rsquo;s specialized hospital is 316, ALERT hospital 513, Yekatit 12 medical college hospital 456, Tikur Anbessa specialized hospital 630(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eData Collection Tools and Procedure\u003c/b\u003e \u003c/p\u003e \u003cp\u003eData was collected using interviewer administered structured questionnaires with questions about demographic characteristics such as age, sex, marital status, residence, educational status, occupation, and income level, diet components, portion size, and other variables for that questionnaire adapted from similar studies in Wolaita\u0026amp; east Malaysia was used. And questionnaires adopted from Subjective Global Assessment Form were used to determine nutritional status of adult patients admitted to public hospital.\u003c/p\u003e \u003cp\u003eThe questionnaires were prepared originally in English and then translated into the local language Amharic for the purpose of data collection, then translated back to English again for consistency of the variables under question and for analysis purpose.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eData collectors\u003c/strong\u003e \u003cp\u003eFor administering the questionnaire three clinical nurses who have data collection experience were recruited to conduct an interview. 1 health officer supervisor was assigned and training on data collection was given for two secessions. And training also given regarding the SGA tool for two secessions.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eOperational definitions\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSatisfaction with Hospital meal; the patient's subjective evaluation, of the nutritional value, flavor, and overall experience of the meals served during their hospital stay and a client were regarded as satisfied if scored mean of \u0026gt;\u0026thinsp;50% and considered as dissatisfied if scored mean of \u0026lt;\u0026thinsp;50%(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNutritional status; Measured using SGA Rating and score and malnutrition criteria were determined based on the results of the SGA scores, which were categorized into three groups: those scored 0\u0026ndash;3 (non-malnourished /well nourished), 4\u0026ndash;8 (moderate malnutrition), and \u0026ge;\u0026thinsp;9 (severe malnutrition)(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), then for analysis moderate malnutrition and severe malnutrition were considered as malnourished.\u003c/p\u003e \u003cp\u003eStandard hospital meal; nutritionally balanced meal that is served to patients which consists of a protein source, vegetables, carbohydrate, and drinks and is created to satisfy dietary recommendations as well as the needs of general patients.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e4.11 Data analysis\u003c/h2\u003e \u003cp\u003eData obtained from institution-based survey using Google docs was checked for completeness \u0026amp;inconsistencies, and then coded, entered, cleaned and transferred to Statistical package for Social Sciences (SPSS) version 27. Descriptive statistics, such as mean, standard deviation, and frequencies were primarily used to summarize and describe the dataset and Odds ratio with 95% confidence interval and level of significance p value of 0.05 used to analyze data and to assess the strength of associations for variables in the study.\u003c/p\u003e \u003cp\u003eBinomial logistic regression analysis techniques was used to see the crude association between the independent variables and the dependent variable and the strength of association between each independent variable regarding satisfaction with hospital meal expressed in an odds ratio (OR) and P values\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Binomial logistic regression with p value of \u0026lt;\u0026thinsp;0.25 was included in multinomial logistic regression to control possible confounders. Multivariable logistic regression analysis was applied to identify significant predictors of satisfaction.\u003c/p\u003e \u003c/div\u003e"},{"header":"Result","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e5.1 Socio-demography characteristics\u003c/h2\u003e \u003cp\u003e The study conducted at 4 selected public hospitals in Addis Ababa, Ethiopia from the selected hospitals 567 individuals were participated in this study. Regarding the study participants, 331(58.4%) were males and 236 (41.6%) were females, 334 (58.9%) were married, 22 (3.9%) were divorced. The mean age of the study participants was 39.5\u0026thinsp;\u0026plusmn;\u0026thinsp;15.2 years with this 192 (33.9%) were 18\u0026ndash;30 years \u0026amp; 33 (5.8%) were greater than 65 years old. Regarding religion of respondents 418 (73.7%) orthodox and 10 (1.8%) were catholic religion followers. From those 433 (76.4%) were urban residents, 294 (51.9%) attended higher education, 7(1.2%) read \u0026amp; write only. Regarding the employment status of the participants, 247(43.6%) were government employees, 24 (4.2%) were pensioned and 79 (13.9%) were house wife\u0026rsquo;s, and 314 (55.4%) of the study participants earn more (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of admitted adult patients at public hospitals in Addis Ababa, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e236\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;43 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44\u0026ndash;56 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u0026ndash;65 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;65 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResidency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e433\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e418\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRead \u0026amp; write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTechnical/vocational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eEmployment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernment employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHouse wife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePensioned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAverage Monthly income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1000ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1001\u0026ndash;2000ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2001\u0026ndash;5500ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5500ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e314\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e55.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Nutritional status of respondents\u003c/h2\u003e \u003cp\u003eThe nutritional status of the respondents were evaluated using SGA tool and their nutritional status was classified as well nourished and malnourished 343 (60.5%) of admitted patients were well nourished and 224 (39.5%) were malnourished (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e5.3 Characteristics of meal service of respondents\u003c/h2\u003e \u003cp\u003eAmong the study participants 442(78.0%) had three meals per day for their hospital stay, 6(1.1%) had single meal per day due to different reasons, from all respondents489 (86.2%) states as meal was delivered on time but 59 (10.4%) reported that meal was not delivered timely and majority of meal delay time was 15\u0026ndash;30 minutes, 503(88.7) of the participants has another food source other than hospital meal. Only 52 (9.2%)skip meal due to new type of meal/ meal aversion.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e5.4 Overall facility experience of respondents\u003c/h2\u003e \u003cp\u003eThe mean hospital stay was 12.95\u0026thinsp;\u0026plusmn;\u0026thinsp;10.03 days with 285(50.3%) of the respondents stay 8\u0026ndash;14 days and 130(22.9%) of them stay in hospital for longer than 14 days. 510 (89.9%) of the participants states that toilets are easily accessible and comfortable whereas 57 (10.1%) says it was not comfortable, 509 (89.9%) of respondents tells hospitals has access to clean water and hand washing facilities, the type of meal which the study participants eat for the majority of their hospital stay was 457 (80.6%) standard meal, 11 (1.9%) pureed diet, and 8 (1.4%) fluid diet,493 (86.9%) of respondents agreed that there is provision of easily chewable meal but 74 (13.6%) disagreed with the provision of chewable meal in hospitals (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOverall characteristics of meal service and facility experience of adult admitted patients at public hospitals in Addis Ababa, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eLength of hospital stay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;7 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u0026ndash;14 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;14 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFrequency of daily meal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOne \u0026amp; Two\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e442\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;Three\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTimeliness of meal delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e489\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDelaying time in minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;15 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;30 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;45 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFood source other than hospital meal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSkipping meal due to new type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e90.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHospital`s toilet easily accessible \u0026amp; comfortable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e510\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHospital`s access to clean water \u0026amp; hand washing facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e509\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eType/sort of meal have you been for the majority of your hospital stay for this time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003estandard meal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e457\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ediabetic menu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehigh protein/ high energy menu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erestricted diet for medical reasons\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eminced or pureed diet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHTN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efluid diets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProvision of easily chewable meal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e493\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e5.5 Patient`s Satisfaction level with hospital meal services\u003c/h2\u003e \u003cp\u003e Patients were asked for their degree of agreement on meal services items and level of satisfaction. They were assigned either as satisfied or not satisfied based on the mean score. The overall satisfaction towards hospital meal services among the 567 study participants was 32.5% (95% CI: [29, 36]). Regarding the items assessing satisfaction level most of patients disagreed on flavor of meal (94.4%), taste of meal (92.5%), flexibility of beds (92.1%), temperature of cold drinks (91.4%), amount of meal (84.5%), rooms privacy to eat (76.9%), room cleanness (73.5%), the way vegetables cooked (71.6%), meal providers behavior (71.1%), variety of foods (70.7%), cleanness of meal providers (66.8%), temperature of hot drinks (64.1%), and cleanness of cups \u0026amp; plates to eat (58.4%).\u003c/p\u003e \u003cp\u003eHowever, patients agreed on time of meal delivery (86.2%), provision of well cooked meal for easily chewing (86.9%), availability of clean water and hand washing facility (89.8%), toilet`s easily accessibility \u0026amp; comfortableness (89.9%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e5.6 Factors associated with the patient\u0026rsquo;s satisfaction level\u003c/h2\u003e \u003cp\u003eDuring the binomial logistic regression analysis variables like education level, age, religion, daily meal frequency (three meals a day), availability of food source other than hospital meal, type/sort of meal used in the hospital, nutritional status, provision of easily chewable food, flavour of meal, and behavior of meal providers were significantly associated with patient satisfaction towards hospital meal services. However, residences, sex, monthly income, marital status, and occupation, were not associated.\u003c/p\u003e \u003cp\u003eIn Multivariable logistic regression analysis, meal flavour, nutritional status, type/sort of meal used in the hospital, provision of easily chewable food and behavior of meal providers were statistically significant whereas religion, level of education, age, food source other than hospital meal, daily meal frequency (three meals a day), were not statistically significant with satisfaction towards hospital meal service (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBinomial and multivariate logistic regression of patient satisfaction with hospital meal service among adult patients admitted to public hospitals in Addis Ababa, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eSatisfaction in (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR (95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR (95%CI)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMeal flavour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48(64.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27(36.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.65(2.26\u0026ndash;10.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.65(2.26\u0026ndash;10.97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136(27.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e356(72.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMeal type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStandard\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e331(72.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e126(27.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.210(1.072\u0026ndash;1.365)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.35(1.912\u0026ndash;4.490)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther meals (cardiac, HTN, fluid meals)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58(52.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52(47.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWell cooked meals for easily chewing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e149(30.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e344(69.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.483(0.294\u0026ndash;0.792)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.483(0.294\u0026ndash;0.792)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(47.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39(52.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMeal providers behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(43.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e126(56.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.517(1.290\u0026ndash;1.786)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.20(1.252\u0026ndash;3.195)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBad\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88(25.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e257(74.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNutritional status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWell nourished\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83(24.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e260(75.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMalnourished\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101(45.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e123(54.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.389(0.271\u0026ndash;0.558)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.389(0.271\u0026ndash;0.558)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eN.B Statistically significant in multivariable logistic regression (AOR) at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eParticipants who states that the meals flavour as good were 4.65 times more satisfied than those who perceived meal flavour as not good (AOR\u0026thinsp;=\u0026thinsp;4.65, 95%CI:[2.26, 10.97]). Participants who receive meal from providers with good behavior were 2 times more satisfied than those who get their meal from providers with poor behavior (AOR\u0026thinsp;=\u0026thinsp;2.2, 95%CI:[1.25,3.20]). Participants who use standard meals in their hospital stay were 2.35 times more satisfied than those who use other meals (cardiac, HTN, fluid meals) (AOR\u0026thinsp;=\u0026thinsp;2.35, 95%CI:[1.91,4.49]). Study participants who claimed the provision of meal for easily chewing are more satisfied than those who didn`t (AOR\u0026thinsp;=\u0026thinsp;0.483, 95%CI: [0.294\u0026ndash;0.792]). Participants whose nutritional status was well nourished are less satisfied than those of malnourished (AOR\u0026thinsp;=\u0026thinsp;0.389, 95%CI: [0.271\u0026ndash;0.558].\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study evaluates patients\u0026rsquo; satisfaction and potential factors regarding hospital meal service in Addis Ababa, Ethiopia. The result showed that 32.5% (95% CI: [29, 36]) of patients satisfied with overall hospital meal service provision. This result was lower than findings of studies conducted in other countries like 80% in Swedish study using the Acute Care Hospital Foodservice, 67.3% in Lusaka province, Zambia, 60.8% Mashhad University of Medical Sciences, Iran, 53.3% in East Malaysia, but it is similar with the previous study conducted in Wolaita zone, Ethiopia which shows 33.6% (95%CI: [29.1, 38.3]) [(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e)(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)]. This result shows patient\u0026rsquo;s satisfaction with hospital meal service is low in Ethiopia and possible explanations for the discrepancy between our country and those countries might be due to differences in socio-economical, cultural, and infrastructure aspects.\u003c/p\u003e \u003cp\u003eAccording to the study findings, socio-demographic variables like age, gender, religion, marital status, educational level, monthly income, length of hospital stay and residency had no impact on the patients' general level of satisfaction. Regarding age, gender, education level, length of hospital stay similar studies also showed as they were insignificant variables with overall meal service satisfaction [(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)].However, the results for residency and monthly income are in contrast of previous study (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), which revealed that patients from rural areas and those receiving 500 Ethiopian Birr or less per month were more likely to be satisfied with hospital meal service than patients from urban areas and patients receiving more than 500 Ethiopian Birr, respectively.\u003c/p\u003e \u003cp\u003ePatients in hospitals have reported varying experiences with different components of meal services. Accordingly 94.4% of patients disagreed on flavor of meal, 92.5% with taste of meal, and 92.1% about flexibility of beds whereas 86.2% agreed on timeliness of meal, 86.9% with provision of easily chewable meal, 71.1% with meal providers\u0026rsquo; behavior. Previous researches\u0026rsquo; that was done provided support for these results [(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)].\u003c/p\u003e \u003cp\u003eThis might be explained by the fact that patient satisfaction was being influenced by many hospital meal service dimensions and characteristics and this suggests that in order toaddress the contributing elements, interventions must be done while taking into account every dimension and aspects of meal service.\u003c/p\u003e \u003cp\u003eIn relation to the predictive variables, patients who thought the hospital meal flavour as nice were more likely to be satisfied than those who thought it didn't. These result is in accordance with earlier studies and it was also suggested that improving the flavour of hospital meals with different enhancers is important to meet expectation of patients towards the meal services [(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e)(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)]. The current as well as previous studies suggested that in order toimprove patient satisfaction with meal, hospitals could incorporate more flavor into their meals using fresh products. Furthermore, eating tasty food made correctly may make you feel better psychologically and raise the value of the meal, which supports the link between participant satisfaction and meal flavor that has been shown.\u003c/p\u003e \u003cp\u003eParticipants who receive meal from providers with good behavior (friendly \u0026amp; polite) were more satisfied than those who get their meal from providers with poor behavior. This result is in line with previous studies [(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e)]. This could be due to friendly and polite approach of providers can make participants feel valued and respected, leading to a greater sense of comfort and appreciation for the service. This emotional and psychological boost can elevate the perceived quality of the meal and the service, resulting in higher satisfaction compared to those who experience poor behavior from providers.\u003c/p\u003e \u003cp\u003eParticipants who use standard meals in their hospital stay were more satisfied than those who use other meals (cardiac, HTN, fluid meals), this result is similar with a study in Hospitals of Lahore, Pakistan which shows the patients who were consuming standard diabetic or cardiac menu were not satisfied with foodservice as compared to the patients who were on restricted or textured modified diet (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) but it is in contrast with study about Food Services in the Teaching Hospitals of Tabriz, Iran which shows food type (special hospital diet or regular) did not significantly influence overall satisfaction with hospital meals and meal services, which found no correlation between food type and meal satisfaction(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The possible reason for this might be due to the low salt and low fat containing meal that is provided for hypertension and cardiac patients.\u003c/p\u003e \u003cp\u003eStudy participants who claimed the provision of meal for easily chewing are more satisfied than those who didn`t this result is in accordance with previous studies [(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e)]. A plausible interpretation for this finding might be that having meal that is well-cooked enhances the dining experience, hence elevating the degree of pleasure with the meal served. The current study showed that from all (567) study participants 224 (30.5%) was well nourished this result is in line with a study by Ogada Irene Mount Saint Vincent University, Department of Applied Human Nutrition, which shows 35.4% well nourished status (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) and participants whose nutritional status was well nourished are less satisfied than those of malnourished but further studies to assess the association between nutritional status and satisfaction with hospital meal service is required.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStrength and limitation of the study\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe study offers up-to-date reflections on patient satisfaction and the factors influencing it at the center. This study may have been limited by its exclusive focus on overall patient satisfaction as perceived by the patients themselves. It did not evaluate the organizational viewpoints, such as the abilities of the team that distributes meals, the cooks, or the medical specialists. The data collectors of this study were partially selected from the study hospitals and this may lead to social desirability bias.\u003c/p\u003e "},{"header":"Conclusion","content":"\u003cp\u003eThe findings of this research revealed low patient\u0026rsquo;s satisfaction with hospital meal service among adult patients admitted at public hospitals. In this study, a significant proportion of participants were agreed on time of meal delivery, provision of well cooked meal for easily chewing, and availability of clean water and hand washing facility while the majority of them had reported unacceptable experiences on aspect of meal flavor \u0026amp; taste, flexibility of beds, and temperature of cold drinks. Meal flavour, meal type, provision of well cooked meals for easily chewing, meal providers behaviour, nutritional status of respondents were identified as statistically associated factors with patient satisfaction on meal service at hospitals. The results also insight the interventions need to be made to address the influencing factors considering each meal service aspects and dimensions.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRecommendation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eHealth managers and health care providers need to work with nutritionists and specialized dieticians should work together to develop meals that take patients' medical circumstances and nutritional needs into account while maintaining a balance of vital nutrients.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAAPHREM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAddis Ababa public health research \u0026amp; emergency management\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eACHFPSQ\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Acute Care Hospital Foodservice Patient Satisfaction questioners\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eALERT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAll Africa Leprosy Rehabilitation and Training Center\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDRM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDisease related malnutrition\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMUAC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMid Upper Arm Circumference\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSGAF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSubjective Global Assessment Form\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical package for Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTASH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTikur Anbessa Specialized hospital\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eapproval and consent to participate\u003c/strong\u003e\u003cstrong\u003e;\u0026nbsp;\u003c/strong\u003ethe ethical \u0026nbsp;clearance was obtained from Institutional Review Board of menlik II Medical and Health Sciences college and official letters was submitted to each respective health facility.After explaining the objectives of the study, informed written consent was obtained from all mothers and caregivers, and anonymity and confidentiality of the data were kept. Respondents have the right not to participate or withdraw from the study at any stage, and all study methods were performed in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e; Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe data used to support the findings of this study are available from the corresponding author upon request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests;\u003c/strong\u003e The authors declare that they have no conflicts of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e; Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eVersion 2: This paper is the original work of me(Mulugeta Taybele), main author \u0026 current corresponding Author. previously one of the Co authors was trying to proceed for publication process eventhough his contribution was significant for our work he doesn't know the details of this research work as a result he missed, one of the co author, main supervisor of the research(Elazar Tadesse,Phd) and had also multiple spelling error as well as email address was missed in the previous version of preprint and also due to personal reasons and work overload the corresponding author is changed.\u003cbr\u003eC.G; Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Visualization, Writing \u0026ndash; original draft\u003c/p\u003e\n\u003cp\u003eM.T; Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Visualization, Writing \u0026ndash; original draft\u003c/p\u003e\n\u003cp\u003eO.k; Conceptualization, Formal analysis, Methodology, Resources, Software, Visualization, Writing and original draft\u003c/p\u003e\n\u003cp\u003eJ.K,Conceptualization, Formal analysis, Methodology, Software, Supervision, Writing, review \u0026amp; editing\u003c/p\u003e\n\u003cp\u003eG. B; Conceptualization, Formal analysis, Methodology, Software, Supervision, Writing, review \u0026amp; editing\u003c/p\u003e\n\u003cp\u003eA.N; Conceptualization, Formal analysis, Methodology, Software, Supervision, Writing, review \u0026amp; editing\u003c/p\u003e\n\u003cp id=\"_Toc98510384\"\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003cstrong\u003e;\u0026nbsp;\u003c/strong\u003eThe authors would like to express their gratitude to respective health facility, data collectors, supervisors and study participants for their diligence and dedication in the collecting and inputting high quality data used in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eIsmail NH, Masman AH, Kamarul Zaman M, Putriana D (2023) Nutritional Status and Factors affecting Food Intake among Hospitalised Patients in Hospital Al-Sultan Abdullah. Environ Proc J [Internet]. ;8(24):229\u0026ndash;35. 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Pan Afr Med J. ;45\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAga TB, Ferede YM, Mekonen EG (2021) Satisfaction and associated factors towards inpatient health care services among adult patients at Pawie General Hospital, West Ethiopia. PLoS One [Internet]. ;16(4 April):1\u0026ndash;11. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1371/journal.pone.0249168\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0249168\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSabo KG, Mare KU, Berhe H, Berhe H (2023) Factors Affecting Satisfaction With Inpatient Services Among Adult Patients Admitted to Arba Minch General Hospital, Southern Ethiopia: A Mixed Method Study. Heal Serv Insights. ;16\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdissa G, Asegidew A, Bekele S (2023) Assessment of Postoperative Patient Satisfaction towards Services Provision in Zewditu Memorial Hospital Addis Ababa Ethiopia. A Cross-Sectional Study. General Surgery and Clinical Medicine [revista en Internet] 2023 [acceso 20 de mayo de 2023]; 1(1): 1\u0026ndash;4. Gen Surg Clin Med [Internet]. ;1(1). 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JMS - J Med Soc 31(2):94\u0026ndash;98\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAminuddin NF, Kumari Vijayakumaran R, Abdul Razak S (2018) Patient Satisfaction With Hospital Food service and its Impact on Plate Waste in Public Hospitals in East Malaysia. Hosp Pract Res 3(3):90\u0026ndash;97\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOsman NS, Nor NM, Sharif MSM, Hamid SBA, Rahamat S (2021) Hospital food service strategies to improve food intakes among inpatients: A systematic review. Nutrients 13(10):1\u0026ndash;26\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiyoba N, Ogada I (2019) Diet satisfaction and associated factors among adult surgical orthopaedic inpatients at a teaching hospital in Lusaka province, Zambia; A hospital-based cross-sectional study. BMC Nutr 5(1):1\u0026ndash;7\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRasouli A, Ebrahimi V, Hamedi Behtash H, Panjeshahin A, Kazemi M, Tarighat-Esfanjani A (2021) Comparison of Patient Satisfaction with Self-operating Food Services and Food Service Contractors in the Teaching Hospitals of Tabriz, Iran. J Human, Environ Heal Promot. ;7(1):54\u0026ndash;9\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Ccedil;elik Z, Başoğlu İ, Yiğit A, G\u0026uuml;neş F (2019) Evaluation of the Level of Food Consumption and Satisfaction with Hospital Food Services in Elderly Inpatients. J Geriatr Sci 2(3):78\u0026ndash;85\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRapo S, Mattson Sydner Y, Kautto E, H\u0026ouml;rnell A (2021) Exploring patient satisfaction with hospital foodservice: A Swedish study using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire. Nutr Diet 78(5):487\u0026ndash;495\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaus C, Sucheran R (2021) Patient satisfaction with foodservice in private hospitals in South Africa. J Crit Rev 8(02):302\u0026ndash;311\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMacKenzie-Shalders K, Maunder K, So D, Norris R, McCray S (2020) Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, plate waste and costs: A systematic literature review. Nutr Diet 77(1):103\u0026ndash;111\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSafarian M, Alinezhad-Nameghi M, Vafisani F, Asadi Z, Sh S (2018) Patient satisfaction with hospital food in the hospitals affiliated to Mashhad University of Medical Sciences. Iran J Nutr Fasting Heal 6(4):191\u0026ndash;197\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFirissa YB, Sultan M, Abdelwahab M, Kifle Belachew F (2023) Disaster response readiness assessment of public hospitals in Addis Ababa City, Addis Ababa, Ethiopia. African J Emerg Med [Internet]. ;13(3):210\u0026ndash;6. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.afjem.2023.06.004\u003c/span\u003e\u003cspan address=\"10.1016/j.afjem.2023.06.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDuerksen DR, Laporte M (2020) Evaluation of Nutrition Status Using the Subjective Global Assessment: Malnutrition, Cachexia, and Sarcopenia. ;0(0)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaus C, FOODSERVICE SATISFACTION LEVELS AMONG PATIENTS IN PRIVATE HOSPITALS IN KWAZULU-NATAL Master of Management Sciences Specialising in Hospitality and Tourism. 2020;(November)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBiosci IJ, Abdalgadir M, Abuagla A (2024) Evaluating patient satisfaction with food services provided in Khartoum teaching hospitals. Int J Biosci 6655:32\u0026ndash;39\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTrinca V (2020) Putting Quality Food on the Tray: Assessing Patients\u0026rsquo; Expectations and Experiences of Meals Served in Sixteen Ontario Hospital. Univ Waterloo\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIrene O, Murambiwa N Nutritional Status and Associated Factors among Hospitalised Zambian Adult Patients Receiving Hospital Prepared Total Nasogastric Tube Feeds\u003c/span\u003e\u003c/li\u003e \u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Menlik II Medical and Health Sciences College ","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Satisfaction, hospital meal service, associated factors","lastPublishedDoi":"10.21203/rs.3.rs-6128623/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6128623/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA sound healthcare system is indispensable for fast and better recovery of patients which involves best medication along with adequate and balanced diet. In public hospitals, hospital meal is the source of nutrition for most patients. Despite the critical role of appropriate hospital feeding in the recovery process of hospitalized patients, there is little understanding of satisfaction with food service in regular hospital settings among adult patients admitted to public hospitals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo assess satisfaction levels with hospital meal service and associated factors among adult patients admitted to public hospitals in Addis Ababa, Ethiopia, 2024.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn Institution-based cross sectional study was conducted from June to July, 2024. Representative samples of 567 adult patients admitted to public hospitals in Addis Ababa, Ethiopia were included in the survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe overall satisfaction towards hospital meal services was 32.5% (95% CI: [29, 36]). Multivariable logistic regression shows Meal flavour (AOR = 4.65; 95%CI: [2.26-10.97]), meal type (AOR = 2.35; 95%CI:[1.912-4.49]), provision of well cooked meals for easily chewing (AOR=0.483; 95%CI:[0.294-0.792]), meal provider’s behaviour (AOR = 2.20;95%CI:[1.252-3.195]), and nutritional status (AOR = 0.389; 95%CI: [0.271-0.558]) of respondents were identified as influencing factors of patient satisfaction on meal service at hospitals. Regarding nutritional status 343 (60.5%) of admitted patients were well nourished and 224 (39.5%) were malnourished.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion and recommendation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research revealed low patient’s satisfaction with hospital meal service among adult patients admitted at public hospitals so health managers and health care providers need to work on how to maintain the good aspects of hospital meal services.\u003c/p\u003e","manuscriptTitle":"Satisfaction with hospital meal service and associated factors among adult patients admitted to public hospitals in Addis Ababa, Ethiopia, 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2025-05-05 15:59:20","doi":"10.21203/rs.3.rs-6128623/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-03-04 09:00:47","doi":"10.21203/rs.3.rs-6128623/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bd29b658-5134-42da-87a7-3cad0a249d5b","owner":[],"postedDate":"May 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-04-19T09:25:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-05 15:59:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-6128623","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6128623","identity":"rs-6128623","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}