The Mediating Role of Patient Satisfaction With Nursing Care Quality in the Association Between Provision of Compassionate Care and Patient Loyalty: A Cross-Sectional Study.

The cross-sectional design measured everything at one time, so it cannot show that compassionate care caused satisfaction or loyalty. The proposed mediation pathway is statistical and does not prove a cause-and-effect sequence. The study was done in five hospitals in Iran, so patients in other settings may have different expectations and care systems. All data were self-reported by hospitalized patients, which can be affected by social desirability and recall bias. Only patients hospitalized for more than 2 days without diagnosed mental health disorders were included, so it may not apply to very short stays or patients with mental health conditions. Ten incomplete questionnaires were excluded, and no double data entry was performed, though 10% of records were checked. Common method bias was tested with a single-factor test, which the authors note has limited sensitivity.

The authors declared no conflicts of interest. The study was funded by Hamadan University of Medical Sciences and was part of the first author's M.Sc. thesis.

Do not conclude that improving compassionate care will cause higher patient loyalty. The study measured associations once, and it did not prove a cause-and-effect pathway.