JPPIPA 9(12) (2023)

Jurnal Penelitian Pendidikan IPA

Journal of Research in Science Education

http://jppipa.unram.ac.id/index.php/jppipa/index

The Relationship Between Patient Satisfaction from Food

Quality and Health Clinic Cleanliness
Pius Weraman1*, Wawan Kurniawan2, Devin Mahendika3, Sri Handajani4, Ernawati Umar5
1 Program Studi Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Nusa Cendana Kupang, Kupang, Indonesia.
2 Program Studi Ilmu Keperawatan, Fakultas Ilmu Kesehatan, Universitas Yayasan Pendidikan Imam Bonjol, Majalengka, Indonesia.
3 Program Studi Kedokteran, Fakultas Kedokteran, Puskesmas Bunguran Tengah, Indonesia.

4 Program Studi Pendidikan Tata Boga, Fakultas Teknik, Universitas Negeri Surabaya, Surabaya, Indonesia.

5 Program Studi Keperawatan, Fakultas Kedokteran, Universitas Sultan Ageng Tirtayasa, Indonesia.

Received: October 14, 2023 Abstract: The correlation between the satisfaction experienced by patients with the
Revised: November 3, 2023 quality of nutritional services and the cleanliness of health clinics has an influence on the
Accepted: December 25, 2023 image of the hospital. This has implications for improving the quality of hospitals in
Published: December 31, 2023 providing food services and the cleanliness of health clinics by serving food that suits the
needs of patients. This research was conducted with the aim of knowing patient
Corresponding Author: satisfaction in service, food quality and cleanliness of health clinics. The research method
Pius Weraman used was a quantitative method with a cross sectional study design where the data
piusweraman@staf.undana.ac.id sample was 53 people. Sampling was taken by total sampling method where the data will
be analyzed using the paired t-test. The results of this research show that there is patient
DOI: 10.29303/jppipa.v9i12.5961 satisfaction with food quality of 75.5% with a p value of 0.064. Practically there is no
difference between expectations and reality in this service. The patient satisfaction with
© 2023 The Authors. This open the cleanliness of the health clinic was 75.5% at a p value of 0.083, which indicates there
access article is distributed under a is no difference between expectations and reality. Apart from that, satisfaction with the
(CC-BY License) appearance of food was 98.1% with a p value of 0.322. Then the satisfaction of the patients
with the taste had a value of 83% with a p value of 0.064. Then the patient's satisfaction
with the texture was 94.3% with a p value of 0.083. Then there is a sense of satisfaction
with the time the food is served with a value of around 98.1% at a p value of 0.322.

Keywords: Cleanliness; Food quality; Patient satisfaction

Introduction appearance of the food, and 81.5% were dissatisfied with

the variety of menus (Nareswara, 2017). Capra et al.
Patient satisfaction with the quality of nutrition (2015), Aliffianti (2015), Agustina (2016), Rahayu (2018),
services greatly influences the overall image of the Rachmawati et al. (2021) shows that patients are very
hospital and has implications for increasing hospital satisfied with food presentation and food service.
income. Several problems that often occur are related to Trisilawati (2021) found that patient satisfaction with
patient satisfaction with the food served, one of which is food services in hospitals is influenced by several
that food served many times in a short period of time factors, including: food quality, staff problems, food
will cause the patient to feel bored. This will cause the presentation, physical environment, hunger factors and
patient's appetite to decrease and the patient's food food quantity and food delivery (distribution). Factors
consumption to decrease (Prawiningdyah, 2019). that can influence patient satisfaction are timeliness of
According to research conducted in Indonesia at type B food distribution, variety of food menus, taste of food,
hospitals in Semarang City Regional Hospital, it showed cleanliness of equipment, and appearance of staff (Siti et
that 92.6% of respondents were dissatisfied with the al., 2016; Zebua, 2018; Noviyanti, 2020; Tulak, 2020;
taste of the food, 53.7% were dissatisfied with the Sudirman, 2021). Research conducted at RSUP dr.
Soeradji Tirtonegoro Klaten stated that 93.3% of patients
___________
How to Cite:
Weraman, P., Kurniawan, W., Mahendika, D., Handajani, S., & Umar, E. (2023). The Relationship Between Patient Satisfaction from Food Quality
and Health Clinic Cleanliness. Jurnal Penelitian Pendidikan IPA, 9(12), 10740–10749. https://doi.org/10.29303/jppipa.v9i12.5961
Jurnal Peneliatian Pendidikan IPA (JPPIPA) Desember 2023, Volume 9 Issue 12, 10740-10749

liked the appearance of the food, 100% liked the taste of center, clinic and hospital level, have a very vital role.
the food, 96.7% rated the food service as good, 90% rated The role of the nurse is very important because they
the cleanliness of the cutlery as clean, 86.7% liked the always interact, have 24 hour contact with the patient
overall acceptability, patient satisfaction, food serving and know the patient's condition during treatment.
and service, plate waste and the level of satisfaction with Service quality influences patient satisfaction in health
patient nutrition services was 96.7% satisfied services, because nursing services determine the quality
(Rachmawati & Afifah, 2021). of health services.
Satisfaction is a model of the gap between expected Satisfaction is a model of the difference between
(should-be) performance standards and actual expectations (what performance standards should be)
performance received by customers (Supriyanto, 2007; and actual customer performance. Patient satisfaction is
Woodruff & Gardial, 1996). Satisfaction is defined as a a subjective value related to the quality of services
person's delight in receiving the expected service or offered (Woodruff & Gardial, 1996). Patient satisfaction
product. The success of health-care services is is related to the quality of hospital services. Hospital
determined by customer satisfaction. According to administration can improve service quality by knowing
Nursalam (2016), the notion of service quality related to the level of patient satisfaction. Loyal patients are a low-
satisfaction is determined by five characteristics known cost "promotional tool."
as "RATER" (responsiveness, assurance, tangible, Having loyal patients increases the health service
empathy, and reliability). The essence of the RATER institution's selling power as well as its potential to
quality idea is to mold attitudes and behavior from profit, so that cross-subsidies to improve service quality
service development in order to deliver strong and basic and rewards offered to the human resources of the
services, so that they may be evaluated based on the health service institution will also raise their wellbeing.
quality of service received. The health workforce's passion is growing, as is their
According to Nursalam (2016), patient satisfaction ability to boost consumer happiness. Patients are Bio-
is influenced by 12 elements, including product or PsychoSocial-Economic-Cultural beings, which means
service quality, pricing, emotional, performance, they must fulfill their biological requirements (health),
aesthetics, product attributes, service, location, psychological needs (satisfaction), socio-economic needs
facilitation, communication, atmosphere, and visual (housing, clothing, food, and social affiliation), and
design. According to Suriyanto (2007), the following cultural needs. Whoever knows the individual wants,
elements influence patient satisfaction: product quality, desires, or expectations of customers or patients has the
service quality, emotional aspects, price, and cost of advantage of engaging with them.
aquaring. Client satisfaction occurs when the client's
Service quality is the degree of providing services requirements and wishes are met; the customer is
efficiently and effectively in accordance with satisfied. Customer satisfaction is the sense that the
professional standards, service standards that are product or service obtained meets or exceeds the
implemented thoroughly in accordance with patient customer's expectations. Patient satisfaction is important
needs (Nursalam, 2016). Services are health services since it is an indicator of the quality of service we deliver,
provided in clinics. Health services aim to overcome a and it is capital for gaining new and loyal patients. If
person's health problems. Patients can provide an they require the same health services again, loyal
assessment of existing health services. Services that meet patients will return. It is also known that devoted
patient expectations will lead to patient satisfaction, but patients will invite others to use the same medical
what will happen instead is that patients will lose facilities.
confidence in getting health services, thereby reducing Loyal customers are a low-cost promotional
the number of patient visits and will experience a technique. Having loyal patients increases such health
decrease in the amount of profits they get at the clinic. care facilities' selling power as well as their ability to
Health services are a form of service provided by earn a profit (improved profitability). In this way,
community health centers, clinics and hospitals. One mutual subsidies to improve service quality and
form of health service at community health centers, rewards given to all human resources in health care
clinics and hospitals is nursing services. Nursing as an institutions will be able to improve further, welfare will
important tool in health services has the responsibility to increase, and enthusiasm for health workers' work will
carry out all nursing actions by providing services increase, as will the willingness to increase customer
according to professional nursing care standards. A satisfaction. Performance will improve where patient
nurse is someone who provides nursing care to a patient care is improved; as a result, patients will be more
while the patient is being treated. Nurses, as providers satisfied, and if the patient need health services again, he
of nursing care services starting at the household, health will use the same services.

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Rates have no effect on loyal clients. Long-term Service

client loyalty will ultimately provide hospital The hospital staff was friendly and the service was
profitability. As a result, pleasure is a valued asset. quick. Health-care institutions are deemed good if they
However, in order to satisfy customers, you must also provide services that prioritize patient needs. The
consider other factors so that there is no over-investment patient's first perception of the nursing services
(the expense of attempting to satisfy customers exceeds delivered determines satisfaction. For example,
income). Diagram depicting the relationship between providing nursing care requires quick, responsive, and
internal and external customer satisfaction. Factors polite service.
influence patient satisfaction are the product or service's
quality, cost, psychological, efficiency, aesthetics, Placement
product attributes, service, placement, accessibility, The location of the room and its surroundings is
communication, environment, and visual design one of the factors that must be considered while
(Nursalam, 2016). selecting a health care facility. In general, the closer the
location is to urban centers or is easily accessible, the
The Product or Service's Quality easier transportation and nice atmosphere will be the
Patients will be satisfied if the outcome of their preferred choice for patients.
evaluation demonstrates that the product or service
used is of good quality. Accessibility
The completeness of facilities, for example, health
Cost facilities encompassing buildings and infrastructure,
The included price is the cost of the goods or parking, nice waiting rooms, and inpatient rooms,
service. Price is a significant consideration, but quality is influences patient satisfaction assessments. Although
the most crucial in achieving patient happiness. this right is not critical in determining patient happiness,
However, this factor has an impact on patients in terms the institution does Health services must pay attention
of money incurred; typically, the higher the price of to facilities in building consumer-attractive methods.
therapy, the higher the patient's expectations.
Communication
Psychological The mechanism for information provided by
Patients who are proud of themselves and believe service providers and complaints from patients is
that others admire them tend to be more satisfied, known as communication. Concerns from patients are
especially if they choose a health care organization that received rapidly by service providers who assist with
already holds that opinion. patient concerns.

Efficiency Environment
Speed, convenience, and comfort in how nurses The environment is one of security and comfort. A
provide medical services, particularly during relatively peaceful, pleasant, cool, and beautiful environment will
short recovery times, ease in meeting patient needs, and have a significant impact on patient satisfaction during
comfort provided, namely by paying attention to the healing process. Aside from that, not only patients
cleanliness, friendliness, and completeness of hospital will like it, but visitors will be pleased and will give
equipment are manifestations of this performance. excellent feedback, impressing visitors to the health care
facility.
Aesthetics
Aesthetics refers to the attractiveness of a hospital Visual Design
as seen by the five senses. The friendliness of care and Visual design include simple decoration of rooms,
the completeness of hospital equipment are two buildings, and street designs. Comfort is also
examples. determined by the spatial layout and decorating.
There are several factors that influence consumer
Product Attributes satisfactions which are broadly categorized into 5
This item symbolizes physical ownership, which categories, namely product quality, service quality,
includes structures and decorations. Product qualities emotional factor, price, and cost of acquiring. Product
include the building's look, cleanliness, and the type of quality refers to how satisfied customers are with the
room class supplied, as well as completeness. items and services they utilize. Performance, reliability,
conformity, durability, features, and other factors all
influence product quality. Service quality refers to how
satisfied customers are with the services they have
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received. The service quality dimension, abbreviated as out primarily in compliance with PGRS principles at
servqual, consists of five dimensions: tangible, RSUs in Bahteramas, Southeast Sulawesi Province.
dependability, assurance, empathy, and responsiveness. There are four indications of the RSU food management
The value scale is scaled from 1-4. Scale 1 is unsatisfied, system among the 14 indicators, Bahteramas.
whereas scale 4 is content. The score value is the scale's Bahteramas did not follow PGRS requirements for menu
mean value (score = the number of n measurements design, ordering and purchasing, cooking, and food
taken on the scale). distribution.
Emotional Factors refers to confidence and sense of At Bhayangkara Hospital showed that
pride in the products, services used compared to dissatisfaction was seen from the amount of leftover
competitors. Emotional factor is measured from the food from patients which exceeded 25%, while the
perceived best score, meaning the perception of the best hospital's Minimum Service Standards (SPM) in
quality compared to competitors. The price of a service Peraturan Menteri Kesehatan RI (2019) were ≤ 20%.
product is measured from the value of the benefits Food service in a hospital is very important, because
compared to the costs incurred by consumers. Price is with food service it is hoped that patients will feel
the price of medical services (medical care) that satisfied. Satisfied patients will of course choose the
consumers must pay. Cost of Acquiring refers to costs same hospital again if they suffer from illness again and
incurred to obtain products or services. recommend it to their friends or family. Ernalia (2014)
Improving service quality is the degree to which discovered a significant relationship between patient
services are provided efficiently and effectively in satisfaction in the internal medicine room and delivery
accordance with professional standards, service room at Mandau Duri Regional Hospital and the
standards that are thoroughly implemented in timeliness of food distribution, menu variations, food
accordance with patient needs, utilizing appropriate taste, cleanliness of equipment, and appearance of food.
technology and research results in nursing services to Nutrition services in hospitals are generally
achieve optimal health. According to Muninjaya (2014), managed in health clinics Nutrition Installation, which
the quality of health services is defined by whether or is also where food is served, with 6 nutrition workers in
not users' demands or expectations are met and obtained the nutrition installation (1 honorary and 1 civil servant),
on time. followed by 4 waiters. The standard number of nutrition
Improving service quality is a critical topic in workers in type D hospitals is adjusted to service needs,
management in both the public and private sectors. This such that with the complexity of nutrition service
occurs because, on the one hand, the public's desire for operations, the number of nutrition workers in health
improved service quality grows year after year, but, on clinics remains insufficient. In general, nutrition workers
the other hand, service delivery procedures have not in hospitals have not received nutrition services training.
improved significantly. According to Donabedian, The findings of a preliminary research on Clinic
service quality may be measured using three variables: inpatients As many as 40% of all patients complained
input, output, and information. Input refers to all of the that nurses were less responsive to patient complaints,
resources required to carry out operations, such as staff, 20% complained about a lack of communication between
funds, medicines, facilities, technology, organization, nurses and patients, 20% complained that nurse services
and information. were less thorough in carrying out nursing actions, and
A process is a professional engagement between 40% complained that nurses did not introduce
service providers and consumers (patients and members themselves to patients. Data on the number of patients
of the general public). Every medical/nursing action hospitalized at clinics in Jember Regency showed an up
must always take the patient's values into account. Every and down in the number of patients hospitalized with
effort is made to reduce the likelihood of recurrence of 100 patients in October, 102 patients in November, 94
complaints or discontent in patients. The patient safety patients in December, 128 patients in January, 80
program strives to improve both patient safety and patients in February, and 84 patients in April. Patient
service quality. Professional contacts are always mindful satisfaction with the services received can be described
of ethical principles regarding patients. using data on the number of inpatients.
Output is the consequence of health care or nursing
services, namely changes in customers, including Method
consumer satisfaction. It is impossible to determine
whether good input and processes resulted in good The paired t test design is used in this analytical
outcomes unless hospital/nursing performance is study (Sugiyono, 2018). This study included 53 persons
measured. Emiliana et al. (2021) research at RSU who were all inpatients at health clinics (Notoatmodjo,
Bahteramas, about food management has been carried 2014). Total sampling was employed as the sample

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strategy. The Chi square test was performed to analyze Based on the table 2, it shows that of the 53
the data (Mulyatiningsih, 2011; Sugiyono, 2015). respondents, the majority expect to be very satisfied
with the aroma of food (75.5%), the remainder expects to
be satisfied with the aroma of food in health clinics
(24.5%) and there were no patients who were dissatisfied
or dissatisfied with the food. food aroma services at
health clinics (0%). Meanwhile, in terms of the reality,
the majority of respondents stated that they were very
satisfied with the aroma of the food, namely 44 people
(83.0%), the remainder stated that they were satisfied
with the aroma of food in health clinics as many as 9
people (17.0%) and there were no patients who were less
satisfied. (0%), especially dissatisfied with the food
aroma service at health clinics (0%).

Table 2. Distribution of Expectations and Reality of

Respondents' Satisfaction with Food Aroma
Figure 1. The paired t test design
Patient’s Hope Reality
Aroma Paired t-test
n % n %
Result and Discussion Very Satisfied 40 75.5 44 83
Satisfied 13 24.5 9 17
According to the chart above, the bulk of the 53 Less Satisfied 0 0 0 0 0.064
respondents were in the 18-29 year age group, with 30 Not Satisfied 0 0 0 0
people (56.6%) and a minor number in the 50-59, 70-79, Total 53 100 53 100
and 80-89 age categories, with 1 person each (1.9%). The
majority, 46 people (86.8%), were female, with 7 people The paired t-test resulted in a p value of 0.064 > 0.05,
(13.2%) being male. The majority, as many as 46 persons indicating that there was no significant difference
(86.8%), were high school graduates, while a tiny between expectations and reality regarding the aroma of
proportion, as many as 1 person (1.9%), were elementary food at health clinics. This indicates that respondents are
school graduates. The bulk of responders were pleased with the food aroma service since expectations
housewives, with 28 persons (52.8%), followed by and actuality are not far apart. The observed satisfaction
fishermen and civil servants, each with one person is satisfaction with the aroma of food, which might
(1.9%). arouse appetite. This study supports the findings of
Rachmawati et al. (2021), who discovered that the aroma
Table 1. Responden’s Characteristic of the meal served can generate appetite (100%), the
Responden’s Characteristic n % flavor of the food served (100%), and the texture of the
Age side dishes is proper and easy to chew (98.89%). The
18 – 29 30 56.6 results of the meal scent analysis revealed that it
30 – 39 13 24.5 matched what the patient expected (Jalilah &
40 – 49 4 7.5 Prapitasari, 2020).
50 – 59 1 1.9 Food aroma is the aroma spread by food which has
60 – 69 3 5.7
a very strong attraction and is able to stimulate the sense
>70 2 3.8
Gender of smell so that it can arouse the appetite (Najmah, 2016).
Man 7 13.2 The aromas emitted by food vary. Likewise, different
Woman 46 86.8 ways of cooking food will give different aromas. The
Education aroma emitted by food is a very strong attraction and is
Elementary 1 1.9 able to stimulate the sense of smell, thereby awakening
Junior High School 3 5.7 the appetite (Peraturan Menteri Kesehatan RI, 2019).
High School 46 86.8 This research is confirmed by the opinion of Rotua &
Bachelor 3 5.7 Siregar (2015) that the aroma of food emitted from the
Occupation
food is able to stimulate the sense of smell and increase
Housewives 28 52.8
Fisherman 1 1.9 appetite. The aroma that each food produces is different,
Farmer 7 13.2 this is influenced by different food processing methods.
Civil Servants 1 1.9 According to the table 3, the majority of the 53
Entreprenuer 16 30.2 respondents expect to be very satisfied with the
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cleanliness of food (75.5%), the remainder with the Table 4. Distribution of Expectations and Reality of
aroma of food in the hospital (24.5%), and there are no Respondents' Satisfaction with Food Appearance
patients who are less satisfied (0%), particularly with Patient’s Hope Reality
Food Appearance Paired t-test
food hygiene services at health clinics (0%), and the fact n % n %
discovered was that the majority of them (81.1%) Very Satisfied 0 0 1 1.9
indicated that they were extremely satisfied, while the Satisfied 53 100 52 98.1
remainder (18.9%) stated that they were satisfied with Less Satisfied 0 0 0 0 0.322
the cleanliness of the food. This condition demonstrates Not Satisfied 0 0 0 0
Total 53 100 53 100
an improvement in satisfaction from satisfied to highly
satisfy. The paired t-test resulted in a p value of 0.083 >
0.05, indicating that there is no significant difference According to the table 4, all 53 respondents
between expectations and reality regarding food expected to be satisfied with the look of the food (100%),
hygiene in General Hospitals. and no patients expected to be very satisfied, less
content, or dissatisfied with the appearance of the food
Table 3. Distribution of Expectations and Reality of (0%). Similarly, of the 53 respondents, the majority,
Respondents' Satisfaction with Food Hygiene namely 52 people (98.1%), stated that they were satisfied
Patient’s Hope Reality with the appearance of the food, the remainder, namely
Food Hygiene Paired t-test 1 person (1.9%), were very satisfied with the appearance
n % n %
Very Satisfied 40 75.5 44 83 of the food, and there were no patients who were less
Satisfied 13 24.5 9 17 satisfied and dissatisfied with the appearance of the
Less Satisfied 0 0 0 0 0.083 Health Clinic food (0%).
Not Satisfied 0 0 0 0 The paired t-test resulted in a p value of 0.322 >
Total 53 100 53 100 0.05, indicating that there was no significant difference
between expectations and reality regarding the
This study agrees with Rachmawati et al. (2021) appearance of food in health clinics. This indicates that
findings about the average amount of conformity people are pleased with the overall presentation of the
between expectations and reality. There are some things meal service. The meal is provided covered, and it is
with a lower appropriateness level than average, such as garnished and appears appealing to consume in order to
the side dishes supplied, which are still warm (105.56%). awaken the hunger.
Based on the data gathered, it is clear that the food is of This study supports the findings of Rachmawati
the highest quality and hygiene, as expected. Similarly, et al. (2021), who discovered that the level of patient
Hartiningsih (2014), Fernika (2017), and Agustina et al. satisfaction with food presentation and food service was
(2018) discovered that the cleanliness of the food very high, with the actual average value being higher
supplied plays a role in influencing the taste of the food than the expected average value. The amount of
served, whether under too hot or too cold settings, congruence between expectations and reality in the
which will impact the sensitivity of the patient's taste accommodation principle demonstrates that
buds to food. respondents were quite satisfied with the average
This study is supported by Rotua et al. (2015) belief outcomes of 105.19%. With this average, there are some
that the cleanliness or temperature of food when foods that are less suitable, such as fruit served covered
presented is a factor that influences the taste of food. (102.22%). This demonstrates that the food and
However, cleanliness is controlled such that it is not beverages delivered to patients are always covered to
overly hot or chilly. Some foods must be served warm, prevent cross-contamination from other substances and
while others must be served cold. The Indonesian are always clean.
Ministry of Health also stressed the principle of heat, Other related research is being conducted at RSUD.
which states that the food that must be served must be According to Nuryani et al. (2020), 81 people (74.3%)
maintained hot by paying attention to the cleanliness of answered that the food served was covered, and
the food before being placed in serving utensils, and the respondents said they were very satisfied with the
heat of the meal must be greater than 600 degrees hospital service. This was to ensure that the food was not
Celsius. contaminated by dust or insects that entered, affecting
the appearance of the food served. The containerization
concept states that each type of food is placed in a
separate container with a lid to prevent cross
contamination.

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Table 5. Distribution of Expectations and Reality of food will vary from person to person. The appearance of
Respondents' Satisfaction with Food Taste the meal when served and the flavor of the food when
Patient’s Hope Reality consumed are the two most important features of
Food Taste Paired t-test
n % n % cuisine.
Very Satisfied 40 75.5 44 83.0 According to the table 6, all 53 respondents (100%)
Satisfied 13 24.5 9 17.0 expect to be satisfied with the texture of the food.
Less Satisfied 0 0 0 0 0.064 whereas in reality, the majority, namely 50 people
Not Satisfied 0 0 0 0 (94.3%), stated that they were satisfied with the texture
Total 53 100 53 100 of the food, the remainder, namely 3 people (5.7%), were
very satisfied with the texture of the food, and there
According to the table 5, 53 respondents were were no patients in the clinic who were dissatisfied or
very satisfied with the taste of the food (75.5%), the rest dissatisfied with the texture of the food.
expected to be satisfied with the taste of the food at the
health clinic (24.5%), and there were no patients who Table 6. The Distribution of Expectations and Reality of
were dissatisfied or dissatisfied with the taste of the food Food Texture Satisfaction among Respondents
in health clinics (0%). Similarly, in reality, the majority of Patient’s Hope Reality
respondents, 44 people (83.0%), stated that they were Food Texture Paired t-test
n % n %
very satisfied with the taste of the food, the remainder, Very Satisfied 0 0 3 5.7
as many as 9 people (17.0%), and there were no patients Satisfied 53 100 50 94.3
who were less satisfied and dissatisfied with the taste of Less Satisfied 0 0 0 0 0.083
food at the health clinic (0%). Not Satisfied 0 0 0 0
The paired t-test resulted in a p value of 0.064 > Total 53 100 53 100
0.05, indicating that there was no significant difference
between expectations and reality about the taste of meals The paired t-test results revealed a p value of 0.083
at the Health Clinic. This indicates that respondents > 0.05, indicating that there was no significant difference
were extremely satisfied with the hospital's services. between expectations and reality regarding food texture,
Respondents were highly delighted with the flavor of implying that respondents were quite satisfied with
the meal given at the Health Clinic since the veggies and food texture services at health clinics. Food has a soft
side dishes tasted wonderful. This study supports the texture, such as rice, while fish and vegetables are served
findings of Rachmawati & Afifah (2021), who discovered cooked. Food texture is a component that can influence
that the flavor of the food supplied was (100%) pleased. food quality since the consistency of the food influences
However, this research contradicts the findings of a the sensitivity of the sense of taste. Foods with a dense
study conducted by the nutrition research and or thick texture trigger the taste senses more gradually.
development section at H. Adam Malik General This research is consistent with the findings of
Hospital in Medan, which found that 52.3% of patients Rachmawati et al. (2021), who discovered that the
did not finish the food menu and 53.1% expressed an texture of side dishes was correct and easy to chew
unpleasant taste in the food menu served by the (98.89%), but the results of the analysis of statements
installation. about the texture of side dishes revealed that the level of
Taste is one of the properties of food, drinks, and compliance with patient expectations was met at 98.89%,
spices that can be defined as a collection of perceptions so it was included in the dissatisfied category because
resulting from sensory stimulation combined with the patient considered the texture of the side dish to be
digestive stimulation in the form of a product difficult for the patient to chew, so it was included in.
impression in the mouth (Peraturan Menteri Kesehatan This study contradicts the conclusions of Rumkital.
RI, 2019). According to Liber et al., flavor can improve a According to Dr. Ramelan Surabaya, respondents
patient's appetite, which can lead to increased food ranked the texture of animal side dishes at breakfast as
consumption and influence the occurrence of food less than appropriate at 5.8%, appropriate at 47.1%, and
waste. The presence of food spices, which are flavoring highly suitable at 47.1%. At lunch, 11.8% of respondents
compounds derived from natural components, is one of thought the texture of animal side dishes was less
the aspects that contribute to the delightful taste of food. suitable, 50% thought it was suitable, and 38.2% thought
Spices added to cooking seek to offer flavor. Herbs and it was very suitable.
spices are flavoring elements that are used to meals to
add flavor and aroma depending on the recipe. Food
ingredient evaluation differs according to a person's
enjoyment or taste. Ratings will differ based on
experience; for example, the taste of the same sort of
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Table 7. Distribution of Respondents' Satisfaction with Conclusions

Food Serving Time Expectations and Reality
Food Serving Patient’s Hope Reality There is no difference between expectations and
Paired t-test
Time n % n % reality for food aroma, implying that patients are quite
Very Satisfied 53 100 52 98.1 satisfied with food aroma in the health clinic. There is no
Satisfied 0 0 1 1.9 gap between expectations and reality when it comes to
Less Satisfied 0 0 0 0 0.322
food hygiene, implying that patients are very satisfied
Not Satisfied 0 0 0 0
Total 53 100 53 100
with food hygiene at health clinics. There is no difference
between expectations and reality in terms of food
presentation, indicating that patients are content with
Based on the table 7, it shows that of the 53
the appearance of food in the health clinic. There is no
respondents, 53 people (100%) expected to be satisfied
with the food serving time and 53 people (100%) were difference between expectations and reality in terms of
very satisfied and there were no expectations of satisfied food taste, indicating that patients are quite satisfied
or less satisfied patients. Likewise, the reality is that the with the taste of food at the health clinic. There is no
majority of respondents stated that they were very discrepancy between expectations and reality regarding
food texture, indicating that patients in the health clinic
satisfied with the food serving time, namely 52 people
are content with the meal texture. There is no difference
(98.1%), the remainder were satisfied with the food
between expectations and reality in terms of food
serving time, namely 1 person (1.9%) and there were no
expectations of patients who were less satisfied. and distribution accuracy, implying that patients are quite
dissatisfied with the time food is served at the health satisfied with food distribution accuracy in health
clinic (0%). clinics.
The results of the paired t-test obtained a p value of Acknowledgments
0.322 > α (0.05), so there was no significant difference Thank you to all parties, especially my institution.
between expectations and reality regarding food serving
times, which means that respondents were satisfied with Author Contributions
food serving times at health clinics. Food serving times Pius Weraman and Wawan Kurniawan: Conceptualisation,
are in the morning at 07.00, afternoon at 12.00 and methodology, formal analysis, writing original draft,
evening at 16.00 and snack serving times are at 10.00 and visualisation, validation, writing, review and editing. Devin
Mahendika and Sri Handajani: Conceptualisation,
16.00 WIT. Based on the research results, it is proven that
methodology, formal analysis, validation, writing, review and
the food distribution time and menus and portions
editing, supervision. Ernawati Umar: Conceptualisation,
served are as expected. This must be maintained because methodology, formal analysis, validation, writing, review and
in general the level of implementation is in accordance editing, supervision.
with the patient's performance and expectations so that
it satisfies the patient. Funding
The findings of this study are consistent with the The research received no specific grant from any funding
findings of Nurqisthy et al. (2016) at Airlangga agency in public, commercial or non-for-profit sectors.
University Hospital, who found that 67.6% of patients
Conflicts of Interest
were satisfied with the timeliness of distributing or The authors declare no conflict of interest.
serving food, while 32.4% were unsatisfied. Similarly,
Rachmawati et al. (2021) found that they were pleased References
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