Determinants of attendant satisfaction with oncology service quality in Tamil Nadu, India: a cross-sectional study

Attendants are continuously involved in coordinating and supporting cancer care, yet their service quality perceptions are rarely modelled as determinants of satisfaction. This study investigates the association between demographic factors and service quality dimensions related to attendants' satisfaction in oncology hospitals. A cross-sectional survey using a structured questionnaire was conducted among 480 attendants (accompanying patients) across oncology hospitals in Tamil Nadu, India. Service quality was assessed using six dimensions: tangibility, responsiveness, empathy, assurance, service reliability, and process reliability. Differences across demographic groups were evaluated using non-parametric statistical tests. Partial Least Squares Structural Equation Modeling (PLS-SEM) was applied to examine the relationships between service quality dimensions and attendant satisfaction, followed by Importance-Performance Map Analysis (IPMA) to prioritize improvement areas. Significant differences in service quality perceptions were observed across gender, age, education, residential status, financing category, and hospital visit frequency, while income and occupation did not show meaningful effects. Tangibility (β = 0.374), responsiveness (β = 0.313), and empathy (β = 0.196) demonstrated significant positive associations with satisfaction, collectively explaining 80.9% of its variance (R² = 0.809), whereas assurance, service reliability, and process reliability were not significantly associated with satisfaction. IPMA result indicate that empathy represents a key area for refinement, while tangibility and responsiveness demonstrate high importance alongside strong performance, suggesting areas to be maintained. Overall, the findings provide insights into factors associated with attendant satisfaction, improving patient-centered oncology services.