Evaluation of Patient Satisfaction with Swedana Therapy at Ayurveda Teaching Hospital, Kirtipur, Nepal

Introduction

Ayurveda is a traditional system of medicine [1], rooted in Vedic literature [2], offering preventive, diagnostic, and therapeutic health services [3]. Globally, traditional medicines are recognized for their accessibility, affordability, and cultural acceptability [4]. Swedana therapy, a key component of Panchakarma in Ayurveda, uses heat to facilitate detoxification and restore balance in the body. It is a widely practiced procedure in Ayurvedic Panchakarma units [5].

Historically, Swedana therapy has been significant in the treatment of conditions ranging from musculoskeletal disorders to stress-related ailments [6]. As one of the Shadavidhopakrama, it holds an important place in Ayurvedic therapeutic practice [7].

Tribhuvan University Ayurveda Teaching Hospital, Kirtipur, Kathmandu, provides outpatient department (OPD), inpatient department (IPD) services, along with specialized Ayurveda services such as Panchakarma and Ksharsutra [8]. The number of patients seeking Panchakarma services is increasing, with Swedana being one of the most predominantly used services in the Panchakarma department. Despite the presence of competent doctors, problems sometimes persist due to hospital policies, work culture, and attitudes displayed by the staff [9].

      Patient satisfaction is a key metric of healthcare quality and reflects both the efficacy and acceptability of Swedana therapy in hospital settings. Factors such as general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with the doctor, accessibility, and convenience are essential in determining the quality of care and the overall patient satisfaction level in the hospital [10]. Despite its prominence, there is limited research on patient experiences with Ayurveda. No studies have been reported on Swedana therapy and patient satisfaction in Nepal. This study aims to address this gap by evaluating patient satisfaction specifically regarding Swedana therapy at the Ayurveda Teaching Hospital.

Methodology
Study Design and Setting: This study employed a cross-sectional descriptive design conducted at the Ayurveda Teaching Hospital, a renowned institution for Ayurvedic treatments in Kirtipur, Nepal. The hospital’s expertise in Swedana therapy made it an ideal setting for evaluating patient satisfaction.
Participants: A purposive sample of 20 patients who had undergone Swedana therapy were selected. Inclusion criteria required participants to have completed at least two therapy sessions within the past month. Patients with chronic conditions were excluded to minimize potential confounding factors.
Data Collection: Structured questionnaires with Likert scale-based responses were used to assess demographic characteristics, therapy-related experiences, and satisfaction levels. Pretesting ensured the reliability and clarity of the questionnaire.
Data Analysis: Descriptive statistics were used to summarize demographic data and satisfaction scores. Responses were analyzed using SPSS software to identify trends and correlations.

Demographic Characteristics:

• Gender: Of the 20 respondents, 65% were female, and 35% were male.
  • Age: The age range of participants spanned from 15 to 72 years, with a mean age of 44 years.
  • Education: Approximately 35% of participants had completed secondary education, followed by 20% with higher secondary and 20% with postgraduate qualifications.
  • Occupation: Housewives constituted the largest group (45%), followed by employed individuals (25%).

Therapeutic Satisfaction:

• Effectiveness: 25% of respondents rated the therapy as highly effective, while the majority expressed moderate satisfaction.
• Environment: While 25% of respondents appreciated the cleanliness and ambiance of the facility, 40% rated the environment as neutral, indicating areas for improvement.
• Humanity of Care: Compassionate care received the highest satisfaction scores, with 35% expressing satisfaction and 10% reporting very high satisfaction.
• Organizational Factors: Scheduling and waiting times drew mixed responses. While 30% were satisfied, 10% expressed dissatisfaction.

Discussion

The study’s findings provide valuable insights into patient experiences with Swedana therapy, highlighting both areas of success and those in need of improvement. The majority of patients expressed satisfaction with the therapy’s effectiveness, particularly its ability to alleviate symptoms and enhance both physical and mental well-being. These findings align with existing literature, which underscores Swedana therapy’s role in detoxification, circulation enhancement, and stress reduction.

       Demographic trends revealed that younger patients and females reported slightly higher satisfaction levels. This may be attributed to differences in health expectations, communication preferences, or the perceived value of Ayurvedic therapies. Such patterns are consistent with broader healthcare research, which emphasizes the importance of tailoring services to demographic characteristics.

            The high satisfaction with the humanity of care reflects the skill and compassion of the therapists. This is a testament to the personalized approach inherent in Ayurveda, which prioritizes the patient’s holistic well-being. However, neutral and dissatisfied responses regarding environmental and organizational factors suggest potential barriers to achieving optimal satisfaction. Cleanliness, comfort, and the overall ambiance of therapy rooms were common concerns.

       Studies focusing on patient satisfaction often emphasize teamwork, the use of technical tools, and the role of information and communication technologies in coordinating care [12]. While much research has been conducted on patient satisfaction with medical services, fewer studies have explored satisfaction with traditional medicine-specific services, particularly the Panchakarma Swedana procedure. A cross-sectional descriptive study on patient satisfaction at Naradevi Ayurveda Hospital in Nepal, involving patients attending the outpatient department, suggested improvements such as the introduction of a health insurance scheme, faster services, and extended OPD hours to improve service quality [13]. Another study focused on identifying the gaps between the “perceived” and “practiced” standards of Panchakarma procedures, underscoring the need for standardized protocols and better patient education [14]. Appropriate questionnaire may become a useful tool to assess quality of health care in Ayurveda hospital [15]. Client satisfaction among patients attending a district Ayush Hospital in Karnataka, which had different Ayush systems, was also done but not focused on Swedana only [16]. The impact of service quality on customer satisfaction of foreigners in Panchakarma therapies was done [17].

        These studies further support the need for addressing environmental and organizational factors to enhance patient satisfaction. Ensuring a clean, comfortable, and efficient service environment is critical for optimizing the therapeutic experience, especially in traditional medicine practices like Ayurveda.

Conclusion

Swedana therapy demonstrates significant therapeutic and patient satisfaction potential, as the majority of patients reported a positive experience. However, addressing gaps in environmental quality, organizational efficiency, and staff training could further enhance patient satisfaction. As Ayurveda continues to gain global recognition, these insights are invaluable for effectively integrating traditional therapies into modern healthcare systems.

Recommendations:

1. Enhance Facilities: Improve cleanliness and ambiance in therapy rooms to create a more relaxing and comfortable environment. Introduce efficient scheduling systems to minimize waiting times and improve overall patient experience.
2. Continuous Training: Provide regular training for staff in effective communication, patient-centric care, and cultural competency to improve the quality of interactions and therapeutic outcomes.
3. Feedback Mechanisms: Implement robust feedback systems to gather patient opinions and concerns in real time, allowing for immediate action and continuous improvement of services.
4. Public Awareness: Increase public awareness of the benefits and limitations of Swedana therapy through informational campaigns, helping to set realistic expectations and enhance patient understanding.

Acknowledgements: The authors are thankful to Ayurveda Campus, IOM, Tribhuvan University, Nepal for giving the platform to carry out the observational research.

Financial Support & Sponsorship: Nil

Conflicts of Interest: Nil

Ethical Compliance: The study did not involve any interventions or clinical trials but focused solely on patient feedback. All data was collected and analyzed in accordance with privacy and ethical guidelines. The study adhered to the principles outlined in the Declaration of Helsinki.

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