Kano Model-Based Analysis of Medical and Nursing Service Needs of Fracture Patients and Their Families

Purpose: To explore the structure of medical and nursing service needs of fracture patients and their families via the Kano model, clarify key service attribute categories and improvement priorities, and provide evidence for optimizing orthopedic service systems. Patients and Methods: A cross-sectional study was conducted among 300 patients and their family members from January 2025 to October 2025. A self-designed Kano questionnaire was used to investigate service satisfaction and demand intensity. Kano attribute classification and Better-Worse coefficient analysis were performed. Data were double-entered and verified using Epidata 3.1, and statistically analyzed using R software. Results: Among the 25 service items, 5 were Must-be (M), 5 were One-dimensional (O), 6 were Attractive (A), and 3 Reverse (R). “Dietary guidance” had the highest satisfaction (75.24%), while “Privacy protection” was the lowest (18.08%). In the Better-worse quartile strategy diagram, there were 14 expected attributes (Quadrant I) (56.00%), 7 attractive attributes (Quadrant II) (28.00%), and 4 indifferent attributes (Quadrant IV) (16.00%). Patients had a stronger demand for health education than family members, and demands varied significantly by age. Conclusion: The Kano model analysis can effectively identify and classify the demand attributes of fracture patients and their families, supporting precise quality improvement in medical and nursing services. Prioritizing Must-be attributes and Improvement Area items, and providing personalized services based on group differences, can significantly enhance service quality and satisfaction. Keywords: fracture patients, Kano model, patient needs, medical and nursing quality, precise care