Depression, anxiety, and healthcare satisfaction among hospitalized patients in Bangladesh: a multicenter cross-sectional study

Depression and anxiety are common among hospitalized patients and may adversely affect treatment experiences, recovery, and overall well-being. Healthcare satisfaction has been increasingly recognized as an important correlate of patients' psychological health; however, evidence among hospitalized patients in Bangladesh remains limited. This study aimed to determine the prevalence of depressive and anxiety symptoms and examine their associations with healthcare satisfaction and selected socio-demographic and clinical characteristics among hospitalized adults in tertiary hospitals in Bangladesh. A multicenter cross-sectional study was conducted between October 2021 and April 2022 in six tertiary hospitals in Dhaka, Bangladesh. Using a multistage sampling technique, 401 hospitalized adult patients were recruited through systematic random sampling. Data were collected via face-to-face interviews using a structured questionnaire, demonstrated excellent internal consistency and construct validity. Depressive and anxiety symptoms were assessed using the validated Hospital Anxiety and Depression Scale (HADS). Healthcare satisfaction was measured using a 32-item questionnaire covering basic facilities, medical staff behavior, quality of care, treatment cost, and healthcare provider practices. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were performed. Overall, 25.2% (95% CI 21.0%–29.4%) of participants had depressive symptoms and 27.7% (95% CI 23.3%–32.1%) had anxiety symptoms. After multivariable adjustment, patients with middle household income had significantly higher odds of depression (AOR = 2.70, 95% CI 1.49–4.89) and anxiety (AOR = 2.84, 95% CI 1.57–5.11) than those with higher income. Hospitalization for ≤ 10 days was associated with lower odds of depression (AOR: 0.06; 95% CI 0.02–0.22) and anxiety (AOR: 0.18; 95% CI 0.06–0.56) compared with longer hospital stays. Living in a nuclear family was associated with lower odds of anxiety (AOR = 0.54, 95% CI 0.33–0.87). Patients who reported dissatisfaction with medical staff behavior had higher odds of anxiety (AOR = 10.45, 95% CI 1.29–84.37), although this estimate should be interpreted cautiously because of the small number of dissatisfied participants. Depressive and anxiety symptoms were common among hospitalized patients in tertiary hospitals in Bangladesh. Healthcare satisfaction, particularly satisfaction with medical staff behavior, together with household income, family structure, and duration of hospitalization, was associated with patients' psychological health. These findings highlight the importance of integrating patient-centered healthcare services with routine mental health screening in hospital settings. However, prospective studies are warranted to confirm these relationships.