<![CDATA[Background: Hemodialysis care creates repeated interactions between healthcare providers, patients, and family members. Families who accompany patients during hemodialysis often evaluate the quality of services while also experiencing emotional tension related to caregiving demands. However, limited evidence has examined the relationship between patient family satisfaction and affective anger among families of hemodialysis patients. Objective: This study aimed to examine the relationship between patient family satisfaction and affective anger among families of patients undergoing hemodialysis at Lampung General Hospital. Methods: This study used an analytical cross-sectional design. The study was conducted in the hemodialysis unit in Bandar Lampung. A total of 179 adult family members of patients undergoing hemodialysis were selected using purposive sampling. Patient family satisfaction was measured using an adapted SERVQUAL-based questionnaire focusing on responsiveness and reliability, while affective anger was assessed using the emotional burden subscale of the Cognitive Behavioural Assessment. Data were analyzed using descriptive statistics and the Spearman Rank correlation test because the data were not normally distributed. Results: Most respondents reported being somewhat satisfied with hemodialysis services (50.8%), followed by satisfied (29.6%), dissatisfied (10.1%), very dissatisfied (8.4%), and very satisfied (1.1%). Affective anger was mostly categorized as low (37.4%), followed by moderate (28.5%), very low (16.8%), high (10.1%), and very high (7.3%). The Spearman Rank correlation test showed a strong, significant, and negative relationship between patient family satisfaction and affective anger (rs = -0.693; p < 0.001). Higher family satisfaction was associated with lower affective anger among family members. Conclusion: Patient family satisfaction was strongly and negatively associated with affective anger among families of hemodialysis patients. Hemodialysis units should strengthen family-centered care through responsive communication, reliable service processes, structured information delivery, and early identification of family emotional distress.]]>
