Patient satisfaction is an important indicator of healthcare service quality, particularly in primary healthcare settings. Nurses’ performance, therapeutic communication, and nursing service quality may influence patients’ perceptions of healthcare services. This study aimed to develop and examine a structural model of patient satisfaction based on nurses’ performance, therapeutic communication, and nursing service quality at Magepanda Community Health Center, Sikka Regency, East Nusa Tenggara, Indonesia. A quantitative observational analytical study with a cross-sectional design was conducted from May to July 2026 involving 422 patients recruited using consecutive sampling. Data were collected using structured questionnaires and analyzed using SPSS version 27 and SmartPLS version 4.0. SEM-PLS was performed using 5,000 bootstrap resamples. Nurses’ performance (β = 0.287; t = 5.812; p < 0.001), therapeutic communication (β = 0.341; t = 7.456; p < 0.001), and nursing service quality (β = 0.456; t = 10.983; p < 0.001) significantly and positively influenced patient satisfaction. Nursing service quality demonstrated the strongest effect. The model explained 78.1% of the variance in patient satisfaction (R² = 0.781), with Q² = 0.612 and SRMR = 0.058. These findings indicate that strengthening nurses’ performance, therapeutic communication, and nursing service quality through an integrated approach may improve patient satisfaction in primary healthcare settings.
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