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Objective: To investigate the needs of the patients in the observation room of the emergency department in a Macau hospital. Method: A descriptive approach was adopted, questionnaires are used to interview the patients in the observation room of emergency department of a Macau hospital. Results: 170 patients completed the questionnaires and the ‘Medical caring needs’ and ‘Patients' conditions’ were their priority. In the patient-self-reports, having ‘cleaned and tidy beds’ and ‘comfortable temperature and quiet environment’ were the prior needs. Moreover, there was significant differences between the sex and health care needs of the patients (P=0.05), and between ‘triage decisions’ and ‘Patients' conditions’ (P=0.02). Conclusion: The findings may provide further understanding of the patients' needs in the emergency department observation room for the medical staff working in the emergency and it could enhance the service quality for the patients. [ABSTRACT FROM AUTHOR]