Compassionate and respectful care among outpatient clients at public health facilities in Northwest Ethiopia: A mixed-methods study

Compassionate, respectful care and associated factors among radiology clients at public hospitals in Addis Ababa, Ethiopia

BACKGROUND

Compassionate and Respectful Care (CRC) is the basic radiology professional practice. Even though it is an essential component for all health practitioners, limited evidence was available in the study area, especially focusing on radiology services. Identifying levels of compassionate and respectful care and associated factors help in recommendations for improvement for radiology professionals to deliver service with a good habit of compassion and respect to their clients. Therefore, this study aimed to assess the level of compassionate and respectful care and associated factors among radiology clients.

METHODS

Facility-based cross-sectional study design was conducted from July 6 -27, 2022 in public hospitals in Addis Ababa, Ethiopia. Those hospitals were Tikur Anbessa Specialized Hospital, Armed Force Comprehensive Specialized Hospital, and St. Paulos Hospital. A systematic random sampling technique was used to select patients visited radiology departments and radiographers. Epi-Data version 6 and SPSS version 26 were used for data entry and analysis, respectively. Bi-variable and multivariable logistic regression analysis models are used to identify associated factors. Statistical significance was determined using a P-value of less than 0.05 and an adjusted odds ratio with a 95% confidence level.

RESULTS

A total of 333 respondents were involved in the study with a response rate of 99.1%. Overall, compassionate and respectful care of radiology service providers were 66.7% and 70.9% respectively. Mode of transport (AOR (Adjusted Odd Ratio) =2.2, 95% CI (Confidence Interval): 1.00-4.81), waiting time (AOR= 4.10, 95% CI; 1.92-8.76), CRC training (AOR= 2.35, 95% CI; 1.34-4.12) and workload (AOR= 4.02, 95% CI; 1.9-8.51,) were significantly associated with compassionate care. Distance (AOR=2.98, 95% CI: 1.34-6.61), mode of transport (AOR=4.9, 95% CI; 2.09-11.5), number of service providers (AOR=0.52, 95% CI; 0.27-0.98), CRC training (AOR=2.15, 95% CI; 1.18-3.93) and workload (AOR=7.04, 95% CI; 3.13-15.8) were significantly associated with respectful care provision among radiology clients.

CONCLUSION

Compassionate and respectful care radiology service provision in Addis Ababa public hospitals was similar as compared with other studies. Waiting time, transportation, the number of service providers, Compassionate and respectful care training, and workload were significantly associated with compassionate and respectful care service provision. Providing adequate compassionate and respectful care training for service providers, reducing waiting time, and balancing the service provider-to-client ratio should enhance compassionate and respectful care service provision.

Patients' and Healthcare Professionals' Perspectives on Preoperative Informed Consent Procedure Obstacles and Potential Solutions, 2021: A Qualitative Study

Background

Informed consent discussions are individualized not only with regard to the patients' surgical condition and goals but also with their varying information needs, health literacy, and anxiety. Information is lacking regarding the views of patients and concerned healthcare professionals on the informed consent process.

Objective

This study is aimed to explore patients' and healthcare professionals' perceived barriers during informed consent process and identify suggested solutions for improvement.

Methods

Patients who underwent elective surgery, anesthetists, and surgeons were the subjects of a qualitative study employing focused group discussions and in-depth interviews. The study participants were chosen through the use of purposeful sampling.

Results

The main barriers identified by the patients include: inadequate explanation about the intended procedure, family's influence in the decision-making, fear of surgery, fear of light/power interruption, inadequate time for discussion, and not letting the family members attend the discussion. On the other hand, healthcare professionals also identified various barriers, which includes: inability of patients to understand the information, limited time to discuss with patients in detail, poorly designed informed consent form, poor awareness of patients, fear of patient refusal for surgery if the risks and associated health problems are explained, lack of adequate investigation to confidently explain about the disease condition, use of medical jargons, poor documentation habit of professionals and lack of legal system regarding ethical dilemmas.

Conclusions and Recommendation

Patients and healthcare professionals have identified avoidable barriers that need the attention of concerned health professionals, educators, and the healthcare delivery system.

Perceived compassionate care and associated factors among patients with mental illness at Tibebe Ghion specialized and Felege Hiwot comprehensive specialized hospital, Northwest Ethiopia

BACKGROUND

Compassion is the first ethical principle of health care to provide high- quality care that influences patient satisfaction and treatment outcome. However, there is limited data on the level of compassionate mental health care practice in low-resource countries like Ethiopia.

OBJECTIVES

This study aimed to assess the level of perceived compassionate care and associated factors among patients with mental illness at Tibebe Ghion specialized and Felege Hiwot comprehensive specialized hospital, North West, Ethiopia, 2022.

METHODS

An institutional-based cross-sectional study design was conducted from June 18 to July 16, 2022, at Tibebe Ghion Specialized and Felege Hiwot Comprehensive Specialized Hospital. A systematic random sampling technique was used. The level of perceived compassionate care was assessed by the validated 12-item Schwartz Center Compassionate Care Scale among 423 patients with mental illness. Epicollect-5 was used to collect data, which was then exported to the Statistical Product and Service solution version 25 for analysis. Variables with a P-value < 0.05, and 95% confidence interval (CI) were used to declare significant variables at the multivariate logistic regression analysis.

RESULT

The level of perceived good compassionate care was 47.5% (95% CI 42.6%-52.4%). Factors including urban residence (AOR = 1.90; 95%CI 1.08-3.36), duration of illness < 24 months (AOR = 2.68; 95% CI 1.27-5.65), strong social support (AOR = 4.43; 95%CI 2.16-9.10), shared decision making (AOR = 3.93; 95% CI 2.27-6.81), low perceived stigma(AOR = 2.97; 95% CI 1.54-5.72) and low patient anticipated stigma (AOR = 2.92; 95% CI 1.56-5.48) were positively associated with good compassionate care.

CONCLUSION AND RECOMMENDATION

Less than half of the patients had received good compassionate care. Compassionate mental health care needs public health attention. Policymakers should emphasize on compassionate care continuity by including it in the health care curriculum and design appropriate policies to strengthen compassionate care.

Evaluation of compassionate and respectful care implementation status in model healthcare facilities: a cross-sectional study

Background

Compassionate respectful, and caring (CRC) creates a pleasant environment for health workforce (HWF), customers, and families. For the past five years, the Ethiopian Ministry of Health (EMoH) has developed a CRC plan to improve person-centered care. Therefore, we aimed to assess the implementation status of CRC and associated factors in the 16 model health facilities (MHFs) in Ethiopia.

Methods

A cross-sectional study was employed from February to April 2021. A structured and semi-structured questionnaire was used to assess the level of CRC implementation in model health care facilities. Epi-data version 4.3 and SPSS version 26 software were used for data entry and analysis, respectively. Binary logistic regressions analysis was used and significance was obtained at the odds ratio with a 95% confidence interval and P-value < 0.05.

Results

A total of 429 HWF participated in a self-administered questionnaire. The prevalence of compassionate and respectful care among HWF were 60.4%, and 64% respectively. Nurse professionals, midwives, having training on CRC, leader promoting CRC, having a conducive working environment and burnout management for HWF were significantly associated with compassionate care practice. Leaders promoting CRC, having a conducive working environment, and burnout management for HWF were significantly associated with respectful care practice.

Conclusion

The findings identified distinct issues related to CRC implementation in each 16 MHF. Addressing HWF skill gaps, a conducive working environment, and burnout management are encouraged CRC continuity. Incorporate CRC in pre-service education, health system strengthening, and motivating HWF are important for CRC strategic implementation.

Level of compassionate health care service provision and its associated factors among health professionals working in public hospitals of Addis Ababa: health professionals’ perspective

Background

Compassionate health care service is important for good clinical outcomes and patient satisfaction. However, complaints of non-compassionate care became very familiar and popular grievance of the community in the health care system. The aim of this study was to assess the level of compassionate health care service provision and its associated factors among health professionals working in public hospitals of Addis Ababa, Ethiopia.

Methods

A facility based cross sectional study was conducted among six public hospitals of Addis Ababa, Ethiopia. Simple random sampling and systematic sampling methods were applied to select hospitals and each study participants respectively. Data were collected from 400 participants using a self-administered structured questionnaire. The mean of compassionate health care was taken as the cut point to label respondent as good and poor compassionate health care service provider. Bivariate and multivariable logistic regressions were done to determine the associated factors for compassionate care provision. Variables with p values < 0.05 at the multivariable analysis were considered as significantly associated with compassionate care provision.

Results

Only 48.0% of health care professionals provided good compassionate care. Learned to be compassionate (AOR = 5.083; CI 95% 2.69, 9.58); patient and their family realistic expectation (AOR = 2.24; CI 95% 1.07, 4.66) were found to be significantly associated with good compassionate health care provision.

Conclusions

and recommendations: Good compassionate health care service provision in Addis Ababa hospitals was very low. Teaching health science and medical students to be compassionate and ensuring health care clients to have realistic expectation may be important to farther enhance compassionate health care service provision.