Influence of nurse-patient relationship on hospital attendance. A qualitative study of patients in the Kwahu Government Hospital, Ghana

Patient satisfaction with quality of care at out-patient departments in selected health facilities in Kumasi, Ghana

BACKGROUND

Health care is an indispensable element for economic growth and development of individuals and nations. Healthcare service quality is associated with patient satisfaction, ensuring the safety and security of patients, reducing mortality and morbidity, and improving the quality of life. Patient satisfaction with health service is linked to increased utilization following contendness with healthcare received from health providers. There is an increasing public perception of poor quality of care among patients visiting public health facilities in Ghana which translates into service dissatisfaction. Meanwhile, patient dissatisfaction will more likely result in poor utilization, disregard for medical advice, and treatment non-adherence. The study was conducted to assess patients' satisfaction with quality of care at the outpatient departments of selected health facilities in Kumasi, Ghana.

METHODS

An institutional-based analytical cross-sectional study was conducted among patients (aged ≥ 18 years) visiting outpatient departments of selected health facilities in Kumasi from October - December, 2019. A systematic sampling technique was adopted to collect quantitative information from 385 respondents using a structured questionnaire. At 95% confidence interval and 5% alpha level, two-level logistic regression models were performed. Model I estimated the crude associations and the effect of covariates was accounted for in Model II. The results were presented in odds ratio with a corresponding 95% confidence interval. All analysis were performed using STATA statistical software version 16.0.

RESULTS

Out of the 385 participants, 90.9% of the participants were satisfied with the services they received. Being married [AOR = 3.06, 95%CI = 1.07-8.74], agreeing that the facility is disability-friendly [AOR = 7.93, 95%CI = 2.07-14.43], facility has directional signs for navigation [AOR = 3.12, 95%=1.92-10.59] and the facility has comfortable and attractive waiting area [AOR = 10.02, 95%CI = 2.35-22.63] were associated with satisfaction with health service among patients. Spending more than 2 h at the health facility [AOR = 0.45, 95%CI = 0.04-0.93] and having perceived rude and irritating provider [AOR = 0.14, 95%CI = 0.04-0.51] had lower odds of satisfaction with health service received.

CONCLUSION

There is a high patient satisfaction with services received at out-patient departments which is influenced by a multiplicity of factors; being married, and agreeing that the facility is disability-friendly, has directional signs for navigation, and the waiting area is comfortable and attractive. The study findings call for the need to develop and implement health delivery interventions and strategies (i.e. patient-centered interventions, disability-friendly facilities, and sustainability and improvement of quality service) to improve and sustain patient satisfaction levels with health care service. These strategies must be directed towards addressing inequalities in infrastructural development and inputs needed for healthcare delivery in the health system.

Pediatric nurse-patient communication practices at Pentecost Hospital, Madina: A qualitative study

Purpose

Delivering quality health care requires effective communication between health care providers and their patients. Nurse-patient effective communication remains a challenge in Ghana, despite criticism and concern expressed by the public. The study, therefore, aims to assess the effective nurse caregivers’ communication practices among pediatric nurses at Pentecost Hospital, Madina.

Methods

A qualitative exploratory and purposive sampling technique were used. Participants were engaged in Focus group discussions or face-to-face interviews. In all, 4 focus group discussions were conducted with 7 participants in each group and 15 face-face in-depth interviews, with a total sample size of 43. The data was content analyzed. Interviews were taped recorded and transcribed verbatim.

Results

The data analysis yielded 3 themes and 11 subthemes. The main themes were: effective communication practices, factors influencing effective communication, and attitudes towards effective communication. The study revealed how the participants communicated with patients who are deaf-mute, anxious, and those who refused treatment. In addition, participants reported how they used techniques such as silence, listening, and leading cues in communicating with patients and their relatives.

Conclusion

Effective communication between pediatric nurses, patients, and their parents is ascertained to be a key tool in the delivery of quality health care. However, several factors are found to hinder this therapeutic communication. Hence, further studies are needed to improve effective communication skills among pediatric nurses and their patients to enhance health care for children.

First-year nursing students' initial contact with the clinical learning environment: impacts on their empathy levels and perceptions of professional identity

Background

Research shows that the clinical learning environment can affect medical learners’ levels of empathy and formation of professional identity. However, few studies examined the impacts of early exposure to the clinical learning environment on first-year nursing students’ empathy levels and professional identity perceptions.

Aim

This study aimed to explore effects of initial contact with the clinical learning environment on first-year nursing students’ empathy levels and perceptions of professional identity.

Methods

This is a mixed-methods study conducted in a medical university and its affiliated hospital in Northeast China. For quantitative analysis, 220 first-year nursing students finished Interpersonal Reactivity Index (IRI) twice before and after their five-day clinical placement in the hospital in June, 2021. Paired samples t tests were used to explore the changes in first-year nursing students’ cognitive empathy, affective empathy and total empathy levels as measured by IRI before and after the clinical placement. For qualitative analysis, 15 first-year nursing students’ diary recording their clinical learning experiences were analyzed. An inductive thematic analysis approach was adopted to extract themes from the content on professional identity in nursing students’ diary.

Results

After the five-day clinical placement, first-year nursing students’ cognitive empathy, affective empathy and total empathy levels all increased. Five themes emerged regarding nursing students’ perceptions of professional identity: (1) Love for the nursing profession; (2) Multiple roles nurses play; (3) Personal characteristics a good nurse needs to have; (4) Deeper understanding of the nursing profession; (5) New understanding of the relationships between patients and nurses, between patients and doctors, and between doctors and nurses.

Conclusions

First-year nursing students’ initial contact with the clinical learning environment helped them enhance empathy levels and shape professional identity. Nursing educators may consider providing nursing students with opportunities of early exposure to the clinical learning setting to cultivate their empathy and develop their professional identity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01016-8.