Midwives and nurses awareness of patients' rights

Development of a patients' satisfaction analysis system using machine learning and lexicon-based methods

BACKGROUND

Patients' rights are integral to medical ethics. This study aimed to perform sentiment analysis and opinion mining on patients' messages by a combination of lexicon-based and machine learning methods to identify positive or negative comments and to determine the different ward and staff names mentioned in patients' messages.

METHODS

The level of satisfaction and observance of the rights of 250 service recipients of the hospital was evaluated through the related checklists by the evaluator. In total, 822 Persian messages, composed of 540 negative and 282 positive comments, were collected and labeled by the evaluator. Pre-processing was performed on the messages and followed by 2 feature vectors which were extracted from the messages, including the term frequency-inverse document frequency (TFIDF) vector and a combination of the multifeature (MF) (a lexicon-based method) and TFIDF (MF + TFIDF) vectors. Six feature selectors and 5 classifiers were used in this study. For the evaluations, 5-fold cross-validation with different metrics including area under the receiver operating characteristic curve (AUC), accuracy (ACC), F1 score, sensitivity (SEN), specificity (SPE) and Precision-Recall Curves (PRC) were reported. Message tag detection, which featured different hospital wards and identified staff names mentioned in the study patients' messages, was implemented by the lexicon-based method.

RESULTS

The best classifier was Multinomial Naïve Bayes in combination with MF + TFIDF feature vector and SelectFromModel (SFM) feature selection (ACC = 0.89 ± 0.03, AUC = 0.87 ± 0.03, F1 = 0.92 ± 0.03, SEN = 0.93 ± 0.04, and SPE = 0.82 ± 0.02, PRC-AUC = 0.97). Two methods of assessment by the evaluator and artificial intelligence as well as survey systems were compared.

CONCLUSION

Our results demonstrated that the lexicon-based method, in combination with machine learning classifiers, could extract sentiments in patients' comments and classify them into positive and negative categories. We also developed an online survey system to analyze patients' satisfaction in different wards and to remove conventional assessments by the evaluator.

Workplace challenges and nurses recovered from COVID-19

Background:

Although many studies have addressed COVID-19, the challenges faced by nurses in their workplace after recovering from this disease have not been investigated. As the backbone of the health system and at the forefront of the fight against COVID-19, nurses are exposed to serious risks of infection and even death. They may also face numerous challenges in their workplace after recovering from COVID-19. It is therefore ethically recommended that the problems of these nurses be solved to increase their job satisfaction and encourage them to remain in their profession.

Objectives:

The present research was conducted to determine the workplace challenges faced by nurses who had recovered from COVID-19.

Methods:

This qualitative study was conducted using the interpretive phenomenological approach proposed by van Manen. The data collected through 17 in-depth semi-structured interviews with 14 eligible nurses at different occupational levels were analyzed using the six steps proposed by van Manen. These nurses had also recovered from COVID-19.

Ethical considerations:

This study was approved by the Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1399.318).

Findings:

Four themes and 20 subthemes extracted from analyzing the data explained the challenges faced by the nurses after their return to work. The themes included declined ethical values (four subthemes), infected nurses, forgotten patients (three subthemes), gradually leaving the job (six subthemes), and corona phobia (seven subthemes).

Conclusion:

The present findings can be used to lay the foundations for adopting humanitarian policies in health organizations in terms of ethical care provision during future pandemics.

Comparison of the importance and observance of the patient's bill of rights from the perspectives of patients and personnel of hospitals in Kerman

Patients' rights are among the most important criteria for evaluating the quality of health services. The current study aimed to determine the importance and observance of the patient's bill of rights. This cross-sectional study was done in Kerman, Iran. The research samples were 217 patients and 204 personnel. The data collection tool was a researcher-made questionnaire in the scope of the patient's bill of rights, and data were analyzed by SPSS 15. The results showed a significant difference between patients and the personnel on the subject of the patient's bill of rights and most of its dimensions (P < 0.01). However, no significant difference was found between their views on the observance of the patient's bill of rights and its dimensions. Also, 35.9% of patients as well as 25% of personnel considered the observance of patients' rights unfavorable. The participants were aware of the importance of the patient's bill of rights. It is necessary, however, to codify and approve the laws related to the rights of patients.

Operationalization of patients' rights in Sudan: Quantifying nurses' knowledge

BACKGROUND

Promoting patients' rights is essential for defining the standards of clinical services within a country. Given their responsibilities, nurses can be the primary target for research to investigate the issue of patients' rights within a healthcare system. As such, assessing the knowledge of nurses about patients' rights is an essential step toward improving the quality of healthcare in limited resource settings like Sudan.

OBJECTIVES

We aimed to assess the level of knowledge about patients' rights among the nursing staff at Friendship Teaching Hospital in Sudan.

METHODS

This hospital-based cross-sectional study was carried out at the Friendship Teaching Hospital in Sudan. We surveyed the totality of nurses (95) at the hospital using an amended survey. The data were analyzed in SPSS software using descriptive and inferential statistics.

ETHICAL CONSIDERATION

The study was approved by the Research Unit of Khartoum Ministry of Health and the Hospital administration. All respondents gave verbal consent prior to participating in the study.

RESULTS

Only 48.4% of the participants knew about the existence of the Sudanese Charter of patients' rights. Nonetheless, our analysis found that 65.8% of nurses had acceptable level of knowledge (scored more than 75% of the total knowledge score) of patients' rights, and none of the participant scored less than 50% of the total knowledge score. Finally, we found no statistical association between the knowledge score and demographic data, educational level, whether the participant knows about the existence of the Charter or not and a number of other factors.

CONCLUSION

Nurses' lack of knowledge about the existence of the Sudanese Charter of patients' rights adopted in 2009 rights confirms the need for further efforts by Ministry of Health to promote the document. Furthermore, further research is needed to investigate the disconnect between nurses' lack of knowledge about the existence of the charter and their awareness of the rights within the charter as well as the actual implementation of rights.

Patient's Bill of Rights: Is it a Challenge for Quality Health Care in Saudi Arabia?

Background:

Increasing interest in patients' rights and the certainty of its impact on the quality of patient care has led to extensive research in both developed and developing countries. In 2006, the Government of Saudi Arabia publicized the Patient's Bill of Rights (PBR) that was aimed at improving patients' and health-care professionals' experience, with a focus on the quality of care provided.

Objective:

To determine the degree of awareness of rights among patients admitted to hospitals in Al-Madinah Al-Munawarah. The results would help policymakers understand the impact of patients' rights, and thus provide them with evidence to provide quality health-care service delivery and patient care through patients' rights.

Methodology:

This is an observational, analytical, cross-sectional study implemented in Al-Madinah Al-Munawarah, Saudi Arabia, using a self-administered questionnaire.

Results:

The study had a response rate of 83.01% and found an association between gender and knowledge for the selected items of patients' rights. However, there was no statistically significant difference between the knowledge of males and females regarding the consent form, with an awareness rate of 90% among the total sample size. However, almost half had never heard about patients' rights.

Conclusion:

This study shows that in Al-Madinah Al-Munawarah, Saudi Arabia, there is a low level of awareness among patients admitted to hospitals regarding their rights. Further, it was found that wall placards, mass media and health-care providers are important sources of knowledge regarding patients' rights. Health-care policymakers in Saudi Arabia should recognize the importance of patients' rights as means of providing better quality care and a higher rate of patient satisfaction by establishing measures to tackle obstacles that may impede the implementation of PBR.

On the violation of hospitalized patients' rights: A qualitative study

BACKGROUND:

Nurses have always been known as an advocate for the rights of patients. The recognition of what is perceived as the violation of patients' rights can help nurses to understand patients' concerns and priorities. Thus, it helps nurses play their supportive roles more effectively.

OBJECTIVE:

The aim of this study was to explore different dimensions of the violation of patients' rights.

RESEARCH DESIGN:

Data were collected utilizing unstructured interviews and field notes. Data analysis was conducted using the qualitative content analysis approach. Prolonged engagement, maximum variation sampling, and member check were among the factors which enriched the research.

PARTICIPANTS AND RESEARCH CONTEXT:

The sample consisted of 18 patients and 11 members of their families. They were purposively selected from two hospitals in Tehran during 2009-2012.

ETHICAL CONSIDERATIONS:

The research was approved by the Ethics Committee of the university and hospitals.

FINDING:

The patients' rights were violated in a variety of ways. There were three main dimensions to this issue: (a) care recession including deprivation of the caregiver's presence and the delay/lack of needed responses; (b) receiving mechanical care including superficiality, lack of emotion, and failure to understand the situation; and (c) being disrespected including humility and aggression.

CONCLUSION:

The patients and their families consider any shortcomings in relation to the patient and the quality of care as the violation of the rights. The findings of the study imply sensitizing managers toward providing appropriate conditions as well as educating nurses to observe patients' rights. It is suggested that the processes leading to the violation of patients' rights be discovered and prevented in the future.

Awareness and Observance of Patient Rights from the Perspective of Iranian Patients: A Systematic Review and Meta-Analysis

BACKGROUND

Recipients of healthcare services have rights, which must be acknowledged and protected. Such rights include observance of acceptable patient physical, mental, spiritual, and social needs guided by commonly accepted rules and regulations. The objective of this study was to conduct a systematic review and meta-analysis of awareness rates and observance of patient rights in Iran from the perspective of the patient.

METHODS

In this study, various references such as Medline (PubMed), Scopus, Scientific Information Database (SID), Google scholar, Magiran, and IranMedex were searched (from August to December 2015). Heterogeneity was assessed using the Q statistic. English and Persian search keywords and combinations included terms such as "patient bill of rights, patient rights, Iranian patient bill of rights, and Persian patient rights." A meta-analysis of the primary search sources was accomplished using STATA (version 11.0).

RESULTS

Initial review included 20 articles of which 12 assessed observance rates of patient rights and three described service awareness rates of recipients concerning their personal rights. Five articles covered both topics and had an estimated 54.2% coverage based on the results of meta-analysis and the random-effects model with the heterogeneity.

CONCLUSION

An Observance rate of patient bills of rights was considered somewhat adequate. However, contradictions in findings noted in this study suggest deficiencies do exist and need to be resolved. There appears a need to better describe and increase awareness rates of healthcare services by patients concerning their own bill of rights.

Evaluation of Patients' Rights Observance According to Patients' Rights Charter in Educational Hospitals Affiliated to Mashhad University of Medical Sciences: Medical Staffs' Views

Introduction

To supply quality services and healthcare, it is evident that medical ethics and patients’ rights, while providing medical and healthcare services need to be observed. This study was conducted to evaluate observance of the Patients’ Rights Charter among medical staff of educational hospitals affiliated to Mashhad University of Medical Sciences.

Methods

This cross-sectional study was conducted in four educational hospitals in Mashhad on eighty physicians, nurses, nurse aids and medical students. Data were collected using a two-part inventory of patients’ rights, including demographic data and inventory of patients’ rights observance. Data analysis was conducted using SPSS-16 as well as descriptive statistics, independent t-test, chi-square, Spearman correlation coefficient and Pearson correlation.

Results

Mean age of subjects was 36.3±8.3. Observance of human rights was perfect by 84.4 percent of subjects. The highest amount of observance of patients’ rights was related to the area of respecting patients’ privacy and observing the principle of confidentiality, which was evaluated to be perfect by all subjects (100%). The lowest value of patients’ rights observance was related to presenting appropriate and adequate information for patients, which was perfect among 48.1% of subjects. There was no significant relation between personal details (age, gender, education and career) and observance of patients’ rights (p>0.05).

Conclusion

Although in this study, the observance of patients’ rights by medical staff is optimal in most areas, the area of providing appropriate and adequate information needs to be promoted. Therefore, it is suggested that more stringent regulatory policies be compiled and implemented to the items of Patients’ Rights Charter along with training courses, to strengthen medical staff’s awareness in this regard.

Relationship between' patient's rights charter' and patients' satisfaction in gynecological hospitals

BACKGROUND

Patient's satisfaction with hospital services is one of the most important indicators of efficiency and quality of services of different hospital wards.

METHODS

This cross-sectional descriptive analytical study was conducted in 2015. The study population included patients in gynecological hospitals of TUMS, and by using questionnaires; data were collected from 304 patients. Statistical analysis was performed using the SPSS 22.

RESULTS

The rights of patients were mainly observed through "quality of care" (Mean ± SD: 9.65 ± 2.62), "knowing the charges and the right to complain"; (Mean ± SD: 6.00 ± 2.5) "presence of an active system to handle complaints of patients in the hospital and explanation of the error that occurred during service provision to patients by the wrongdoer" is the lowest (7.5 ± 2.62). It was found that patients' satisfaction is below the mean and its different aspects are higher than the mean level. However, the services of physicians and feeding recorded the highest and lowest satisfaction, respectively (19.4 ± 4.25, 20.77 ± 4.39). The mean score of satisfaction of patients admitted with nursing physical care was 24.5 ± 6.2.

CONCLUSION

Overall, patients' satisfaction with hospital services was close to the mean. Deficiencies and grievances should be resolved with a correct measure.

Nurses' knowledge and performance of the patients' bill of rights

BACKGROUND

Observance of the patients' bill of rights is one of the main features of moral codes in hospitals. In this regard, nurses bear great responsibility because they spend a long time with patients. Therefore, the continuous evaluation of the nurses' performance and assessing their knowledge about the patients' bill of rights are a need.

OBJECTIVES

We aimed to determine the nurses' awareness of the patients' rights and measure their performance in this regard. Research design and participants: This cross-sectional study was carried out in 2013. To measure the nurses' knowledge and performance, 250 nurses and 300 patients were surveyed. The participants were selected randomly from five teaching hospitals in Tehran, Iran. Two questionnaires, one for nurses (17 questions) and the other for patients (11 questions), were applied. The data were analyzed in SPSS software using descriptive and inferential statistics. Ethical consideration: The research protocol was submitted and approved by the research and ethics committees of the participating hospitals. Additionally, the consent of all of the participants was obtained before the study.

FINDINGS

The mean score of the nurses' knowledge regarding the patients' rights was acceptable (69.85 ± 11.7 of 85). Furthermore, the mean score of nurses' performance in observing the patients' rights was relatively acceptable (11.2 ± 4.6 of 22). More experienced and educated nurses had higher knowledge regarding the patients' rights, and patients with higher education level or experience of being hospitalized were less satisfied with the nurses' performance.

CONCLUSION

Nurses' knowledge of the patients' bill of rights was acceptable; however, observance of the patients' rights was not. It seems that notification of the patients' bill of rights has increased the nurses' awareness of the patients' rights, although improvement of the nurses' performance needs more extensive measures.

Health providers' compliance with pregnant women's Bill of Rights in labor and delivery in Iran

Background:

Delivery is one of the most important crises with mental, social, and deep emotional dimensions in women's life. Health providers’ respect to pregnant women's Bill of Rights, as an important component of providing humanistic and ethical care, is of utmost importance. This study aimed to determine health providers’ compliance with the pregnant women's Bill of Rights in labor and delivery and some of its related factors in 2013.

Materials and Methods:

This descriptive, cross-sectional study was carried out on the subjects selected through census sampling (N = 257) from among the healthcare providers working in the labor rooms of four educational hospitals. The data were collected by a self-reported questionnaire whose validity and reliability were established. Data were analyzed through descriptive and inferential statistics.

Results:

The compliance with pregnant women's Bill of Rights was found to be at a very high level in 22.8% of the midwifery students, 28.6% of the residents of obstetrics and gynecology, 21.9% of the interns, 50% of the obstetrics and gynecology faculty members (professors), and 31.9% of the midwives. There was a significant difference between the five groups of service providers in terms of overall compliance with mothers’ rights (P = 0.002). The results showed that the residents in higher years of education (P = 0.001), midwifery students in higher semesters (P = 0.001), midwives with more work experience (P < 0.001), and personal experience of being hospitalized in labor room (P < 0.001) had a higher compliance with Bill of Rights. Meanwhile, there was no significant difference in compliance with Bill of Rights between labor and age (P = 0.82).

Conclusions:

The results showed that the health providers’ compliance with the pregnant women's Bill of Rights was not acceptable in the labor room. Therefore, necessary actions are needed to remove the barriers against pregnant women's compliance of Bill of Rights and to facilitate the compliance with it in hospitals.

Rights and duties policy implementation in Chile: health-care professionals' perceptions

Objective

To explore the perceptions of health professionals in an integrated network of public provision of health services regarding the implementation of the Law on Rights and Duties of People in Chile.

Method

Qualitative descriptive study. A stratified qualitative sample of 53 professionals from five low complexity centres and one from a high complexity centre, all part of the integrated network of health services in Valdivia, Los Rios Region, Chile, were selected according to the criteria of an overall saturation of the explored dimensions. The information was gathered through a semi‐structured, in‐depth interview carried out after signing the informed consent. Data were analysed using an inductive approach of content analysis.

Results

Three categories emerged from the interviews: conceptualization and knowledge, factors influencing the implementation and recommendations for strengthening the implementation, and seven subcategories. It was highlighted that health professionals in the health‐care network perceived difficulties in implementing the Law on rights and duties of patients. Among them were the lack of knowledge about the Law, poor exposure and a lack of resources for its implementation. They suggested adapting the infrastructure of the institution and offering training as recommendations to improve the implementation of the Law.

Conclusions

There are hindering factors for the implementation of the Law related to organizational and professional gaps in the institutions providing health care.

The Nursing Students' Views About the Patient's Rights at the West Black Sea Universities in Turkey

BACKGROUND

The members of healthcare team have an important role in implementation and protection of patient's rights. Contemporary nursing entails an ethical responsibility to advocate and protect the patients' rights.

OBJECTIVES

This study was designed to evaluate how ready nursing students, at the end of their education, were to play the role of patient's rights advocates and to discuss ethics education in nursing.

MATERIALS AND METHODS

This descriptive study was performed on nursing students at Black Sea Universities in the academic year 2010-2011. Data were collected using a structured questionnaire about students' attitudes regarding patients' rights including patient's rights regulations. The association between gender and students' attitudes was analyzed using Chi-square test.

RESULTS

The mean age of the 238 participants was 22.11 ± 1.21 years and 82.8% of them were female. The majority of the nursing students held desirable attitudes toward patient information, truth telling, and protection of patients' privacy and medical records. However, the students' views about the rights of patients to refuse treatment, children's active participation in treatment, prioritization of the quality of life in treatment, and respect for the rights of dying patients were less satisfactory.

CONCLUSIONS

The results of this study was concerning with regard to nursing students' readiness for duties such as patient's rights advocacy. Therefore, it proposes ethics education that covers both patient's rights and the obligations of nurses to defend these rights.

The effect of an education-based intervention on self-reported awareness and practice of Iranian nurses in observing patients' rights

Background:

For patients’ rights to be observed, first patients and health care providers should be aware of these rights. Nurses’ lack of awareness of these rights leads to their inability to recognize patients’ legal and ethical issues, and reduces the quality of provided services. This study was conducted to determine the effect of an education-based intervention on self-reported awareness and practice of nurses in observing patients’ rights.

Methods:

In this quasi-experimental study, awareness and practice of 90 nurses on Patient’s Bill of Rights were examined in case and control groups, before, 2 and 4 weeks after an educational intervention program on. Participants were selected from teaching hospitals of Mazandaran University of Medical Sciences, Iran. Data was gathered using the valid and reliable 21-item questionnaire in a 3-point Likert scale during a 5-month period from October 2013 to March 2014. For data analysis, descriptive statistical methods, paired t-test, and repeated measure analysis of variance at significant level P<0.05 were used.

Results:

Participants’ mean age and work experience were found 37.1±5.71 years and 11.76±5.99 years respectively. Mean scores of nurses’ awareness and practice before intervention were 15.12±2.19 and 9.13±2.36, accordingly. Repeated measure analysis of variance test showed a significant difference in awareness and practice of nurses before and after intervention (P<0.001).

Conclusion:

Enhancing nurses’ awareness on Patient’s Bill of Rights through revision of educational curriculum in nursing schools, together with considering appropriate relevant content in continuous education programs in health systems can lead to improved quality of nursing care services.

Knowledge and attitude of Saudi health professions' students regarding patient's bill of rights

BACKGROUND

Patient's rights are worldwide considerations. Saudi Patient's Bill of Rights (PBR) which was established in 2006 contained 12 items. Lack of knowledge regarding the Saudi PBR limits its implementation in health facilities. This study aimed to investigate the knowledge of health professions' students at College of Applied Medical Sciences (CAMS) Riyadh Saudi Arabia regarding the existence and content of Saudi PBR as well as their attitude toward its ineffectiveness.

METHODS

A 3-parts survey was used to collect data from 239 volunteer students participated in the study. Data were analyzed by descriptive and analytical statistics using SPSS.

RESULTS

RESULTS showed that although the majority of students (96.7%) believe in the ineffectiveness of patient's rights, half (52.3%) of them had perceptual knowledge regarding the existence of Saudi PBR and only 7.9% of them were knowledgeable about some items (1-4 items) of the bill. Privacy and confidentiality of patient was the most common known patient's rights. Students' academic level was not correlated to neither their knowledge regarding the bill existence or its content nor to their attitude toward the bill. The majority of the students (93%) reported that only one course within their curriculum was patient's rights-course related. About one quarter (23.4%) of the students reported that teaching staff used to mention patient's rights in their teaching sessions.

CONCLUSION

The Saudi health professions students at CAMS have positive attitude toward the ineffectiveness of patient's rights nevertheless they showed limited knowledge regarding the existence of Saudi PBR and its contents. CAMS curriculums do not support the subject of patient's rights.

Assessing knowledge of the patient bill of rights in central Saudi Arabia: a survey of primary health care providers and recipients

BACKGROUND AND OBJECTIVES

Little is known about the implementation of the patient bill of rights (PBR) in Saudi Arabia. Therefore, this study was conducted to explore to what extent health care recipients and providers know about the bill and its implementation.

DESIGN AND SETTING

A cross-sectional survey conducted on health care professionals and patients at Primary Health Care Centers in Riyadh, Saudi Arabia, during July 2010.

PATIENTS AND METHODS

The study employed a self-administered questionnaire to collect data from 500 patients (aged 18 years or older) and 500 health care providers (physicians and nurses) in primary health care (PHC) centers in Riyadh. Data was collected on the respondents' knowledge of the existence and contents of the bill, the extent to which the bill is implemented, and the obstacles that may hinder bill implementation. The data was analyzed and presented in a descriptive fashion.

RESULTS

More than three quarters of patients and one third of PHC providers did not know about the existence of the bill. Among those who knew about its existence, about three quarters of patients and almost half of PHC providers had little (or very little) knowledge about the bill contents. In general, patients scored lower means of perception than PHC staff about the implementation of the bill's aspects. PHC staff reported several obstacles that may hinder the implementation of the PBR in Saudi Arabia.

CONCLUSIONS

Patients and health care providers lack necessary knowledge about the PBR. More dissemination of information about the bill, taking into account the particularities of the Saudi population is needed. Future research is required to establish measures that are effective in ensuring that patients rights are ensured.

Knowledge about patients' rights among professionals in public health care in Finland

BACKGROUND

The legal rights of patients include civil rights for patients and the duties of healthcare professionals. Knowledge of legislation and the ability to put juridical norms into practice are among the main aspects of professionals.

AIM

The aim of the study was to describe the level of healthcare professionals' knowledge about patients' legal rights and to describe background variables associated with the knowledge. The legal rights are based on the Finnish Act on the Status and Rights of Patients.

METHOD

The data were collected from healthcare professionals (nurses and physicians) in public health care in Finland (recruited N = 290, responded n = 191) with a questionnaire designed for the study. The response rate was 66%. The data were analysed statistically.

RESULTS

Healthcare professionals were partially familiar with patients' legal rights. The right to good health care, treatment and access to care and right to self-determination were the best-known areas. The respondents lacked knowledge on the right to information and the right to use the services of patient ombudsman. Based on self-evaluation, half of the respondents thought that they had weak knowledge of the legislation on patients' rights. However, they perceived knowledge about patients' rights as being important. There was no correlation between respondents' self-evaluated knowledge and actual scoring on the knowledge test.

CONCLUSION

These results implicate a need for further education aimed at healthcare professionals and development of professional training about patients' legal rights.