Patients' healthcare, education, engagement, and empowerment rights' framework: Patients', caretakers' and health care workers' perspectives from Oromia, Ethiopia

Active and direct patient participation in health professions education: A narrative overview of literature from the global south

OBJECTIVES

Patients traditionally played a passive role in health professions education (HPE). However, their active involvement is increasingly valued, particularly in higher-resourced regions of the world known as the Global North. This study explores active and direct patient involvement in HPE contexts in the Global South (GS) regions of the world.

METHODS

A narrative review of literature was conducted, utilising a systematic search of multiple electronic databases. 3966 abstracts were identified, and 80 full texts were reviewed. Ultimately, five papers were included in the final corpus.

RESULTS

The selected studies were set in five GS countries, involving undergraduate, postgraduate medical and pharmacy training. Real patients, their caregivers and standardized patients acted as teachers or assessors focusing on learners' history-taking, communication skills, and professionalism. Challenges included cultural sensitivity and safety concerns, e.g. during home visits. Educators faced difficulties in patient recruitment, training and compensation.

CONCLUSION & PRACTICE IMPLICATIONS

Active and direct patient involvement in HPE within GS contexts remains limited. Current efforts focus on patients as teachers or assessors, with little contribution to educational design, instruction and mentoring. Educators may be overlooking the potential of diverse cultural perspectives to enhance patient engagement in HPE, making this a valuable area for future research.

Patient autonomy in self-managing their bronchial asthma exacerbation and its associated factors, 2024

Introduction

Asthma, a global chronic respiratory condition, varies in patient autonomy due to limited resources, health literacy, and cultural beliefs, emphasizing the importance of understanding this autonomy for improved asthma management.

Methods

A cross-sectional study was conducted at Jimma University Comprehensive Specialized Hospital, involving face-to-face interviews with 175 patients. Data was collected on sociodemographic characteristics, clinical factors, and autonomy levels using a validated Patient Autonomy Preference Index. Descriptive statistics and binary logistic regression analysis were used.

Results

A total of 175 participants were recruited, out of them 41.7% (95% CI: 31.19, 40.41)) of participants were autonomous in managing their asthma exacerbation. 127 (72.6%) of study participants were female, with a mean age of 47.51 (SD ± 13.96), 101(57.7%) were live in urban areas, 54 (30.9%) had no formal education, 140 (80%) were married, 112 (64%) had health insurance, and 102(83.3%) obtained health information about their condition from healthcare workers. Reside in an urban area (AOR = 3.24; 95% CI: 1.40-7.49, p < 0.006), have health insurance (AOR = 4.30; 95% CI: 1.76-10.51, p < 0.001), those doing regular exercise (AOR = 4.79; 95% CI: 1.69-13.64, p < 0.003), have family history (AOR = 7.47; 95% CI: 1.61-34.60, p < 0.01), have a duration above five years since diagnosis (AOR = 0.44; 95% CI: 1.04-1.26, p < 0.003), and participants with a high level of health literacy (AOR = 1.10; 95% CI: 1.00-1.20, p < 0.042) become associated with being autonomous in managing asthma exacerbation.

Conclusion and recommendation

Only around forty-two percent of study participants were autonomous in managing their asthma exacerbation. Thus healthcare providers should give due attention to those who reside in rural areas, are not insured, recently diagnosed with asthma, and with low health literacy to enhance patient autonomy and self-management practices, ultimately improving health outcomes for individuals with asthma.

Dimensions of patient-centred care from the perspective of patients and healthcare workers in hospital settings in sub-Saharan Africa: A qualitative evidence synthesis

INTRODUCTION

The United States Institute of Medicine defines patient centred care (PCC), a core element of healthcare quality, as care that is holistic and responsive to individual needs. PCC is associated with better patient satisfaction and improved clinical outcomes. Current conceptualizations of PCC are mainly from Europe and North America. This systematic review summarises the perceived dimensions of PCC among patients and healthcare workers within hospitals in sub-Saharan Africa (SSA).

METHODS

Without date restrictions, searches were done on databases of the Web of Science, Cochrane Library, PubMed, Embase, Global Health, and grey literature, from their inception up to 11th August 2022. Only qualitative studies exploring dimensions or perceptions of PCC among patients, doctors and/or nurses in hospitals in (SSA) were included. Review articles and editorials were excluded. Two independent reviewers screened titles and abstracts, and conducted full-text reviews with conflicts resolved by a third reviewer. The CASP (critical appraisal skills program) checklist was utilised to assess the quality of included studies. The framework synthesis method was employed for data synthesis.

RESULTS

5507 articles were retrieved. Thirty-eight studies met the inclusion criteria, of which 17 were in the specialty of obstetrics, while the rest were spread across different fields. The perceived dimensions reported in the studies included privacy and confidentiality, communication, shared decision making, dignity and respect, continuity of care, access to care, adequate infrastructure and empowerment. Separate analysis of patients' and providers' perspective revealed a difference in the practical understanding of shared-decision making. These dimensions were summarised into a framework consisting of patient-as-person, access to care, and integrated care.

CONCLUSION

The conceptualization of PCC within SSA was largely similar to findings from other parts of the world, although with a stronger emphasis on access to care. In SSA, both relational and structural aspects of care were significant elements of PCC. Healthcare providers mostly perceived structural aspects such as infrastructure as key dimensions of PCC.

TRIAL REGISTRATION

PROSPERO Registration number CRD42021238411.

Health literacy and patient rights awareness in ethnic Hungarian mothers in Eastern Europe

OBJECTIVES

The paper proposes to identify the determinants of patients' rights awareness in mothers and to examine the relationship of health literacy with awareness of those rights.

METHODS

Our results are based on data from a convenience sample of 894 non-health professional ethnic Hungarian mothers from Hungary, Romania and Slovakia. Health literacy is measured with the HLS-EU-16 questionnaire.

RESULTS

Analysis of variance reveals a significant association of health literacy with patient rights awareness. Our results show that health literacy is the highest among patients who filed a complaint through formal channels and/or took legal measures to restore their rights upon violation. A logistic regression model is built to identify the likelihood of having high patient rights awareness, that is, acting formally for the restoration of rights upon infringement. The model controls for covariates. When controlled for covariates, the likelihood of having high patient rights awareness increases with age, and is higher for mothers with highest education, for inhabitants of larger towns, as well as for those with adequate health literacy.

CONCLUSIONS

The findings of our study have implications for health policy, as they reveal significant inequalities in patient rights culture.

Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review

This comprehensive review delves into the critical role of effective hospital administration in shaping patient outcomes within the healthcare ecosystem. Exploration of key components, strategies, measurement methodologies, and future trends elucidates the multifaceted nature of hospital administration. Key findings underscore the profound impact of administrative decisions and practices on patient safety, satisfaction, and overall well-being. The review highlights the importance of patient-centred care and interdisciplinary collaboration for enhancing patient outcomes. It emphasises the significance of data-driven measurement and benchmarking, which are instrumental in assessing hospital performance and fostering continuous improvement. Looking ahead, emerging technologies, evolving healthcare policies, and persistent challenges are drivers of change in healthcare administration. However, amidst these transformations, the overarching message remains consistent: effective hospital administration is integral to improving patient outcomes. The conclusion calls for a collective commitment from healthcare leaders and policymakers to prioritise the development of capable administrators, invest in technology, promote value-based care, and address healthcare disparities. This collaborative effort ensures that the pursuit of better patient outcomes remains at the forefront of healthcare administration, ultimately shaping the future of healthcare for generations to come.

Respecting, protecting and fulfilling the human right to health

Background

Human rights are best protected, promoted and guaranteed when they can compel binding and enforceability duty. One prominent criticism of category of human rights which includes the human right to health is that it is difficult, to assign the duties that correspond to these rights, because of stark disparity in how the main duty bearers approach their duties.

Methods

This paper adopts a doctrinal approach to examine and evaluate the duties to the right to health. The method in this study entails a detailed literature search to systematically evaluate the legal implications, regulations, arguments and policy regarding the nature of the obligation to the right to health. This study also engages with normative and philosophical aspects of human rights.

Results

This paper posits that human rights protect against common, serious, and remediable threats and risks, and ensure that there are remedies from governments and third parties. However, it is difficult to compel duties especially in regard to the right to health. First it is not easy to achieve a uniform standard for duty bearers implied by the words ‘highest attainable physical and mental health.’ Theorists discussed in the paper outline views of what this could mean, from serious to common health concerns. Second, the right to health is not a legally established right in many jurisdictions, making it difficult to enforce. This paper outlines different layers of state and non-state legal duty bearers to enforce the right to health.

Conclusion

The duty to respect, protect, fulfil and even remedy the right to health, will often be meaningless in practice without a clear identification of the necessary duty bearers to enforce them. The law is the starting point for this to not only enshrine this right as a legally enforceable one but also to clearly identify duty bearers. Without this, the human right to health as outlined under international and regional human rights law generates an implausible, or even impossible, profusion of duties. There remains much work still to be done especially on the moral and legal fronts in order to fully guarantee this right.

Trial Registration

Not applicable

Our work does not report results of a health care intervention on human participants. Registration is therefore not applicable.