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

Knowledge of the Patients' Bill of Rights and Influencing Factors Among University Nursing Students

Background Nursing students, the future nursing workforce, are expected to be exposed to ethically challenging situations in their workplaces, and they must be knowledgeable about patients' rights to provide holistic care. However, limited research was cited on the knowledge of nursing students regarding the Bill of Rights and the factors influencing their knowledge. Purpose This study aimed to assess nursing students' knowledge of the patients' bill of rights and determine what factors influence this knowledge in Saudi Arabia. Methods A descriptive cross-sectional research study was conducted with a convenience sample of nursing students (N = 210) in a Saudi nursing college. Data were collected using a questionnaire that consists of three parts: demographic characteristics, knowledge of the patients' bill of rights, and six open-ended and reflective questions. Descriptive statistics and response analysis are used. Results The statistics showed that the total knowledge score about patients' rights ranged from 19 to 34, with a mean of 26.11 ± 2.32, among nursing students. About two-thirds of students reported adequate knowledge (n = 118, 65.5%), compared to those who had inadequate knowledge (n = 62, 34.5%). In addition to academic level and age, students reflected on many factors that shape their ethical knowledge, such as integrated, interprofessional learning experiences, workshops, a supportive and ethical learning environment, and the presence of an ethical committee. Conclusion Continuous efforts to foster ethics education with inspiring learning content and innovative instructional material are vital to improving nursing students' knowledge and readiness. Interprofessional education (IPE) sessions and awareness programs are effective strategies to improve their ethical awareness and knowledge.

Current state of ethical challenges reported in Saudi Arabia: a systematic review & bibliometric analysis from 2010 to 2021

Background

Over the past few years, five domains of importance about the current state of bioethics in Saudi Arabia have shaped the perspective of most research: doctor-patient relationship, informed consent, do-not-resuscitate, organ donation, and transplantation, medical students’ knowledge and attitudes about medical ethics curriculum. This systematic review aimed to systematically identify, compile, describe and discuss ethical arguments and concepts in the best-studied domains of bioethics in Saudi Arabia and to present cultural, social, educational, and humane perspectives.

Methods

Six databases were searched using Boolean operators (PubMed, Embase, Web of Science, Scopus, CINAHL, Google Scholar) from December 2020–June 2021. The search and report process followed the statement and flowchart of preferred reporting items for systematic reviews and meta-analyses (PRISMA).

Resutls

The search resulted in 1651 articles, of which 82 studies were selected for a final review and assessment. There is a gradual increase in research, whereby a substantial increase was observed from 2017. Most of the published articles focused on ‘Organ Donation & Transplantation’ with 33 articles, followed by ‘Doctor-Patient Relations’ with 18 publications. Most of the published articles were from Central Province (33), followed by Western Province (16). The authorship pattern showed a collaborative approach among researchers. The thematic analysis of keywords analysis showed that ‘Saudi Arabia,’ ‘attitude PHC,’ ‘organ donation,’ ‘knowledge and education,’ and ‘donation’ have been used the most commonly.

Conclusion

This systematic quantitative synthesis is expected to guide researchers, stakeholders, and policymakers about the strengths and gaps in knowledge and attitudes regarding medical ethics in Saudi Arabia, both among the general public and health professionals.

Observance of patients' rights by physicians and nurses from the COVID-19 patients' perspective

Observance of patients' rights is a significant indicator in evaluating the quality of healthcare services. The COVID-19 pandemic has become a global crisis and affected the interactions between healthcare providers and patients. This study examined the COVID-19 patients' viewpoint about the observance of their rights by physicians and nurses. This study is a descriptive cross-sectional work of research conducted on the COVID-19 patients in Zanjan Province, Iran, in September 2020. The subjects were selected through convenience sampling, and data was collected using a two-section questionnaire consisting of a demographic characteristics survey and a Likert-type scale for evaluating patients' rights observance. The validity and reliability of the questionnaire were found to be acceptable, and the collected data was analyzed in SPSS v.26 using descriptive statistics, independent t-test, and ANOVA test. The mean score of observance of patients' rights was 69.60±7.36, representing a moderate level. The highest and lowest scores for the observance of patients' rights were related to the dimensions of courteous communication and responsibility, respectively. A significant relationship was found between the observance of patients' rights and their marital status, health insurance, and education level (P<0.05). This study showed that the observance of the COVID-19 patients' rights has not been affected by the social agitation caused by this disease.

Awareness, Intention to Act and Action in the Exercising of Patients' Rights: A Case Study of Patients in Khmer Soviet Friendship Hospital, Phnom Penh, Cambodia

Background and Objectives

In Cambodia, the patients' rights guideline was officially released in 2007 as a measure of the government policy to promote greater awareness and empower Cambodian people to exercise their rights as patients. The aim of this study was to identify the proportion of patients aware of the existence of patients' rights and compare the proportions of patients intending to exercise their rights and those actually exercising their rights among the aware and unaware groups.

Methods

Data were collected with a structured questionnaire, using face-to-face interview technique, from 142 randomly selected outpatients visiting the Khmer Soviet Friendship Hospital in Phnom Penh, Cambodia. Intention to exercise patients' rights was measured on a 5-point Likert scale (ranging from 1 "definitely not" to 5 "definitely yes").

Results

The proportion of Cambodian patients who were aware of the existence of patients' rights was 31.0% (95% CI: 23.5, 39.3). The average intention to act scores was 4.0±0.5 for the whole group, and 4.3±0.4 and 3.9±0.5 for those aware and unaware of the existence of patients' rights, respectively. The difference in the mean scores of intentions to act between the aware and unaware groups was statistically significant (mean difference =0.40, 95% CI: 0.22, 0.58, t₁₄₀=4.514, P< 0.001). Patients reported a total of 250 situations in which they believed they should take action to exercise their rights and 96 times that they took action (38.4%, 95% CI: 35.46, 41.34).

Conclusion

The proportion of Cambodian outpatients aware of the existence of patients' rights and the proportion of outpatients that exercised their rights were both low. Nevertheless, it appeared that raising awareness of the existence of patients' rights raised patient's intention to act, which corresponds to the hierarchy-of-effects behavioral model.

The Awareness of Patients' Bill of Rights among Medical Interns and Medical Students at Tabuk University

BACKGROUND

Incorporating patient priorities and preferences into their healthcare can improve desirable proximal outcomes related to communication such as the patient feeling heard, understood, respected and engaged in their care, which can soften the negative effects of the illness and can help clinicians in decision-making.

AIM

To determine the level of awareness and knowledge of Patients' Bill of Rights and factors affecting it among undergraduate students and medical interns.

METHODS

This is a cross-sectional study carried out in Tabuk city among all medical interns doing their clinical rotations at Tabuk city (n = 70) as well as the 4th, 5th and 6th-year medical students, Tabuk University (n = 219). An English self-administered valid and reliable questionnaire, based on patients` Bill of Rights (PBR) document published by the Ministry of Health (MOH), Kingdom of Saudi Arabia (KSA) was utilised for data collection.

RESULTS

The study included 205 medical students and interns out of invited 289, giving a response rate of 70.9%. All were Saudis. Almost two-thirds (69.3%) reported hearing about patients` bill of rights. Among those who have heard about these rights, 40.2% gained their information from lectures whereas 16.2% gained the information from hospital posters. The total knowledge score about Patients` Bill of Rights ranged between 0 and 32 (out of a possible maximum of 34) with a mean ± SD of 24.6 ± 4.6 and median (IQR) of 25 (23-27). There was a significant positive correlation between student`s age and total score of knowledge of patients` bill of rights, Spearman`s correlation coefficient (r) = 0.18, p = 0.014. The mean rank of the total knowledge score was 83.98 among 4th-grade medical students and reached to 125.07 among medical interns, p = 0.003.

CONCLUSION

Overall awareness and Knowledge of the senior medical students and interns in the College of Medicine, Tabuk University regarding patients` rights age acceptable. However, some deficient issue needs to be improved.