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      Patients’ perception of quality of nursing care; a tertiary center experience from Ethiopia

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          Abstract

          Background

          Nursing care closely influences patients’ satisfaction with the overall quality of care, and the importance of measuring patient satisfaction with nursing care cannot be emphasized enough. Data are however scarce regarding patients’ perception of quality of nursing care in Ethiopia. We performed this study to assess patient’s perception of the quality of nursing care in a tertiary center in Ethiopia.

          Methods

          Data were collected prospectively using Quality of Nursing Care Questionnaires-patient of Safford & Schlotfeldt. A total of 340 patients were included using systematic random sampling and data were analyzed using SPSS for windows version- 20.

          Result

          The nursing care performance was highest for nurse-physician relation (mean = 3.95) and low for education and home care preparation and physical care (mean score of 2.79 and 2.89 respectively). The emotional care and nurse administration mean score were 3.5 and 3.83 respectively. The overall nursing quality was neither satisfying nor dissatisfying (mean of 3.39). While only 36% of the respondents were satisfied with the nursing care, patient education has the strongest (AOR of 7.4) association with satisfaction.

          Conclusion

          Patients perceived low quality of physical care, education and preparation for home care but better nurse-physician relation and nursing administration. However the overall quality measure was neither satisfying nor dissatisfying. This calls for an action from the health care administrators, educators and other stakeholders to improve the patient perception of quality nursing care.

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          Most cited references26

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          Patients' experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care.

          To determine what aspects of healthcare provision are most likely to influence satisfaction with care and willingness to recommend hospital services to others and, secondly, to explore the extent to which satisfaction is a meaningful indicator of patient experience of healthcare services. Postal survey of a sample of patients who underwent a period of inpatient care. Patients were asked to evaluate their overall experience of this episode of care and to complete the Picker Inpatient Survey questionnaire on specific aspects of their care. Patients aged 18 and over presenting at five hospitals within one NHS trust in Scotland. 3592 questionnaires were mailed to patients' homes within 1 month of discharge from hospital during a 12 month period. Two reminders were sent to non-responders; 2249 (65%) questionnaires were returned. Almost 90% of respondents indicated that they were satisfied with their period of inpatient care. Age and overall self-assessed health were only weakly associated with satisfaction. A multiple linear regression indicated that the major determinants of patient satisfaction were physical comfort, emotional support, and respect for patient preferences. However, many patients who reported their satisfaction with the care they received also indicated problems with their inpatient care as measured on the Picker Inpatient Survey; 55% of respondents who rated their inpatient episode as "excellent" indicated problems on 10% of the issues measured on the Picker questionnaire. The evidence suggests that patient satisfaction scores present a limited and optimistic picture. Detailed questions about specific aspects of patients' experiences are likely to be more useful for monitoring the performance of various hospital departments and wards and could point to ways in which delivery of health care could be improved.
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            Hospitalized patients' participation and its impact on quality of care and patient safety.

            To understand the extent to which hospitalized patients participate in their care, and the association of patient participation with quality of care and patient safety. Random sample telephone survey and medical record review. US acute care hospitals in 2003. A total of 2025 recently hospitalized adults. Hospitalized patients reported participation in their own care, assessments of overall quality of care and the presence of adverse events (AEs) in telephone interviews. Physician reviewers rated the severity and preventability of AEs identified by interview and chart review among 788 surveyed patients who also consented to medical record review. Of the 2025 patients surveyed, 99.9% of patients reported positive responses to at least one of seven measures of participation. High participation (use of >4 activities) was strongly associated with patients' favorable ratings of the hospital quality of care (adjusted OR: 5.46, 95% CI: 4.15-7.19). Among the 788 patients with both patient survey and chart review data, there was an inverse relationship between participation and adverse events. In multivariable logistic regression analyses, patients with high participation were half as likely to have at least one adverse event during the admission (adjusted OR = 0.49, 0.31-0.78). Most hospitalized patients participated in some aspects of their care. Participation was strongly associated with favorable judgments about hospital quality and reduced the risk of experiencing an adverse event.
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              Client satisfaction and quality of health care in rural Bangladesh.

              To assess user expectations and degree of client satisfaction and quality of health care provided in rural Bangladesh. A total of 1913 persons chosen by systematic random sampling were successfully interviewed immediately after having received care in government health facilities. The most powerful predictor for client satisfaction with the government services was provider behaviour, especially respect and politeness. For patients this aspect was much more important than the technical competence of the provider. Furthermore, a reduction in waiting time (on average to 30 min) was more important to clients than a prolongation of the quite short (from a medical standpoint) consultation time (on average 2 min, 22 sec), with 75% of clients being satisfied. Waiting time, which was about double at outreach services than that at fixed services, was the only element with which users of outreach services were dissatisfied. This study underscores that client satisfaction is determined by the cultural background of the people. It shows the dilemma that, though optimally care should be capable of meeting both medical and psychosocial needs, in reality care that meets all medical needs may fail to meet the client's emotional or social needs. Conversely, care that meets psychosocial needs may leave the clients medically at risk. It seems important that developing countries promoting client-oriented health services should carry out more in-depth research on the determinants of client satisfaction in the respective culture.
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                Author and article information

                Contributors
                teshgish@gmail.com
                yeshidinbera@yahoo.com
                atnemekonnen@yahoo.com
                Journal
                BMC Nurs
                BMC Nurs
                BMC Nursing
                BioMed Central (London )
                1472-6955
                14 August 2019
                14 August 2019
                2019
                : 18
                : 37
                Affiliations
                [1 ]GRID grid.460724.3, School of Nursing, Saint Paul’s Hospital Millennium Medical College (SPHMMC), ; Addis Ababa, Ethiopia
                [2 ]GRID grid.460724.3, Department of Pediatrics and Child Health, , Saint Paul’s Hospital Millennium Medical College (SPHMMC), ; P.O. Box 1271, Addis Ababa, Ethiopia
                Author information
                http://orcid.org/0000-0002-1182-4932
                Article
                361
                10.1186/s12912-019-0361-z
                6694623
                31427889
                29e7c1bb-6372-4443-9355-1684c5c5c1af
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 November 2018
                : 24 July 2019
                Funding
                Funded by: SPHMMC
                Award ID: grant4
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Nursing
                quality-nursing care,perception,patient,ethiopia
                Nursing
                quality-nursing care, perception, patient, ethiopia

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