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埃塞俄比亚南部锡达马地区公共卫生机构中患者对结核病治疗服务的满意度及治疗依从性

Patient satisfaction on tuberculosis treatment service and adherence to treatment in public health facilities of Sidama zone, South Ethiopia.

作者信息

Nezenega Zekariyas Sahile, Gacho Yohannes H Michael, Tafere Tadese Ejigu

出版信息

BMC Health Serv Res. 2013 Mar 22;13:110. doi: 10.1186/1472-6963-13-110.

Abstract

BACKGROUND

Patient compliance is a key factor in treatment success. Satisfied patients are more likely to utilize health services, comply with medical treatment, and continue with the health care providers. Yet, the national tuberculosis control program failed to address some of these aspects in order to achieve the national targets. Hence, this study attempted to investigate patient satisfaction and adherence to tuberculosis treatment in Sidama zone of south Ethiopia.

METHODS

A facility based cross sectional study was conducted using quantitative method of data collection from March to April 2011. A sample of 531 respondents on anti TB treatment from 11 health centers and 1 hospital were included in the study. The sample size to each facility was allocated using probability proportional to size allocation, and study participants for the interview were selected by systematic random sampling. A Pre tested, interviewer administered questionnaire was used to collect the data. Collected data was edited, coded and entered to Epi data version 3.1 and exported to SPSS version 16. Confirmatory factor analysis was done to identify factors that explain most of the variance observed in most of the manifested variables. Bivariate and Multivariate analysis were computed to analyze the data.

RESULT

The study revealed 90% of the study participants were satisfied with TB treatment service. However, 26% of respondents had poor adherence to their TB treatment. Patient perceived on professional care, time spent with health care provider, accessibility, technical competency, convenience (cleanliness) and consultation and relational empathy were independent predictors of overall patient satisfaction (P < 0.05). In addition to this, perceived waiting time was significantly associated with patient satisfaction (Beta = 0.262). In multivariate analysis occupational status, area of residence, perceived time spent with health care provider, perceived accessibility, perceived waiting time, perceived professional care and over all patient satisfaction were significantly associated with adherence to TB treatment (P < 0.05). Moreover, patient waiting time at reception room (Adjusted OR = 1.022, 95% CI 1.009, 1.0035) and Patient treatment phase (Adjusted OR = 0.295, 95% CI 0.172, 0.507) were independent predictor of adherence to TB treatment.

CONCLUSION

The finding of this study showed that patients' perceptions on health care provider interaction had a significant influence on patient satisfaction and adherence to TB treatment. Moreover, absence of drugs and long waiting time had a negative outcome on patient adherence. Therefore, the problem needs an urgent attention from programme managers and health care providers to intervene the challenges.

摘要

背景

患者依从性是治疗成功的关键因素。满意的患者更有可能利用医疗服务、遵守治疗方案并继续选择医疗服务提供者。然而,国家结核病控制规划未能解决其中一些方面的问题以实现国家目标。因此,本研究试图调查埃塞俄比亚南部锡达马地区患者对结核病治疗的满意度和依从性。

方法

2011年3月至4月,采用定量数据收集方法进行了一项基于机构的横断面研究。研究纳入了来自11个卫生中心和1家医院的531名接受抗结核治疗的受访者。每个机构的样本量采用与规模成比例的概率分配法进行分配,访谈的研究参与者通过系统随机抽样选取。使用预先测试的、由访谈员实施的问卷收集数据。收集到的数据进行编辑、编码并录入Epi数据3.1版本,然后导出到SPSS 16版本。进行验证性因素分析以确定能够解释大多数显性变量中观察到的大部分变异的因素。计算双变量和多变量分析以分析数据。

结果

研究显示90%的研究参与者对结核病治疗服务感到满意。然而,26%的受访者对结核病治疗依从性较差。患者对专业护理、与医疗服务提供者相处的时间、可及性、技术能力、便利性(清洁程度)以及咨询和关系同理心的感知是患者总体满意度的独立预测因素(P < 0.05)。除此之外,感知等待时间与患者满意度显著相关(β = 0.262)。在多变量分析中,职业状况、居住地区、与医疗服务提供者相处的感知时间、感知可及性、感知等待时间、感知专业护理以及患者总体满意度与结核病治疗依从性显著相关(P < 0.05)。此外,患者在候诊室的等待时间(调整后的比值比 = 1.022,95%置信区间1.009,1.0035)和患者治疗阶段(调整后的比值比 = 0.295,95%置信区间0.172,0.507)是结核病治疗依从性的独立预测因素。

结论

本研究结果表明,患者对医疗服务提供者互动的感知对患者满意度和结核病治疗依从性有显著影响。此外,药物短缺和长时间等待对患者依从性有负面影响。因此,该问题需要项目管理者和医疗服务提供者紧急关注,以应对这些挑战。

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