Maternal and Child Health, Motta Health Office, Motta, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2021 Jun 11;16(6):e0252444. doi: 10.1371/journal.pone.0252444. eCollection 2021.
Compassionate and respectful care is a pillar for improving health-seeking behaviour. It has given much attention globally, following the concerns that healthcare often falls significantly; however, less research emphasis was paid in the last decade. Therefore, this study aims to assess compassionate and respectful care and associated factors among outpatient clients at public health facilities in Northwest Ethiopia, 2020.
A facility-based quantitative cross-sectional study supplemented with the qualitative findings was conducted from 30 February to 30 March 2020. A semi-structured interviewer-administered questionnaire was used to collect the quantitative data among 593 participants. Systematic and purposive sampling techniques were used to select the quantitative and qualitative participants, respectively. A semi-structured interview guide was also employed for the qualitative data collection. Epi-Data version 4.6 and SPSS version 25 were used for data entry and analysis, respectively. The bi-variable and multivariable logistic regression model was fitted to identify the factors associated with each outcome variable (compassionate and respectful care separately). Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value less than 0.05 were used to declare the strength and factors statistically associated with the outcome variables.
Overall, 72.8% and 82.6% of the respondents experienced compassionate and respectful care, respectively. Patients attending primary or above education (AOR: 0.35; 95% CI: 0.21-0.59), attending at the hospital (AOR: 0.59; 95% CI: 0.39-0.88), new clients (AOR: 0.33; 95% CI: 0.16-0.70) and service users who had three or more visits (AOR: 0.34; 95% CI: 0.17-0.71) were negatively associated with compassionate care. On the other hand, female patients (AOR = 0.53; 95% CI: 0.32-0.87), aged over 36 years (AOR = 0.43; 95% CI: 0.20-0.90), primary or above school attended clients (AOR = 0.18; 95% CI: 0.09-0.36), waiting two or more hours (AOR = 0.28; 95% CI: 0.13-0.62), and use public or private transport access (AOR: 0.49; 95% CI: 0.29-0.83) were negatively associated with a respectful care.
Compassionate and respectful care provided to the outpatient clients in public health facilities of northwest Ethiopia was high. However, our result suggests that immediate actions are necessary to address respectful and compassionate care at hospitals, and hospital management should adopt mitigation measures. Consideration should be given to foster patient-centric services and educate the health care workers about compassionate and respectful care.
关爱和尊重是改善寻医行为的一个重要支柱。人们普遍关注这一点，因为医疗保健往往显著不足；然而，在过去十年中，对这方面的研究关注较少。因此，本研究旨在评估埃塞俄比亚西北部公立卫生机构门诊患者的关爱和尊重护理情况及其相关因素，研究时间为 2020 年 2 月 30 日至 3 月 30 日。
本研究采用基于设施的定量横断面研究，并辅以定性研究结果。在 2020 年 2 月 30 日至 3 月 30 日期间，使用半结构式访谈者管理问卷收集了 593 名参与者的定量数据。采用系统抽样和目的抽样技术分别选择定量和定性参与者。还使用半结构式访谈指南收集定性数据。Epi-Data 版本 4.6 和 SPSS 版本 25 分别用于数据录入和分析。采用双变量和多变量逻辑回归模型来确定与每个结果变量（分别为关爱和尊重护理）相关的因素。使用调整后的优势比（AOR）和 95%置信区间（CI）以及 p 值<0.05 来表示与结果变量相关的因素的强度和统计学意义。
总体而言，72.8%和 82.6%的受访者分别经历了关爱和尊重护理。接受过小学及以上教育的患者（AOR：0.35；95%CI：0.21-0.59）、在医院就诊的患者（AOR：0.59；95%CI：0.39-0.88）、新患者（AOR：0.33；95%CI：0.16-0.70）和就诊次数超过 3 次的患者（AOR：0.34；95%CI：0.17-0.71）与关爱护理呈负相关。另一方面，女性患者（AOR=0.53；95%CI：0.32-0.87）、年龄超过 36 岁的患者（AOR=0.43；95%CI：0.20-0.90）、接受过小学及以上教育的患者（AOR=0.18；95%CI：0.09-0.36）、等待 2 小时或以上的患者（AOR=0.28；95%CI：0.13-0.62）和使用公共或私人交通工具的患者（AOR=0.49；95%CI：0.29-0.83）与尊重护理呈负相关。
埃塞俄比亚西北部公立卫生机构门诊患者得到了较高水平的关爱和尊重护理。然而，我们的研究结果表明，需要立即采取行动来解决医院的尊重和关爱护理问题，医院管理层应采取缓解措施。应考虑促进以患者为中心的服务，并教育医疗保健工作者关爱和尊重护理。
