Chitha Wezile W, Mnyaka Onke R, Ncinitwa Akhona, Giwu Olona, Mashao Teboho, Mabophe Kuhle, Nomatshila Sibusiso C, Funani Itumeleng, Essel Vivien, Ntlongweni Xolelwa, Maake Kedibone, Sithole Nomfuneko, Khosa Ntiyiso, Masemola Maphoko, Ngcobo Ziyanda, Mulamu Murendeni, Mkabela Bongiwe, Sibulawa Siyabonga, Swartbooi Buyiswa, Mokobane Godfrey, Mabunda Sikhumbuzo A
Department of Public Health, Walter Sisulu University, Mthatha, South Africa.
Department of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, Sisson Street Fortgale, Mthatha, 5099, South Africa.
BMC Health Serv Res. 2024 Dec 18;24(1):1566. doi: 10.1186/s12913-024-12002-y.
Patient experience of care surveys are an important component of performance improvement and clinical effectiveness because they serve as a good proxy for patient's satisfaction and the quality of care. The purpose of this study was to assess patients' experience of care in four referral hospitals in two of South Africa's rural provinces.
A cross-sectional study was conducted in four public hospitals in Eastern Cape (Nelson Mandela Academic (NMAH) and St. Elizabeth (SEH)) and Mpumalanga provinces (Rob Ferreira (RFH) and Themba) for two weeks in July 2022. Systematic random sampling was used to select 662 outpatients. A validated patient experience of care questionnaire measuring demographics, access to care, availability of medicines, cleanliness, staff attitudes and waiting times was used. The level of statistical significance was p-value ≤ 0.05.
Females accounted for 71.6% (474/662) of participants; the median age was 47 years and 20.2% (133/657) required assistance with a disability. Only 19.0% (31/659) of patients had been turned away from hospital previously; one hospital was reported to not be clean (68.5%, 111/162); more than two-thirds of Mpumalanga province participants (223/329, 67.8%) reported absence of drinking water (p-value < 0.0001); 68.5% (111/162) of Themba participants did not think that the hospital was clean compared to NMAH's 82.2% (134/163) who thought it was clean (p-value < 0.0001). At least 70% of participants in each of the hospitals found the health professionals to be respectful towards patients (p-value < 0.0001). In all hospitals, at least half of the participants did not know the processes to be followed when lodging a complaint (p-value = 0.002). None of the four hospitals met all the national targets. And only two out of 28 potential domains exceeded 80% or the cut-off score for satisfaction.
Whilst hospitals have been implementing various quality measures to improve patient's experience of care, there are a few concerns such as non-availability of drinking water, lack of knowledge of complaints processes and waiting times that were mostly reported to be unacceptable. Efforts should be made to address the highlighted areas that affect patient experiences to continue improving patient care.
The study forms part of a clinical trial which was registered on 19 May 2022 in the South African National Clinical Trial Registry with ref: DOH-27-052022-6854. The URL of trial registry record is: https://sanctr.samrc.ac.za/ .
患者护理体验调查是绩效改进和临床效果的重要组成部分，因为它们是患者满意度和护理质量的良好指标。本研究的目的是评估南非两个农村省份的四家转诊医院中患者的护理体验。
2022年7月，在东开普省的四家公立医院（纳尔逊·曼德拉学术医院（NMAH）和圣伊丽莎白医院（SEH））以及姆普马兰加省的四家公立医院（罗布·费雷拉医院（RFH）和滕巴医院）进行了为期两周的横断面研究。采用系统随机抽样法选取662名门诊患者。使用一份经过验证的患者护理体验问卷，该问卷用于测量人口统计学特征、就医便利性、药品供应情况、清洁程度、工作人员态度和等待时间。统计学显著性水平为p值≤0.05。
女性占参与者的71.6%（474/662）；中位年龄为47岁，20.2%（133/657）的参与者因残疾需要帮助。之前只有19.0%（31/659）的患者被医院拒诊；据报告，有一家医院不干净（68.5%，111/162）；姆普马兰加省超过三分之二的参与者（223/329，67.8%）报告没有饮用水（p值<0.0001）；滕巴医院68.5%（111/162）的参与者认为医院不干净，而纳尔逊·曼德拉学术医院82.2%（134/163）的参与者认为医院干净（p值<0.0001）。每家医院至少70%的参与者认为医护人员对患者尊重（p值<0.0001）。在所有医院中，至少一半的参与者不知道投诉的流程（p值=0.002）。四家医院均未达到所有国家目标。在28个潜在领域中，只有两个领域超过了80%或满意度的临界分数。
虽然医院一直在实施各种质量措施以改善患者的护理体验，但仍存在一些问题，如饮用水供应不足、对投诉流程缺乏了解以及等待时间过长，这些问题大多被报告为不可接受。应努力解决影响患者体验的突出问题，以持续改善患者护理。
该研究是一项临床试验的一部分，于2022年5月19日在南非国家临床试验注册中心注册，注册号为：DOH-27-052022-6854。试验注册记录的网址为：https://sanctr.samrc.ac.za/ 。
