Tsion Assefa

Determinants of satisfaction with health care provider interactions at health centres in central Ethiopia: a cross sectional study.

BackgroundIn primary health care, provider-patient interaction is fundamental platform and critically affects service delivery. Nevertheless, it is often ignored in medical research and practice and it is infrequently subjected to scientific inquiry, particularly in Ethiopia. This study aimed to assess patient satisfaction with health care provider interactions and its influencing factors among out-patients at health centers in West Shoa, Central Ethiopia.MethodsA cross sectional facility based study was conducted on 768 out-patients of six health centers in West Shoa Zone, Central Ethiopia. The total sample size was allocated to each of the six health centers based on patient flow during the ten days prior to the start of data collection. Pre-tested instruments were used for data collection and the data were analyzed using SPSS version 16.0 statistical software. Factor score was computed for the items identified to represent the satisfaction scale by varimax rotation method. Using this regression factor score, multivariate linear regression analysis was performed and the effect of independent variables on the regression factor score was quantified.ResultsSeventy three percent of the respondents perceived that providers empathy was good and 35% complained that providers were not technically competent enough. In addition, 82% of the respondents rated non-verbal communication by the providers to be good, very good or excellent on a five-point ordinal scale. Regardless of the process, only 34.1% of the patients implied that the consultations made a difference in understanding their illness and coping with it. Generally speaking, 62.6% of the patients reported that they have been satisfied with their visit. Perceived empathy, perceived technical competency, non-verbal communication, patient enablement, being told the name of once illness, type and frequency of visit, knowing the providers and educational status were main independent predictors of patient satisfaction in this study. Furthermore, very good empathy (Beta = -4.323), fair non-verbal communication (Beta = -0.188), fewer expectations met (Beta = -0.169) and disagreement to technical competency (Beta = -0.156) had greater negative influence on patient satisfaction. On the other hand, excellent non-verbal communication (Beta = 0.114) and being told the name of once illness (0.109) had pronounced positive influence on patient satisfaction.ConclusionThe present study showed that interpersonal processes including perceived empathy, perceived technical competency, non-verbal communication and patient enablement significantly influence patient satisfaction. Therefore, health care providers should work towards improving the communication skill of their professionals along with having technically competent workers which could possibly affect the perception of the patient about all of the variables identified as independent predictors of patient satisfaction in this study.

Predictors of perceived empathy among patients visiting primary health-care centers in central Ethiopia

BACKGROUND Empathy is crucial to the achievement of patient centeredness consultations. However, it has not been frequently studied particularly in resource-limited settings. OBJECTIVE To identify predictors of patient reports indicating greater empathy among providers during patient visit to primary health-care facilities. PARTICIPANTS A cross-sectional study was conducted to assess the level of satisfaction among 768 out-patients, who consecutively visited six health centers in central Ethiopia. Patients were recruited from health centers under study based on proportional to size allocation. Multiple linear regression was used to assess the relationship between empathy scores and other patient factors. RESULTS The mean perceived empathy score was 31.34 ± 8.37 (range of possible values: 10-50). Patient-related factors that were negatively associated with perceived empathy were Tigre and Guraghe ethnicity [β = -4.45; 95% confidence interval (CI) = -6.86 to -2.03], Wakefena religion (β = -2.09; 95% CI = -3.82 to -0.35), lack of privacy during consultation (β = -1.62; 95% CI = -2.57 to -0.68), involvement of family in consultation (β = -1.45; 95% CI = -2.17 to -0.12) and not revealing ones own private issues (β = -1.25; 95% CI = -2.17 to -0.33). Positive associations with provider empathy scores were found for those who reported knowing their provider (β = 2.42; 95 CI = 1.70 to 4.13), non-verbal communication (β = 0.88; 95% CI = 0.80 to 0.96) and perceived technical competency (β = 0.12; 95% CI = 0.05 to 0.19). CONCLUSIONS Perceived empathy in this study was lower than the findings reported in earlier studies. Health-care providers committed to the delivery of patient-centered care should take note of the determinants of better empathy as perceived by their clients.

Determinants of patient enablement at primary health care centres in central Ethiopia: a cross-sectional study

Abstract Background Patient enablement is associated with behaviours like treatment adherence and self-care and is becoming a well-accepted indicator of quality of care. However, the concept of patient enablement has never been subjected to scientific inquiry in Ethiopia. Objectives The aim of this study was to determine the degree of patient enablement and its predictors after consultation at primary health care centres in central Ethiopia. Method Data were collected from 768 outpatients from six primary health care centres in central Ethiopia during a cross-sectional study designed to assess patient satisfaction. Consecutive patients, 15 years or older, were selected for the study from each health centre. Multinomial logistic regression was performed to identify predictors of patient enablement using SPSS (version 16.0). Results The study showed that 48.4% of patients expressed an intermediate level of enablement, while 25.4% and 26.2% of the patients expressed low and high levels of patient enablement, respectively. Four models were developed to identify predictors of patient enablement. The first model included socio-demographic variables, showing that residence, educational status and occupational status were significantly associated with patient enablement (p < 0.05). This model explained only 20.5% of the variation. The second and third models included institutional aspects, and perceived doctor–patient interaction and information sharing about illness, respectively. They explained 31.1% and 64.9% of the variation. The fourth model included variables that were significantly associated with patient enablement in the first, second and third models and explained 72% of the variation. In this model, perceived empathy and technical competency, non-verbal communication, familiarity with the provider, information sharing about illness and arrangement for follow-up visits were strong predictors of patient enablement (p < 0.05). Conclusion The present study revealed specific predictors of patient enablement, which health care providers should consider in their practice to enhance patient enablement after consultation.

Incidence and determinants of stillbirth among women who gave birth in Jimma University specialized hospital, Ethiopia

Introduction Worldwide approximately 2.7 million are stillborn, more than 98% of these occur in developing countries. To address the problem, incidence and determinants of stillbirth must be understood. Therefore the aim of this study was to assess incidence and determinants of stillbirth among women who gave birth in Jimma University specialized hospital. Methods A cross-sectional study design among 413 mothers who gave birth in Jimma specialized hospital was employed. Study subjects were selected by systematic sampling technique from the list of women who gave birth in hospital in one month study period. Data were collected by using pretested and structured questionnaire. Data were edited, cleaned, coded, entered and analyzed using SPSS-20 statistical software. Univarate and bivariate (logistic regressions) analysis was employed. Results The incidence rate of stillbirth in the Hospital during a month period was 8% or 80 per 1000 total births. The predictors that showed an independent close association with stillbirth were absence of complication (OR = 0.1, 95% CI (0.04-0.2)), referral from other health facility (OR = 0.3, 95% CI (0.1-0.7)), having antenatal care (OR = 0.3, 95% CI (0.1-0.7)) and normal vaginal delivery (OR = 0.2, 95% CI ( 0.1-0.8)). Conclusion The incidence rate of stillbirths in our setting is high and the identified determinants were related to both ante-partum and intra-partum-period. Therefore, effort should be made to improve antenatal, obstetric services and delivery services in terms awareness, access, timing and referral system to emergency care and specialized service to reduce the number of stillbirths.