Facilitators and Barriers of Patient Centered Care Practice in Public Hospitals of Benishangul Gumuze Regional State, South West Ethiopia

Tamiru Bogale
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Abstract

Background: Patient centered care has become a central for the nation’s healthcare system all over the world. However the major issues facing healthcare systems around the world was not well explored. Therefore this study aims to identify facilitator and barriers to implement patient centered care practice in public hospitals in Benishangul Gumuze regional state, South West Ethiopia, 2019. Methods: Institution based Qualitative case study design was employed. Thirty two purposively selected participants from different category were interviewed. Ethical clearance sheet was obtained from Pawe health science college ethical review board. Seventeen face to face in depth interview, two focused group interview and systematic observation was conducted. Deductive analysis was employed manually to analyze text data. Results: The analysis result yields multiple driving and hindering factors of patient centered care practice. Information related factor, service expansion, feedback mechanism and health policy were identified as facilitators. In contrast patients’ health literacy level, health care provider characteristics, patient empowerment, shortage of resource, organizational capacity, shortage of specialty care, managerial skill, legislation related factor and organizational culture are identified as a barrier to practice patient centered care. Conclusion: Patient centered care practice in public hospitals had cheaply driven or hindered by multiple factors. Patient health literacy level, patient empowerment, and family and friend involvement in patient care were perceived as a tough barriers. Investing on the improvement of patient health literacy and patient empowerment may fasten the transformation of the current health care practice in to patient centered care practice in the healthcare setting.
埃塞俄比亚西南部Benishangul Gumuze地区州公立医院以患者为中心的护理实践的促进因素和障碍
背景:以患者为中心的护理已成为世界各地国家医疗保健系统的核心。然而,世界各地医疗保健系统面临的主要问题并没有得到很好的探讨。因此,本研究旨在确定2019年埃塞俄比亚西南部Benishangul Gumuze地区公立医院实施以患者为中心的护理实践的促进因素和障碍。方法:采用基于机构的定性案例研究设计。有目的地从不同类别中选择32名参与者进行访谈。伦理许可表从Pawe健康科学学院伦理审查委员会获得。进行了17次面对面深度访谈、2次焦点小组访谈和系统观察。文本数据的分析采用人工演绎分析。结果:分析结果产生了以患者为中心的护理实践的多种驱动因素和阻碍因素。信息相关因素、服务扩展、反馈机制和卫生政策是促进因素。患者健康素养水平、医护人员特征、患者授权、资源短缺、组织能力、专科护理短缺、管理技能、立法相关因素和组织文化是实施以患者为中心的护理的障碍。结论:公立医院以患者为中心的护理实践受到多种因素的驱动或阻碍。患者健康素养水平、患者赋权以及家人和朋友参与患者护理被认为是一个困难的障碍。投资于提高患者健康素养和患者赋权,可能会加快当前医疗保健实践向以患者为中心的医疗保健实践的转变。
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