Patients Perception on Patient Centered Care in Orthopaedic Department at Kenyatta National Hospital

Abstract

Background: Care delivery is multifaceted, and there is a need to integrate different processes to achieve high-quality care. Patient-centered care emphasizes communication, physical and emotional comfort, cultural responsiveness, and care coordination. However, the delivery of patient-centered care in orthopedic wards has not been effectively investigated, which presents the need to understand the needs and wellbeing of admitted orthopedic patients. Purpose of the study: To investigate the patient perception of patient-centered care in the orthopedic department at Kenyatta National Hospital Methods: This was a cross-sectional study utilizing both qualitative and quantitative techniques. A consecutive sampling technique was used to sample 426 orthopedic patients. Quantitative data include demographic characteristics, communication approach, physical wellbeing, cultural responsiveness, and care coordination. These components of patient-centered care were measured using a three-point Likert scale. A purposive sampling technique was used to recruit seven patients into two focus group discussions (FGDs). Descriptive analysis was used to document quantitative data, while content analysis was used to analyze qualitative data. Results: Out of 426 participants, 68%(290) were male, 53.3% (227) of the patients were aged between 25 to 40 years, and 52.3% (223) of the patients in orthopedic wards had a secondary level of education. It was established that most patients reported effective perceived communication, although there were challenges in communicating test findings to patients. There was a mixed perception of the physical wellbeing of patients, with many patients perceiving nurses as highly non-responsive compared to doctors. In assessing emotional wellbeing, 70.9% of the patients did not have access to professional counselors to help them cope with their condition and stay in the ward. Most participants illustrated the need for change regarding their emotional wellbeing in the orthopedic department, which was more evident in those who had stayed in the wards for four weeks or more. The principle of cultural responsiveness was well respected among most care providers, while few healthcare providers did not consult patients on anything, especially nurses. Coordination of care, especially in dispensing drugs and providing test results, were not well documented. Conclusion and recommendations: The hospital has made major efforts in providing patient-centered care, although there are still challenges in all of the principles of patient centered care. Therefore, providing efficient guidelines for well-coordinated patient care in the orthopedic department is essential.