PERCEPTIONS’ OF PATIENT-CENTERED CARE AND ASSOCIATED FACTORS AMONG ADULT PATIENTS ADMITTED TO WEST HARARGE PUBLIC HOSPITALS, OROMIA REGIONAL STATE, ETHIOPIA : MIXED STUDY

Abstract

ackground: Patient-centered care is poorly implemented in clinical practice in Ethiopia, which leads to Poor patients’ outcome. However, there is no published mixed study on ‘patients` perception of patient-centered care and associated factors at public hospitals in Ethiopia. Particularly there is no research on the perception of patient centered care at the eastern part of Ethiopia. Objective: To assess perceptions of patient-centered care and associated factors among admitted adult patients to West Hararge Zone Public Hospitals, Oromia Regional State, Ethiopia from September 20, to October 20, 2024. Methods: A multicenter sequential explanatory mixed methods study was conducted among adult patients admitted to West Hararge public hospitals. Multi-stage sampling procedure and structured interviewer-administered questionnaires were used for Quantitative data collection. Data were xi entered into Epidata 3.1 and exported to STATA 17 for analysis. Binary logistic regression was applied to assess the relationship between the perception of patients and associated factors. Those variables with a p-value < 0.25 in bivariate analysis were transferred to multivariate analysis and were taken as significantly associated variables with a p-value < 0.05 at a 95% confidence interval. An explanatory qualitative study was employed. Purposively 24 participants that grouped into four Focused Group discussions were selected. Semi-structured open-ended guide line questions, Radio tape recorder and field note taker were used for data collection. Data collection were conducted after the quantitative data analysis to complement and clarify the quantitative results, facilitating integrate through a connecting approach. The qualitative data was examined to find meaning full patterns using codebook thematic analysis. Results: A total of 508 participants were included in the study, which resulted in a responses rate of 99.6%. The overall poor perceptions of patient-centered care among study participants was found to be 62.8%. urban residence (AOR: 2.15; 95% CI: 1.31-3.53); length of hospitalization (AOR: 2.98; 95% CI: 1.19-7.47), unavailability of prescribed medication (AOR: 2.53; 95% CI: 1.57-4.07 ); difficulty of access to hospital service (AOR: 2.49; 95% CI: 1.58-3.92);lack of information about treatment options (AOR:1.98; 95% CI: 1.23-3.18);lack of participants involvement in their management decisions (AOR: 1.80; 95% CI: 1.19-2.85); and poor intimacy with healthcare providers (AOR: 1.93; 95% CI: 1.23-3.01) were the factors significantly associated with poor patients perception of patient centered care. The codebook thematic analysis generates two major themes, dimension of patient centered care and associative factors. The findings of the qualitative data complemented the result of the quantitative data. Conclusion: The study revealed a high magnitude of poor perceptions of patient-centered care among participants. Urban residence, prolonged hospitalization, unavailability of prescribed medications, difficulty of access to hospital service and lack of information about treatment options, lack of involvement in their management decisions making process and patients’weak intimacy with healthcare providers were factors significantly associated with poor patients’ perception of patient centered care. To enhance patient-centered care, hospitals should Ensure that xii availability of prescribed medications, adequate numbers of qualified health care providers, safe Environment for patients and easy access to hospitals service.