Inpatients’ awareness of admission reasons and management plans of their clinical conditions at a tertiary hospital in South Africa

BACKGROUND Inpatient awareness of the reason for their admission and the planned management enhances patient compliance and empowers patients to be resourceful in subsequent consultations. The objective of this study was to determine patients' awareness of their clinical conditions while admitted to an academic hospital. METHODS A survey was conducted at Dr George Mukhari Academic Hospital in Pretoria, from 6 to 17 December 2010, on 264 inpatients drawn from a population of 837 through a systematic sampling method. Data on inpatient awareness were collected using a researcher-administered questionnaire, which was available in English, as well as isiZulu and Setswana. Components of patients' global awareness were clinical diagnosis, necessity for admission, planned management, possible condition cause(s), duration of admission, and planned investigations, operations and procedures. We conducted regression analysis on possible predictors of global awareness: age, marital status, occupation and educational level. The SAS (Release 9.2) was used for data analysis. RESULTS One hundred and thirty-six inpatients (51.5%) had global awareness of their clinical conditions and management plans. High degrees of awareness were reported on clinical diagnosis 206 (78.0%), reason for admission 203 (76.9%), planned management 206 (78.0%), and current medication 222 (84.1%). Fifty (18.9%) respondents were aware of their estimated admission duration. Patients who were informed of admission duration were likely to be informed of their planned management (p < 0.01). When health care practitioners did not volunteer information, most respondents (>69%) did not seek information. When information was provided, the majority of respondents (>70%) reported understanding the information. The proportion of patients who acknowledged the shared responsibility by the health care practitioner and the patient to raise awareness among the inpatients was significantly more than those who did not (p = 0.03). Patients' age, marital status, occupation and educational level were not predictors of global awareness (p > 0.05). CONCLUSIONS The proportions of respondents who were aware of the different aspects of health care ranged from 18.9% to 84.1%. About half of respondents had global awareness of their admission reasons and management plans. Raising awareness of patients' clinical conditions should be part of the health care practitioner-patient encounter.