Patients’ perception of care during special radiological examinations

Background: Patients’ perception of care is considered to infl uence their satisfaction with the service provided. However, this has received minor attention in radiography practice in Nigeria with no quantitative study from available literature search. Method: A total of 200 self-completion questionnaires were delivered to four radiology departments within the north-eastern states of Nigeria (50 to each centre). The questionnaires included questions on patient demographics as well as ordinal scales for patients to rate their care on various indices and a 10 visual analogue scale to rate their overall satisfaction, while an open-ended question was used to assess patients’ expectation of radiology staff. 142 questionnaires (71%) were returned. Both descriptive and inferential statistics were done. Tests were two-tailed with p<0.05 indicating statistical signifi cance. Results: Patients’ perception of care correlated signifi cantly with patients’ satisfaction. Conclusion: Good staff-patient interaction and proper organisational behaviour could improve patients’ perception of care. INTROdUCTION With the recent rhetoric of health care reform, patient care has been the major focus of most discussions, reasons possibly being the need to reinforce strategies whereby care is of benefi t to patients and to enhance a more fulfi lling practice among health care providers. Indeed, the way in which patients view the care that they receive from their health care providers can greatly infl uence their satisfaction with their examinations. Because of the ongoing health-sector reform in Nigeria, which emphasises healthcare delivery based on a servicepact between the government and the governed, there is a need to assess patients’ levels of satisfaction with diagnostic tests.1 Patients’ perception of care is an indicator of the quality of care and is frequently included in health-care planning and evaluation.2 Diagnostic imaging involving contrast media is done in relatively large numbers. Radiographers may therefore consider some of these examinations as routine duties, but these investigations are not routine experiences for the patients receiving them. They can be stressful and, at best, uncomfortable examinations that may place patients in both physical and emotional stress. This is particularly true for the young and for very old patients. Dealing effectively with such clinical situations involves several abilities. One is the ability to show empathy and sensitivity to the needs of others, allowing one to meet those needs in a constructive manner, rather than merely sympathising or reacting to stress. Understanding and compassion should be accompanied by an appropriate response.3 Several investigators studying patient satisfaction showed that the mode of medical-care delivery appears to be more important to patients than the care itself. Even though patients’ perception of care is considered to infl uence their satisfaction with the service provided, it has received minor attention in radiography practice in Nigeria, with no quantitative study on its importance from available literature research. This study therefore aimed at investigating patients’ perception of care during special radiological examinations, in order to assist radiology nurses, radiographers and radiologists to enhance patient care, health care planning, quality measurement and evaluation in radiology departments. To the best of the authors’ knowledge, this was the fi rst attempt at quantifying patient care in diagnostic radiology. METHOd This was a descriptive and exploratory study. A convenient sample consisting of patients who came for special radiological examinations during a six-month period (from March 2008 to September 2008) was approached to participate in the study until all the questionnaires allocated to each centre had been distributed to patients. Ethical clearance and patient consent were obtained. Patients with mental impairment were excluded from the study; only patients who were literate and could fi ll in the questionnaires were included. The data-collection instrument used was a self-completion, 18-item scale questionnaire. It contained 18 questions (both open-ended and closed-ended) divided into three sections. Section A contained four questions, which sought to obtain patient demographic data, such as age, sex, academic qualifi cation and occupation. Lower academic qualifi cations (secondary-school certifi cates and teachers’ grade II certifi cates) were coded ‘1’, while higher academic qualifi cations (degrees, higher and lower diplomas and Nigerian certifi cates in education) were coded ‘2’. Students and private sector-based patients were coded ‘3’, while public servants were coded ‘4’. Section B was divided into three categories, which included four Likert-format questions on the patient rating of factors affecting patient care before, during and after examination. ‘Strongly disagree’ was rated ‘1’, ‘disagree’ was rated ‘2’, ‘agree’ was rated ‘3’ and ‘strongly agree’ was rated ‘4’. A 10-point visual analogue scale was designed and used to score overall satisfaction with the examination. A high score in scale indicated a high level of satisfaction and a score of ‘1’ denoted no satisfaction at all. Section C was an open-ended question that sought to obtain patients’ views or opinions about what medical staff should do for patients coming for examination. Vol. 1 No. 1 Page 1 of 3 Original Research Ugwu, Shem & Erondu PHCFM http://www.phcfm.org A fri ca n Jo ur na l o f P rim ar y H ea lth C ar e & F am ily M ed ic in e