BMC Health Services Research最新文献

Background: Effective communication between healthcare providers and family members is essential for improving patient outcomes. This study aimed to assess the quality of communication (QoC) in intensive care units (ICUs) and identify factors influencing its level.

Method: A cross-sectional descriptive design was used to evaluate the QoC among family members of ventilated ICU patients. Non-probability convenience sampling was utilized, with a total of 186 family members of ventilated patients in ICUs recruited from the largest hospitals of the four Jordanian health sectors in Amman. The Quality of Communication Questionnaire was used to assess family members' perceptions of communication with medical doctors (MDs) and registered nurses (RNs).

Results: The mean total score of the quality of communication level for MDs was 57.44(SD = 8.55), and 55.33(SD = 9.26) for RNs. A significant paired t-test (t = 7.778, p < 0.001) indicates that the QoC score for MDs (M = 57.44, SD = 8.55) was statistically significantly higher than that for RNs (M = 55.33, SD = 9.26). Family members are more likely to rate the level of QoC for MDs higher than that for RNs. Higher QoC ratings were associated with surgical diagnosis, those cared for in private hospitals, those with prior ICU experience, higher educational level, longer visit time, and hospital-related employment.

Conclusion: Family members of Jordanian ventilated patients in ICUs reported moderate to high QoC with MDs and moderate levels for RNs; with the mean score for MDs being higher than that for nurses. Significant variations are linked to certain demographic factors. These results underscore the need for culturally sensitive, tailored support approaches to strengthen family members' interaction with HCPs during an ICU stay.

Background: Despite some progress towards disability rights in Cambodia, women with disabilities still experience inequitable access to maternity care. To provide a context-specific understanding of this complex issue, we conducted a study exploring the perspectives of key stakeholders from across the health and disability sectors regarding disability-inclusive maternity care in three locations of Cambodia: Phnom Penh, Kampong Speu, and Kampot.

Methods: This study employed a qualitative descriptive approach, using semi-structured interviews with twelve government and non-governmental stakeholders. Data were transcribed verbatim, translated from Khmer to English, anonymised, and thematically analysed using the WHO Quality of Care framework.

Results: Alongside presenting findings relevant to (1) Perceptions and conceptualisation of disability-inclusive maternity care, results were thematically presented across the relevant WHO Quality of Care framework components, including (2) Competent and motivated human resources; (3) Essential physical resources; (4) Provision of care; (5) Experience of care. All stakeholders unanimously agreed that maternity care services for women with disabilities were not inclusive, including the absence of disability-inclusive maternity care policies, guidelines and training for the healthcare workforce. Barriers to access were exacerbated when health services lacked sufficient human resources, equipment and referral systems to accommodate the needs of this population. Government stakeholders conceptualised disability-inclusive care as equal treatment without discrimination. Some commended existing social protection funding and considered it adequate to support access to maternity care. In contrast, non-governmental stakeholders emphasised that equitable maternity care requires both accessible infrastructure and services and more effective implementation of social protection measures.

Conclusion: This study provided the context of the disability-inclusive maternity care in Cambodia from the perspectives of key stakeholders. The study highlighted that the Cambodian health system was inadequately responding to the maternity care needs of women with disabilities. A collaborative approach among government staff and relevant stakeholders is needed to develop a disability-inclusive maternity care policy and ensure effective implementation, monitoring, and evaluation. Additionally, capacity building for healthcare providers with disability inclusion is essential to ensure that women with disabilities are not left behind when they access maternity care.