Abstract
In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in condemned hospitals which lacked piped water, electricity and essential medical equipment. Receiving quality care, and principally patient-centred care, in the face of such challenges is unlikely and consequently leads to the following question: “Are patients receiving patient-centred care in public hospitals?”A qualitative, explorative, descriptive and contextual study was conducted to explore and describe the perceptions of professional nurses regarding patient-centred care in public hospitals in Nelson Mandela Bay. Semi-structured interviews were conducted with a total of 40 purposively selected professional nurses working in public hospitals in Nelson Mandela Bay, Eastern Cape Province. Interviews were analysed according to the method described by Tesch in Creswell (2009:192).Professional nurses perceive patient-centred care as an awareness of the importance of the patient's culture, involving the patient's family, incorporating values of love and respect, optimal communication in all facets of patient care and accountability to the patient. Factors which enable patient-centred care were a positive work environment for staff, nursing manager's demonstrating exemplary professional leadership, continuous in service education for staff and collaborative teamwork within the interdisciplinary team. Barriers to patient-centred care were a lack of adequate resources, increased administrative work due to fear of litigation and unprofessional behaviour of nursing staff.
Highlights
The need for patient-centredness has become an important global issue, having been identified by the Institute of Medicine of the United States National Academies of Science as one of six attributes of quality health care (World Health Organisation, 2007:5)
The International Alliance of Patients' Organisations' (IAPO) Declaration on Patient-Centred Health Care states that “the essence of patient-centred health care is that patients are at the centre of the health care system and the system is designed around them” and “the required outcome of health care is a better quality of health, and/or of life, as defined by the patient (IAPO, 2007:12)
In the South African context, the concept of patient-centred care is endorsed in the Constitution of South Africa Second Amendment Act, no. 3 of 2003 (South Africa, 2003) in which it is stated that all citizens have the right to health care that is caring, free from harm and as effective as possible
Summary
The eight Batho Pele principles seek to introduce a new approach to service delivery that puts people first, and encapsulates the stated values of public service in South Africa, which directly relate to the concept of patient-centred care These principles state that citizens should be consulted about the level and quality of the public services they receive and, wherever possible, be given a choice about the services that are offered; be told what level and quality of public services they will receive so that they are aware of what to expect; have equal access to the services to which they are entitled; be treated with courtesy and consideration; be given full, accurate information about the public services they are entitled to receive; be told how national and provincial departments are run, how much they cost, and who is in charge. Public services should be provided economically and efficiently in order to give citizens the best possible value for money
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