Patient Charter Research Articles

Literacy-related factors and knowledge of patient rights charter: evidence from nurses in selected hospitals in Ghana.

Systems of across the world have developed and implemented patient rights policies to protect and improve the provider-patient relationship. The Patient Charter of Ghana was developed in 2002 to improve service quality and protect patients' rights. However, it is not yet known whether those at the frontline of healthcare delivery can read and understand the contents of the charter. While studies have explored the socioeconomic and institutional level factors related to awareness and knowledge of the Patient Rights Charter, there is a lack of literature on its readability and comprehensibility among nurses. This study assesses nurses' knowledge of the Patient Rights Charter and associated literacy-related factors. An exploratory cross-sectional design and quantitative methods were used to collect data on knowledge, comprehension, and readability of the Patient Rights Charter. 205 nurses from four district hospitals in the Central Region were recruited using proportional and total enumeration sampling. Data were collected using structured questionnaires and were processed using SPSS (version 26) and an online text readability consensus calculator (version 2.0). Descriptive and inferential statistical analyses were performed, and data were presented using simple frequencies, readability statistics, and regression output. The results show the charter is written at a higher reading grade level; Flesch-Kincaid Grade Level (13.36), Simple Measure of Gobbledygook (11.57), and Coleman-Liau Readability Index (14.2). The average reading grade level score was 14. The Gunning Fox Index (15.40) and the Flesch Reading Ease Score (34%) show the patient charter is difficult to read and will require at least 14 years of education to be able to read. 87.3% of nurses were able to read and comprehend the charter. Very few (8.3%) read at frustration level. Nurses' actual comprehension of the charter was the only significant predictor of knowledge of the charter. Comprehension of the patient charter is an important predictor of its knowledge. The results emphasize the need to enhance the readability and comprehensibility of the charter for providers. Hospitals can stimulate nurses' knowledge of the charter by simplifying the charter's language and deliberately educating nurses on its content.

Is there a legal and ethical duty on doctors to inform patients of the likely co-payment costs should they be treated by practitioners who have contracted out of medical scheme rates?

A hypothetical scenario is presented in which a female patient is admitted to a private hospital to undergo a mastectomy and breast reconstruction. The surgeons and anaesthetists conducting the different procedures charge three times the medical aid rates. When the patient asks what the co-payments are likely to be, she is informed by the doctors’ accounts section that they can only provide this information after each procedure. The patient’s medical scheme also advises her that it cannot determine the likely co-payments unless she completes the assessment form sent to her. The form requires her to include the costs reflected against the relevant ICD10 codes. The patient cannot complete the form because the doctors’ accounts sections have not informed her about the proposed procedures and the likely costs of each. This article builds on a previous article discussing doctors’ overarching responsibility to disclose medical treatment costs in advance. The present article outlines the legal requirements in the South African Constitution, the National Health Act and the Health Professions Act, and refers to the Promotion of Access to Information Act and Consumer Protection Act. Similar to the earlier article, this article addresses the ethical requirements of the Health Professions Council of South Africa and the internationally recognised biomedical ethical principles. Furthermore, it also refers to the National Patients Charter, the government’s policy document on health care services.

THE UTILITY OF HEALTHCARE SYSTEM BEFORE AND DURING THE COVID-19 PANDEMIC

According to the European Charter of Patients’ Rights, every person has the right to access health services in accordance with their health needs. The aim of this study is to analyze the utility of the healthcare service before and during the COVID-19 pandemic. Material and methods: An anonymous survey was conducted through a questionnaire in Google Forms among individuals over 20 years old (n=645), who were divided into several groups. Documentary, sociological and statistical methods were applied. Results: 58.4% of respondents reported that they maintained their GP visits during the COVID-19 pandemic. 43.3% of them had no obstacles to contact him/her by phone and 45.7% had no obstacles to visit him/her in person. Conclusion: The spread of the SARS-CoV-2 virus has presented the health system with many challenges, one of which is the burden on all its levels. However, between patient and doctor there is an established relationship, adequate communication and mutual trust.

A Patient Charter for Chronic Urticaria.

Chronic urticaria (CU) is the recurring development of wheals (aka "hives" or "welts"), angioedema, or both for more than 6weeks. Wheals and angioedema occur with no definite triggers in chronic spontaneous urticaria, and in response to known and definite physical triggers in chronic inducible urticaria. Approximately 1.4% of individuals globally will have CU during their lifetime. The itching and physical discomfort associated with CU have a profound impact on daily activities, sexual function, work or school performance, and sleep, causing significant impairment in a patient's physical and mental quality of life. CU also places a financial burden on patients and healthcare systems. Patients should feel empowered to self-advocate to receive the best care. The voice of the patient in navigating the journey of CU diagnosis and management may improve patient-provider communication, thereby improving diagnosis and outcomes. A collaboration of patients, providers, advocacy organizations, and pharmaceutical representatives have created a patient charter to define the realistic and achievable principles of care that patients with CU should expect to receive. Principle (1): I deserve an accurate and timely diagnosis of my CU; Principle (2): I deserve access to specialty care for my CU; Principle (3): I deserve access to innovative treatments that reduce the burden of CU on my daily life; Principle (4): I deserve to be free of unnecessary treatment-related side-effects during the management of my CU; and Principle (5): I expect a holistic treatment approach to address all the components of my life impacted by CU. The stated principles may serve as a guide for healthcare providers who care for patients with CU and translate into better patient-physician communication. In addition, we urge policymakers and authors of CU treatment guidelines to consider these principles in their decision-making to ensure the goals of the patient are achievable.

Plain Language Summary of principles for improving the care of people with eosinophil-associated diseases.

Eosinophil-associated diseases (EADs) are a group of conditions in which eosinophils (a type of white blood cell) are thought to play a key role in the disease and how it develops. Some EADs are common, such as atopic dermatitis (also called eczema) and a subtype of asthma called eosinophilic asthma, while others are rare, such as hypereosinophilic syndrome (a condition in which a person has a very high number of eosinophils in both the blood and one or more organs). People with EADs face many problems related to their conditions. Symptoms such as severe abdominal pain, itch, or shortness of breath impact both the patient as well as their friends and family. Patients with EADs also experience delays to diagnosis and treatment as well as financial barriers. Healthcare professionals sometimes fail to recognize the complex set of symptoms that characterize an EAD, and this may cause delays in reaching a correct diagnosis. As a result, it may take longer for a patient to get the best care and the most effective treatments, which may contribute to poor health. The goal of this charter is to describe the key elements of good quality care, which all people with EADs deserve, as well as to present an action plan to improve health and overall well-being for people with EADs. Proposed use of this patient charter: The principles described in this charter (a written guide to achieve an outcome) show the core elements of quality care that people with EADs must receive. They also describe clear steps to reduce the burden on patients and their caregivers and to improve patient health outcomes. We urge healthcare professionals, hospitals, and policymakers around the world to adopt these principles quickly. By doing this, people with EADs will be more likely to receive an accurate and timely diagnosis and have access to quality care and treatment in the right setting.

Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study.

Global health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights. In a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes. We contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic. The role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries.

Pattern and outcomes of medical malpractice cases in Ghana: a systematic content analysis.

Medical malpractice complaints are apparently on the rise in Ghana. Though it has been suggested that medico-legal training programmes should emphasise the kinds of legal problems that healthcare staff encounter most frequently in practice, no comprehensive study currently analyses the pattern and outcomes of existing case laws. Systematic content analysis. Medical malpractice case laws sourced from Ghanaian legal repositories, media platforms and other grey literature sources. Nine case laws were retained. Most of the cases (n=7) involved negligence. Emerging patterns of cases are complex, including patients' access to their medical records, practising without a license/ out of scope, refusal to treat, and the development of complications following surgical interventions. Obstetrics & Gynaecology, Surgery, and Paediatrics were the main clinical specialties involved in the malpractice cases identified. The pattern of the cases suggests that all medical specialties are potentially at risk, although most of the cases emerged from Obstetrics & Gynaecology, Surgery, and Paediatrics. Medico-legal training for healthcare staff should emphasise the duty of care and adherence to the Ghana Health Service Patient Charter. None declared.

A Renewed Charter: Key Principles to Improve Patient Care in Severe Asthma.

Asthma is a heterogenous respiratory disease, usually associated with chronic airway inflammation and hyper-responsiveness, which affects an estimated 339 million people worldwide. Severe asthma affects approximately 5–10% of patients with asthma, approximately 17–34 million people globally, more than half of whom have uncontrolled disease. Severe asthma carries a substantial burden of disease, including unpredictable symptoms and potentially life-threatening flare-ups. Furthermore, severe asthma has a substantial burden on health care systems and economies worldwide. In 2018, a group of experts from the clinical community, patient support groups, and professional organisations joined together to develop the Severe Asthma Patient Charter, which set out six principles to define what patients should expect for the management of their severe asthma and what should constitute a basic standard of care. Since the publication of that original Charter in 2018, several important changes have occurred, including an improved understanding of asthma and effective asthma management; several new therapies have become available; and finally, the COVID-19 pandemic has placed a spotlight on respiratory conditions, the workforces that treat them, and the fundamental importance of health care system resilience. With those developments in mind, we, representatives of the academic, clinical, and patient advocacy group communities, have updated the Charter to Improve Patient Care in Severe Asthma with a focus on six principles: (1) I deserve a timely, comprehensive assessment of my asthma and its severity; (2) I deserve a timely, straightforward referral to an appropriate specialist for my asthma when it is not well controlled; (3) I deserve to understand what makes my asthma worse; (4) I deserve access to treatment and care that reduces the impact of asthma on my daily life; (5) I deserve not to be reliant on systemic corticosteroids; (6) I deserve to be involved in decisions about my treatment and care.

Patient’s Rights in Iran and Iraq

Background: The aim of this study was to compare, review, and evaluate the studies on patients right in Iran and Iraq. Methods: This is a review study conducted by searching the Iranian and Iraqi databanks, such as Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology, Iran Medex, Iraqi Academic scientific journals, and Google Scholar for both Iranian and Iraqi articles from 2002 to 2017 using the keywords, such as “Patient Rights”, “Patient Rights Charter”, “Patient Rights Observance”, “Iraq”, “Iran”, and “Patient Awareness and Rights”. Results: Of a total of 32 Iranian and Iraqi articles, only 25 articles met the aim of our study. Conclusion: The growing number of articles published indicates that from 1999 forwards, this topic began to attract the attention of Iranian researchers in a gradual manner, as for the Iraqi researchers, their attention has been attracted from 2013 onwards. Also, despite the poor knowledge of physicians about the patients’ rights in Iran, they have shown acceptable awareness and attitude regarding some patients’ rights. The same is true for Iraqi doctors and health care providers, but they have shown unsatisfactory consequences for some of the rights of Iraqi patients. Patient education through media and careful observation of the patient rights charter, and educating healthcare professionals, and developing professional training on patients’ legal rights by engaging them in educational sessions and lectures on patient rights is necessary. Adequate monitoring of practice according to the patient charter is strongly suggested.

A study of Patient's rights in Iran and Iraq:

Objective: The aim of this study was to compare, review and evaluate the prior studies about patients right that have been made, to this point, regarding patient rights in Iran and Iraq. Methods: This is a review study conducted by searching the Iranian and Iraqi databanks such as: Scientific Information Database(SID), Iranian Research Institute for Information Science and Technology, Iran Medex and Academic scientific journals Iraqi and google scholar for both Iranian and Iraqi articles from 2002 to 2017 using the keywords such as Rights, Rights Rights Observance, Iraq, Iran, and Awareness and Rights. Results: Total of 32 Iranian and Iraqi articles, only 25 of which achieved the goal of our study. Conclusion: The growing number of articles published indicates that from 1999 forwards, this topic began to attract the attention of Iranian researchers in a gradual manner, as for the Iraqi researchers, their attention has been attracted from 2013 onwards. and despite the poor knowledge of physicians about the patients' rights in Iran; they have shown acceptable awareness and attitude regarding some patients' rights. The same is true for Iraqi doctors and health care providers, but they have shown unsatisfactory consequences for some of the rights of Iraqi patients. Recommendation: Patient education through media and careful observation of the Patient Rights Charter, and educating healthcare professionals, and developing professional training on patients' legal rights by engaging them in educational sessions and lectures on patient rights is necessary. Adequate monitoring of practice according to the Patient Charter is strongly suggested.

Reporting violations of European Charter of Patients\u2019 Rights: analysis of patient complaints in Croatia

BackgroundThe European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights submitted through the official complaints system and to a non-governmental organization in Croatia.MethodsThe official system for patients’complaints in Croatia does not have a common pathway but offers different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients’ complaints from the official regional committees sent to the Ministry of Health. We also analysed the complaints received by the Croatian Association for the Protection of Patient’s Rights (CAPR) and mapped them to the ECPR.ResultsThe aggregated official data from the Ministry of Health in 2017 and 2018 covered only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR received a total of 440 letters, out of which 207 contained 301 complaints about violations of patients’ rights in 2017–2018. The most common complaint was the Right of Access to health care (35.3%) from the ECPR, followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%).ConclusionsReporting and dealing with patients’ complaints about violations of their patients’ rights does not appear to be effective in a system with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients’ rights and to plan actions to improve the complaints system for effective health care.

Fibrotic interstitial lung disease - palliative care needs: a World-Café qualitative study

ObjectivesThe importance of palliative care in those with advanced fibrotic interstitial lung diseases (F-ILD) is recognised, but the palliative care requirements of patients and caregivers affected by F-ILD regardless of...

Patient Engagement: an Assessment of Canadian Radiotherapy Programs' Current Practices, Perceived Barriers, and Facilitators.

Patient engagement and education have been mandated across Canadian radiation oncology programs (ROP). Guidance documents include the 2014 Canadian Association of Radiation Oncology (CARO) Radiation Therapy Patient Charter, the 2016 Canadian Partnership for Quality Radiotherapy (CPQR) Patient Engagement Guidelines (PEG) for Canadian Radiation Treatment Programs, and Accreditation Canada's 2017 refresh of Cancer Care Standards. Since little is known regarding uptake of these guidance statements, Canadian ROP were surveyed to assess current patient engagement and education practices. An e-survey was sent to Canadian ROP (n = 44). The survey focused on awareness and uptake of the CARO Patient Charter, CPQR PEG, and patient education practices. Survey development was guided by these documents and expert consensus, including CARO's Quality and Standards Patient Education/Engagement working group. Many (71%) responding ROP were familiar with the CARO Patient Charter, while 24% reported use. More than half (53%) of ROP were aware of the CPQR PEG, but approximately third (37%) had previously completed a self-audit. Most (88%) ROP view a pan-Canadian, evidence-based approach to educational materials beneficial and feasible (80%), with the majority (89%) willing to share their best practices across the radiotherapy community. Patient engagement and education are nationally mandated and supported by guidance documents. However, gaps have been identified across ROP for awareness and use of available tools, as well as uptake of their processes critical to quality of care. Understanding current practices will inform CPQR/CARO-supported pan-Canadian initiatives to optimize uptake, including development of CPQR Patient Education Guidance for Canadian Radiation Treatment Programs.

Designing a Valid and Reliable Questionnaire for Evaluation of Professional Ethics of Midwives by Parturients

Background: Pregnancy and childbirth are sensitive and particular periods in women’s lives. Midwives play an essential role in ensuring mother’s and fetus’s health by the recognition of the needs and complexities of this period. Midwives increase the quality of care, gain the trust of pregnant women, communicate more effectively with them, and increase their satisfaction and cooperation by following the ethical principles and standards that express their professional commitment to society. Therefore, the awareness of the principles of professional ethics and adherence to the Charter of Patients’ Rights is a critical element of the midwife’s success in ensuring mother’s and neonate’s health. Therefore, monitoring the observance of these principles by midwives, similar to other health care providers, is essential to improve the quality of services and ultimately parturients’ satisfaction. For this purpose, it is necessary to have a valid and reliable tool to assess midwives’ professional ethics status. Objectives: In this study, a questionnaire was developed to assess this issue by parturients, who are primary stakeholders in this process. Methods: This qualitative and quantitative study was performed to design a reliable and valid questionnaire evaluating midwives’ professional ethics by parturients. Based on the literature review and consultation with midwifery professors and staff, the initial questionnaire was prepared with 26 items. A survey of 15 experts evaluated the content and face validity ratio. The final questionnaire with 20 items was completed by 200 parturients hospitalized in Valiasr Hospital of Fasa University of Medical Sciences, Fars, Iran, within 2018 - 2019. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the construct validity. The reliability was confirmed by the determination of internal consistency. Results: The 26 items of the questionnaire defined in the first step were reduced to 20 items with a content validity ratio higher than 0.49 and a content validity index higher than 0.79. Using EFA and CFA, 20 items were included in two dimensions and confirmed. Its reliability was reported as 0.89 using Cronbach’s alpha. Conclusions: This study aimed to design a valid and reliable questionnaire for the assessment of midwifery professional ethics in the delivery process. One strength of the present study, compared to those of mentioned studies, is performing both EFA and CFA. In this study, some goals of EFA consist of determining questionnaire dimensions, standardizing questionnaires, reducing the items (from variables to factors), and assessing homogeneity and discrimination in construct validity. The EFA is often used in the early stages of research to collect information about the interactions in a set of variables. The obtained results revealed that the designed questionnaire is a valid and reliable tool for the evaluation of midwifery professional ethics by parturients, which can be applied in other studies in Iran.

Evaluation of the Observance of the Charter of Rights of Patients with Mental Disorders from the Perspective of Nurses and Patients in Panj Azar Hospital in Gorgan in 2020

Background: One of the most essential indicators of quality evaluation of health services is to assess the status of patients' rights, especially in those with mental illness due to their physical and mental conditions, and how health care providers and recipients interact. Objectives: This study aimed to investigate the observance of the Charter of Rights of Patients with Mental Disorders from the perspective of nurses and patients in Panj Azar Hospital in Gorgan in 2020. Methods: This descriptive cross-sectional study was performed in 2020 among 100 patients admitted to the Psychiatric Ward and 200 nurses working in the psychiatric ward selected by simple random sampling. Data were collected using a demographic questionnaire and a self-made questionnaire. Data were entered into SPSS version 18 and analyzed using descriptive statistics, chi-square test, and independent t-test. Results: In this study, the results showed that the mean age of the subjects was 52.7 ± 22.4 years, and the highest age group of the study participants was 21 - 30 years. Overall, 196 (65.3%) participants were married, and 191 (63.7%) recommended others to return to this hospital. The mean scores of observance of the patient's charter from the nurses' and patients' points of view were 59.26 ± 6.26 and 57.98 ± 8.13, respectively. The subgroup with highest score was respect for the right to free choice and decision making in both groups. The level of compliance with the Charter of Patients' Rights was good and average from both nurses patients’ point of view. Furthermore, there was only a significant relationship between the views of nurses and patients in the subgroups of respect for patient privacy, compliance with the principle of confidentiality (P = 0.001), and access to an efficient grievance redressal system (P = 0.001). Conclusions: Overall, it is inferred that in most cases, nurses are aware of the extent of their compliance with their charter of rights, and from the patients' point of view, the level of compliance with the charter of patients was often moderate.

Evolution of haemophilia integrated care in the era of gene therapy: Treatment centre's readiness in United States and EU.

Evolution of haemophilia integrated care in the era of gene therapy: Treatment centre's readiness in United States and EU.

Actions and re-actions of civic society and Patients Advocacy Groups across Europe during Covid-19 pandemic: Sharing good practices for more resilient Health Care Systems

The recent pandemic seriously affected national health systems worldwide. The focus of the 2021 edition of the European Patients’ Rights Day was on patient organizations’ concrete reactions to it, offering answers to people and actions that should be put in place in order to have more resilient healthcare systems, starting from the 14 rights stated in the European Charter of Patients’ Rights. From their experiences emerged the great reforming force of civic organizations and Patient Advocacy Groups, capable of responding promptly to new needs by managing services, building alliances, quickly signalling necessary normative or procedural changes, mobilizing resources (both human and economic), introducing and promoting practices from which it will not be necessary to go back when everything is over. We still perceive the urgent need to better address the consequences of the Covid-19 pandemic. Evidence collected during the crisis show that Covid-19 has had a significant impact – for instance - on Non-Communicable Diseases. Indeed, oncological and chronic patients have been left almost alone for several months. Rather than recalling the impact of Covid, the 15th European Patients’ Rights Day wanted to highlight actions and reactions that have civic & patients' organizations as protagonists: actions realized despite the pandemic and reactions put in place to mitigate its impact.

Do gastroenterologists have medical inertia towards coeliac disease? A UK multicentre secondary care study

ObjectiveThis study aimed to assess if there is secondary care medical inertia towards coeliac disease (CD).DesignGroup (1): Time from primary care presentation to diagnostic endoscopy was quantified in 151 adult...

Correlation between professional commitment and awareness and compliance with the Charter of Patients' Rights in Nursing and Midwifery Staff

Correlation between professional commitment and awareness and compliance with the Charter of Patients' Rights in Nursing and Midwifery Staff

A graphic elicitation technique to represent patient rights

BackgroundA patient charter is an explicit declaration of the rights of patients within a particular health care setting. In early 2020 the Save the Children Emergency Health Unit deployed to Cox’s Bazar Bangladesh to support the establishment of a severe acute respiratory infection isolation and treatment centre as part of the COVID-19 response. We developed a charter of patient rights and had it translated into Bangla and Burmese; however, the charter remained inaccessible to Rohingya and members of the host community with low literacy.MethodsTo both visualise and contextualise the patient charter we undertook a graphic elicitation method involving both the Rohingya and host communities. We carried out two focus group discussions during which we discussed the charter and agreed how best to illustrate the individual rights contained therein.ResultsLogistical constraints and infection prevention and control procedures limited our ability to follow up with the original focus group participants and to engage in back-translation as we had planned; however, we were able to elicit rich descriptions of each right. Reflecting on our method we were able to identify several key learnings relating to: 1) our technique for eliciting feedback on the charter verbatim versus a broader discussion of concepts referenced within each right, 2) our decision to include both men and women in the same focus group, 3) our decision to ask focus group participants to describe specific features of each illustration and how this benefited the inclusivity of our illustrations, and 4) the potential of the focus groups to act as a means to introduce the charter to communities.ConclusionsThough executing our method was operationally challenging we were able to create culturally appropriate illustrations to accompany our patient charter. In contexts of limited literacy it is possible to enable access to critical clinical governance and accountability tools.