PATIENTS' PERCEPTIONS AND PRACTICES RELATING TO PATIENTS'S RIGHTS AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

Abstract

Patient's rights encompass legal and ethical issues in the provider-patient relationship. These included the following, rights to privacy, quality medical care without prejudice, right to informed decisions about care and treatment options and right to refuse treatment. Few studies on perceptions and practices of patients relating to the protection of their rights exist in Nigeria. .This study therefore, assessed patients' perceptions and practices relating to their rights at the University College Hospital (UCH), lbadan, Nigeria. The study was a descriptive cross-sectional survey. A validated questionnaire was used to collect data from 380 consenting patients selected through a three-stage stratified random sampling technique from 20 units in five outpatient clinics the records of the Service Compact with All Nigerians (SERVICOM) were reviewed from inception in May 2005 to June 2008. Data were analyzed using descriptive, Anova, T-test and Chi-square statistics, The overall mean age of the respondents was 46.2±18.4 years and 58.9% were females. Majority (79.7%) were Yoruba. Respondents' levels of education were as follows: secondary (26.8%), primary (20.3%), no formal education (19.7%), Polytechnic (14.2%) and University (13.2%). Over a quarter (25.6%) of the respondents, (12.0% males and 13.6% females), were aware of patients' bill of rights. More respondents with post-secondary, school education (16.6%). were aware of their rights than others (8.4%), (p<0.05). Majority (83.7%) had never asserted their rights when violated. The outcome of protests by the few ( l 5.5%) that asserted their rights such as rights to privacy, medical care without prejudice, right to confidentiality and protection of patients' medical information to mention a few included inaction (1.8%), discouragement from other patients (1.3%) and threat from health care providers (1.1%). Hindrances encountered by those who tried to assert their rights included uncertainty of where to report to (5.8%), complaints not acted upon (3.4%) and rebuke from fellow patients (2.1%). Respondents' reaction to poor services included annoyance (11.0%), bad feelings (15.8%) and lapses overlooked (19.7%). More than half of the respondents (54.5%) perceived the services received to be satisfactory. Significantly more respondents (19.1%) in the medical outpatient Department perceived the quality of services to be satisfactory than those in Surgical outpatient (5.6%), Obstetrics and Gynaecology (11.7%), Ear, Nose, Throat and Eye Departments (18.0%) (p<0.05). The common reasons given by respondents for failure of health care providers to protect patients' rights included: staff shortage (42.4%), busy schedule of workers (25.5%) and lack of equipment (15.5%). The review of SERVICOM records showed that 54 complaints were reported, the main complaints included: missing case notes (14.8%); lack of courtesy from Nurses (11.1%); missing x-ray jackets (7.4%); patients not attended to (5.6%) and cancellation of surgery (5.6%). The reporting of cases of violations of patients' rights to SERVICOM is low. Assertive communication strategies' and public enlightenment are needed to sensitize and empower patients on their rights and liberty to complain when such rights are violated.