Patient Engagement in Decision Making and Associated Factors among Outpatients with Selected Non-Communicable Chronic Diseases in Public Hospitals of West Shoa, Ethiopia,2020

Abstract

Background: Despite the importance of patient engagement in health care decision-making in the care of patients with chronic diseases, there is limited information about it and the factors affecting it in Ethiopia in general and in the Public Hospitals of West Shoa in particular. Thus this study is designed to assess the engagement of patients with selected chronic non-communicable diseases in health care decision making and associated factors in public hospitals of West Shoa Zone, Oromia, Ethiopia.Methods: Facility-based cross-sectional study design was used. Systematic sampling was used for the selection of study participants from June 7 – July 26, 2020. Standardized, pretested, and structured Patient Activation Measure was used to measure patient engagement in healthcare decision-making. Descriptive analysis was done to determine the magnitude of patient engagement in health care decision-making. Multivariate logistic regression analysis was used to determine factors associated with patients’ engagement in the health care decision-making process. Adjusted odds ratio with a 95% confidence interval was calculated to measure the strength of association. Statistical significance was declared at p<0.05. The results were presented by tables and graphs.Results: A total of 406 patients with chronic diseases participated in the study yielding a response rate of 96.2%. Less than a fifth [19.5% (95% CI: 15.5, 23.6)] of participants in the study area had a high engagement in their health care decision-making. Educational level (college or above) [AOR=5.2, 95% CI (1.76-15.46)], duration of diagnosis >5 years [AOR= 1.8, 95% CI (1.03-3.2)], health literacy [AOR=1.15, 95% CI (1.06-1.24)], autonomy preference in decision making [AOR=1.35, 95% CI (1.03-1.96)] were factors significantly associated with participants’ engagement in health care decision making among patients with chronic diseases. Conclusion- Low number of respondents had a high engagement in their health care decision-making. Preference for autonomy in decision making, educational level, health literacy, duration of diagnosis with the disease were factors associated with patient engagement in health care decision making among patients with chronic diseases in the study area. Thus individualized patient-centered care and patient empowerment is essential among patients with chronic non-communicable diseases.