Patient perspectives on interpersonal aspects of healthcare and patient-centeredness at primary health facilities: A mixed methods study in rural Eastern Uganda

Abstract

Introduction Patient-centered care (PCC) is an approach to involve patients in health care delivery, to contribute to quality of care, and to strengthen health systems responsiveness. This article aims to highlight patient perspectives by showcasing their perceptions of their experience of PCC at primary health facilities in two districts in Uganda. Methods A mixed methods cross-sectional study was conducted in three public and two private primary health care facilities in rural eastern Uganda. In total, 300 patient exit survey questionnaires, 31 semi-structured Interviews (SSIs), 5 Focus Group Discussions (FGDs) and 5 feedback meetings were conducted. Data analysis was guided by a conceptual framework focusing on (1) understanding patients' health needs, preferences and expectations, (2) describing patients perceptions of their care experience according to five distinct PCC dimensions, and (3) reporting patient reported outcomes and their recommendations on how to improve quality of care. Results Patient expectations were shaped by their access to the facility, costs incurred and perceived quality of care. Patients using public facilities reported doing so because of their proximity (78.3% in public PHCs versus 23.3% in private PHCs) and because of the free services availed. On the other hand, patients attending private facilities did so because of their perception of better quality of care (84.2% in private PHCs versus 21.7% in public PHCs). Patients expectations of quality care were expressed as the availability of medication, shorter waiting times, flexible facility opening hours and courteous health workers.

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“…show their perceptions of their experiences (Waweru et al, 2020). The inclusion of patients in this study would have enriched our views on interpersonal relationships.…”

People-centred primary health care: a scoping review

“…Empathy, communication in multicultural languages, people's involvement in making decisions and designing and implementing solutions effectively empower individualized care for their health [57,59,61]. Empathic support, communication with their doctors, understanding of problems, providers' skills, and management plans were required for improved satisfaction and the effect of interpersonal care [61,62,70]. Communication between service users and providers enhanced high perceived empathy in consultation, trust in relationships, and positive experiences and satisfaction [50,62].…”

Communication skills of general practitioners in Nairobi, Kenya: a descriptive observational study

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