Awareness of diagnosis and treatment plan among patients in the Accident and Emergency Department of a Nigerian tertiary hospital.
Main Article Content
Keywords
Accident and Emergency, Diagnosis Awareness, Knowledge
Abstract
Background: Patient-centred care has a correlation to the effectiveness of patient engagement, patient care, and perceived quality of care. Even in the emergency room, awareness of diagnosis and treatment plans is a critical component in every doctor-patient interface as it enhances patient-centred care. This study aims to assess awareness of diagnosis and treatment plans among patients in the accident and emergency department.
Methodology: This is a cross-sectional study conducted at the accident and emergency department of the University of Port Harcourt Teaching Hospital.
Result: One hundred and ninety-seven respondents were recruited into this study comprising of 51.3% males and 48.8% females. Most 86.8% of the respondents were aware of their diagnosis, of which 91.8% knew the accurate diagnosis. Majority 84.8% of the respondents were aware of the treatment, while 68.8% of the respondents were aware of the names of the medications, most of the respondents 59.4% had no knowledge of the side effects of the medications. The majority, 61.4% were involved in the management decision. No significant relationship existed between the socio-demographic characteristics and knowledge of diagnosis and treatment plan.
Conclusion: The chaotic and overcrowded nature of the accident and emergency department should not hamper the delivery of patient-centred care. Although, findings obtained from this study reveal that the majority of the respondents are aware of their diagnosis and treatment plan, a portion of respondents do not understand their plan of care; this indicates the need for further studies to identify interventions that would ensure that gaps in the physician -patient communication are filled as this optimizes patients’ satisfaction of care received, gives better sense of control of their total situation and better quality of life.
References
2. Samuels-Kalow ME, Stack AM, Porter SC. Effective Discharge Communication in the Emergency Department. Annals of Emergency Medicine. 2012:60(2);152-159
3. Sebastian NM, Jesha MM, Sheela PH, Arya SN. Gaps in doctor patients' communication: a community-based study. International Journal of Community Medicine and Public Health. 2016, 3 (1), 264-269
4. Mercer LM, Tanabe P, Pang PS, Gisondi MA, Courtney DM, Engel KG, et al. Patient perceptive on communication with the medical team: pilot study using the communication assessment tool-item (cat-t) patient. Educ Counsel. 2008, 73 (2), 220-223.
5. Giua C, Mucherino S, Floris N, Keber E, Makoul G, Scala D et al. Adaptation of communication assessment tool for community pharmacist in medication adherence and minor diseases management. Pharmacia. 2022, 69(2), 57-578
6. Cook JLE, Fioratou E, Davey P, et al Improving patient understanding on discharge from the short stay unit: an integrated human factors and quality improvement approach. BMJ Open Quality 2022;11
7. Fritz Z, Schlindwein A, Slowther A-M. Patient engagement or information overload: patient and physician views on sharing the medical record in the acute setting. Clin Med. 2019; 19(5): 386- 391.
8. Huang J, Chiovenda A, Shao Y, Ma H, Li H, Good MD. Low level of knowledge regarding diagnosis and treatment among inpatients with schizophrenia in Shanghai. Neuropsychiatr Dis Treat. 2018 4;14:185-191. doi: 10.2147/NDT.S152917
9. Pirasath S., Kumanan T., and Guruparan M. A Study on Knowledge, Awareness, and Medication Adherence in Patients with Hypertension from a Tertiary Care Centre from Northern Sri Lanka. Int J Hypertens2017. p. 9656450. doi: 10.1155/2017/9656450
10. Berger O, Grønberg BH, Loge JH, Kaasa S, Sand K. Cancer patients' knowledge about their disease and treatment before, during and after treatment: a prospective, longitudinal study. BMC Cancer. 2018 Apr 3;18(1):381. doi: 10.1186/s12885-018-4164-5
11. Teklu AM, Abraham M, Legesse T, Bekele M, Getachew A, Aseffa B, et al. Awareness of diagnosis, treatment plan and prognosis among patients attending public hospitals and health centers in Addis Ababa, Ethiopia. PloS ONE. 2022, 17(6), e0270397
12. Slater BA, Huang Y, Dalawari P. The impact of teach-back method on retention of key domains of emergency department discharge instructions. J Emerg Med 2017;53(5):e59-e65. doi: 10.1016/j.jemermed.2017.06.032.
13. Mahajan M, Hogewoning JA, Zewald JJA,Kerkmeer M, Feitsma M, van Rijssel D A. The impact of teach-back on patient recall and understanding of discharge information in the emergency department: the emergency Teach-Back (EM-TeBa) study. Int J Emerg Med 2020 ;13(1):49.doi: 10.1186/s12245-020-00306-9.
14. Willems S, Messachalck CD, Deveugele M, Derese A, Maeseneer JD. Socio-economic status of the patient and doctor-patient communication: does it make a difference? Patient Educ Counsel. 2005, 56(2), 139-146.
15. Yadav AK, Budathoki SS, Paudel M, Chaudhary R, Shrivastav VK, Malla GB. Patients Understanding of their Diagnosis and Treatment Plans During Discharge in Emergency Ward in a Tertiary Care Centre: A Qualitative Study. JNMA J Nepal Med Assoc. 2019 Sep-Oct;57(219):357-360
16. Leora I. H, John P. M, Christine C, Robert L.F, Ursula C.B, Sandhya K, et al. Quality of Discharge Practices and Patient Understanding at an Academic Medical Center. JAMA Intern Med. 2013;173(18):1715–1722
17. Bulut H, Tanrıkulu G, Dal Ü, Kapucu S. How much do ED patients know about medication prescribed for them on discharge? A pilot study in Turkey. J Emerg Nurs. 2013 May;39(3):e27-32
18. Vashi A, Rhodes KV. "Sign right here and you're good to go": a content analysis of audiotaped emergency department discharge instructions. Ann Emerg Med 2011;57:315–22.
19. Scott C, Andrews D, Bulla S, Loerzel V. Teach-Back Method: Using a Nursing Education Intervention to Improve Discharge Instructions on an Adult Oncology Unit. Clin J Oncol Nurs. 2019 Jun 1;23(3):288-294. doi: 10.1188/19.CJON.288-294.