Protocol of mixed-methods assessment of demographic, epidemiological and clinical profile of decentralised patients with cancer at Nelson Mandela Academic Hospital and Rob Ferreira Hospital, South Africa

Chitha, Wezile; Jafta, Zukiswa; Mnyaka, Onke; Hongoro, Danleen; Godlimpi, Lizo; Swartbooi, Buyiswa; Williams, Natasha; Zungu, Christopher; Buthi, Lazola; Kuseni, Sibulelo; Nasila, John Sungwacha; Sibulawa, Siyabonga; Giwu, Olona; Mavimbela, Awam; Essel, Vivien; Mabunda, Sikhumbuzo A.

doi:10.1136/bmjopen-2021-054983

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…This barrier could potentially be addressed in one of two ways: Firstly, transportation to the hospital on the day of the oncology consultation could be arranged through provision of a dedicated hospital bus service to patients. 32 Secondly, it might be possible to decentralise the oncology consultation to a lower-level healthcare facility which is closer to a patient’s place of residence, 33 thereby facilitating attendance of the consultation. Both proposed solutions are likely to have financial implications for the resource-constrained South African public healthcare system.…”

Section: Discussionmentioning

confidence: 99%

Patient’s attitudes and perceptions around attending oncology consultations following surgery for colorectal cancer: A qualitative study

et al. 2023

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Background: The oncology consultation following surgery for colorectal cancer (CRC) is usually the first step in the receipt of chemotherapy. Non-compliance with this consultation results in non-receipt of recommended chemotherapy, when appropriate, and worse clinical outcomes. This study sought to explore South African patients’ attitudes and perceptions around attending scheduled oncology consultations following their CRC surgery. Methods: Semi-structured qualitative interviews were conducted with patients who had surgery for CRC at a quaternary South African hospital and who had to decide whether they would return for an oncology consultation. The “Model of health services use” informed the design of the interview guide, which included questions on factors that impact health seeking behavior. Demographics of participants, CRC disease stage, and compliance with scheduled oncology consultations were also collected. Descriptive statistics were used to analyse the quantitative data, while deductive thematic analysis was used to analyse the qualitative data. Results: Seven participants were interviewed. The median age was 60.0 years and four participants (57.1%) were female. Black African, White, and Asian participants accounted for 85.7% of the study sample. Most participants had stage III CRC (71.4%). The oncology consultation no-show rate was 14.3%. Participant’s knowledge and beliefs around CRC proved to be an important predisposing factor that influenced follow-up decisions. Family support and religion were cited as important enabling factors. Travel costs to the hospital and frustrations related to the clinic appointment booking/scheduling process were cited as important disabling factors. Lastly, the participant’s self-perceived need for additional oncology care also appeared to influence their decision to return for ongoing oncology consultation after the initial surgery. Conclusion: Several contextual factors can potentially influence a patient’s compliance with a scheduled oncology consultation following CRC surgery. A multipronged approach which addresses these factors is required to improve compliance with oncology consultations.

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Section: Discussionmentioning

confidence: 99%

Patient’s attitudes and perceptions around attending oncology consultations following surgery for colorectal cancer: A qualitative study

et al. 2023

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Assessing patients’ experience of care in four referral hospitals: a cross-sectional survey of outpatients in two South African rural provinces

Chitha,

Mnyaka,

Ncinitwa

et al. 2024

BMC Health Serv Res

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Background Patient experience of care surveys are an important component of performance improvement and clinical effectiveness because they serve as a good proxy for patient’s satisfaction and the quality of care. The purpose of this study was to assess patients’ experience of care in four referral hospitals in two of South Africa’s rural provinces. Methods A cross-sectional study was conducted in four public hospitals in Eastern Cape (Nelson Mandela Academic (NMAH) and St. Elizabeth (SEH)) and Mpumalanga provinces (Rob Ferreira (RFH) and Themba) for two weeks in July 2022. Systematic random sampling was used to select 662 outpatients. A validated patient experience of care questionnaire measuring demographics, access to care, availability of medicines, cleanliness, staff attitudes and waiting times was used. The level of statistical significance was p-value ≤ 0.05. Results Females accounted for 71.6% (474/662) of participants; the median age was 47 years and 20.2% (133/657) required assistance with a disability. Only 19.0% (31/659) of patients had been turned away from hospital previously; one hospital was reported to not be clean (68.5%, 111/162); more than two-thirds of Mpumalanga province participants (223/329, 67.8%) reported absence of drinking water ( p -value < 0.0001); 68.5% (111/162) of Themba participants did not think that the hospital was clean compared to NMAH’s 82.2% (134/163) who thought it was clean ( p -value < 0.0001). At least 70% of participants in each of the hospitals found the health professionals to be respectful towards patients ( p -value < 0.0001). In all hospitals, at least half of the participants did not know the processes to be followed when lodging a complaint ( p -value = 0.002). None of the four hospitals met all the national targets. And only two out of 28 potential domains exceeded 80% or the cut-off score for satisfaction. Conclusions Whilst hospitals have been implementing various quality measures to improve patient’s experience of care, there are a few concerns such as non-availability of drinking water, lack of knowledge of complaints processes and waiting times that were mostly reported to be unacceptable. Efforts should be made to address the highlighted areas that affect patient experiences to continue improving patient care. Trial registration The study forms part of a clinical trial which was registered on 19 May 2022 in the South African National Clinical Trial Registry with ref: DOH-27-052022-6854. The URL of trial registry record is: https://sanctr.samrc.ac.za/ . Supplementary Information The online version contains supplementary material available at 10.1186/s12913-024-12002-y.

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Protocol of mixed-methods assessment of demographic, epidemiological and clinical profile of decentralised patients with cancer at Nelson Mandela Academic Hospital and Rob Ferreira Hospital, South Africa

Cited by 2 publications

References 6 publications

Patient’s attitudes and perceptions around attending oncology consultations following surgery for colorectal cancer: A qualitative study

Patient’s attitudes and perceptions around attending oncology consultations following surgery for colorectal cancer: A qualitative study

Assessing patients’ experience of care in four referral hospitals: a cross-sectional survey of outpatients in two South African rural provinces

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