Journal – Injury
Article type – Journal research article – Clinical research
Publication date – Jul – 2022
Authors – Ferdinand B.R. Mayer, Anadi Bulaya, Caris E. Grimes, Simba Kaja, John K.H. Whitaker
Keywords – Care quality, Grounded theory, Lower-middle income country, orthopaedics, patient care, Zambia.
Open access – Yes
Speciality – Trauma and orthopaedic surgery
World region Southern Africa
Country: Zambia
Language – English
Submitted to the One Surgery Index on July 30, 2022 at 2:46 am
Abstract:

Background
Injuries are a significant cause of mortality and morbidity, particular in low- and middle-income countries (LMICs). While there is a focus on increasing injury care capacity, less attention is given to assessing, improving, and understanding the quality of care provided, especially from a patient perspective. This study therefore aims to understand what patients from a Zambian orthopaedic ward believe good quality care to be, to identify its key components, and contribute to better understanding what patients believe local healthcare priorities could be.

Methods
Patients admitted to the orthopaedic ward of a Zambian tertiary care hospital were invited to take part in-depth face-to-face interviews. Interviews were continued until thematic saturation was achieved. Interviews were recorded and transcribed. Analysis was done using an inductive grounded theory approach.

Results
Of 13 patients approached, 12 consented to take part. Analysis of the themes from the transcripts led to the emergence of four core categories of quality care which are important to the patient: i) restoring the patient to normality (category: ‘restoring normality’), ii) establishing trust between patients and providers (‘trusting the provider’), iii) respecting the patient and allowing them to maintain autonomy (‘autonomy and respect’) iv) finding ways for patients to enjoy their time in the hospital (‘enjoying life’). From these results, a patient perspective theory of quality care emerged. This theory posits the idea that high-quality care in this context needs to fulfil these four core categories. Additionally, these core categories were ranked on significance and priority.

Conclusion
The hierarchy of core categories could help to identify areas to improve care quality in this setting. Not only has this study helped to determine local priorities for achieving high-quality care but can encourage others to test injured patient perceptions of care quality in comparable settings.

OSI Number – 21679

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