Theses and dissertations (Health Sciences)
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Item A survey of patient satisfaction of the DUT Homoeopathic Community Health Centre (DUT HCHC)(2022-05-13) Adandé, Adhiéman Sihle; Couchman, Ingrid; Brijnath, ShraddhaBackground Patient satisfaction is a vital area of research concerning the quality of healthcare. Satisfied patients are more likely to benefit from their healthcare, keep their appointments and comply with medical regimes such as proper medication upon given instructions from their healthcare practitioner (Hills and Kitchen, 2007: 243). Herr (2008) conducted a similar study on patient satisfaction at the Homoeopathic Community Health Centre (HCHC) at Durban University of Technology (DUT). Although there has been renovation at the community health since then, more than five years have passed without any evaluation. Patient satisfaction is a patient-focused indicator of healthcare services. Therefore, evaluating patient satisfaction is a good criterion for analysing the quality and relationship between patients and healthcare practitioners. Therefore, patient dissatisfaction is a significant factor for changing healthcare services or complaints against a healthcare practitioner (Miri, Nejad and Soltani, 2016: 89). Thus, continuous improvement in healthcare quality is a daily goal for all healthcare services, such as clinics and professionals who work in healthcare. To thrive in a competitive marketplace, it is essential for healthcare organisations and their practitioners to recognise that viewing patients as customers and improving customer satisfaction has direct implications on healthcare quality (Harding and Taylor 2010: 928; Stavins 2006:29). This study evaluated patient’s feedback to create a patient satisfaction survey for use at the HCHC at DUT continually. Aim The aim of this study was to conduct a patient’s satisfaction of the service provided at the DUT HCHC, with the purpose to identify shortfalls/gaps such as to improve every aspect of patient satisfaction, which positively contributes to the overall treatment and service being provided at the DUT HCHC. Methodology The sample group of the first 70 patients that consulted at the DUT HCHC between July 2020 and March 2021, that voluntarily participated in this study were included in the study by means of convenience sampling. The use of a self-administered questionnaire to establish patient satisfaction was applied. No names were required and all data has been kept strictly confidential. This information will subsequently be used to improve the quality of the service provided at this facility and increase the degree of patient satisfaction experienced. Results In this study there was generally a high degree of satisfaction with the healthcare and services provided. Areas of particularly high satisfaction were, Patient’s arrival at the community health centre where they were both promptly and politely greeted, as well as the overall interaction between the student Homoeopath, Administrative staff as well as the Clinician on duty and the patient. Areas that demonstrated lower degree of satisfaction were advertising by media and signage, signage, toilet accessibility for disabled patients and parking. Conclusion The feedback from the patient satisfaction survey will subsequently serve to improve the quality of the service provided at the DUT HCHC and increase the degree of patient satisfaction experience.Item The relationship between occupational coping self- efficacy of nurses and patient satisfaction scores in a private hospital in KwaZulu-Natal(2022-05-09) Ghirdhari, Sewak; Orton, Penelope Margaret; Naidoo, Vasanthrie; Orton, Penelope; Naidoo, VaBrief background of the Study The nursing profession is faced with high levels of work stress such as staff shortages, poor working conditions, lack of resources, job dissatisfaction and burnout, which tends to compromise quality of care rendered to patients. The research was to establish whether nurses’ occupational coping self- efficacy had any association with patient satisfaction scores. Aim of the study The aim of this research was to describe any relationship between occupational coping self- efficacy of nurses and patient satisfaction scores in a selection of wards in a private hospital in KwaZulu-Natal. Methodology A quantitative, cross-sectional, descriptive survey design was used to conduct the study. Data was collected using questionnaires. The quantitative data was analysed statistically. The statistics used included descriptive statistics such as frequencies, measures of central tendency and measures of dispersion. Factor analysis was used to explore the structure of the data and in order to test for significant trends in the data, inferential statistics were applied. Results The results revealed that although the recording was done objectively, the outcome was not positively achieved due to the unforeseen covid-19 pandemic. Results were skewed due to all wards unable to participate in research. The nurses completed their tool but unable to meet the expected patient ratio. Sample realization of 100% was achieved.Item Patient satisfaction at the Durban University of Technology Chiropractic Day Clinic using a prevalidated survey(2021-12-01) Ruthnam, Mary Ann; Varatharajullu, DesireeAIM: The aim of this study was to determine the level of patient satisfaction at the Durban University of Technology Chiropractic Day Clinic and to establish if there is any association between patient demographics (age, gender, ethnicity, income) and patient satisfaction. SUBJECTS: Patients attending the Durban University of Technology Chiropractic Day Clinic were approached to participate in the study. METHODOLOGY: Patients who attended the Durban University of Technology Chiropractic Day Clinic between June and September 2020 were informed about the research study at the reception desk by the reception staff. The patients who were interested agreed to participate, and those who were within the inclusion criteria, were handed a letter of information and an informed consent by the reception staff. Each potential participant was required to read and understand the letter of information, as well as read, understand and sign the consent form. Each patient was then handed a questionnaire, and the patient was given time after their consult to complete the questionnaire. The consent forms and questionnaires were placed into separate boxes and a code was allocated to each questionnaire before the data were captured. RESULTS: A total of 150 questionnaires were analysed and it was revealed that the patients attending the Durban University of Technology Chiropractic Day Clinic are satisfied with all aspects of the clinic, except finance. It was also shown that there was no association between patient demographics (age, gender, ethnicity and income) and satisfaction. CONCLUSION: The findings of this study correlated with some studies on the association of patient demographics and satisfaction but was not in line with all those findings.Item A quality framework for radiographic service delivery in regional hospitals in the eThekwini District, KwaZulu-Natal(2021-12-01) Gam, Nkululeko Phalson; Sibiya, M. N.Background Generally, diagnostic imaging services in Africa are challenged by many factors including lack of equipment and personnel, quality assurance and quality control measures, quality management and monitoring and evaluation frameworks. These challenges are further compounded by a lack of understanding of the factors responsible for poor imaging service delivery and the mitigation strategies. Furthermore, there is paucity of context specific research on diagnostic imaging service delivery in African counties including South Africa. A practice framework was deemed necessary to guide quality of services in diagnostic imaging services in regional hospitals within the eThekwini district of KwaZulu-Natal. Aim The aim of this study was to explore the factors affecting quality in diagnostic imaging departments of the regional hospitals in the eThekwini District of KwaZuluNatal in order to develop a framework that can be used to improve quality. Method A convergent parallel mixed methods design was employed to explore factors affecting quality in medical imaging departments in regional hospitals in the eThekwini District of KwaZulu-Natal in South Africa. In addition, a stratified random sampling strategy was used for quantitative data collection whilst a purposive sampling strategy was used for the qualitative strand. The quantitative strand of the study used a questionnaire administered to patients to measure their levels of satisfaction with service delivery rendered by the diagnostic imaging departments. Data in the quantitative strand were analysed using Version 26.0 of the SPSS and tests such one sample t-test, univariate analysis, Analysis of Variance (ANOVA), Levene's Test for Equality of Variances, Spearman’s rho and independent sample t-tests were used. Furthermore, the quantitative strand consisted of an image reject analysis to investigate rates at which images were rejected and reasons for rejection. The qualitative strand involved in-depth one-on-one interviews with doctors, radiographers, Radiography Managers and hospital wide Quality Assurance Managers. Questions regarding quality of service delivery, possible areas and strategies to improve quality were posed to participants. Responses were recorded through notes made by the primary researcher together with voice recordings. Content analysis was used to analyse qualitative data. Findings The construct that emerged from analysis of results from the patient satisfaction survey were cleanliness, staff, comfort, communication and booking times. There was significant agreement that all the aspects investigated were acceptable to the patients (M>3.5, SD>7). However, although patients were satisfied with comfort in the imaging departments in general, they were dissatisfied with the comfort of the waiting area. Reject rate analysis was conducted in three regional hospitals and the reject rates were different for each hospital (Hospital A = 12.67%, Hospital B = 10.67% and Hospital D = 4%). The average reject rate for all the hospitals was higher than the WHO benchmark of 10%. Twenty eight participants including nine doctors, 13 radiographers, three QA Managers and three Radiography Managers were interviewed across the four regional hospitals during the qualitative strand. Four themes emerged following analysis of qualitative data and these included definition of quality of imaging services by the participants, inadequacy of clinical provisions, leadership and management of medical imaging departments as well as facilities and resources. Issues expressed by the participants regarding inadequacy of clinical provisions included patient referral protocols, communication, image quality and radiology reports. Furthermore, regarding leadership and management participants expressed opinions on roles and responsibilities, accountability, monitoring of working hours and National Core Standards. Lastly, facilities resources included issues such as inadequacy of imaging equipment, inadequacy of staffing, and inservice training. Conclusion The findings reported in the current thesis and the resulting framework are highly relevant to policy and practice particularly in the eThekwini District. The involvement of patients and healthcare professionals in identifying challenges and solutions is a major strength of the current research. The current study has also uncovered the deficiencies in diagnostic imaging services in the eThekwini district around radiographers’ knowledge of the National Core Standards. Finally, if implemented, the framework developed can be used to enhance equipment testing and maintenance policies and improve staff and patient satisfaction as well as staff development. These should increase quality in diagnostic imaging servicesItem Development and validation of a patient satisfaction monitoring tool for the Durban University of Technology Chiropractic Clinic(2018) Singh, Ashmindher; Varatharajullu, Desiree; Cruickshank, GillianBackground Patient perceptions of the value of services and care they obtain at healthcare practices offer healthcare providers and staff important information to effect improvements. Studies have shown a high rate of patient satisfaction of patients receiving chiropractic care. South Africa is distinguished as the only country in Africa to offer training in chiropractic. Currently, only two tertiary establishments in South Africa, the Durban University of Technology and the University of Johannesburg offer a master’s in Chiropractic degree. There is, however, no feedback system currently implemented at the Durban University of Technology Chiropractic day clinic for patients to indicate levels of satisfaction. Patient satisfaction surveys are considered as a means of gathering patients valued opinions on primary health care services that they have received. This study evaluated the patients’ feedback in creating a patient satisfaction survey for use at the DUT CDC on a continual basis. Aim The aim of this study was to develop a valid and reliable patient satisfaction questionnaire, which could easily be used on a routine basis in order to monitor patient satisfaction levels at the DUT CDC in terms of quality of care, accessibility and interpersonal factors. Method This study consisted of three phases. Phase one was a preliminary review of the literature on questionnaire design and conceptual frameworks. Phase two consisted of instrument development, expert group and pilot testing. The development of the instrument and its contents was informed by the review of the literature and questionnaire exemplars from phase one. In this phase, a second questionnaire was developed and trialled with the expert group, as it was used to rate the significance of the questions on the patient satisfaction questionnaire (PSQ); subsequently the PSQ was piloted. Phase three was the handing out of the PSQ and the rating patient satisfaction questionnaire (RPSQ) to patients attending at the DUT CDC. Results The PSQ and RPSQ questionnaires were completed by 400 patients. The patients gave their suggestions as to which statements should be included in the final PSQ. The statements with a majority agreement were included in the final PSQ. The final PSQ was shown to be reliable with Cronbach's Alpha score of 0.93. Conclusion The final PSQ could help to continually monitor patient satisfaction at the DUT CDC. The clinic committee could utilise the feedback to implement or build on quality improvement initiatives, which would assist in demonstrating a commitment to patient-centred care and improve the overall healthcare experience at the DUT CDC.Item Patient perception survey : Durban University of Technology Homoeopathic Day Clinic(2008) Herr, Benjamin Jamie; Naude, David F.Within healthcare, patient satisfaction is a combination of need, expectation and the experience of care being provided. Patient satisfaction is an intermediate outcome, and is an important measure of the quality of the overall care provided. Healthcare which does not satisfy the patient is usually less effective, because less satisfied patients tend not to comply with instructions, they take longer to follow up with appointments and they have a poor understanding of their medical condition (Wilkin, Hallam and Dogget, 1994; AI-Assaf, 1998). The provision of overall quality healthcare for patients is a key motivation for many service providers. Therefore, determining the level of patient satisfaction forms a very important part of managing and fulfilling the patients' healthcare needs (Smith, 2001a). Furthermore, surveys of patient satisfaction form an essential role in assessing public opinion of the service provided. Thus, the evaluation of the service provided by a clinic can be reflected in the degree of satisfaction perceived by individuals receiving the services as elicited by a patient perception survey. This study assess patient’s perception of the service provided at the Homoeopathic Day Clinic (HDC) at the Durban University of Technology (DUT). The use of a self-administered questionnaire to establish patient satisfaction was applied. No names were required and all data has been kept strictly confidential. This information will subsequently be used to improve the quality of the service offered at this facility and increase the degree of patient satisfaction experienced. The sample group of the first 100 patients that consulted the HDC at the DUT between July and November 2007 that voluntarily participated in this study were included in the study by means of convenience sampling.In this study there is generally a high degree of satisfaction with the healthcare and services provided. Areas of particularly high satisfaction are related to patients’ arrival to the clinic where they were both promptly and politely greeted, as well as in relationship to the approachability/friendliness of the Homoeopathic student, and the instructions given on how to take the medicine. Areas that revealed lower degrees of satisfaction are advertising, both in media and by signage, as well as the accessibility of the clinic for disabled patients.Item Patient satisfaction at the Durban Institute of Technology chiropractic day clinic(2006) Thoresen, BrucePatient satisfaction is an important, desired measure of quality of care and has a significant influence on the perceived quality of care and outcome of treatment, and for this reason, it holds great value to the treating clinician. Satisfied patients are more likely to comply with treatment instructions and advice, remain with their service provider and refer others. Dissatisfaction, in the event of an unfavourable outcome, can result in legal action and complaints to regulatory bodies. Studies have indicated a high level of satisfaction with chiropractic care; however, none have been in a student clinic setting even in view of the suggested importance in the literature. In view of this significance and lack of understanding of the patients’ satisfaction / dissatisfaction in the history of DIT’s clinic operation the question remains as to what extent the students at the DIT Chiropractic Day Clinic satisfy their patients. This study evaluated the patient satisfaction at the DIT Chiropractic Day Clinic in order to establish a baseline for future comparison. Cronbach’s alpha scores were used to determine questionnaire reliability in a South African student context.