Patients' knowledge and exercise of their rights at the University College Hospital, Ibadan.

BACKGROUND: Patient rights have recently become the centre of national attention in the healthcare practice and Nigerians are becoming more aware of their rights. Despite this awareness, there is gap between their knowledge and ability to exercise their rights. The study was designed to assess University College Hospital patients' knowledge and exercise of their rights. METHOD: This descriptive, cross-sectional study utilized a 45-item and self-administered questionnaire to gather information from three hundred and sixty (360) patients. The sample size was statistically determined and the respondents were randomly selected from Out-Patient Department. Ethical issues were duly considered. Data collection spanned four weeks. Data were analysed through the use of Statistical Package for Social Sciences (SPSS) version17. RESULTS: Most of the respondents (94.2%) have good knowledge of rights and few (37.2%) of them denied being actively involved in making decisions on issues concerning their care. However, about half (50.8%) claimed they were not fully informed about the diagnosis and treatment plans regarding their health conditions. About 75.0% of the respondents reported that they would seek redress if their rights are infringed upon. CONCLUSION: Patients have good knowledge of their rights, yet they are not fully exercising these rights. Patients should be encouraged to participate in the decision making process on their health issues because it is a channel towards achieving positive patient outcomes. Adequate information about care including the risks of procedures, cost implications of care and possible outcomes of care among others should be provided. Provision of more information by health care providers may enhance patients' decision making and exercise of rights.

A pilot study assessing litigation in health care services in Nigeria.

Litigation in healthcare system especially in nursing practice is rapidly increasing globally. Litigation affords an individual explanation and compensation for perceived wrong acts. It also serves to control all service providers. However, observation shows that health care providers in Nigeria behave as if they are litigation proof even in the presence of gross malpractice and negligence. The prime concern of this study attempts finding out Nigerians attitudes to litigation. This paper reports the result of the qualitative aspect of the study. In-depth interviews were conducted from January, 2006- March, 2007 for purposive and randomly selected fifty (50) adults from different ethnic, cultural, and social backgrounds. The study was carried out in Ibadan, the largest city of Nigeria. The instrument was a semi structured interview guide designed to assess the use of orthodox medical practice by Nigerians; examine Nigerians experience of unethical practice or injustice; identify Nigerians' attitude to litigation in health care practices and identify factors responsible for their attitudes to litigation. Data were analysed using content analysis. The result shows that Nigerians utilize the hospitals and are aware of their rights as consumers of healthcare services but show poor attitudes to litigation for different reasons. This attitude was found to be a function of the prevailing socio-cultural factors in Nigeria. Litigation is at low ebb in Nigeria, health care providers should endeavour to deliver safe and ethically sound care despite the prevailing circumstances. Health care is a fundamental human right and so, should be provided with dignity and people should have access to dignified treatment always.

Perception and management of cancer among the Yoruba in Ibadan, Nigeria.

Prevalence and mortality rates of cancer are on the increase worldwide. Its management is blurred by misconception in Nigeria particularly. This study therefore examines the Yoruba perception and management of cancer using health belief model as the theoretical framework. The study utilised both qualitative and quantitative approaches. It was carried out in Ibadan metropolis in Nigeria. For the qualitative data a total of 19 Focus group discussions (190 people) among people aged 20 years above 45 in-depth interviews and structured observation were held. For quantitative data, a simple random sampling technique was employed in selecting 450 people at the household level while non-probability sampling was used for the 45 people living with cancer (PLWC) and 75 health care providers. The result showed that cancer is perceived as a major health problem. It is commonly called "Jejere" literally meaning a devouring disease. Cancer is associated with natural causes due to unhealthy life styles such as nutritional pattern and indiscriminate use of both orthodox and traditional drugs. Socio-economic factors of the people determine management of cancer (43.4% and 33.0% for money and occupation respectively).Result showed that (60%) preferred and use the orthodox medical care for various reasons such as precison about treatment positive outcome of care among others. Utilization of modern healthcare however was associated with high cost. Education and occupation have significant relationship with perceived cause of cancer p < 0.05, respectively. Variables like sex, age, and religion were not significant to perceived causes (p > 0.05) of cancer. The perceived cause of cancer does not have any relationship with the choice of cancer care p > 0.05. The available health care is significant to the choice of cancer care p < 0.05. The choice of cancer care depends on variables like sex, age, education and occupation p < 0.05, while religion is insignificant to the choice of cancer care p > 0.05. The problems encountered at the health care institutions were not significant to their utilization pattern p > 0.05, in order words, the benefits derived out-weighs the problems. Perception of cancer was not tied to the usual Yoruba perception of diseases. Cancer care depends largely on economic factors and facilities for cure rather than cultural factors. It is recommended that the government should focus on the following for effective management of cancer: encourage mass literacy of the people and the indigenous practitioners; provide social support; and fund cancer research.

Informed consent in a tertiary hospital in Nigeria: how involved is the nurse?

INTRODUCTION: We reviewed the nurse's involvement and role perception on informed consent in LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria OBJECTIVES: The study aimed at determining the nurses' knowledge, attitude and perception of role in informed consent and the level of participation in the procedure. METHODS: A descriptive cross sectional study of the nurses in the medical and surgical units of LAUTECH Teaching Hospital was carried out using semi structured questionnaire. RESULTS: Sixty five nurses participated in the study. A high proportion - 60 (92.3%) had heard of informed consent but only 26(40%) had correct and adequate knowledge of informed consent. Forty (61.5%) had participated as witnesses to the procedure of seeking informed consent. Participation was only sometimes in 38 (58.5%) of respondents. Forty seven (86.2%) nurses wanted nurses to be involved in obtaining informed consent because it improves quality of patient care while 38(58.5%) nurses believed that involvement of nurses should be because it is the nurses' statutory responsibility. CONCLUSION: It would appear that the knowledge of informed consent among nurses was inadequate and nurses were not adequately carried along in the process. Training of nurses in this important procedure would greatly enhance the quality of patient care.