Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care; resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.
References
[1]
Boer, J.D., Nieboer, A.P. and Cramm, J.M. (2017) A Cross-Sectional Study Investigating Patient-Centered Care, Co-Creation of Care, Well-Being and Job Satisfaction among Nurses. Journal of Nursing Management, 25, 577-584. https://doi.org/10.1111/jonm.12496
[2]
Kuipers, S.J., Cramm, J.M. and Nieboer, A.P. (2019) The Importance of Patient-Centered Care and Co-Creation of Care for Satisfaction with Care and Physical and Social Well-Being of Patients with Multi-Morbidity in the Primary Care Setting. BMC Health Services Research, 19, Article No. 13. https://doi.org/10.1186/s12913-018-3818-y
[3]
Magner, C., Greenberg, N., Timmins, F., O’Doherty, V. and Lyons, B. (2021) The Psychological Impact of COVID-19 on Frontline Healthcare Workers “From Heartbreak to Hope”. Journal of Clinical Nursing, 30, e53-e55. https://doi.org/10.1111/jocn.15841
[4]
Khamisa, N., Oldenburg, B., Peltzer, K. and Ilic, D. (2015) Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses. International Journal of Environmental Research and Public Health, 12, 652-666. https://doi.org/10.3390/ijerph120100652
[5]
Toh, S.G., Ang, E. and Devi, M.K. (2012) Systematic Review on the Relationship between the Nursing Shortage and Job Satisfaction, Stress and Burnout Levels among Nurses in Oncology/Haematology Settings. International Journal of Evidence-Based Healthcare, 10, 126-141. https://doi.org/10.1111/j.1744-1609.2012.00271.x
[6]
Dinh, J.E., Lord, R.G., Gardner, W.L., Meuser, J.D., Liden, R.C. and Hu, J. (2014) Leadership Theory and Research in the New Millennium: Current Theoretical Trends and Changing Perspectives. The Leadership Quarterly, 25, 36-62. https://doi.org/10.1016/j.leaqua.2013.11.005
[7]
Tingvold, L. and Munkejord, M.C. (2021) Shared Goals, Communication and Mutual Respect in Multicultural Staff Teams: A Relational Coordination Perspective. Nursing Open, 8, 957-965. https://doi.org/10.1002/nop2.704
[8]
Nickel, W.K., Weinberger, S.E. and Guze, P.A. (2018) Principles for Patient and Family Partnership in Care: An American College of Physicians Position Paper. Annals of Internal Medicine, 169, 796-799. https://doi.org/10.7326/M18-0018
[9]
Wagner, E.H., Austin, B.T., Davis, C., Hindmarsh, M., Schaefer, J. and Bonomi, A. (2001) Improving Chronic Illness Care: Translating Evidence into Action. Health Affairs, 20, 64-78. https://doi.org/10.1377/hlthaff.20.6.64
[10]
Brom, L., Hopmans, W., Pasman, H.R.W., Timmermans, D.R., Widdershoven, G.A. and Onwuteaka-Philipsen, B.D. (2014) Congruence between Patients’ Preferred and Perceived Participation in Medical Decision-Making: A Review of the Literature. BMC Medical Informatics and Decision Making, 14, Article No. 25. https://doi.org/10.1186/1472-6947-14-25
[11]
van der Meer, L., Nieboer, A.P., Finkenflügel, H. and Cramm, J.M. (2018) The Importance of Person-Centered Care and Co-Creation of Care for the Well-Being and Job Satisfaction of Professionals Working with People with Intellectual Disabilities. Scandinavian Journal of Caring Sciences, 32, 76-81. https://doi.org/10.1111/scs.12431
[12]
Gittell, J.H., Douglass, A., Ancona, D., Backman, E. and Parrot, K. (2011) Relational Leadership: New Developments in Theory and Practice. Brandeis University (White paper), Waltham.
[13]
Stuart, E.H., Jarvis, A. and Daniel, K. (2008) A Ward without Walls? District Nurses’ Perceptions of Their Workload Management Priorities and Job Satisfaction. Journal of Clinical Nursing, 17, 3012-3020. https://doi.org/10.1111/j.1365-2702.2008.02316.x
[14]
Labrague, L. and McEnroe-Petitte, D. (2018) Job Stress in New Nurses during the Transition Period: An Integrative Review. International Nursing Review, 65, 491-504. https://doi.org/10.1111/inr.12425
[15]
Salmond, S.W. and Echevarria, M. (2017) Healthcare Transformation and Changing Roles for Nursing. Orthopedic Nursing, 36, 12-25. https://doi.org/10.1097/NOR.0000000000000308
[16]
Bloom, D.E., Canning, D. and Fink, G. (2014) Disease and Development Revisited. Journal of Political Economy, 122, 1355-1366. https://doi.org/10.1086/677189
[17]
Khan, G., Kagwanja, N., Whyle, E., Gilson, L., Molyneux, S., Schaay, N., et al. (2021) Health System Responsiveness: A Systematic Evidence Mapping Review of the Global Literature. International Journal for Equity in Health, 20, Article No. 112. https://doi.org/10.1186/s12939-021-01447-w
[18]
Kumar, A.S., Chen, L.C., Choudhury, M., Ganju, S., Mahajan, V., Sinha, A., et al. (2011) Financing Health Care for All: Challenges and Opportunities. The Lancet, 377, 668-679. https://doi.org/10.1016/S0140-6736(10)61884-3
[19]
Kress, D.H., Su, Y., Wang, H. (2016) Assessment of Primary Health Care System Performance in Nigeria: Using the Primary Health Care Performance Indicator Conceptual Framework. Health Systems & Reform, 2, 302-318. https://doi.org/10.1080/23288604.2016.1234861
[20]
Al Rashidi, B., Al Wahaibi, A.H., Mahomed, O., Al Afifi, Z. and Al Awaidy, S. (2020) Assessment of Key Performance Indicators of the Primary Health Care in Oman: A Cross-Sectional Observational Study. Journal of Primary Care & Community Health, 11, 1-13. https://doi.org/10.1177/2150132720946953
[21]
World Health Organization (2018) Delivering Quality Health Services: A Global Imperative. OECD Publishing, Switzerland, UK.
[22]
Henker, H., Fox-Lewis, S., Tep, N., Vanna, D., Pol, S. and Turner, C. (2018) Healthcare Workers’ Perceptions of an Organizational Quality Assurance Program Implemented in a Resource-Limited Setting: A Qualitative Study. Health Promotion Perspectives, 8, 179-186. https://doi.org/10.15171/hpp.2018.24
[23]
Plooy-Cilliers, F., Davis, C. and Bezuidenhout, R.-M. (2014) Research Matters. Juta and Company Ltd., Cape Town.
[24]
Merriam, S.B. and Tisdell, E.J. (2009) Qualitative Research: A Guide to Design and Implementation. Jossey-Bass, San Francisco.
[25]
Guba, E.G. and Lincoln, Y.S. (1994) Competing Paradigms in Qualitative Research: Handbook of Qualititaive Research. Sage, Thousand Oaks.
[26]
Polit, D.F. and Beck, C.T. (2014) Nursing Research: Principles and Methods: Principles and Methods. Lippincott Williams and Wilkins, Philadelphia.
[27]
Shenton, A.K. (2004) Strategies for Ensuring Trustworthiness in Qualitative Research Projects. Education for Information, 22, 63-75. https://doi.org/10.3233/EFI-2004-22201
[28]
Engle, R.L., Mohr, D.C., Holmes, S.K., Seibert, M.N., Afable, M., Leyson, J. and Meterko, M. (2021) Evidence-Based Practice and Patient-Centered Care: Doing Both Well. Health care Management Review, 46, 174-184.
[29]
Agoritsas, T., Heen, A.F., Brandt, L., Alonso-Coello, P., Kristiansen, A., Akl, E.A., et al. (2015) Decision Aids that Really Promote Shared Decision Making: The Pace Quickens. BMJ, 35, Article No. g7624. https://doi.org/10.1136/bmj.g7624
[30]
Mirzaei, M., Aspin, C., Essue, B., Jeon, Y.-H., Dugdale, P., Usherwood, T., et al. (2013) A Patient-Centered Approach to Health Service Delivery: Improving Health Outcomes for People with Chronic Illness. BMC Health Services Research, 13, Article No. 251. https://doi.org/10.1186/1472-6963-13-251
[31]
Dwamena, F., Holmes-Rovner, M., Gaulden, C.M., Jorgenson, S., Sadigh, G., Sikorskii, A., et al. (2012) Interventions for Providers to Promote a Patient-Centred Approach in Clinical Consultations. Cochrane Database of Systematic Reviews, Article No. CD003267. https://doi.org/10.1002/14651858.CD003267.pub2
[32]
Onwujekwe, O. (2013) Moving Nigeria from Low Coverage to Universal Health Coverage: Health System Challenges, Equity and the Evidence-Base. 74th Inaugural lecture of the University of Nigeria, Enugu, 1-33. https://www.researchgate.net/profile/Obinna_Onwujekwe/publication/317267470_Moving_Nigeria_from_low_coverage_to_universal_health_coverage_national_health_system_challenges_equity_and_the_evidence-base/links/592f1958a6fdcc89e7773723/Moving-Nigeria-from-low-coverage-to-universal-health-coverage-national-health-system-challenges-equity-and-the-evidence-base.pdf
[33]
World Health Organization and the United Nations Children’s Fund (2018) A Vision for Primary Health Care in the 21st Century: Towards Universal Health Coverage and the Sustainable Development Goals. World Health Organization, Geneva.
[34]
Aregbeshola, B.S. and Khan, S.M. (2017) Primary Health Care in Nigeria: 24 Years after Olikoye Ransome-Kuti’s Leadership. Frontiers in Public Health, 5, Article No. 18. https://doi.org/10.3389/fpubh.2017.00048
[35]
Adeloye, D., David, R.A., Olaogun, A.A., Auta, A., Adesokan, A., Gadanya, M., et al. (2017) Health Workforce and Governance: The Crisis in Nigeria. Human Resources for Health, 15, Article No. 32. https://doi.org/10.1186/s12960-017-0205-4
[36]
Besada, D., Eagar, D., Rensburg, R., Shabangu, G., Hlahane, S. and Daviaud, E. (2020) Resource Requirements for Community-Based Care in Rural, Deep-Rural and Peri-Urban Communities in South Africa: A Comparative Analysis in 2 South African Provinces. PLoS ONE, 15, Article ID: e0218682. https://doi.org/10.1371/journal.pone.0218682
