Perceptions of Nurses on Challenges and Opportunities for Implementing Patient Centered Care to Critically ill Patients at Consultant Hospitals in Dar es Salaam, Tanzania

Abstract

Background: Patient Centered care (PCC) is a caring approach which advocates partnership in care between health care workers, patients and family. This approach is known worldwide and has shown to improve outcome of both ambulatory and critically ill patients. Despite its importance, empirical literature has evidenced the worldwide problem in implementing PCC to critically ill patients. This study was expected to come up with the challenges and opportunities available in the context of Tanzania with their effect in PCC implementation. Objective: The general objective of this study was to describe challenges and opportunities for implementing PCC to critically ill patients. Methodology: The study used analytical cross-sectional design. Proportionate stratified sampling was used to ensure that the sample was representative, that is, nurses from Muhimbili National Hospital (MNH), Muhimbili Orthopaedic Institute (MOI) and Jakaya Kikwete Cardiac Institute (JKCI) were represented proportionally. Simple random sampling was used to select respondents for the study. A sample of 152 nurses was used and this was drawn from a study population comprising a total of 250 nurses. Data was collected using questionnaires and was analyzed using descriptive analysis, Chi-square, bivariate and multivariate logistic regression. Results: The results showed no significant challenges that hinder implementation of PCC and on the other hand it revealed that family conference/meeting was an available opportunity for PCC implementation with p=0.001, AOR 3.47 (1.34-3.51). It was further revealed that a demographic characteristic, that is, nurses work experience has influence on PCC implementation with p value of 0.027 and AOR 2.26 (1.09-4.67). Conclusion: This study revealed no significant challenge on the implementation of PCC among nurses in Tanzanian context particularly at three consultant hospitals in Dar es Salaam. It was further revealed that availability of family meetings can significantly enhance PCC implementation. Therefore, for successful implementation of PCC the hospitals’ management can use family conference as available opportunity to foster PCC implementation. However, more research needs to be done in the subject area