Assessing clinicians’ awareness and perceptions of patients’ rights in Mulago National Referral Hospital

Abstract

Background: Patient rights encompass essential rules for interactions between patients and healthcare providers, including but not limited to: access to care, respect, communication, dignity, confidentiality, Privacy, refusal of treatment, medical records, and consent. These rights are upheld best when clinicians are aware of them. Although many studies focus on patients and the general public, there is a lack of research on clinicians' perceptions and awareness of patient rights in Uganda. This study aims to address this gap. Objective: To assess clinicians’ awareness and perception of patients’ rights in clinical care at Mulago National Referral Hospital. Methods: The study employed a qualitative cross-sectional approach, conducting 18 in-depth interviews with clinicians (9 medical doctors and 9 nurses) from Mulago National Referral Hospital. Data collection involved audio-recorded interviews, and the analysis was carried out using inductive thematic analysis with NVivo version 12 software. Participants were selected purposely to ensure diversity in age, gender, education, profession, and experience. Results: Fifteen of eighteen (15/18) participants demonstrated a good understanding of human and patient rights in particular. They could accurately define and provide examples of patient rights, such as the right to information, respect, non-discrimination, access to care, privacy, autonomy, and the right to refuse treatment. These rights were linked to professional codes, patient charters, the Hippocratic Oath, and ethical principles like autonomy, justice, beneficence, and non-maleficence. A few participants showed limited awareness, often due to a lack of refresher training. Participants agreed that all patient rights are equally important and none should be prioritized over the other. While respecting these rights generally promotes quality care and adherence, it can sometimes delay decision-making, as seen with the right to refuse treatment. Participants were divided on the use of deception, but agreed that accurate information should be provided at the right time. Regarding the feasibility of implementing patient rights in Uganda, some clinicians believed all rights are feasible, but most acknowledged challenges. Difficulties include ward congestion, insufficient resources, cultural and religious beliefs, and gaps in knowledge. These challenges were categorized into infrastructure, resource-related issues, cultural beliefs, and knowledge gaps. Conclusions and Recommendations: It was found that clinicians are aware of patient rights and generally support their importance in promoting quality care. Challenges like limited space, underfunding, cultural beliefs, and knowledge gaps hinder the implementation of these rights. Recommendations include enhanced training for both clinicians and the public, increasing the health budget, improving staffing levels, developing insurance policies, and strengthening reporting and monitoring mechanisms to better uphold patient rights in Uganda.