Determinants of parents’ perception of quality of paediatric oncology care at Kenyatta National Hospital

Abstract

Background: Global childhood cancer morbidity and mortality is on the increase. Quality care for childhood cancer patients is an important determinant of disease outcome in regard to mortality, quality of life and satisfaction with the care. Patients’ assessment of care provided is an important dimension of quality care provision. Existing literature indicate there is an increasing demand for high quality cancer care. However little is known of what constitutes quality care for cancer patients. Hence there is inadequate knowledge in regard to current perceptions of what quality cancer care is. Determining parents’ perception of quality of paediatric oncology care at Kenyatta National Hospital is necessary to establish baseline information on the current quality of care being provided to childhood cancer patients admitted at the hospital. Objective: To determine factors contributing to parents’ perception of quality of paediatric oncology care at Kenyatta National Hospital. Study methodology: This was a cross sectional descriptive quantitative and qualitative study at the paediatric oncology wards of Kenyatta National Hospital. The wards were purposively selected and systematic sampling was used to select study participants in each ward, who were the parents of childhood cancer patients admitted at the hospital. Data collection was done by use of a semi structured questionnaire which was administered to the parents. Focused group discussions with parents who had not been subjected to the questionnaire were conducted with the aim of obtaining in-depth qualitative information on their experiences regarding paediatric cancer care delivery processes at Kenyatta National Hospital. The sample size consisted of 107 parents. Data was analyzed using the statistical program for social sciences (SPSS) version 20 by xvi use of descriptive and inferential statistics. Chi square test was used to establish significance between variables and the data was presented in tables as well as bar and pie charts. Results: Out of 107 parents of childhood cancer patients, 57.9% were satisfied with the care services they received whereas 42.1% were dissatisfied. This satisfaction was determined by adequate availability of resources for pediatric cancer treatment [OR=3.10; 95%CI=1.39-6.90; P=0.005], sufficient care delivery processes [OR=2.87; 95%CI=1.28-6.43; P=0.009] and adequate infrastructure/environment [OR=2.59; 95%CI=1.17-5.74; P=0.018]. The main reasons attributed to dissatisfaction as mentioned by FGD participants include; delay in commencement of treatment, unavailability of chemotherapy drugs and blood, delay in carrying out tests and availing of results, lack of information about their children’s illness and treatment and congestion. Conclusion: Even though 57.9% of the respondents were satisfied with the care services, a considerable number (42.1%) were dissatisfied. There is need for the hospital management to enhance effective communication between parents and service providers and to address the issue of congestion as well as unavailability of required resources and amenities for the care of childhood cancer patients. There is also need for the hospital to involve parents in support groups.