an-najah national university of...1 al-najah national university faculty of nursing application of...
TRANSCRIPT
1
Al-Najah National University
Faculty of nursing
Application of patient rights among hospitalized
patients: A study conducted in Nablus and Tulkarem
hospitals.
Prepared by:
Ahmad Alawnih
Osama Nasrallah
Omar karous
Thaaer Mansour
Supervised by:
Dr.Adnan Al_sarhan
Mr . Mohammd Merae
2009 _ 2010
2
A Word of Thanks
To us and we must tread with recent academic life of the pause go back to
the years spent in rehab with the University Teachers of customers who
helped us so much shedding so great efforts in building tomorrow's
generation to send the nation's new ...
Before we offer our deepest thanks and gratitude, appreciation and love to
those who carried a message in the most sacred life ...
To those who have paved us the way of science and knowledge ...
To all our teachers distinguished .......
"Be the world .. If you can not so be educated, if you can not love the
scientists, if you can not hate them."
I particularly appreciate and thank:
Dr. Adnan Sarhan
That we say to him booby-words of the Messenger of Allah peace be
upon him:
"The fish in the sea, and birds in the sky, to reach the milestone of good
people"
I also extend my thanks to him sponsor research, to our knowledge of
optimism and to move forward, to whom follow up and keep us, to us to
stop when they strayed.....
Mrs: Mohamed Marei
3
We also thank everyone who helped to complete this research and gave
us help us extend a helping hand and provided us with the information
necessary to complete this research
Who help us in our present darkness, light shines, which was sometimes
stand in our way.
As for the thanks of the special type we thank also to all those who have
not stood by our side, and stood in the roads and impeded the march of
our research, and the laying of the thorns in the way we looked not for
their presence to have felt the joy of research, and the sweetness of
positive competition, and without them, when we arrived to where we are
they have the thanks of us all ......
4
ACKNOWLEDGEMENT
To those of his fingers to give us a moment of happiness
To reap the thorns from Derby to pave me the way to science
A big heart (my dear father)
To my wisdom and scientific.....
And to the literary dream
To my way.... Straight
The road to........ Guidance
To the fountain of patience and optimism and hope
Both to exist after God and His Messenger,( my mother dear)
Cindy and my strength after God
To those who taught me the science of life
To those who have shown me what is the most beautiful of
(My brother's life)
To those who tasted the most beautiful moments with them
To those I will miss them...... I hope that they will miss me
From God to make them my brothers in God ...... I loved God and of
students of faculty of(the Nursing - Najah National University)
To the combination of pleasure and sorrow
To a person I know.......... Will not know me
To whom I wish to remind them if they reminded me
To those who wish to keep their photos in my eyes (My friends)
5
Table of Content:
Abstract 1
CHAPTER 1 2
1.Introduction 3
1.1 Background 3
1.1.1.Bill of Rights 4
1.1.2Patient bill of responsibilities 7
1.1.3.Every patient or client has the following responsibilities 8
1.2.Demography 9
1.2.1.Nablus city 9
1.2.2.Tulkarem city 10
1.3.Significance of study 10
1.4.Objectives 12
1.5.Hypothesis 13
CHAPTER 2 14
2. Literature Reviews 15
CHAPTER 3 22
3.Methodology 23
3.1 Sample design 23
6
3.2 Sample 23
3.3 Characteristic of sample 24
3.4 Setting 24
3-5 Instruments 24
3-5-1 Questionnaire 24
3.5.1.1.First part :Patient 25
3.5.1.2.Second part :The Nurse stuff 27
3-6.Data collections 29
3-7. Piloting 29
CHAPTER 4 30
4. Data analysis 30
4.1.First part: patient 31
4.2.Second part :The Nurse stuff 36
CHAPTER 5: 41
Data Results 41
5.1.Patient results 42
5.1.1.Introduction 42
5.1.2.Study hypotheses 45
5.2.Second part : nursing results 50
5.2.1.Introduction 50
7
5.2.2.The Study Result 50
5.2.3.Study hypothesizes 56
5.3.Conclusion 62
5.4.Our Recommendation 63
Nurses questionnaire 64
Patient questionnaire 67
References 70
8
TABLES
Table (1): The distribution of the study sample according to the variable of the Age.
Table (2): The distribution of the study sample according to the variable
of the sex.
Table (3): The distribution of the study sample according to the variable
of Educational Level:
Table (4): The distribution of the study sample according to the variable
of the Place of Residence
Table (5) : The distribution of the study sample according to the variable
of the Knowing about rights:
Table (6): The distribution of the study sample according to the variable of the Age.
Table (7): The distribution of the study sample according to the variable
of the sex:
Table (8): The distribution of the study sample according to the variable of
the Place of Residence:
Table (9): The distribution of the study sample according to the variable
of Educational Level:
Table (10) : The distribution of the study sample according to the variable
of the years of experience:
Table (11) : The distribution of the study sample according to the variable
of the Salary:
9
Table (12): means ,standard deviations , percentages and the study degree
for the study questions:
Table (13) : shows the results of One Way Anova for the patients'
attitudes towards there rights due to the variable of the age.
Table (14): Shows t- test for the patients' attitudes towards the patients'
rights due to the variable of sex
Table (15) : shows the results of One Way Anova for the patients'
attitudes towards there rights due to the variable of the educational level.
Table (16) : shows the results of One Way Anova for the patients'
attitudes towards there rights due to the variable of the place of
residence.
Table (17) : The distribution of the study response on the question no. 1
Table (18) : The distribution of the study response on the question no. 2
Table (19) : The distribution of the study response on the question no. 3
Table (20) : The distribution of the study response on the question no. 4
Table (21): means ,standard deviations , percentages and the study degree
for the study questions:
Table (22) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the age.
Table (23): Shows t- test for the nurses' attitudes towards the patients'
rights due to the variable of sex
Table (24) : shows the results of One Way Anova for the nurses ' attitudes
towards the patients' rights due to the variable of the educational level.
10
Table (25) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the place of residence.
Table (26) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the years of
experiences.
Table (27) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the salary.
11
Abstract:
Patient's rights law is intended to secure good medical practice, but
it can also serve to improve understanding between patients and medical
staffs if both were aware of their rights. Awareness and practice of the
new patient's rights law in Nablus and Tulkarem hospitals was explored
through a survey of 62 patient (above18 years) and 62 nurses randomly
selected by cross-sectional study,the data collected by direct interview
with both patients and nurses ,two questionnaire used in our study , one
for the patient and one for the nurse.
76% of patient say that there right are applicated in the hospital, and
72% of nurses also say that they application the patient right, so that the
sum of patient right application is 74% applicated in the different
hospitals in Nablus and Tulkarem hospitals.
12
CHAPTER 1
Introduction
13
1. Introduction:
The issue of patient rights in medical research has developed over the
years because of unethical practices that have occurred in the past. So that
the research and study was started to eliminate and decreased these
malpractice, which that maintain and safe the right of patient that must be
applicator in every clinical area.
Patients' rights vary in different countries and in different areas, often
depending upon prevailing cultural and social norms.
A Patient's Bill of Rights is a statement of the rights to which patients are
entitled as recipients of medical care. Typically, a statement articulates
the positive rights which health care team and hospitals ought to provide
patients, thereby providing information, offering fair treatment, and
granting them autonomy over medical decisions.(wikipedia.org. Patient
rights).
1.1 Background:
Formalized in 1948, the Universal Declaration of Human Rights
recognizes “the inherent dignity” and the “equal and unalienable rights of
all members of the human family”. And it is on the basis of this concept
of the person, and the fundamental dignity and equality of all human
beings, that the notion of patient rights was developed. In other words,
what is owed to the patient as a human being, by physicians and by the
state, took shape in large part thanks to this understanding of the basic
rights of the person. (WHO, 1993).
14
Different models of the patient-healthcare team relationship have been
developed, and these have informed the particular rights to which patients
are entitled.
In North America and Europe, for instance, there are at least four
models which depict this relationship: the paternalistic model, the
informative model, the interpretive model, and the deliberative model.
Each of these suggests different professional obligations of the physician
toward the patient. For instance, in the paternalistic model, the best
interests of the patient as judged by the clinical expert are valued above
the provision of comprehensive medical information and decision-making
power to the patient (WHO, 2008).
Medication administration is a complex task which involves human,
device, and environmental influences. Nursing practice standards for
medication administration include the Five Rights, namely, right
medication, dose, patient, time, and route. Failure to apply the five rights
may contribute to clinical practice errors which could result in fatal
patient outcomes. In addition to the clinical practice standards related to
medication administration, technology such as medication infusion
devices adds an additional factor which could influence the five rights.
(Salima, S.2008).
1.1.1 Bill of Rights:
The Universal Declaration of Human Rights has been instrumental in
enshrining the notion of human dignity in international law, providing a
legal and moral grounding for improved standards of care on the basis of
our basic responsibilities towards each other as members of the “human
family”, and giving important guidance on critical social, legal and
15
ethical issues. But there remains a great deal of work to be done to clarify
the relationship between human rights and right to health, including
patient rights.
Recognizing this challenge, the United Nations Commission on
Human Rights (UNHCR) has designated a Special Rapporteur to provide
it with a report that examines and clarifies the broader relationship
between human rights and the right to health. This report has great
importance for the World Health Organization, whose mission is to
ensure “health for all”. Grounding this mission in a fundamental human
right to health would be an important milestone, and a great step forward
realizing this goal (WHO, 2008). (Patient Bill of Rights and
Responsibilities Catonsville, Hospital, Information).
A Patient's Bill of Rights is a statement of the rights to which patients
are entitled as recipients of medical care. These rights are:
Understand and use these rights. If for any reason you do not
understand or you need help, the hospital MUST provide
assistance, including an interpreter.
Receive treatment without discrimination as to race, color,
religion, sex, national origin, disability, sexual orientation,
source of payment, or age.
Receive considerate and respectful care in a clean and safe
environment free of unnecessary restraints.
Receive emergency care if you need it.
Be informed of the name and position of the doctor who will
be in charge of your care in the hospital.
16
Know the names, positions and functions of any hospital
staff involved in your care and refuse their treatment,
examination or observation.
A no smoking room.
Receive complete information about your diagnosis,
treatment and prognosis.
Receive all the information that you need to give informed
consent for any proposed procedure or treatment. This
information shall include the possible risks and benefits of
the procedure or treatment.
Receive all the information you need to give informed
consent for an order not to resuscitate. You also have the
right to designate an individual to give this consent for you if
you are too ill to do so. If you would like additional
information, please ask for a copy of the pamphlet “Do Not
Resuscitate Orders — A Guide for Patients and Families.”
Refuse treatment and be told what effect this may have on
your health.
Refuse to take part in research. In deciding whether or not to
participate, you have the right to a full explanation.
Privacy while in the hospital and confidentiality of all
information and records regarding your care.
Participate in all decisions about your treatment and
discharge from the hospital. The hospital must provide you
with a written discharge plan and written description of how
you can appeal your discharge.
Review your medical record without charge. Obtain a copy
of your medical record for which the hospital can charge a
17
reasonable fee. You cannot be denied a copy solely because
you cannot afford to pay.
Receive an itemized bill and explanation of all charges.
Complain without fear of reprisals about the care and
services you are receiving and to have the hospital respond
to you and if you request it, a written response. If you are not
satisfied with the hospital’s response, you can complain to
the New York State Health Department. The hospital must
provide you with the State Health Department telephone
number.
Authorize those family members and other adults who will
be given priority to visit consistent with your ability to
receive visitors.
Make known your wishes in regard to anatomical gifts. You
may document your wishes in your health care proxy or on a
donor card, available from the hospital.(Public Health
Law(PHL).
1.2 Demography:
1.2.1. Nablus city:
Is a Palestinian city in the northern West Bank, approximately
63 kilometers (39 mi) north of Jerusalem, with a population of 321,000.
Located in a strategic position between Mount Ebal and Mount Gerizim,
it is the capital of the Nablus Governorate and a Palestinian commercial
and cultural center.
Nablus lies in a strategic position at a junction between two ancient
commercial roads; one linking the Sharon coastal plain to the Jordan
18
valley, the other linking Nablus to the Galilee in the north, and the
biblical Judea to the south through the mountains. The city stands at an
elevation of around 550 meters (1,804 ft) above sea level, in a narrow
valley running roughly east-west between two mountains: Mount Ebal,
the northern mountain, is the taller peak at 940 meters (3,084 ft), while
Mount Gerizim, the southern mountain, is 881 meters (2,890 ft) high.
(http://www.asiarooms.com).
According to the Palestinian Central Bureau of Statistics (PCBS), Nablus
had a population of 134,116 inhabitants in mid-year 2006. In the PCBS's
1997 census, the city had a population of 100,034, including 23,397
refugees, accounting for about 24% of the city's residents. Nablus' Old
City had a population of 12,000 in 2006.The population of Nablus city
comprises 40% of its governorates inhabitants. (Palestinian Central
Bureau of Statistics Population, Housing and Establishment Census
2007).
1.2.2.Tulkarem city:
Ṭūlkarem is a Palestinian city in the Tulkarm Governorate in the extreme
northwestern West Bank and North-Central Israel. According to the
Palestinian Central Bureau of Statistics, Tulkarm city and the adjacent
refugee camp had a population of approximately 58,962 inhabitants at
mid-year 2006.Its land area consists of 28,793 dunam.
http://en.wikipedia.org/wiki/Tulkarm.
19
1.3.Significance of study:
Since the patient rights are the factors to improve the quality of life
and fixed the full meaning of human right the study of human rights have.
Taken wide rang of research among the countries and improve their
point of view. Application of patient rights is very important title to be
studying here in Palestine because since we have been practice among the
hospitals just few of this rights are applied in their and we aimed to
enhance the health organization to take it into consideration and plicate it
in the hospitals.
Assuring that the rights of patients are protected requires more than
educating policy makers and health providers; it requires educating
citizens about what they should expect from their governments and their
health care providers—about the kind of treatment and respect they are
owed. Citizens, then, can have an important part to play in elevating the
standard of care when their own expectations of that care are raised, some
countries have recognized this, and have advanced their knowledge of
genomics in public, academic and scientific spheres. Some follow
democratic procedures to vote on resolutions pertaining to genomics.
This knowledge and active engagement empowers lay individuals to
make informed decisions about the future of genomics, both at the
personal and at the policy level.
The creation of effective patient protection laws relies on public
knowledge of genetic science and its applications, along with an
awareness of the ethical, social, and legal issues surrounding genomics.
20
In light of the present need for increased awareness of human rights
as they relate to health, and to patient rights more particularly, this section
provides information on the rights of patients in various countries,
including examples of exercised rights. Links to human rights
organizations are also provided.
1.4 Objectives:
Health care team is dedicated to their patient's well-being and best
interest, as defined by the patient. Every patient has a right to privacy and
a right to have input into their care. Every patient also has a right to bias-
free access and care, delivered by a health care team conscious of the
effects of social and ethnic discrimination on health access and care.
We intend to conduct this study in order :
To estimate the degree of patient right application in the Nablus
hospitals.
To describe the benefits of application of patient rights in
hospitals, which this helps in provide optimum care for these
patients.
To evaluate the services that provides.
To describe if that all patients are take there rights without any
differentiation between them.
To identify patient needs and priorities, particularly when in
conflict with the student’s.
To protect the patient's rights to privacy and autonomy at all
times.
To identify the effects of intolerance and discrimination on the
health care of non-dominant ethnic and social groups.
21
1.5 Hypothesis:
Some patients feel that their rights are persecuted in the hospitals
toward the nursing practice in the hospitals.
There are no significant references at (α =0.05) level about the
nurses' attitudes towards the patients' rights due to the variable of
the name of the years of experiences.
There are no significant references at (α =0.05)level about the
nurses' attitudes towards the patients' rights due to the variable of
the name of the salary.
22
CHAPTER 2
Literature Reviews
23
2. Literature Reviews:
Patients' rights in the European Union, The rights of patients to
receive health care in other member states of the European Union (EU)
are dependent upon both individual rights and social rights. The problem
is that these rights differ in character and the way they can be claimed.
The right to health care falls under the category of social rights which
require the state to provide the necessary health care services (Hermans,
2007).
International human rights for mentally ill persons: The Ontario
experience this article is part of a working project which assesses
Ontario's mental health legislation and practice vis-à-vis international
human rights standards. The paper focuses on procedural safeguards
provided by the major international human rights instruments in the field
of mental health law such as the UN Principles for the Protection of
Persons with Mental Illness (MI Principles) and the European Convention
on Human Rights as interpreted by the European Human Rights
Court.(Zuckerberg, 2007).
Giuglani, C., m etal, Trecan, G., (August 2009). Concluded in his
research about Evolution of patient's complaints in a French university
Hospital: is there a contribution of law regarding patient's rights? That the
study revealed an increase with time in the number of complaints for
medical issues in a university hospital, as well as increase in the
perception of medical error after the passing of a law regarding patients
rights in France.
24
Rutebemberwa,E., Pariyo1,G.,(August 2009).concluded in his
research about lake of effective communication between communities
and hospitals in Uganda : a qualitative exploration of missing links. That
there is still lack of effective communication between the communities
and the hospitals that serve them in Uganda. This deprives the
communities of the right to participate in the improvement of the services
they receive, to assume their position as stakeholders. Various avenues
could be instituted including using associations in communities, rapid
appraisal methods and community meetings.
Patients like (and dislike) patient-centered communication for
thoughtful, considered reasons that appear grounded in their values and
expectations about physicians, patients, and the clinical encounter.( Sara
L. Swenson a, Patti Zettler a, Bernard Lo, 2006).
Providing adequate medical treatment, while respecting the patient’s
right to self-determination, is the wise course to take in order to avoid
problems. When a patient is a mature minor, his wishes should also be
respected. In the case of a minor patient lacking decision-making
capacity, the wishes of the parents should be respected as much as
possible. We hope that this matter will be considered in a balanced way,
having in mind the ethical, legal, and medical aspects of each case.
(Tomonori Ariga, 2009).
No news isn’t necessarily good news for patients waiting for the
results of medical tests. The first study of its kind finds doctors failed to
inform patients of abnormal cancer screenings and other test results 1 out
of 14 times. The failure rate was higher at some doctors’ offices, as high
as 26 percent at one office. Few medical practices had explicit methods
for how to tell patients, leaving each doctor to come up with a system. In
25
some offices, patients were told if they didn’t hear anything, they could
assume their test results were normal.(Johinson, 2009).
Savanna,R., Reid (August 2009). doing research about injection drug
use , unsafe medical injections, and HIV in Africa . and concluding from
this study that The reuse of injecting equipment in clinical settings is
well documented in Africa and appears to play a substantial role in
generalized HIV epidemics. injection drug use (IDU), of heroin and
stimulants, is a growing risk factor for acquiring HIV in the region. IDU
is increasingly common among young adults in sub-Saharan Africa and is
associated with high risk sex.
It is the consensus of experts in the patient-safety field that little has
changed to improve the safety of hospital care since the Institute of
Medicine's 1999 report, To Err Is Human. The report noted that in order
to be successful, "safety must be an explicit organizational goal that is
demonstrated by clear organizational leadership. . . . This process begins
when boards of directors demonstrate their commitment to this objective
by regular, close oversight of the safety of the institutions they shepherd."
Leape and Berwick agree, noting that safety cannot become an
institutional priority "without more sustained and powerful pressure on
hospital boards and leaders — pressure that must come from outside the
health industry.", In hospital care, the challenge is to reform corporate
governance to make hospital boards take their responsibility for patient
safety at least as seriously as they take the hospital's financial condition
(George,2006).
Physicians strive for the maximal well-being of patients, and safety is
inherently a priority. But is patients' safety, as Annas claims (May 11
issue),a legal "right"? Its absence is as conspicuous as that of the right to
26
food, shelter, or even health care. Daily, 9 million Americans are hungry,
600,000 sleep without roofs over their heads, and 45 million face illness
without health insurance. Troubling as it is, we regularly accept these
gross inequities as the price of living with capitalism (James, 2006).
Katherine Wiltenburg Todrys1 and Joseph J Amon (November
2009).Doing research about human rights and access to HIV prevention
and treatment for internal migrants. And concluding from this study that
more people migrate within their country than out of it. Internal migrants
are those individuals who change residence from one civil division to
another within their country of origin. Gaps in internal migrants' access to
HIV/AIDS services--either as a result of official restrictions or cultural
and linguistic care and treatment, states are less able to realize goals of
reduced HIV incidence and burden of disease, and the public health
community may face the emergence of drug-resistant strains resulting
from interruptions in barriers--have significant consequences: individuals
are less able to access prevention.
Alan, m et al., (December 2009) doing research about informed consent
from patients participating in medical education: a survey from a university
hospital in Jamaica . And concluding from this study that as medical
educators, we are responsible to adhere to ethical and legal guidelines
when we interact with patients. It is apparent that there is urgent need for
policy development at the UWI to guide clinicians and students on their
interactions with patients.
Physicians are committed to the health and safety of their patients.
Unfortunately, many hospitals have not been. Lawsuits to motivate
hospital boards to adopt evidence-based safety standards, including those
recommended by the 100,000 Lives Campaign, can literally save lives.
27
Continuing old medical malpractice debates cannot. In promoting
patients' safety, physicians and lawyers can work together to achieve a
common goal — to save the lives of patients in hospitals — that neither
profession is likely to achieve alone. (George,2006).
Laura Nyblade, Anne Stangl, Ellen Weiss and Kim Ashburn (August
2009) doing research about combating HIV stigma in health care settings:
what works? And concluding from this study that there are three main
immediately actionable causes of HIV-related stigma in health facilities:
lack of awareness among health workers of what stigma looks like and
why it is damaging; fear of casual contact stemming from incomplete
knowledge about HIV transmission; and the association of HIV with
improper or immoral behavior. And To combat stigma in health facilities,
interventions must focus on the individual, environmental and policy
levels.
The American Medical Association has identified 18 states in which
physicians and institutional health care providers are having grave
difficulties obtaining affordable professional liability insurance. (
Michelle M. M e tal, Troyen A. Brennan,2003).
Physicians and hospitals are warning that patients may find medical
care unavailable unless something is done—meaning the enactment or
strengthening of tort reform legislation. (William M. Sage,2003).26.
Some patient safety proponents argue that a systems approach to
protecting patients is inhibited by current law and call for removing the
risk of liability from reporting medical errors. (Peter P. Budetti,2005).
28
If physicians are overly concerned about liability, they may take
actions that jeopardize patient welfare, such as excessive testing or
treatment.( Peter D. Jacobson,2005).
Hospitals reporting lower infection rates are safer and that informed
consumers will obtain safer care has driven many U.S. states to consider
legislation requiring report cards on nosocomial infections.( Robert A.
Weinstein, Jane D. Siegel, P.J. Brennan,2005).
Most patient-safety experts continue to believe that the threat of
liability is the primary barrier to the development of effective and
comprehesive patient-safety programs in hospitals.( George J.
Annas,2006).
2-21. In the absence of a comprehensive social insurance system, the
patient’s right to safety can be enforced only by a legal claim against the
hospital.( George J. Annas,2006).
There is a Barriers that prevent Middle Eastern women from
seeking medical consultation for Urinary incontinence Most common
barriers include the misconceptions about the causes of and
availability of treatment options for UI and embarrassment.( Ahmed
S. Omar M,2010).
There is an increase with time in the number of complaints for
medical issues in a university hospital, as well as an increase in the
perception of a medical error after the passing of a law regarding patients'
rights in France. ( Camila G, Nathalie G, Valia F, Jérémie J, Sergio E ,
Julie B ,and Gwenaelle V,2009).
29
Current initiatives in Congress to limit liability for pharmaceutical
injuries and medical malpractice make it timely to examine how much
legal concerns actually contribute to public health crises such as the flu
vaccine shortage. (Michelle M. Mello, Troyen A. Brennan,2005).
Physician and patient are bound in a partnership that requires both
individuals to take an active role in the healing process. Such a
partnership does not imply that both partners have identical
responsibilities or equal power.( American Medical Association,1993).
The dearth of abortion providers undermines the availability of safe,
legal abortion, and has serious implications for women's access to
abortion services and health service planning.( Jane H , Kathryn S,
Phyllis O,2009).
Complaints for medical issues increased from 1998 to 2004. Error or
delay in diagnosis/treatment and surgical/ medical complication were the
main reasons for complaints.( Camila G, Nathalie G, Valia F, Jérémie J,
Sergio E , Julie B ,and Gwenaelle V,2009).
.
30
CHAPTER 3
Methodology
31
3.Methodology:
This chapter deals with the study method, community and sample, in
addition to the tool, credibility, reliability, variables, procedures and
statistical processes.
Surveying, descriptive and analytic method was used for its suitability for
the study purposes.
The Study consists of two parts :
The Patients.
The nursing staff.
3.1 Sample design :
Descriptive (cross-sectional) design was used to get more distribution
of data, get more accuracy in the result .The study discuss the application
of patient right in hospitals the suitable sample selection is simple random
selection .
3.2 Sample :
Cross-sectional. Governmental and private hospitals situated in Nablus
and Tulkarem cities of Palestine ,the study sample consists of (62) nurses
and (62) patients who have been hospitalized at the mentioned hospitals.
This sample was selected randomly sample by taken all nurse and all
patient whom found in the selected ward.we select the medical and
sergical ward for both male and female.
32
3.3 .Characteristic of sample:
People have admitted to hospital for at least 2 days, they are above 18
years old. Disclosing criteria people under 18 years old and admitted to
the hospitals for less than 2 days.
3.4. Setting:
This study was conducted in Palestine ( Nablus and Tulkarem cities )
Specifically in:
a) Rafedia governmental hospital.
b) AL-Watane governmental hospital.
c) Specialized Nablus hospital.
d) Specialized Arab hospital.
e) Thabit Thabit hospital.
3.5. Instruments:
3.5.1. Questionnaire:
The Study consists of two parts:
The Patients.
The nurse staff.
3.5.1.1.First Part :Patient.
Questionnaire for collecting information has been developed after
surveying some previous studies dealing with the same subject. The
questionnaire consisting of three parts as the following:
33
Part One:
Includes the introduction, several elements which emphasize the target of
the study, kind of data that the researchers need to collect from the study
sample in addition to a paragraph aims in order to encourage the targeted
individuals to respond frankly on the study questions after satisfying the
tested people that the information will be secret and will not be used
except for the scientific research only.
Part Tow:
Includes general information dealing with the independent variables of
the study like age, sex, educational level, place of residence and knowing
about rights.
Part Three:
Includes 18 paragraphs dealing with the questions that the patients in the
mentioned hospitals will response to.
Credibility:
The study tool was subjected for the test by experts who recommended
for its validity for the achieving of the study purposes.
Reliability:
Was tested by using Khronapach Alpha test which was (0.8447) . And
this result is acceptable for the study purposes.
34
Procedures:
The study has been made according to the following:
- Preparing the study tool.
- The study sample is identified.
- Distribution of the questionnaire.
- Gathering the questionnaire.
- Statistically processing by using the statistical package for social
science (SPSS).
- Gathering the responds.
-Results, and - Recommendations.
Study Design:
The study includes the following variables:
- Independent variables:
1- Age : which has four levels (15-25, 26-35, 36-45, 46 and more )
2-Sex: with two levels (Male and Female).
3-Educational level : which has four levels (Illiterate, Primary,
secondary and university).
4- Place of Residence : which has three levels ( City, Village and camp).
- Dependent variables:
The means for the responds of the study sample on its questions about
the patients' attitudes towards there rights in the hospitals.
35
3.5.1.2.Second Part: The Nurse staff :
Study Tool:
Questionnaire for collecting information has been developed after
surveying some previous studies dealing with the same subject. The
questionnaire consisting of three parts as the following:
Part One:
Includes the introduction, several elements which emphasize the target of
the study, kind of data that the researchers need to collect from the study
sample in addition to a paragraph aims in order to encourage the targeted
individuals to respond frankly on the study questions after satisfying the
tested people that the information will be secret and will not be used
except for the scientific research only.
Part Tow:
Includes general information dealing with the independent variables of
the study like age, sex, educational level, place of residence and knowing
about rights.
Part Three:
Includes 20 paragraphs dealing with the questions that the Nursing stuff
in the mentioned hospitals will response to .
Credibility:
The study tool was subjected for the test by experts who recommended
for its validity for the achieving of the study purposes.
Reliability:
Was tested by using Khronapach Alpha test which was (0.8907) . And
this result is acceptable for the study purposes.
36
Procedures:
The study has been made according to the following:
- Preparing the study tool.
- The study sample is identified.
- Distribution of the questionnaire.
- Gathering the questionnaire.
- Statistically processing by using the statistical package for social
science (SPSS).
- Gathering the responds.
-Results, and recommendations.
Study Design:
The study includes the following variables:
Independent variables:
1- Age: which has four levels (20-30, 31-40, 41- 50 and 51 and more)
2-Sex: with two levels (Male and female).
3-Educational level : which has four levels (diploma Bachelor and High
studies ).
4- Place of Residence : which has three levels ( City, Village and camp).
5- Years of Experiences : which has four levels ( Less than 6 months,
from 6 months – 5 years m 5-10 years and more than 10 years).
6- Salary : which has four levels ( Less than 1500 N.S, 1500-2500, 2000-
2500 and more than 2500).
37
Dependent variables:
The means for the responds of the study sample on its questions about
the nursing stuff ' attitudes towards the rights of the patients in the
hospitals.
3.6 Data collections:
The data collected by face to face interview. Which we get the answer
by direct question directed toward participles, to be get accurate answer
and clarify any misunderstanding of the question. This gives our research
more variability and reality.
3.7. Piloting:
We applied this questioner on 20 samples, conducted in 5 hospitals in
Nablus and Tulkarem hospitals. The result of this sample was as the
following:
-70% of patients stated that their rights are provided by health team
providers.
-80% of nurses believes that they apply patient's bill of right in
governmental and private hospitals .
During piloting we didn't face much problems, many patients stated that
the questions where clear and direct which made it easy to conduct our
tool, and we have intended to take feedbacks from health care providers
and patients about our study as whole and the tool specifically .
38
CHAPTER 4
Data Analysis & Results
39
4.1.First part: Patient
Table (1): The distribution of the study sample according to the variable of the Age.
Percentage No. Age
27.4 17 15-25
27.4 17 26-35
14.5 9 36-45
30.6 19 40 years and more
100% 62 Total
1
2
3
4
40
Table (2): The distribution of the study sample according to the variable
of the sex.
Percentage No. Sex
48.4 30 Male
51.6 32 Female
100% 62 Total
1
2
41
Table (3): The distribution of the study sample according to the variable
of Educational Level:
Percentage No. Educational Level
11.3 7 Illiterate
21.0 13 Elementary
33.9 21 Secondary
33.9 21 University
100% 62 Total
1
2
3
4
42
Table (4): The distribution of the study sample according to the variable
of the Place of Residence
Percentage No. Place of Residence
37.1 23 City
40.3 25 Village
22.6 14 Camp
100% 62 Total
1
2
3
43
Table (5) : The distribution of the study sample according to the variable
of the Knowing about rights:
PercentageNo.Knowing about rights
96.860Yes
3.22No
100%62Total
1
2
44
4.2.Second part
The Nurse staff :
Table (6): The distribution of the study sample according to the variable of the Age.
Percentage No. Age
56.5 35 20-30
24.2 15 31-40
16.1 10 41-50
3.2 2 51 and more
100% 62 Total
1
2
3
4
45
Table (7): The distribution of the study sample according to the variable
of the sex:
Percentage No. Sex
48.4 30 Male
51.6 32 Female
100% 62 Total
1
2
46
Table (8): The distribution of the study sample according to the variable
of the Place of Residence:
Percentage No. Place of Residence
45.2 28 City
45.2 28 Village
9.6 6 Camp
100% 62 Total
1
2
3
47
Table (9): The distribution of the study sample according to the variable
of Educational Level:
Percentage No. Educational Level
43.5 27 Diploma
48.4 30 Bachelor
8.1 5 High Studies
100% 62 Total
1
2
3
48
Table (10) : The distribution of the study sample according to the variable
of the years of experience:
Percentage No. Years of experience
4.8 3 Less than 6 months
41.9 26 From 6 months – 5 years
24.2 15 From 5- 10 years
29.1 18 More than 10 years
100% 62 Total
1
2
3
4
49
Table (11) : The distribution of the study sample according to the variable
of the Salary:
Percentage No. Salary
8.1 5 Less than 1500 N.S
14.5 9 1500-2000
22.6 14 2000-2500
54.8 34 More than 2500
100% 62 Total
1
2
3
4
50
CHAPTER 5
Discussion
51
5.1.Patient results :
5.1.1.Introduction:
This study aims at identifying the patients' attitudes towards there rights
in the hospitals due to several factors . Also it aims at identifying several
study variables like age ,sex, educational and place of Residence.
For achieving the study purpose, a questionnaire consisting of (18)
paragraphs has been developed, distributed among of (62) individuals of
study sample, gathered, codified, entered the computer and statistically
processed by using the statistical package of social science (SPSS).
First : The results of the study question which is:
What are the patients' attitudes towards there rights in the
Palestinian hospitals?
For achieving the question purpose, means and percentages for each
paragraphs were used.
The paragraphs means were given the following scale:
Less than 50% is low
Between 50-75% is medium
More than 75% is high.
And the following table shows the study results about its questions:
Table (12): means ,standard deviations , percentages and the study
degree for the study questions:
52
Paragraph
No.
Paragraph Mean standard
deviations
Percentages Response
Degree
1. Health care services provide in
suitable way for patients.
3.20 0.63 80.00 High
2. Patient can object on the level of
health services which are
provided to him
3.20 0.90 80.00 High
3. I' am well informed about my
doctor.
2.70 0.75 67.50 Medium
4. I' am well informed about my
illness.
3.22 0.83 80.50 High
5. I' am provided with realistic
information about my health
status.
3.29 0.79 82.00 High
6. Nurses respects my privacy and
confidentiality about my illness.
3.42 0.66 86.00 High
7. Nurses are supportive.
(emotionally & psychologically ).
3.22 0.71 80.50 High
8. Nurses respect my believes and
religious.
3.59 0.49 90.00 High
9. Nurse explains treatment process
and how to deal with it.
2.54 0.91 88.50 High
10. I sign consent inform and the
health care providers clarify all
3.37 0.48 84.00 High
53
potential complication before any
major procedure.
11. I have the right to choose my own
doctor.
2.48 0.97 62.00 Medium
12. I have the right to refuse the
treatment.
2.83 0.90 71.00 Medium
13. The relationship between the
health care team and patient good
relationship.
3.29 0.71 82.00 High
14. The health care team listen
attentively to patients complains
and suggestions.
2.91 0.73 73.00 Medium
15. The patient participates in his
treatment process.
2.24 0.84 56.00 Medium
16. The method used by Health staff
to talk about the problem of
patient is the style required.
2.80 0.76 70.00 Medium
17. The health care services provided
equally to the patients.
2.98 0.83 74.50 Medium
18. I feel respected and treated
friendly by health care providers.
3.24 0.80 81.00 High
The Total Degree 3.03 0.45 76.00 High
54
It has shown from the previous table that the response degree was from
Medium to high .
1.There are paragraphs have gotten high degree which are (1, 2, 4, 5, 6, 7,
8, 9, 10, 13, 18) ..
2. There are paragraphs have gotten medium degree which are
(3,11,12,14, 15, 16, 17).
3. None of the paragraphs has gotten a low degree
Finally, the total degree was (76.00% ) which refers to medium degree.
5.1.2.Study hypotheses:
Hypothesis (1) :
There are no significant references at (α =0.05) level about the patients'
attitudes towards there rights due to the variable of the name of the Age.
There is a relationship between the age and health status, Functional
health literacy was markedly lower among older age groups.The
Association Between Age and Health Literacy Among Elderly Persons
David W. Baker.
For achieving this , One Way ANOVA Test was used ,and table (7)
shows it:
55
Table (13) : shows the results of One Way Anova for the patients' attitudes towards
there rights due to the variable of the age.
Sum of
squares
D f Mean
square
F Sig.
Between
groups
0.395 3 0.132 0.620 0.605
Within
groups
12.316 58 0.212
Total 12.711
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the patients' attitudes towards there
rights due to the variable of the age.
The significant was (0.605) which is higher than (0.05) and that means
there are no differences between the ages levels towards the subject.
56
Hypothesis (2):
There are no significant references at (α =0.05) level about the patients'
attitudes towards there rights due to the variable of sex.
For achieving this hypothesis, t-test for two independent samples was
used .The results were as the following:
Table (14): Shows t- test for the patients' attitudes towards the patients'
rights due to the variable of sex
Patients T Sig.
Male
(n=30)
Female
(n=32)
means s.deviation means s.deviation
2.99 0.49 3.07 0.42 -0.642 0.523
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the patients' attitudes towards there
rights due to the variable of sex
The significant was (0.523) which is higher than (0.05) and that means
there are no differences between the males and females towards the
questions of the subject.
When compare our result with Palestinian Central Bureau of Statistics
Population, Housing and Establishment Census 2007. 1,193,244 males
and 1,157,339 females. The male/female sex ratio totaled 103.1
57
males/100 females. There is rapprochement between our values and theirs
study. Palestinian Central Bureau of Statistics.
Hypothesis (3):
There are no significant references at (α =0.05) level about the patients'
attitudes towards there rights due to the variable of the name of the
Educational level.
For achieving this , One Way Anova Test was used ,and table (9) shows
it:
Table (15) : shows the results of One Way Anova for the patients'
attitudes towards there rights due to the variable of the educational level.
Sum of
squares
D f Mean
square
F Sig.
Between
groups
1.140 3 0.380 1.906 0.139
Within
groups
11.571 58 0.199
Total 12.711 61
58
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the patients' attitudes towards there
rights due to the variable of the educational level.
The significant was (0.139) which is higher than (0.05) and that means
there are no differences between the educational levels towards the
subject.
Hypothesis (4):
There are no significant references at (α =0.05) level about the patients'
attitudes towards there rights due to the variable of the name of the Place
of residence .
For achieving this , One Way Anova Test was used ,and table (10) shows
it:
Table (16) : shows the results of One Way Anova for the patients'
attitudes towards there rights due to the variable of the place of
residence.
Sum of
squares
D f Mean
square
F Sig.
Between
groups590.
0.986 2 0.493 2.480 0.092
Within
groups
11.726 59 0.199
Total 12.711 61
59
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the patients' attitudes towards there
rights due to the variable of the place of residence. .
The significant was (0.092) which is higher than (0.05) and that means
there are no differences between the place of residence levels towards the
subject.
5.2.Second part : nursing results :
5.2.1.Introduction
This study aims at identifying the nurses' attitudes towards there rights of
the patients in the hospitals due to several factors . Also it aims at
identifying several study variables like age ,sex, educational , place of
Residence , experiences and the salary.
For achieving the study purpose, a questionnaire consisting of (20)
paragraphs has been developed, distributed among of (62) individuals of
study sample, gathered, codified, entered the computer and statistically
processed by using the statistical package of social science (SPSS).
5.2.2.The Study Result:
First : The results of the study question which is:
What are the nurses' attitudes towards the patients' rights in the
Palestinian hospitals?
For achieving the question purpose, frequencies for the first four
paragraphs, means and percentages for the other paragraphs were used.
60
Table (17) : The distribution of the study response on the question no. 1
Percentage No. Are there any rights of patients?
95.2 59 Yes
4.8 3 No
100% 62 Total
1
2
61
Table (18) : The distribution of the study response on the question 2.
Percentage No. Do all patients have the same
rights?
77.4 48 Yes
22.6 14 No
100% 62 Total
1
2
62
Table (19) : The distribution of the study response on the question 3.
Percentage No. Does the workplace "a government
hospital / special" affects the
application of the patient's rights?
58.1 36 Yes
41.9 26 No
100% 62 Total
1
2
63
Table (20) : The distribution of the study response on question 4.
Percentage No. Do you believe in the
importance of the application
of the patient's rights?
96.8 60 Yes
3.2 2 No
100% 62 Total
1
2
The paragraphs means were given the following scale:
Less than 50% is low
Between 50-75% is medium
More than 75% is high.
And the following table shows the study results about its questions:
64
Table (21): means ,standard deviations , percentages and the study degree
for the study questions:
Paragrap
h No.
Paragraph Mean standard
deviations
Percentages Response Degree
5. All patients' rights applied 2.93 0.75 73.00 Medium
6. All nurses apply the patient's rights 2.64 0.74 66.00 Medium
7. The salary has relation to the extent the application of those rights
2.85 1.15 71.00 Medium
8. There is internal and external monitoring for the application of those rights
3.00 0.67 75.00 Medium
9. There is seriousness from the control to monitor the application of these rights
3.01 0.58 75.00 Medium
10. There is a distinction between patients in the application of their rights (the status of the patient, income level)
2.64 0.97 66.00 Medium
11. The nurse is obliged to apply the patient's rights
3.51 0.67 88.00 High
12. Patients are aware of their rights 2.90 0.67 73.00 Medium
13. There a relationship between experience and the ability to apply the rights of patients
3.41 0.77 85.00 High
14. Is there a relationship between educational level and extent of application of the rights of patients
3.09 0.80 77.00 High
65
15. The rights of patients are applied in private hospitals as much as than in governmental hospitals
3.03 0.95 76.00 High
16. Nurse who works in both private and governmental hospital deals with in same level with the patient disagreed Last whether in private or governmental
2.51 0.90 63.00 Medium
17. the patient in private hospital get better care than in the governmental hospital
2.93 1.00 73.00 Medium
18.
It is different from your application over the rights of a patient from one patient to another
2.32
1.02
83.00
High
19. You circulated by the supervisors concerning the rights of patients
2.88 0.94 72.00 Medium
20. All nurses apply the rights of patients in the required form?
2.66 0.74 66.50 Medium
The Total Degree 2.89 0.31 72.00 Medium
It has shown from the previous table that the response degree was from
Medium to high .
1.There are paragraphs have gotten high degree which are (11,
13, 14, 15, 18) .
2. There are paragraphs have gotten medium degree which are
(1, 2,3, 4, 5, 6, 7, 8, 9, 10 , 10, 12, 16, 17, 19, 20).
3. None of the paragraphs has gotten a low degree
66
Finally, the total degree was (72.00% ) which refers to medium
degree.
5.2.3.Study hypothesizes:
Hypothesis (1):
There are no significant references at (α =0.05) level about the nurses'
attitudes towards the patients' rights due to the variable of the name of the
Age.
For achieving this , One Way Anova Test was used ,and table (22) shows
it:
Table (22) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the age.
Sum of
squares
D f Mean
square
F Sig.
Between
groups
0.157 3 0.0522 0.524 0.667
Within
groups
5.784 58 0.0997
Total 5.940 61
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the nurses' attitudes towards the
patients' rights due to the variable of the age.
67
The significant was (0.667) which is higher than (0.05) and that means
there are no differences between the ages levels towards the subject.
Hypothesis (2):
There are no significant references at (α =0.05) level about the nurses'
attitudes towards the patients' rights due to the variable of sex.
For achieving this hypothesis, t-test for two independent samples was
used .The results were as the following:
Table (23): Shows t- test for the nurses' attitudes towards the patients'
rights due to the variable of sex
Patients T Sig.
Male
(n=30)
Female
(n=32)
means s.deviation means s.deviation
2.88 0.30 2.91 0.23 -0.334 0.739
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the nurses' attitudes towards the
patients' rights due to the variable of sex.
The significant was (0.739) which is higher than (0.05) and that means
there are no differences between the males and females towards the
questions of the subject.
68
Hypothesis (3):
There are no significant references at (α =0.05) level about the nurses''
attitudes towards the patients' rights due to the variable of the name of the
Educational level.
For achieving this , One Way Anova Test was used ,and table (24) shows
it:
Table (24) : shows the results of One Way Anova for the nurses ' attitudes
towards the patients' rights due to the variable of the educational level.
Sum of
squares
D f Mean
square
F Sig.
Between
groups
0.233 2 0.117 1.206 0.307
Within
groups
5.707 59 0.0967
Total 5.940 61
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the nurses' attitudes towards the
patients' rights due to the variable of the educational level.
The significant was (0.307) which is higher than (0.05) and that means
there are no differences between the educational levels towards the
subject.
69
Hypothesis (4):
There are no significant references at (α =0.05) level about the nurses'
attitudes towards the patients' rights due to the variable of the name of
the Place of residence .
For achieving this , One Way Anova Test was used ,and table (25) shows
it:
Table (25) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the place of residence.
Sum of
squares
D f Mean
square
F Sig.
Between
groups590.
0.0320 2 0.0160 0.160 0.853
Within
groups
5.908 59 0.100
Total 5.940 61
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the nurses' attitudes towards the
patients' rights due to the variable of the place of residence. .
The significant was (0.092) which is higher than (0.853) and that means
there are no differences between the place of residence levels towards the
subject.
70
Hypothesis (5):
There are no significant references at (α =0.05) level about the nurses'
attitudes towards the patients' rights due to the variable of the name of
the years of experiences .
For achieving this , One Way Anova Test was used ,and table (26) shows
it:
Table (26) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the years of
experiences.
Sum of
squares
D f Mean
square
F Sig.
Between
groups590.
0.0467 3 0.0155 0.153 0.927
Within
groups
5.894 58 0.102
Total 5.940 61
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the nurses' attitudes towards the
patients' rights due to the variable of the years of experiences. .
The significant was (0.092) which is higher than (0.853) and that means
there are no differences between the years of experiences levels towards
the subject.
71
Hypothesis (6):
There are no significant references at (α =0.05) level about the nurses'
attitudes towards the patients' rights due to the variable of the name of
the salary .
For achieving this , One Way Anova Test was used ,and table (26) shows
it:
Table (27) : shows the results of One Way Anova for the nurses' attitudes
towards the patients' rights due to the variable of the salary.
Sum of
squares
D f Mean
square
F Sig.
Between
groups590.
0.414 3 0.138 1.447 0.239
Within
groups
5.527 58 0.0952
Total 5.940 61
It has been shown from the previous table that there are no significant
references at (α =0.05) level about the nurses' attitudes towards the
patients' rights due to the variable of the salary. .
The significant was (0.092) which is higher than (0.239) and that means
there are no differences between the salary levels towards the subject.
72
5.3.Conclusion:
76% of patient say that there right are applicated in the hospital, and
72% of nurses also say that they application the patient right, so that the
sum of patient right application is 74% applicated in the different
hospitals in Nablus and Tulkarem hospitals.
73
5.4.Our Recommendation:
1.Justice on the right of patients to seek healthcare in another Member
State.
2.Ensuring the safety and quality of the care that patients will receive in
another Member State.
3.For increased cooperation between healthcare systems in a number of
key areas.
4.Enhancements of health or knowledge must be derived from the
research.
5.To promote the interests and well-being of the patients of health care
providers and health care facilities.
6.To promote better communication between the patient and the health
care provider.
7.public policy will be recognized a patient's bill of rights and
responsibilities in health care facility or health care setting.
74
Nurses questionnaire :
Age
20_30 31-40 41-50 more than 51.
Sex:
Male Female
place of permanent residence:
City village camp.
educational level
Diploma Bachelor PhD
Field Experience:
less than 6 months 6 months_ 5 years 5_ 10 years
more than 10 years .
the salary that you get (NIS):
Less than 1500 1500 -2000 2000 -2500
over 2500
75
No Yes Question
Are there any rights of patients?
Do all patients have the same rights?
Does the workplace "a government hospital / special" affects the application of the patient's rights?
Do you believe in the importance of the application of the patient's rights ?
Strongly Disagree
Disagree Strongly Agree
Agree Question
All patient's rights applied?
All nurses apply the patient's rights ?
Salary has relation to the extent the application of those rights?
There are internal and external monitoring for the application of those rights?
There is a seriousness from the control to monitor the application of these rights?
There is a distinction between patients in the application of their rights (the status of the patient, income level)?
76
Is the nurse is obliged to apply the patient's rights?
Patients are aware of their rights?
There a relationship between experience and the ability to apply the rights of patients?
There a relationship between educational level and extent of application of the rights of patients?
The rights of patients are applied in private hospitals as much as than in governmental hospitals?
Nurse who works in both private and governmental hospital deals with in same level with the patient disagreed Last whether in private or governmental?
The patient in private hospital get better care than in the governmental hospital?
Is it different from your application over the rights of a patient from one patient to another?
77
You circulated by the supervisors concerning the rights of patients?
All nurses apply the rights of patients in the required form?
:العمر
فأكثر . 51 50_41 40 _ 31 30_20
:الجنس أنثى كرذ
:مكان الإقامة الدائم مدينة قرية مخيم .
: المستوى التعليمي دراسات عليا بكالوريوس دبلوم
الخبرة العملية:
سنة 10سنوات أكثر من 10_ 5 سنوات 5أشهر _ 6أشهر من 6اقل من
ل) :الراتب الذي تحصل عليه (بالشيك
2500أكثر من 2500- 2000 2000- 1500 1500اقل من
78
لا نعم السؤال
هل هنالك حقوق للمرضى؟
لحقوق؟هل كل المرضى لهم نفس ا
هل لمكان العمل " مستشفى حكومي/ خاص " علاقة بمدى تطبيق حقوق المرضى؟
هل تؤمن بأهمية لتطبيق حقوق المرضى؟
أوافق السؤال بشدة
أعارض أعارض أوافق بشدة
هل تعتقد أن جميع حقوق المرضى تطبق؟
هل تعتفد أن جميع الممرضين يطبقون حقوق المرضى؟
ل تعتقد أن للراتب علاقة بمدى رغيتك ه بتطبيق تلك الحقوق؟
هل تعتقد أن هنالك رقابة داخلية وخارجية تهتم بمراقبة تطبيق تلك الحقوق؟
79
أوافق السؤال بشدة
أعارض أعارض أوافق بشدة
هل تعتقد أن هنالك جدية من قبل المراقبة
لمراقبة مدى تطبيق هذه الحقوق؟
تعتقد أن هنالك تمييز بين المرضى في هل تطبيق حقوقهم (مكانة المريض,مستوى دخله)؟
هل الممرض مجبر لتطبيق حقوق المريض؟
هل تعتقد أن المرضى مدركون لحقوقهم ؟
هل هنالك علاقة بين الخبرة والقدرة على تطبيق حقوق المرضى؟
مي ومدى هل هنالك علاقة بين المستوى التعلي تطبيق حقوق المرضى؟
هل تعتقد بأن حقوق المرضى تطبق في المستشفيات الخاصة بقدر أوسع منه في
المستشفيات الحكومية؟
هل تعتقد أن الممرض الذي يعمل في المجالين الخاص والحكومي يتعامل بنفس الأسلوب مع المريض إذا اختلف تواجد المريض سواء في
ومي ؟الخاص أو الحك
هل تعتقد أن المريض في المستشفى الخاص يحصل على رعاية أفضل منه في المستشفى
80
الحكومي ؟
هل يختلف لدبك مدى تطبيق حقوق المريض من مريض لآخر؟
هل عمم عليكم من قبل رؤسائكم قوانين تتعلق بحقوق المرضى ؟
هل تعتقد أن جميع الممرضين يطبقون حقوق رضى بالشكل المطلوب؟الم
Patient questionnaire:
Age
15-25 26-35 36-45 more than 46
Sex:
Male female
Educational level
Not educated school university
Place of permanent residence:
City town camp
Did you know that there rights to the patients?
Yes No
81
Strongly
Disagree
Disagree Agree Strongly
Agree
Question
Health care services provide in suitable
way for patients.
Patient can object on the level of health
services which are provided to him
I' am well informed about my doctor.
I' am well informed about my illness.
I' am provided with realistic
information about my health status.
Nurses respects my privacy and
confidentiality about my illness.
Nurses are supportive. (emotionally &
psychologically ).
Nurses respect my believes and
religious.
Nurse explains treatment process and
how to deal with it.
I sign consent inform and the health
care providers clarify all potential
complication before any major
procedure.
82
I have the right to choose my own
doctor.
I have the right to refuse the treatment.
The relationship between the health
care team and patient good
relationship.
The health care team listen attentively
to patients complains and suggestions.
The patient participates in his treatment
process.
The method used by Health staff to talk
about the problem of patient is the style
required.
The health care services provided
equally to the patients.
I feel respected and treated friendly by
health care providers.
83
:العمر
. فأكثر 46 45_36 35_26 25_15
:الجنس
ر أنثىذك
: المستوى التعليمي غير متعلم أساسي ثانوي جامعي .
:مكان الإقامة الدائم مدينة قرية مخيم .
هل تعلم بوجود حقوق للمرضى؟
لا نعم
84
أوافق الالسؤ بشدة
أعارض أعارض أوافق بشدة
تعتقد أنه يتم تقديم الرعاية الصحية هل بالشكل المناسب للمريض ؟
تعتقد أن المريض بإمكانه هل الاعتراض على مستوى تقديم الرعاية
الصحية له ؟
يتم تزويدك بالمعلومات حولهل المعالج ؟ طبيبك
ت كافيه عنبمعلوما كإخبار يتم هل
مرضك؟
الطبي الطاقم بواسطة كإخبار يتمهل ؟ واقعية بكل الصحية كحالت عن
يتم المحافظة على أسرار المريضهل
؟الخاصة بمرضه بينه وبين الطاقم
85
أوافق السؤال بشدة
أعارض أعارض أوافق بشدة
قبل من النفسي الدعم على حصلهل ت ؟ الصحية الطواقم
الدينية كومعتقدات كمبادئ احترام يتمهل ؟ الطبية الطواقم قبل من
كل بالشرح ات/ين الممرض يقومهل وكيفية كل المقدمة العلاج خطة عن
؟ معها التعامل
العمليات ورقة على بالتوقيع قومهل ت
كافة توضيح ويتم عملية عمل عند ؟ المحتملة المضاعفات
المشرف الطبيب اختيار في الحق هل لك ؟ كعلاج على
كل المقدم العلاج رفض في الحق هل لك ؟
86
أوافق السؤال بشدة
أعارض أعارض أوافق بشدة
تعتقد أن العلاقة بين المريض وبين هل ؟ جيدة الطاقم الصحي علاقة
هل يتقبل الطاقم الطبي الاجابة على رحاتهم؟شكاوى المرضى ومقت
مشاركة في بال هل يقوم المريضوضع الخطة العلاجية من قبل الطاقم
الصحي ؟
تعتقد أن الأسلوب المستخدم من قبل هل الطاقم الصحي في الحديث عن مشكلة
؟ هو الاسلوب المطلوبالمريض
تقديم طريقة في بالعدالة شعرتهل ؟ كل الصحية الرعاية
الطواقم قبل من والاحترام بالود شعرتهل ؟ الطبية
87
References:
1. AHA,(1992)http://www.who.int/genomics/public/patientrights/en/. Accessed (1-7-2009).
2. Ariga,T.,(2009) Refusal of blood by Jehovah’s Witnesses and the
patient’s right to self-determination, Legal Medicine. 11, 138–140.
3. Johinson,K.,(2009) HEALTH / PATIENT'S RIGHTS : Bad test
results often don’t reach patients .8 ,15-17.
4. American Medical Association,1993.Health care providers'
attitudes towards termination of pregnancy: A qualitative study in
South Africa, 33.Jane H , m et al, Phyllis O., BMC Public Health.
2009; 9: 296.Published online 2009 August 18. doi: 10.1186/1471-
2458-9-296 Evolution of patients' complaints in a French
university hospital: is there a contribution of a law regarding
patients' rights? Camila G., Gwenaelle V,2009, BMC Health
Services Research ,9:141doi:10.1186/1472-6963-9-141.
5. Annas GJ. The patient's right to safety -- improving the quality of
care through litigation against hospitals. N Engl J Med ,
2006;354:2063-2066.
6. Bill of Rights, Public Health Law(PHL)2803 (1)(g)Patient’s
Rights,
10NYCRR,405.7,405.7(a)(1),405.7(c),www.health.state.ny.us/prof
essionals/patients/...rights/docs/english.pdf,excited (2.7.2009).
7. Common Ground Tort Reform and the Patient Safety Movement:
Seeking Peter P. Budetti, current as of January 31, 2010.Online
article and related content,. 2005;293(21):2660-
662(doi:10.1001/jama.293.21.2660) JAMA.
88
8. Combating HIV stigma in health care settings: what works? Laura
Nyblade Anne Stang, Journal of the International AIDS Society
2009, 12:15doi:10.1186/1758-2652-12-15.
9. Evolution of patients' complaints in a French university hospital: is
there a contribution of a law regarding patients' rights? Camila G.,
Gwenaelle V,2009, BMC Health Services Research
,9:141doi:10.1186/1472-6963-9-141.
10. Evolution of patients' complaints in a French university hospital: is
there a contribution of a law regardingvpatients'rights?
Giugliani,C.,Gault,N.,Fares,V.,Jegu,.J,Trolli,S.,Biga,J.,Trecan,G.,B
MC, Health Services Research, 2009, 9:141,10.1186/1472-6963-9-
141.
11. Hermans,M.(2007). Patients' rights in the European Union
.European journals of public health.(7).11-17.
12. http://en.wikipedia.org/wiki/Tulkarm.
13. (http://en.wikipedia.org/wiki/Patient_rights accessed
9/2/2010.9pm.
14. Injection drug use, unsafe medical injections, and HIV in Africa:A
systematic review,Savanna R Reid, BMC ,Harm Reduction Journal
,2009,1186/1477-7517-6-24.
15. Informed consent from patients participating in medical education:
a survey from a university hospital in Jamaica , Alan ,T., m et al,
BMC Research ,2009, 2:252doi:10.1186/1756-0500-2-252.
16. Improving Relations Between Attorneys and Physicians, Peter D.
Jacobson; M. Gregg Bloche, current as of January 31, 2010.Online
article and related content. 2005;294(16):2083-2085
,doi:10.1001/jama.294.16.2083) JAMA.
89
17. Infection-Control Report Cards — Securing Patient Safety Robert
A..,m et al, Brennan, M.D. n engl j med, 353;3 www.nejm.org july
21, 2005.
18. James,J,(2006) Medical Malpractice and Patient Safety ,patient
safety and legal right. 355:734-736.
19. Jeorge,G.,(2008) The Patient's Right to Safety — Improving the
Quality of Care through Litigation against Hospitals,354:2063-
2066.
20. Jeorge,G.,(2006) The Patient's Right to Safety — Improving the
Quality of Care through Litigation against Hospitals,354:2063-
2066.
21. Legal Concerns and the Influenza Vaccine Shortage,Michelle
M.,Troyen A.JAMA. 2005;294:1817-1820.
22. Lack of effective communication between communities and
hospitals in Uganda: a qualitative exploration of missing
links,Rutebemberwa,E., Ekirapa Kiracho1,E.,Okui1,O.,Walker,D.,
Mutebi,A.,Pariyo,G.,BMC, Health Services Research , 2009,
9:146,10.1186/1472-6963-9-146.
23. Medical Liability And Patient Safety, William M. Sage,2003,Ju l
y/Au g u s t 2 0 0 3, HEALTH A F FA I R S ~ Vo l u m e 2 2 , Nu m
b e r 4.
24. Measuring the barriers against seeking consultation for urinary
incontinence among Middle Eastern Women,Ahmed S. El-Azab,
Omar M.Shaaban, BMC, Women's Health, 2010, 10:3
10.1186/1472-6874-10-3.
25. Nablus city, http://www.asiarooms.com, excited( 2.2.2010).
90
26. Palestinian Central Bureau of Statistics, 2008. Population, Housing
and EstablishmentCensus 2007 , Census Final Results in The West
Bank – Summary (Population and Housing).Ramallah -
Palestine.accessed at 12/4.1010.
27. Palestinian Central Bureau of Statistics, 2008. Population, Housing
and EstablishmentCensus 2007 , Census Final Results in The West
Bank – Summary (Population and Housing).Ramallah -
Palestine.accessed at 12/4.1010.
28. Salima, S.etal.(2008)Right Medication, Right Dose, Right Patient,
Right Time, and Right Route: How Do We Select the Right
Patient-Controlled Analgesia (PCA), Device. Medscap
etoday.,02/14/2008; Pain Manag Nurs. 2007;8(4):140-145,
accessed 22/7/2009.
29. Sara .L. /Swenson , Patti. Z ., Bernard .L., (2006). away’: Patient
experiences of biomedical and patient-centered communication,
Patient Education and Counselin.61 ,200–211.
30. The Association Between Age and Health Literacy Among Elderly
Persons David W. Baker, Metro Health Medical
Center,MetroHealth Drive,The Journals of Gerontology: Series
B,Volume 55, Issue 6.
31. The new medical crisis, Michelle M. M e tal, Troyen A.
Brennan,2003, n engl j med 348;23, January 31, 2010.
32. Within but without: human rights and access to HIV prevention
and treatment for internal migrants,Wiltenburg
Todrys,K.,Amon,J.,BMC,Globalization and Health 2009, 5:17
doi:10.1186/1744-8603-5-17.
33. (WHO.2008) http://www.who.int/genomics/public/patientrights/ .
accessed (1-7-2009) .
91
34. Zuckerberg,J.(2007). International human rights for mentally ill
persons.The Ontario experience. 30. 512–529.