The fake patient: A research experiment in a Ghanaian hospital (original) (raw)
Related papers
The introduction sets out two central ideas around which this collection of articles on hospital ethnography has been organised. The first is that hospitals are not identical clones of a global biomedical model. Hospitals take on different forms in different cultures and societies. Medical views and technical facilities may vary considerably leading to different diagnostic and therapeutic traditions. The second idea, related to the first, is that biomedicine and the hospital as its foremost institution is a domain where the core values and beliefs of a culture come into view. Hospitals both reflect and reinforce dominant social and cultural processes of their societies. The authors further discuss some methodological and ethical complexities of doing feildwork in a hospital setting and present brief summaries of the contributions, which deal with hospitals in Ghana, South Africa, Bangladesh, Mexico, Italy, The Netherlands, Papua New Guinea, Egypt and Lebanon. r
A B S T R A C T Patients’ abandonment in the hospital have been one of the most serious social problem affecting patients and the hospitals alike in contemporary society. At different time from one hospital to another, you find a lot of patients who are abandoned by their relations or family. This precarious and humiliating situation have reached an extent that it draw the attention of the hospitals management and medical social workers on what should be done to curtail and remedied the problem. In the researcher field work at the Irrua Specialist Teaching Hospital, effort was made to understand the concept of patients’ abandonment in the hospital, its causes and the effects of such abandonment on the patients and how the problem of patients’ abandonment can be solved. In this project therefore, attempt will be made by the researcher to relate field work experience on patients’ abandonment generally. Chapter one of this project examine briefly the hospital as an Agency and chapter two examine the problem of patients’ abandonment in the hospital. In chapter three, selected cases of patients abandoned in the Irrua Specialist Teaching Hospital are reported. In chapter four, effort was made to relate the theoretical knowledge of social to field practice and the important of field work experience in social work practice was also examined. Chapter five of the project is conclusion and recommendation. This project is fully based on field work experience of the researcher and it provides some vital information needed to understand the concept of patients abandonment in the hospital and such information will be of great importance to social work practice in the hospital setting.
Social Science & Medicine, 1997
The simulated client method (SCM) has been used for over 20 years to study health care provider behavior in a first-hand way while minimizing observation bias. In developing countries, it has proven useful in the study of physicians, drug retailers, and family planning services. In SCM, research assistants with fictitious case scenarios (or with stable conditions or a genuine interest in the services) visit providers and request their assistance. Providers are not aware that these clients are involved in research. Simulated clients later report on the events of their visit and these data are analyzed. This paper reviews 23 developing country studies of physician, drug retail, and family planning services in order to draw conclusions about (1) the advantages and limitations of the method: (2) considerations for design and implementation of a simulated client study; (3) validity and reliability: and (4) ethical concerns. Examples are also drawn from industrialized countries, related methodologies, and non-health fields to illustrate the issues surrounding SCM. Based on this review, we conclude that the information gathered through the use of simulated clients is unique and valuable for managers, intervention planners and evaluators, social scientist, regulators, and others. Areas that need to be explored in future work with this method include: ways to ensure data validity and reliability: research on additional types of providers and health care needs; and adaptation of the technique for routine t.se. ~ 1997 Else-
Respecting patients' dignity has been described as a fundamental part of nursing care. Many studies have focused on exploring the concept of patients' dignity and satisfaction from the patient and nurse perspective, but knowledge is limited regarding nursing perceptions of the impediments they pose to patients' satisfaction and experiences of the patients themselves. The main objective of the study was to explore the issue of patients' rights and satisfaction from the perspective of patients. The study used the descriptive survey technique and the sample size for the study was 700 respondents. The study comprised all persons who were 15 years and above and were currently residing at Winneba in the central region of Ghana for the past two years and simple random techniques under probability sampling procedure was used in selecting respondents for the study. Questionnaire, observation and structured interview were the research instruments used to collect the data. All the respondents (100%) strongly agree and agree that patients' rights violations has serious implications if not checked, and all the respondents (100%) strongly agree and agree that public education, awareness of human rights, improving the health facilities and resourcing health workers are required to deal with the practice in Ghana. The study concluded that patients' rights violations a social canker in various Ghanaian communities which clearly violates the protection of the fundamental human rights and has serious implications on Ghanaians. The root cause of the abuses at the hospitals is the impoliteness and corruption on the part of health workers. The study recommended that the media and other bodies in Ghana should continue educate citizens and create human rights awareness among the entire populace particularly health workers to desist from violating human rights especially the rights of the sick. Hospitals apply all the safety and quality standards to Health as spelt out in the patients act. This is crucial to ensure patient safety and confidence in Health services.
Learning from the medics: professionalism and ethical implications of 'practicing on the poor'
Often entitled International Health Experiences (IHE's), medical electives abroad in resource-poor countries have become ever more common within a medics education. The Lancet in 1993 citing benefits for doctors-in-training including: increased cultural sensitivity; enhanced community and social awareness; improved clinical and communications skills; and, a greater understanding of the challenges of working in scarce resources. With continued interest in these global health issues, the British Medical Association has acknowledged the ethical concerns, and the risk of double standards when undertaking electives in unfamiliar societies and with vulnerable patients. However, unlike the architectural equivalent 'live international projects', our medical peers have begun openly discussing the potential hypocrisy in North-South international educational practices. As a result, medics have highlighted the important role and responsibility of university schools to foster and formalise professional ethical training for students intending to serve patients, no matter what context. This paper thus looks to investigate what the architectural sister practices could learn from the medical education and their IHE criticisms. Perhaps, like the medics, universities that run international live projects need to examine and focus on the serious ethical issues that their current programmes perpetuate. If architectural educators really feel a justifiable need to conduct studio practice on vulnerable clients, then surely they also need to find a way of properly understanding and incorporating the ethical consequences of encouraging design beyond standard practice too?
Concealment in consultative encounters in Nigerian hospitals
Pragmatics, 2011
Although communication in medical practice is reputed for exactitude and objectivity, many doctors in several countries make equivocal, concealing utterances in certain situations when relating with clients. This phenomenon, despite its importance in doctor-client interaction, has received little attention from language scholars who have discussed concealment mainly as a strategy in news delivery. The present study examines concealment items in the interaction between doctors and clients in South-western Nigerian hospitals and their pragmatic implications for medical communication in Nigeria. Fifty conversations between doctors and clients on several ailments were tape-recorded in the six states of South-western Nigeria. Structured and unstructured interviews were conducted with selected doctors and clients. The corpus was examined for the linguistic and pragmatic resources deployed by doctors in concealing information, and was analysed using Jacob Mey's theory of pragmeme and insights from the literature on news delivery strategies. Concealment was found to take place between doctors and clients in a two-phase mode: Referential and pragmatic. Utterances which have descriptive forms at the referential level assume subjective and divergent shades in the context of concealment at the pragmatic level. Nine concealment strategies (jargonisation, veiling, forecasting, mitigation, stalling, normalisation, dysphemisation, euphemisation and doublespeak) were found to be employed to achieve four broad goals: Preventive, palliative, culture-compliant and confidential with respect to 25 diseases /medical procedures. Concealment in consultative encounters takes into account the socio-psychological security needs of clients and attends positively to clients' cultural expectations.
2024
Medical ethics have long embodied a set of common values that guide actions for medical doctors and other healthcare professionals in serving the community. However, internationally accepted ethical codes are not always interpreted or practiced among all hospitals, especially when they face such critical challenges as HIV/AIDs, Ebola, and COVID-19 outbreaks. Even though many case studies revealed how hospitals responded to these emergency situations, we still do not know the extent to which African hospitals observe ethical practices such as beneficence, non-maleficence, autonomy, and justice in facing these outbreaks. This paper demonstrates how healthcare professionals at a Liberia's hospital followed ethical practices. The primary data were collected by administering a questionnaire survey among 100 healthcare professionals, including doctors, nurses, midwives, and administrative personnel, in July 2022. The analysis was done using Microsoft Excel. We found that almost all the healthcare professionals in the survey had observed mandates to protect patient confidentiality and privacy. However, about 65% agreed that patients were entitled to have autonomy to decide on possible treatment options. Considering possible discrimination against patients in case of Ebola or COVID-19 outbreaks, 94% agreed that patients' admission to the hospital had been based on illness types. In securing the safety of healthcare professionals in dealing with Ebola and COVID-19 patients, about 81% and 69% of the respondents said that they had had adequate PPEs and complied with safety protocols, respectively. These results show some weakness of the hospital in terms of eliminating discrimination against some patients with a particular illness despite the overall good availability of protective measures.
Sick Healers: Chronic Affliction and the Authority of Experience at an Ethiopian Hospital
2015
At fistula hospitals in Ethiopia, patients who are not cured of their incontinence are hired as "nurse aides" to perform essential nursing duties in the ward and operating theater. An array of tensions surrounds the work of these women, tensions that are emblematic of their chronic-but secret-patient status. If accidentally disclosed, the women's ongoing illness episodes sabotage their ability to administer treatment, such as injections.