Sağlık Kurumlarından Hizmet Alanlar Gözünden Hasta Hakları Konusundaki Uygulamalara Yönelik Tutum Ve Değerlendirmeler

Amaç: Bu çalışmanın amacı, hizmet alanlar gözünden ülkemizdeki sağlık hizmetlerinin nasıl algılandığı, yaşanmakta olan sağlık sorunlarını algılamaları, hasta hakları ve sorumlulukları konusundaki bilgi ve farkındalık düzeylerinin algılanması, hasta ve hasta yakınlarının tutum ve davranışlarının değerlendirilmesi ile sağlık hizmetlerinden genel memnuniyet düzeylerinin algılanmasına ilişkin genel bir bilgi toplamaktır.  Yöntem: Araştırma bağlamında Sakarya ve İstanbul ilinde Haziran-Temmuz 2019’da bir anket çalışması yürütülmüştür. Saha çalışması kolayda örnekleme yöntemi ile belirlenen gönüllülük esasına dayalı olarak 200 katılımcı üzerinde gerçekleştirilmiştir. Bulgular: Araştırma bulgularına göre, sağlık hizmetlerinde yaşanan sorunlar arasında doktorların ilgisizliği, uzun bekleme süreleri, yanlış teşhis ve tedaviler ile çalışan sayısının yetersizliği öne çıkmaktadır. Katılımcıların cevapları genel olarak ele alındığında sağlık hizmetleriyle ilgili yaşanan sorunları dört boyut altında toplanabileceği gözlenmektedir.  Bunları sağlık kurumlarında hizmet kalite duyarlılığı, sağlık çalışanlarının ilgisizliği, hasta hakları farkındalık düzeyi ve hastaların kaba ve saygısız davranışları olarak ifade etmek mümkündür. Ayrıca, hastane seçiminde etkili olan faktörler ile hastanede yaşanan sorunlar demografik özelliklere göre de değişmekte olduğu da araştırma bulguları arasındadır.    Sonuç: Sağlık sektörünün bir hizmet sektörü olması sebebiyle, hizmetlerin başarısı ve hasta memnuniyeti açısından insan unsuru kritik önem arz etmektedir. Bu bağlamda tüm sağlık çalışanları (hekim, hemşire, tıbbi sekreter ve diğer görevliler) kadar hasta ve hasta refakatçılarının da hak ve sorumluluklarının bilincinde olacak şekilde davranmak zorundadırlar. Sağlık sisteminin etkin işlemesi sadece hakların bilinmesiyle değil, sorumlulukların da bilinmesi ve yerine getirilmesi ile mümkün olacaktır. Ancak hak ve sorumluluklar konusundaki bilgi ve farkındalık düzeyinin yetersiz olduğunu söylemek yanlış olmayacaktır.    

Attitudes and Evaluations of Service Receivers (Patients) Of Health Institutions on Patient Rights Practices

Health is one of the most important part of human life. Even if human beings have all the means other than health, they need health in order to enjoy the life.  But it seems that we do not understand its value and importance for our lives unless we loose it. Maybe the phrase of ”Health is the beginning for everything” may be the best description for its importance. With modern life, health has become an increasingly important issue. Hence, investment decisions as well as regulatory actions in the healthcare industry are among the most debated issues of recent years.According to the World Health Organization, health is defined not only as illness or disability, but, as physical, mental and social well-being. That is, in order to be able to talk about healthy body, we need to have a healthy mind and mood besides lack of a physical problem (Başol and Işık, 2015.)The aim of this study is to examine the level of knowledge, usage and awareness about the perception of health services, patient rights and responsibilities from the perspective of those who benefit from the services provided by health institutions in Turkey. Along with this aim, we also wanted to gather information about attitudes and behaviors and satisfaction levels of patients and their companions benefitting from the health services. In this context, healthcare planning activities play an important role in health services. The most important purpose of healthcare services is to improve and protect the health of the society. Health institutions need to provide patient satisfaction to a broad and heterogeneous group of people in the context of health care recipients. The issue of “patients’ rights and responsibilities” has become more critical in this respect. Today, in developed countries, the quality of health services is increased by the awareness of individual rights and responsibilities as both patients and service providers and behaving accordingly. This has resulted in a positive relationship between the patients and health professionals, hence leading to solutions for any kind of problems that might arise in due course (Saruç, 2007: 2).Patient right is a reflection of human rights on health services. The aim of Patient Rights is to protect the integrity and reputation of the patient due to being a mere human, to emphasize the basic human rights in health services, to help people to benefit fully from health services, to minimize the impact of systemic problems, to reinforce the relationship between patients and health personnel and to actively participate in the treatment process of patients as well as to encourage, to prevent and reduce errors arising from professional practices (http://www.istanbulsaglik.gov.tr/w/sb/duyurular/belge/av_ahsen_dinc_saglik_huhuk_hasta_hak_02072017.pdf). In the context of the research, a survey was conducted in Sakarya and İstanbul in June-July 2019. The field study was conducted on 200 participants on a voluntary basis selected through convenience sampling. In the formation of data collection instrument, the questionnaire, we have conducted several interviews with a number of experts as well as people who are the target audience of healthcare services. Following three pilot studies, the final draft of the survey instrument was finalized. For the participants, 55% of them were men, 45% were women and 55% were married. 50% are between 18 and 33 years old, and 20.5% are 50 years and older. In terms of occupational status, the participants were mainly students, lecturers, civil servants and workers. In terms of education, it is seen that approximately half of the participants have university level and above, and nearly 40% have a university degree. In terms of income, half of the participants had an income of 0-4000 TL and half of them were in the range of 4001-8000 TL. In terms of insurance coverage, of the 85% were covered by the SGK (Social Security Department) and only a small fraction had a private health insurance. In terms of experience, one forth have visited a health institution in the last 15 days, 1/4 have visited during the last one months and 17% of the participants have visited a health institution in the last 2 months. Of those participated to the study have indicated that they had experienced a problem with a hospital or a health organization. In order to seek redress or solve their problems, participants tend to complain mostly to the patients’ right department, CİMER (Presidential Communication Center for putting complaints by public), hospital administration, family physician, health director and ALO184, respectively. The most important reason for the hospital preference of the participants is the competence of the physician, and followed by satisfaction with the physician and ease of making an appointment with the physician. On the other hand, the most important problem experienced by the participants in health institutions today is the indifference and lack of responsiveness of physicians. Long waiting times and insufficient number of health workers are followed. Findings of factor analysis indicated the existence of four factors affecting participants’ attitudes towards and perceptions of health institutions. These dimensions were named as “quality sensitivity in health institutions”, “apathy of health workers”, “patients rights awareness level” and “rude and disrespectful patient behaviors”.Also findings indicate that despite the existence of legal regulations on patient rights in our country, it is seen that these rights are not known sufficiently by health workers and patients. Most patients do not know where to go about the problems they face and they find it difficult to find someone to take care of and sometimes may suffer from insensitive behaviors from the hospital staff. On the other hand, patients should fulfill their responsibilities when receiving services from the health care facility. Patients and their companions may sometimes display rude and disrespectful behaviors towards health workers. Furthermore, some patients think their problem is the most important and urgent one compared to other patients’ problems, and may behave rudely and disrespectfully towards other patients. As for conclusion, it is important for health professionals and all patients to have information about the existing documents, legal regulations and practices, and to increase the awareness of the society and health professionals on this issue in order to increase the level of knowledge and practice in patient rights and to provide better quality health services. This awareness will contribute to reducing legal problems and the severity of health workers. Improving the continuity of health education by improving the knowledge level of health workers and patients about patient rights and responsibilities will contribute to the process.

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