Assessment of Quality of Care for Children with Sickle Cell Disease in the South Tongu District of Ghana: Nurses’ Perspective

Abstract

Sickle cell disease (SCD) is a genetic disorder of erythrocytes with frequent episodes of vaso-occlusive crisis and complex morbidities. Studies identify gaps in quality of care for children with SCD including poor knowledge of providers and inadequate logistics. South Tongu district of Ghana records increasing incidence of SCD children’s morbidities and prolonged hospitalizations. Aims: The study sought to examine the quality of nursing care for children with SCD in South Tongu district and identify opportunities for improvement. The study was conducted in the two hospitals of the South Tongu district of Ghana. Study Design: A descriptive cross-sectional survey was employed to examine nurses’ knowledge of comprehensive care and their perspectives on quality of structures, processes and outcomes of care for SCD children. Methodology: Convenient sampling method was used to obtain data from 74 nurses using structured questionnaires based on Donabedian model. Results: Results showed a mean score of 10.25 out of 20 (51%) indicating inadequate knowledge of comprehensive care. Nurses’ perception regarding quality of service structures for SCD children obtained the worst evaluations (mean=41.50); mostly in the aspects of service logistics and supplies, and access to emergency vehicles (ambulance). The process dimension had the best evaluation (mean=58.68), followed by outcome (mean=43.17). Communication problems within the nursing team and interpersonal relationships with SCD children/families were major challenges affecting quality care in the process and outcome domains. A weak positive relationship (p=0.188) was found between the process and outcome measures. Conclusion: The study suggests continuous education and training of nurses on comprehensive care for children with SCD and strengthening of all the dimensions of quality care, particularly the structure.