Exploring Patients' Perspectives towards the Customized Health Education Protocol for Chronic Illnesses in the Primary Health Care Services in West Bank: A mixed Methods Study رسالة دكتوراة

Abstract

Background: Non communicable disease also known as chronic illness kill 41 million people each year, 74% globally. A 17 million people each year die before age 70. 77% of non-communicable disease death with 86% of premature death occurs in low- and middle-income countries. Non-communicable diseases are the leading causes of mortality and morbidity in Palestinian society, it responsible for 68.5% of all Palestinian fatalities in 2020. Non- communicable diseases caused by unhealthy behaviors; hence, changing these behaviors will reduce the incidence of these diseases. Aim: To explore The Effectiveness of Provided Health Education Protocol for chronic illness in primary health care services in west bank. Methodology: A mixed method study was carried out between January-March in 2024 in primary health clinics of Ministry of Health selected in Ramallah district. A total of 377 representative sample of non-communicable diseases patients selected conveniently to complete a translated world health organization STEP wise approach. Additionally, 15 non-communicable diseases participants as a focus group was interviewed purposefully. Results: The quantitative results assessed the participants’ behaviors including: Smoking status of participants, dieting behavior and physical activity behavior. Participants in the study reported consuming a median of two servings of fruits and vegetables daily. A (89.7%) of participants integrated walking into their daily lives with a median frequency of five days per week and an average daily time of fifteen minutes. Regarding smoking advice, (85.6%) of patients reported getting it either rarely or never. A need for better nutritional counseling is needed since (95.5%) of patients reported rarely or never receiving advice regarding diet. The results also showed that (91.5%) of patients never receive guidance on physical activity. A need for regular medication counseling is noticed as (84.9%) of patients received infrequent pharmaceutical advice. A statistically significant relation between education provided by healthcare providers and dieting behavior is detected among non –communicable disease patients at α level = 0.05(p=0.000). There was a significant relationship between low fats diet advice provided by healthcare providers and raised cholesterol levels (p = 0.031). Additionally, there was a significant relationship between low sugar diet advice provided by healthcare providers and fasting blood sugar levels (p = 0.014), as well as Glycated hemoglobin levels (p = 0.045).The qualitative results emerged three major themes were explored from the voices of non-communicable diseases patients attended the governmental primary health clinics in Ramallah governorate, in accordance to perceptions of non-communicable disease from patients’ point of view in the qualitative evident content analysis that are: (i) the V effectiveness of health education during routine clinic visits; (ii) barriers to provide sufficient health education & (iii) alternative sources for acquiring information. Conclusion: A negligible advice from healthcare professionals' regards practicing regular physical activity, eating a healthy diet, stopping tobacco, and adhering to prescribed medication. Therefore, the study recommended to improve therapeutic communication between the health workers and the patients with assurance that patients receive thorough advice customized to their particular needs and situation