Quality of nursing care among patient with cancer in Mongolia

Abstract

Background: According to the World Health Organization, worldwide there were 19 million people diagnosed with cancer in 2022 and in that same year, 9.9 million people died from cancer. In Mongolia, 5,981 people were diagnosed with cancer in 2021, and 4,559 people died of cancer. Among them 72.5% of cancer patients are diagnosed at a late stage, and 60% of them die less than a year after diagnosis, while 80% of people with the disease are over the age of 45 (Center for Health Development, Mongolia 2021). Within Mongolia, 24,000 people receive treatment and nursing care under the supervision of the National Cancer Center. (National Center for Cancer Research website) In 2013, a consumer satisfaction survey conducted in Mongolian public healthcare hospitals showed that 62.4% of clients were not satisfied with their medical care and services (Gaalan et al., 2018). A comfortable, clean environment, respectfulness and helpfulness of nurses, and explanation of procedures performed by nurses had a significant influence on patient satisfaction in Mongolia. (Tsogbadrakh et al., 2016) This research was conducted because there are currently no studies examining nursing care at the National Cancer Center. Aim: To investigate the factors related to level of quality nursing care among cancer patients at the National Cancer Center Hospital in Mongolia. Materials of Methods: A convenience sampling method was used to select 265 inpatients at the National Cancer Center. The socio-demographic questionnaire had 8 items. The Quality Oncology Nursing Care Scale-QONCS questionnaire was used. This questionnaire consists of 34 items and 5 sub-dimensions to assess the quality of nursing care based on patients’ perceptions and expectations of nursing care during hospitalization. The study data were analyzed by using SPSS 21.0 software. Demographic data was assessed using descriptive statistics and correlation of the results were determined by Pearson’s correlation analysis. The relationship between the client’s gender, education, income, and quality of care was determined by multiple regressions. A value of p≥0.05 was considered as statistically significant. Results: The mean score of the quality of nursing care assessment was 136.96±19.54, which means that the cancer patients rated the overall quality of nursing care as satisfactory or good. Considering the subgroups, the average score of the client support subgroup is 70.86±9.20; the average score of connectedness is 18.44±5.15; the average subgroup score for value is 17.93±2.45; and the average score of respectability is 13.23±2.00, which means that these care services are rated at a good level by the evaluation of cancer patients. However, the average score of beliefs was 16.49±7.65, which was rated at a medium level by the evaluation of cancer patients. Therefore, it suggests that nurses should consider patient belief and spirituality in care when providing nursing care to cancer patients. Correlation of the evaluation of the quality nursing of care and gender was negative and weak (r=-0.152, p=0.013) and the relationship between the assessment of the quality of nursing care and the educational level of the study participants was also negative and weak (r=-0.25, p=0.0001). According to multiple regression analysis results, gender (R2=.02) and education (R2=.06) are predictor variables of patients’ evaluation of nursing care quality. Conclusions: 1. Clients with cancer rated the overall quality of nursing care as satisfactory. The subdimensions of being supported and confirmed, sense of belonging, being valued, and being respected are assessed as satisfactory; while the spiritual care sub-dimension was rated at a moderate level. 2. Gender and education were significant related to the factors in the evaluation of the quality of nursing care among patients.