Unveiling Patient Satisfaction at a Nigerian Eye Clinic
In the battle against blindness, patient satisfaction is a powerful yet often overlooked measure of success.
When we think of quality healthcare, we often focus on clinical outcomes and advanced technology. Yet, for patients navigating the challenges of eye care in Nigeria, satisfaction with the service itself is a crucial part of the healing journey. At the University of Calabar Teaching Hospital (UCTH), a dedicated team has placed this concept under the microscope, revealing surprising insights about what truly matters to patients when sight itself is on the line.
In resource-limited settings like Nigeria, eye care facilities face significant challenges—from limited equipment to overwhelmed specialists.
Glaucoma, a leading cause of irreversible blindness, exemplifies this crisis. Studies at UCTH have revealed that many patients present with advanced disease, with nearly half showing severe optic nerve damage at their first visit .
"The expectations may be based on their experiences with care providers, environment, social background, peer group, and personality," researchers note, highlighting the complex interplay of factors that shape patient perceptions 1 .
Within this challenging context, patient satisfaction becomes more than just a comfort metric; it's a vital component of effective treatment. Satisfied patients are more likely to adhere to medication regimens, keep follow-up appointments, and recommend services to others—all critical factors in managing chronic eye conditions that require long-term care 1 .
To objectively measure patient experiences, researchers at UCTH conducted a cross-sectional study of patients who had accessed the hospital's ophthalmic counselling services 1 .
Between February and April 2019, researchers recruited 120 patients who had used the counselling services between January 2016 and December 2018 1 . The approach was meticulous:
All registered adult patients who had accessed counselling services were eligible, excluding those too ill to participate, non-consenting patients, and minors 1 .
All interviews were conducted in a private screening room within the eye clinic to ensure patient comfort and confidentiality 1 .
Researchers used a semi-structured interviewer-administered questionnaire that was pretested and validated to ensure reliability 1 .
A modified Likert scale with three response options—"very satisfied," "satisfed," and "not satisfied"—was used to rate satisfaction levels across various service dimensions 1 .
This rigorous methodology allowed researchers to capture both the quantitative metrics and qualitative nuances of patient experiences.
The study participants represented a diverse cross-section of the community, with a mean age of 45.32 years and a majority (60%) being male 1 . Education levels varied, with most participants (48.3%) having tertiary education, while a small percentage (3.3%) had no formal education 1 .
Overall Satisfaction
Time Spent Satisfaction
Correctly Identified Counsellor
Perhaps most notably, the study highlighted the success of task-shifting—where trained non-clinical staff provide specialized services. Despite not being ophthalmologists, the social workers delivering counselling achieved remarkable satisfaction rates, suggesting that empathy and communication training may be as valuable as clinical expertise in certain aspects of patient care 1 .
The promising results from Calabar align with broader trends across Nigeria's healthcare landscape. A comparative study conducted in Ogun State primary health centers found that satisfaction with eye care services (mean score: 3.7±0.4) actually surpassed satisfaction with general family medicine services (mean score: 3.5±0.3) 7 .
Data from Ogun State primary health centers study 7
Common themes of dissatisfaction also emerged across studies, primarily relating to waiting times and resource limitations 7 .
Long waiting times
Cost of services
At UCTH's antenatal clinic—a different department within the same institution—long waiting times (57%) and cost of services (40.3%) were the primary sources of patient dissatisfaction 5 , indicating systemic challenges that transcend individual departments.
What does it take to conduct rigorous patient satisfaction research in a clinical setting? The UCTH study employed several specialized tools and approaches:
| Research Tool | Function | Application in UCTH Study |
|---|---|---|
| Semi-structured questionnaire | Allows standardized data collection while permitting exploration of individual experiences | Captured both quantitative metrics and qualitative insights |
| Likert scale | Measures attitudes on a continuum from positive to negative | Enabled rating of satisfaction levels (very satisfied/satisfied/not satisfied) |
| Interviewer administration | Ensures comprehension and complete responses | Particularly valuable with varying literacy levels among patients |
| Confidential environment | Promotes honest feedback without fear of repercussions | Conducted in private screening rooms away from treatment areas |
The UCTH study concludes with a powerful recommendation: "Training and retraining of allied support staff to render ophthalmic counselling services in order to ease the workload of the Ophthalmologist should be encouraged in resource-limited settings" 1 .
This research demonstrates that even with limited resources, healthcare facilities can achieve remarkable patient satisfaction by focusing on human-centered care, effective communication, and strategic task-shifting. The findings offer a blueprint for other resource-limited settings seeking to enhance patient experiences without substantial financial investment.
Focusing on patient experience and empathy in service delivery
Ensuring clear understanding between providers and patients
Training non-clinical staff for specialized support roles
As one study aptly noted, "Patients counselling is gradually taking a front line in holistic health care management in most health care facilities throughout the world" 1 . The work at UCTH's eye clinic not only validates this approach but lights the way forward for compassionate, effective eye care that sees the whole person—not just the disease.
For those interested in exploring this topic further, the original research is available in the Ghana Medical Journal (2020;54(2):76–81) under the title "Patients' satisfaction with ophthalmic counselling services in a tertiary hospital in Calabar, South-South Nigeria."