Patient attitudes to major surgery in rural Kenya

In this Kenyan study of patient perceptions of major surgery and involvement in decisions to operate, the attitudes of 89 female and 23 male patients who had undergone major surgery at a district hospital were studied. Semi-structured interviews were conducted in the wards by a social worker who had no employment or other relationship with the hospital. In 48 cases the decision about the operation was taken jointly by patient and doctor, while in 49 cases the decision was reportedly taken by the doctor alone. In 81 cases (64 female and 17 male) a relative or friend accompanied the patient to hospital. Only 21 patients reported being told details about the operation before the event. One quarter of the patients (housewives and school children) admitted feeling afraid or nervous prior to the operation while two-thirds reported having felt either confident or resigned about it. Ninety-eight patients characterized the care as good while seven felt it was poor.