Experiences and Expectations of Relatives Regarding the Care of Patients Admitted to a Regional Hospital in the Kavango East Region, Namibia
DOI:
https://doi.org/10.25159/2520-5293/19478Keywords:
expectations, experiences, communication, hospitals, patient care, qualitative, quality of health care, satisfactionAbstract
Family involvement in patient care within hospital settings is increasingly being acknowledged as fundamental to enhancing communication, quality of care, and patient decision-making. In Namibia, there is a notable lack of research on the experiences and expectations of relatives regarding the care of patients admitted to medical and surgical wards at a regional hospital in the Kavango East region, Namibia (hereafter the hospital). This study aimed to explore and describe the experiences and expectations of relatives regarding the care of patients admitted to the hospital. A qualitative approach was employed utilising an exploratory, contextual and descriptive design. The study was conducted from August to October 2024 among relatives of patients admitted to medical and surgical wards at the hospital. Data was collected through semi-structured interviews with the relatives of 15 patients who were selected via a purposive sampling method. All interviews were audio recorded and transcribed verbatim. The data was analysed using a thematic analysis. The study identified four key themes, namely: (1) experiences of relatives regarding patient care; (2) expectations of hospital and healthcare professionals; (3) hospital environment and facilities; and (4) staffing and management processes. Thus, it can be concluded that the study findings fill a critical gap in current understanding of the role of relatives regarding patient care by translating abstract concepts into specific, measurable actions. The study findings can be used to develop targeted interventions and ongoing strategies to support family-inclusive care models in hospital settings worldwide.
References
Abdul Halain, A., M. Halim, N. Salwana, and N. Asyikin. 2022. “Family Involvement in Patient Care: A Scoping Review.” Journal of Nursing Management 30 (1): 88–102.
Adugbire, B. A. 2025. “Psychosocial Support for Relatives of Hospitalized Patients: A Framework for Practice.” International Journal of Nursing Studies 122: 104–115.
Alkhaibari, A., S. Almutairi, and M. Alotaibi. 2023. “Challenges to Implementing Family-Centered Care in Low-Resource Settings: A Systematic Review.” Global Health Action 16 (1).
Alvarado, C., and T. Smith. 2021. “The Global Movement Towards Family-Centered Care: Policy and Practice Implications.” World Health and Population 21 (1): 34–45.
Amarneh, B. H. 2024. “Workflow Optimisation and Interdisciplinary Rounding to Mitigate Nursing Shortages in Critical Care.” Journal of Clinical Nursing 33 (5): 789–801.
Appleton, J., M. Clark, D. Peters, and J. Wilson. 2024. “Healthcare in Rural and Underserved Regions: Systemic Challenges and Adaptive Strategies.” Rural and Remote Health 24 (1): 18–30.
Auld, M. L., S. J. Lewis, J. C. Wright, and E. J. Robinson. 2021. “Reducing Clinical Errors through Standardised Handoffs: A Systems Engineering Approach.” BMJ Quality and Safety 30 (10): 825–835.
Bello, A., C. Okafor, and T. Oloko. 2023. “The Interdependence of Emotional Workload and Communication in Hospital Care: A Qualitative Study.” Journal of Advanced Nursing 79 (3): 1124–1136.
Birru, M., H. Tilahun, and Y. Baheretibeb. 2024. “The Impact of Family Involvement in Care Coordination on Patient Outcomes in Sub-Saharan Africa.” PLoS Global Public Health 4 (2).
Boehm, L, M., H. K. Stolldorf, and M. B. Patel. 2021. “Family Presence in the Adult ICU: A Review of Best Practices.” American Journal of Critical Care 30 (4): 288–296.
Bowen, M. 1978. Family Therapy in Clinical Practice. New York: Jason Aronson.
Braun, V., and V. Clarke. 2006. “Using Thematic Analysis in Psychology.” Qualitative Research in Psychology 3 (2): 77–101. https://doi.org/10.1191/1478088706qp063oa DOI: https://doi.org/10.1191/1478088706qp063oa
Brown, T. A., and V. Clarke. 2006. “Thematic Analysis: A Practical Guide.” The Psychologist 19 (11): 80–83.
Byttebier, G. 2022. Underfunding in Public Health Systems: Causes, Consequences, and Solutions. Oxford: Oxford University Press.
Daniel, F., G. Mihretie, and Y. Assefa. 2022. “The Relative Impact of Environmental Upgrades versus Staff-patient Interactions on Perceived Care Quality in Ethiopian Hospitals.” BMJ Open 12 (5): e059234.
Dewi, S. K., and E. Nazriati. 2024. “Gaps in Psychosocial Care for Caregivers in Patient- and Family-Centered Care Implementation.” Journal of Patient Experience 11.
Emmamally, W. 2018. “Overcoming Healthcare Professionals’ Resistance to Family-Centered Care: Locus of Control and Partnership Building.” International Journal of Africa Nursing Sciences 9: 120–126.
Engel, G. L. 1977. “The Need for a New Medical Model: A Challenge for Biomedicine.” Science 196 (4286): 129–136. https://doi.org/10.1126/science.847460 DOI: https://doi.org/10.1126/science.847460
Falzarano, F., B. A. Pinto, R. A. Alvaro, and E. Vellone. 2022. “The Biopsychosocial Needs of Patients and Families: A Scoping Review.” Journal of Clinical Nursing 31 (17–18): 2447–2460.
Forsgren, E., A. Årestedt, and J. Öhlén. 2025. “Developing New Interpretations in Patient- and Family-Centered Care Research.” Nursing Inquiry 32 (1): e12589.
Gregory, S., A. Young, and P. D. Norton. 2023. “The Healing Environment Theory: Framing Physical Spaces as Integral to Holistic Care.” Health Environments Research and Design Journal 16 (2): 45–59.
Gwaza, E., and G. Msiska. 2022. “Family Involvement in Caring for Inpatients in Acute Care Hospital Settings: A Systematic Review of Literature.” SAGE Open Nursing 8. https://doi.org/10.1177/23779608221089541 DOI: https://doi.org/10.1177/23779608221089541
Hamukwaya, S. T. 2019. “The Traction of Family-Centered Care within the Namibian Healthcare System.” Namibian Journal of Health Sciences 3 (1): 28–35.
Hernandez, L., C. López, and M. Torres. 2023. “Ensuring Credibility in Qualitative Research: Member Checking and Peer Debriefing.” Qualitative Health Research 33 (1): 85–95.
IPFCC (Institute for Patient- and Family-Centered Care). 2010. “What is PFCC?” Accessed August 9, 2025. https://www.ipfcc.org/about/pfcc.html
Joo, J. Y. 2024. “Health Literacy and Plain Language Communication as Essential Components of Family-Centered Care.” Patient Education and Counseling 119: 108061.
Kehali, T., Y. Berhane, and A. Gize. 2020. “The Impact of Hospital Environments on the Experiences of Relatives of Admitted Patients.” Ethiopian Journal of Health Development 34 (1): 24–29.
Kojwang, B. 2021. “The Blend of Modern Medical Practices and Traditional Family Structures in Namibia’s Healthcare System.” Journal of Namibian Studies 29: 45–60.
Lasater, K. B., M. D. McHugh, and L. H. Aiken. 2021. “Nurse Staffing Ratios and Patient Outcomes: A Longitudinal Study.” Medical Care 59 (10): 889–895.
Lasater, K. B., M. D. McHugh, L. H. Aiken, D. M. Sloane, and E. French. 2019. “Patient Perceptions of Care Quality: The Influence of Nurse Staffing.” Journal of Nursing Care Quality 34 (3): 205–210.
Lechner, B. E., A. P. Meyer, and S. T. Nkosi. 2024. “The Paradox of PFCC: Burdening Families without Adequate Support.” Global Qualitative Nursing Research 11.
Liu, W., X. Chen, and J. Li. 2022. “Thick Description for Strengthening Transferability in Qualitative Health Research.” Qualitative Report 27 (1): 28–40.
Loomis, J. A., S. D. Block, and J. A. Tulsky. 2019. “Mindful Communication: Engaging Families as Partners in Care.” Journal of Palliative Medicine 22 (2): 153–158.
Marion, L., P. D. Smith, and T. J. Weber. 2024. “Addressing Current Issues to Enhance the Overall Healthcare Experience.” Health Affairs 43 (4): 512–520.
Martínez-García, M., C. López-Cano, and I. Torres-Sánchez. 2021. “Family Participation in Care: Reducing Stress and Enhancing the Healthcare Experience.” Journal of Clinical Nursing 30 (1–2): 72–81.
Meyer, A. P., P. D. Smith, and T. T. Nkosi. 2021. “Inductive and Deductive Coding in Thematic Analysis: A Practical Guide.” International Journal of Qualitative Methods 20: 1–10.
MoHSS (Ministry of Health and Social Services, Namibia). Annual Report 2022. Windhoek: MoHSS.
Moser, A., and I. Korstjens. 2021. “Practical Guidance to Sampling and Recruitment in Qualitative Research.” European Journal of General Practice 27 (1): 200–208.
Moulaisson, C. 2024. “Moral Distress among Nurses: Causes, Consequences, and the Impact on Relational Care.” Nursing Ethics 31 (2): 145–156.
Mutema, E. 2025. “Infrastructural and Policy Gaps in Family Inclusion within Hospital Protocol Development.” Journal of Health Policy and Planning 40 (1): 3–10.
Nowell, L. S., J. M. Norris, D. E. White, and N. J. Moules. 2017. “Thematic Analysis: Striving to Meet the Trustworthiness Criteria.” International Journal of Qualitative Methods 16 (1): 1–13. https://doi.org/10.1177/1609406917733847 DOI: https://doi.org/10.1177/1609406917733847
Palinkas, L. A., S. M. Horwitz, C. A. Green, J. P. Wisdom, N. Duan, and K. Hoagwood. 2020. “Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research.” Administration and Policy in Mental Health and Mental Health Services Research 42 (5): 533–544. https://doi.org/10.1007/s10488-013-0528-y DOI: https://doi.org/10.1007/s10488-013-0528-y
Patel, R., A. Singh, and V. Kumar. 2022. “Triangulation in Qualitative Research: Comparing Responses and Linking Accounts to Observations.” Qualitative Research Journal 22 (2): 200–210.
Polit, D. F., and C. T. Beck. 2019. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 11th ed. Philadelphia: Wolters Kluwer.
Powell, T., S. J. Jackson, and M. K. Chen. 2022. “Resource Dependency Theory and Healthcare: The Effect of Supply Chain Management on Care Reliability.” Health Care Management Review 47 (1): 52–61.
Ree, E., O. Østerås, and K. A. E. van Rijsbergen. 2020. “Nurse-Implemented Family Conferences to Reduce Stress in Critical Care: A Systematic Review.” Intensive and Critical Care Nursing 59. https://doi.org/10.1016/j.iccn.2020.102849 DOI: https://doi.org/10.1016/j.iccn.2020.102849
Reynolds, L., M. B. Davies, and C. E. Johnson. 2025. “Integrating Emotional Well-Being into Holistic Care Models for Patients and Families.” Journal of Holistic Nursing 43 (1): 15–28.
Saragosa, M., K. Kuluski, and B. Whitney. 2023. “Global Evidence on Family Involvement: Improving Medication Adherence, Reducing Readmissions, and Enabling Better Care Transitions.” Health Policy 127: 1–8.
Shields, L., J. Pratt, and J. Hunter. 2021. “Family Centred Care: A Review of the Literature.” Journal of Child Health Care 25 (2): 343–355.
Smith, P. D., A. P. Meyer, and T. T. Nkosi. 2020. “Poor Health Literacy and Unclear Medical Jargon: Contributors to Family Worry and Anxiety.” Patient Education and Counseling 103 (10): 2025–2032.
Stonestreet, J. S. 2014. “Structural Empathy: Beyond Individual Compassion in Healthcare.” Theoretical Medicine and Bioethics 35 (1): 1–15.
Thomas, J., and A. Harden. 2021. “Procedures for Data Collection in Qualitative Systematic Reviews.” In Systematic Reviews in Qualitative Research, edited by K. Seers and H. Lloyd, 101–110. London: Sage.
US DoHHS (United States Department of Health and Human Services). 2025. “Federal Policy for the Protection of Human Subjects.” 45 C.F.R. § 46. Accessed August 9, 2025. https://www.hhs.gov/ohrp/regulations-and-policy/regulations/common-rule/index.html
Wiedermann, W., A. von Eye, and C. Spiel. 2024. “Relational Coordination Theory: Sharing Timely and Accurate Information to Build Trust.” Journal of Applied Psychology 109 (2): 245–261.
WHO (World Health Organization). 2021. “Global Patient Safety Action Plan 2021–2030.” Accessed August 9, 2025. https://www.who.int/teams/integrated-health-services/patient-safety/policy/global-patient-safety-action-plan
Zamuee, N. K. 2022. “The Crucial Role of Families in Caregiving and Decision-Making in Rural Namibia.” Journal of African Health Sciences 22 (2): 345–351.
Zhang, W. 2024. “Maintaining Confidentiality and Anonymity in Qualitative Research: The Use of Pseudonyms.” Research Ethics 20 (1): 45–58.