Expectations of combatants regarding the responsiveness of the healthcare system to their needs during rehabilitation

Abstract

A sustainable healthcare system is the foundation of social well-being and a key factor in achieving the sustainable development goals of nations, particularly during times of military conflict. Armed conflicts present significant challenges to healthcare systems, especially in terms of their ability to respond sensitively to the needs of military personnel during comprehensive rehabilitation. Objective: To evaluate the expectations of combatants regarding the responsiveness of the regional healthcare system to their needs during rehabilitation and to identify key opportunities for improving the patient-centeredness of rehabilitation services. Materials and Methods. The study included 49 combatants undergoing rehabilitation in healthcare facilities in Dnipro, Ukraine. A sociological research method was used, involving standardized interviews with a questionnaire based on the components of responsiveness defined by the World Health Organization, assessed using a ten-point Likert scale. Data analysis was conducted using Microsoft Excel and R Commander (version 4.2.1) with descriptive and inferential statistical methods, including correlation-regression analysis. Data were summarized through weighted averages and their confidence intervals (CI). Results were considered statistically significant at p<0.05. Results and Discussion. The average score for healthcare system responsiveness during the rehabilitation of combatants ranged from 8.2 (95% CI 7.5–8.8) for freedom of choice of healthcare providers to 9.8 (95% CI 9.6–10.0) for respect for patient dignity. The most consistent ratings were observed in the components of respect for dignity, confidentiality, and quality of living conditions. The overall level of responsiveness of the healthcare system during rehabilitation was rated at 8.9 (95% CI 8.6–9.2). Correlation analysis revealed statistically significant relationships between various elements of responsiveness, such as respect for dignity, confidentiality, timeliness of care, and access to social support (r=0.30 ÷ 0.70; p<0.05). Linear regression analysis confirmed that the key determinants of healthcare system responsiveness were respect for patient dignity, confidentiality, and the quality of living conditions. Conclusions. The study demonstrated a high demand among combatants for a patient-centered rehabilitation system that ensures respect for dignity, quality living conditions, effective communication, confidentiality, and access to social support.