ABSTRACT
Physicians, as
health care providers, require information to effectively carry out their
duties. They need relevant, accurate and up-to-date information when making
clinical decisions as the cost of wrong diagnosis could be fatal. It has,
however, been observed that the information behaviour of physicians in
government hospitals and the quality of their work delivery fall below
acceptable standards. Also, there is uncertainty as to what extent physicians’
information behaviour affect their work effectiveness. This study was therefore
carried out to investigate the relationship between information behaviour and work
effectiveness of physicians in selected government hospitals in Edo State,
Nigeria.
The study
adopted a survey research design. The population for the study comprised all
the physicians in general and tertiary hospitals in Edo State. Purposive
sampling was used to select 6 out of the 12 government hospitals because they
are well known. Since the population was not very large, census was used to
include all the 623 physicians in the study. A structured questionnaire titled
“Information behaviour and work effectiveness of physicians in government
hospitals in Edo State” (IBWEPQ) was used to gather data. The questionnaire was
validated and the Cronbach’s Alpha reliability test for the constructs yielded
0.728 for information needs, 0.986 for information retrieval and 0.756 for work
effectiveness. Out of the 623 copies of questionnaire administered, 516 (82.8%)
were retrieved for analysis. Six hypotheses were tested at 0.05 level of
significance. Descriptive and regressive/correlation inferential statistics were
used to analyze the data collected.
The findings
revealed a positive relationship between information needs of physicians and
their work effectiveness (r = 0.422: p< 0.05); a positive relationship
between information seeking behaviour of physiciansand their work effectiveness
(r = 0.090:p<0.05);a positive relationship
between information consulted and their work effectiveness (r = -0.159: p<0.05). However, there was a negative
relationship between information retrieval by physicians and their work effectiveness
(r = 0.004:p<0.05); a negative relationship
between information they usedand their work effectiveness (r = 0.605: p<0.05). The findings also revealed that
the major health information need of physicians in government hospitals in Edo
State was on treatment and test of patients (87.2%); the major sources of
information consultedincluded medical texts, colleagues and the Internet
(97.9%, 97.1%, 90.3%, respectively); the major challenges facing physicians in
government hospitals were ignorance of existing relevant materials, lack of
time and financial constraints (100%; 97.1%; 96.9%,
respectively); respondents’ commitment to organizational goals wasnot
satisfactory (34.4%).
The study concluded that financial
constraints and lack of time adversely affected physicians’ ability to access
relevant materials necessary for work effectiveness. The study recommended that
the management of government hospitals should boost their e-libraries and
provide better working conditions for physicians to enhance their service
delivery and commitment to organizational goals. Physicians in government
hospitals should be pro-active in updating themselves in general medical
knowledge in order to keep abreast emerging diseases.
CHAPTER ONE
INTRODUCTION
1.1 Background
to the Study
Physicians play
a critical role in the search for an acceptable quality of life. They make
decisions that positively or adversely affect the wellbeing of individuals and
populations. Since such decisions are based on information it is imperative to
know that the way physicians perceive, gather, and use information have serious
health and wellness implications. It is expected by stakeholders in a society
that is increasingly becoming health conscious and phenomenally advancing in
science that care providers, particularly physicians, cannot just do their work
in a perfunctory manner; but that the important task of bringing relief to the
sick should be done effectively and with a high sense of professionalism. Of
all professions, the medical profession may perhaps be singled out as a career
that should be least tolerant to mediocrity and a laissez faire attitude to
work. This is because there is much at stake in dealing with health issues. The
aphorism that “health is wealth” underscores the important role health plays in
the overall wellbeing of a nation. The productive capacity of a society is
inextricably tied to the health of the citizenry.
The Constitution
of the World Health Organization, which came into force on April 7, 1948,
defined health “as a state of complete physical, mental and social well-being”
(Sartorius, 2006: 662). Specifically, in Nigeria, the evolution of the health
care sector has come a long way and may be traceable to various
European expeditions in the early-to mid-nineteenth century (Chuke, 1988). The
early church missionaries played a major role in the establishment of health
care centres for the people. Indeed, the
first hospital in Nigeria was the Sacred Heart Hospital in Abeokuta, built by
the Roman Catholic Mission in 1885 (Scott-Emakpor, 2010). Nigeria has had
several National Development Plans in which health care delivery was a major
component. It has however been observed that she has not come close to
achieving the lofty objectives in the Development Plans. As a matter of fact,
services have hopelessly deteriorated to the extent that industrial actions by
all classes of doctors became the order of the day in the 1980s (Scott-Emakpor,
2010). It was at the same time in the 1980s that a Military Government in
Nigeria gave as a reason for the Military intervention in the deplorable state
of health services, declaring "our teaching hospitals have been reduced to
mere consulting clinics" (Cited in Scott-Emakpor, 2010:58). The situation
seems not to have changed much today.
The unsavoury situation in the Nigerian health sector
may have given rise to medical tourism for a range of care needs. According to the Nigerian Sovereign
Investment Authority (NSIA), Nigerians spend $1billion annually for medical
tourism (PwC, 2017). Instructively, the published Ministry of Health budget
proposal for 2016 totalled $1.3billion while total government expenditure was
$5.85billion for 2015 (PwC, 2017). The implication of this is that the cost of
medical tourism is almost 20% of the total expenditures on public sector care,
including capital and operating costs of all the health facilities nationwide.
Medical tourism constitutes a huge drain to the scarce resources and the
external reserves of the nation. It has a negative impact on the Nigerian
health sector and on the overall economy. In some of the surveys that have been
conducted to identify some of the factors that motivate patients to seek health
care abroad it has been found that a key theme running through the responses is
lack of trust in the local healthcare delivery system (PwC, 2017). There is
lack of confidence in medical treatment in Nigeria. The medical tourists feel that they will not
be given the correct treatment for their conditions; that the care will not be
delivered by healthcare professionals with the required competence; and that
there is no clear protocols to ensure proper diagnosis and treatment. In the
healthcare delivery system, like any other profession, relevant information is
crucial to the healthcare providers. Adequate, timely and accurate information
is, no doubt, a necessity in enhancing the health profile of any given society.
Reflecting on the vital role information plays in the
workplace and the society, Olatunji (2009) draws a relationship between
judicious use of relevant information and nation-building process. It is an
important tool for societal development and advancement. Alakpodia (2010) opined that one of the bases
of accessing whether a country is developed or not is the extent to which its
information availability and accessibility is enhanced to improve its
socio-economic growth. Basically,
information is the major key to every individual and organizational
success. Information plays a significant
role in our individual lives and our professions; it is a crucial feature of
production of good, service, consumption and exchange in the information
society. The global community has entered an era where the source of wealth and
power is increasing from information and human mental creativity as compared to
physical resources (Martin, 1995).
Information plays a crucial role in the workplace
setting of the physicians. For one to be informed, it is necessary to be armed
with the requisite information; thus information is vital in the life of any individual or
organization. Tiamiyu (2003) conceptualizes information as the meaning that a
person infers from some communicated data. This definition recognizes that
information is only formed in the minds of human beings as they interpret data.
It is also the outcome of conscious observations, thoughts and actions. Another
way of understanding the concept of information is to see it as statements of
facts, figures, ideas and creative works of the human intellect, which are by
way of reasoning interrelated and being communicated, recorded and distributed
formally in any format (Reitz, 2004). Information is not independent of social
practices. It serves as a reliable basis for adequate successful behaviour.
Without information, no individual or business can anticipate
circumstances.
Information feeds anticipation because the more information one
receives, the better an individual or business can anticipate and therefore
make informed decisions. Persons that can better anticipate situations become
masters of circumstances while people or organizations that cannot properly
anticipate their circumstances become victims of the situation. This also
applies to physicians because of the nature of their work. Physicians need to seek timely and accurate
information to better anticipate their job effectively and efficiently at the
end of the day.
Information behaviour is a concept that refers to how
an individual needs, seeks and uses information in different situations. Wilson (2000:49) defined information behaviour
as the “totality of behaviour in respect to sources and channels of
information, including both active and passive information seeking and
information use. Information behaviour
involves face-to-face interactions, as well as the passive receiving of
information.” Examples of passive
information behaviour may include information received from television or radio
without having any intention of acting on the information provided. On the
other hand, Wilson (2007: 8) further explained that information seeking
behaviour is “purposive seeking for information as a result of the need to
satisfy set goals.”
As
posited by Gorman (1995) the information need of physicians can be viewed in
four dimensions: (i) Unrecognized
needs. This type of need exists when
physicians are not aware of the information they need or their knowledge is
insufficient to fulfil the needs. Unrecognized needs should be known from
physicians’ knowledge of clinical practices.
This need cannot depend on information system because the user cannot
recognize their need. The potentials for
the use of automated reminder systems and diagnostic decision support systems
may be ignored because the physician would not know how to search for these
needs. (ii) Recognized needs are articulated by physicians as something needing
further examination although not always followed up. (iii) Pursued needs are recognized needs that are
followed up. (vi) Satisfied needs are recognized and pursued needs where
answers are found.
Olatunji, Ibegwan and Odugbemi (2002) affirmed that information need of
physicians is connected to issues on medical decisions that will involve the
area of specialization, educational level, and years of experience. For example, the paediatric physicians will
be in quest of information on how to handle children’s health conditions while
the obstetrics and gynaecologists will be interested in women information
related health issues in the emergency room. Other physicians seek for
information to handle cases that are before them in order to carry out their
work, effectively. In fact, physicians more often need information related to
patient-specific decisions, such as questions about treatment, diagnosis,
drugs and other medical opinions and patient management, information to
update their professional knowledge in general
and also for their understanding of a particular disease. Physician’s information need will lead to
information seeking.
Akpan-Atata (2012:15) “reveals that information needs often reflect the
age and changing socio-economic, health, family and personal circumstances of
people and are therefore not permanent but ever changing.’’ As rightly observed
by Ucak and Kurbanoglu (2008), information need and information seeking
behaviour are two of the most important research areas of the user’s studies
and they are two complementary concepts which are affected by many
factors. They further stated that
research carried out in these areas of user’s studies indicate that information
need and information seeking behaviour of physicians vary from one career to
another. So, such different needs and
behaviours necessitate information seeking behaviours. For information seeking to take place the
individual must be actively and consciously searching for information. Information seeking is a conscious effort to
gain information; and information behaviour is the ‘totality’ of all
information interactions from unintentional and passive encountering to active
seeking (Case, 2012).
Information seeking is a process and action undertaken
by an individual to locate current information from the various media available
in the libraries; that is, books encyclopaedias, journals and more currently
electronic sources, in order to make informed decisions. Information seeking is a behaviour when there
is a task to accomplish in an individual’s mind; for example, preparing to
write an examination, the individual actively seeks information by reading
books and having discussions with people until the need is satisfied (Kaur,
2010). Information seeking is a
conscious effort to acquire information to solve problems in daily
activities. Information seeking reveals
that there is a gap in the knowledge of the seeker and there is a desire to
bridge the gap; in order to fill up the gap the seeker interacts with the
information sources in the library or archival centres.
Nnadozie (2014) described sources of information as
carriers of information and this can be in the form of physical objects on
which information is recorded for preservation, utilization and dissemination,
such as books, periodicals, documents, newspapers and also in electronic media
( e.g. Internet and CD), but to mention a few.
They are transmitted orally, audio-visually and electronically. These are materials or sources from which
seekers find information, wisdom to be informed, and become knowledgeable that
will enable them to carry out their work effectively, in order to make
decisions and guide actions. These sources are considered to be reliable,
relevant, accurate, up-to-date, timely, comprehensive, credible and adequate
information for making useful, effective and efficient decision at workplace.
Again, Tiamiyu (2003) stated that information sources are documents generally
stored in different media print and non-print formats (such as books, journals,
newspapers, maps, paintings, computers, sound and video recordings, database on
various media). In addition, people themselves serve as important storehouse
and conveyors of information that is transmitted by printing, audio-visually
and electronically. Aina (2004) emphasized that users of information sources
must have the ability to use large and significant amount of stored
information. Therefore, there is need for accessibility and relevancy of information
since the use of information sources can effectively impact physician’s
clinical decisions and work effectiveness.
In submission, information sources refer to where to locate and retrieve
the information for problem-solving in order to be effectively and efficiency
at work place.
Information retrieval is concerned with searching for
materials that are relevant to users’ information needs (Dunlop and Reid,
1998). This view is corroborated by Mutshewa (2008) who noted that information
retrieval involves the retrieval of information from a collection which could
be a manual library catalogue, a database or Internet in response to
information for problem solving. It is essential for the physician to search
for specific information to make a clinical decision. Information retrieval may sometimes pose
little or no difficulty and at other times a huge challenge. For example, if
there are few information sources like 15-20 books available and information is
contained in two or more of them, it will be easy for one to browse through the
books to get the one that has the needed information. But if the number of
information sources from which to search for needed information is huge (say
about 15,000 volumes of book), then it becomes really difficult to go through
all the sources to get the needed information, so the physician is faced with
an information retrieval challenge. The physician may then need to depend on
information retrieval device to get the needed information. Harter (1986) defines information retrieval
as a device interposed between a potential user of information and the
collection of information itself.
Information retrieval system could be a library catalogue, an online
public access catalogue (OPAC), a CD-ROM or online database such as Ebscohost,
Jastor, Science direct, PubMed. These
retrievals help the users to access the needed information by acquiring
information and putting it to use.
Information use by physicians is based on diagnosis,
treatment, drugs and other medical opinions and work effectiveness. This has to do with the Physician’s use of
the right information which is accurate and relevant to make a clinical
decisions in day to day activities. There are different stages of use which can
be recognized. The first stage of use
simply involves examining whether information is worth using, the usefulness of
the information or whether it fails to satisfy need. The second stage is
whether the use of the information is relevant for meeting the need of good
clinical decisions that would help the physician’s practice. Information use is considered in respect to
the types of work to handle by the physician in the hospitals.
One of the most important aspects of physicians’ work
effectiveness is the availability and accessibility to right health information
which will enable them to manage patients’ case effectively. This involves
clinical decision-making and clinical judgment made by physicians to decide
specific aspects of cares such as diagnosis, choice of tests, and prescription of
drugs, surgery and therapy. Some of
these health information needed by the physicians include information about the
spread of particular diseases, to get information on patient-related treatment
and tests. Therefore, physicians needed to have access to relevant information;
this is especially the case for epidemiologists who examine the patterns of
illness in the population and try to know with accurate information why certain
groups or individuals develop a particular disease, whereas others do not. Such information is particularly relevant in
matters relating to a disease condition that is of public health issue. The
question as to why physicians need certain information to enhance their
productivity may further be explained by the critical nature of their work
which requires that before they can make clinical decisions they must seek adequate and right information at the right
time and at the right place. Accurate, relevant and adequate use of health
information is thus a very important aspect in the daily clinical practice of
the physician.
It must be reiterated that for physicians to be more
effective, succeed, and achieve their goals, timely and relevant health
information is highly necessary. Ibenne (2010) draws an analogy by saying that
information is like what the central nervous system is to the body. It
controls, directs and monitors the functioning of different organs of the
system. Therefore, having access to
credible, trustworthy and valid information at the right time, helps the
physicians to save the lives of patients.
It has, however, not been quite easy for a number of
physicians to attain optimum effectiveness in the manner they carry out their
routine tasks. The factors responsible for this are numerous; namely, the
individual, the organization, and the environment, to mention a few. Whereas
the individual physicians may have a large share of the blame as a result of
personal characteristics, the organization where they carry out their duties
cannot be absolved completely. Work has a way of impinging on workers’
effectiveness and productivity.
It can no longer be taken for granted the huge impact
technology makes on the effectiveness and efficiency of workers. Physicians
would therefore need to be abreast of recent trends in technological
advancement to hone their skills otherwise their methods would soon be outdated
thus affecting negatively their effectiveness. This is where the information
behaviour of physicians becomes very important since they would need to take
advantage of easy access to accurate, up-to-date and relevant information
offered by modern technology.
Non-availability of relevant information sources also hamper work
effectiveness of the physicians. Another factor is financial constraint; that
is, when the management of the hospitals are not willing to support financially
by providing necessary equipment for use.
Work effectiveness is one of the
important goals and values of any organization or institution in which an
individual works; it continues to exist as a crucial element in organizational
behaviour. It has been noted that
improving work effectiveness is one of the primary reasons for organizational
or institutional growth and success.
Work effectiveness is all about individual potential, aspirations and
contribution to organization or institution gains, effectiveness, and
survival. Work effectiveness is one of
the most essential factors within work, involving maintaining and increasing
productivity for organization or institution.
Conway (2015) noted that physicians cannot afford to ignore their work
effectiveness simply because it is only when their work effectiveness is
improved upon that they can render quality services and provide patients with
prompt attention. Yahya and Johari (2009) viewed work effectiveness as one of
the important indicators in managing organizational performance. They further explained that a growing
emphasis has been on employee work effectiveness as a source of competitive
edge to promote responsiveness in enhancing overall organizational
effectiveness. Work effectiveness can be
defined as doing the right thing at the time; that is, when the employee is
doing the job rightly and making continuous contributions in improving the
organization or institution (Abayomi, 2015).
Further, it refers to how workers deal with their works and how they
accomplish different tasks in the organization or institution.
Shadare and Hammed (2009) proposed the following guidelines to measure
work effectiveness: quality of work services delivery, information/knowledge of
patients records, physicians work
commitment and clinical decision making.
Whereas clinical judgment is useful in day-to-day management of
patients, access to relevant information sources needed by the physicians,
adequate information skill, sufficient computer-based services are equally
necessary for a better job performance.
The working place is vital to work effectiveness; this implies adequate
facilities that aid work effectiveness.
These include access to needed information, information seeking,
information sources, information retrieval and information use and of course a
conducive work place.
Work
effectiveness of physicians could be measured in an organization or hospital
through the following indicators: Quality of work service delivery, physicians
information/knowledge management of the patients, physicians work commitment to
organization or hospital values, clinical decision making. For physicians to be
effective at work place the ability to discharge quality high service to the
community it serves is very important.
Therefore, availability, accessibility and up-to-date information is
highly needed because effectiveness has to do with doing the right thing at the
right time (Nwachukwu, 2007; Mosadeghrad, 2013). In addition, work effectiveness has been
found to be a very effective way of improving and delivery service in the
medical field (Novack, Suchman, Clark, Epsein, Najberg and Kaplan, 1999). Impliedly, if there will be work
effectiveness in government hospitals in Edo State they will need to put in
place quality assurance standards for the organizations. This will ensure that service delivery and
effectiveness will not fall below standard. To measure standards for work effectiveness
will entail the following:
Patient’s
Information/knowledge management: This
has to do with managing patient’s information effectively and efficiently and
being able to take accurate and prompt decision. It also means to seek
knowledge, knowledge base search and retrieval tools to create new knowledge
collaborative decision-making process and support tools (Wyatt, 1991; Korthari,
et al, 2011) . Physicians’ effectiveness
in patients’ information management consists of tacit knowledge of patients. This type of information is considered
“health status” of patient own complex knowledge in current and past medical
conditions that the physicians may not know about (Abidi, 2001). However, such knowledge is vital for
physicians to know, especially when it comes to the diagnosis and prescription
treatments of illness.
Physicians
Work commitment: A great premium is to be placed on
organizational or hospitals’ values and this includes maintaining
confidentiality to patients, ensuring good relationship between colleagues and
patients, accountability for any course of actions in the organization (Freund,
2005). Work commitment is an internal decision which cannot be forced. It happens when one’s thoughts and emotions
are pointing to the same direction.
Clinical decision making: Sound and
practical decisions that are needed to deal effectively with critical
situations and are based on careful analysis and diagnosis. In other words, it
means clinical judgment made by physicians to decide specific aspects of care
such as diagnosis, choice of tests, prescription of drugs, surgery and therapy
(Mandin, Jones, Woloschuk and Harasym, 1997).
For effective work in the hospitals every physician
should be armed with the right information. The relevance of information to
effectiveness is that it is necessary for physicians to have access to
information which must be provided at the right time, in the right quality and
quantity (Menachemi, Langley and Brooks, 2007; Ndukwe, 2005). It should be located at the right place and
properly disseminated. Physicians need information to keep them abreast and to
inform others about the current discoveries in the field of medicine;
information is also crucial for better work effectiveness to make specific
clinical decision. Information is a
vital resource, a key currency for work effectiveness (Komolafe-Opadeji, 1999
and Zakari, 2015).
This study
provides a general picture of information behaviours and work effectiveness of
physicians in government hospitals in Edo State. The question may be asked, who
are physicians? Physicians may be described as persons who have been educated,
trained and licensed to practice the art and science of medicine (Stedman’s
Medical Dictionary, 2006; Dawes & Sampson, 2003). A practitioner of
medicine as contrasted with a surgeon is a person who formally and legally
accepts patients for admission to a health care facility. In other words, a
physician is a registered medical practitioner who specializes in the treatment
of diseases and disorders. They are also responsible for the patients care
throughout their stay in the hospital. Physicians work in three healthcare
levels: primary (e.g. family health centres, clinics, General Practitioners),
secondary (e.g. general hospitals) and tertiary (or specialist hospitals). This study focuses on physicians working in
secondary and tertiary hospitals who are identified as clinicians working in
hospitals. Almost all hospital
physicians specialize in a particular area of medicine or surgery, such as
anaesthetics, cardiology, ophthalmology, paediatrics or pathology.
Cheibi and Abba (2003) and Ajuwon (2015) affirmed that physicians have
vital roles in achieving health care goals of a given state or country;
updating knowledge with relevant information is very important for health
professionals to deliver quality and sustainable health care services to their
patients. However, this is possible only when there is sustainable access to
health information sources. Graham,
Fional and Colin, (2011) identified the duties of the physician as
follows: Physicians carry out duties
such as conducting medical histories and physical examination to assess the
patients, to investigate, and carry out diagnosis on chronic conditions. Diagnosis is a vital element of physician’s
expertise in medical practice and it is based on knowledge and strong
assessment skills. Also physicians work
collaboratively with the healthcare team to provide optimal care. This includes providing referrals to other
practitioners or services that the patient may need. They provide reports and updates of patient’s
condition and needs to other services such as physical therapists.
Another important role of physicians is that they provide continuous
care for the patient while in the hospital.
They manage and treat variety of medical conditions from minor cuts to
mental health to palliative care to surgery. Therefore, physicians need
information required to manage complexity and risk in situations that often
times are uncertain and changing.
Physicians play a vital role as an advocate for patients and
families. They help the patients go
through a complex medical system to be able to obtain most patient-centred care
in a cost effective manner. The physicians work to identify and meet the need
of the individual patient, the practice population and the community by working with a variety of partners in the community, public health
sector and hospital system. In addition,
physicians offer information that patients can use to make informed decisions
about their treatment plan. The work of the physicians are to keep their
professional knowledge and skills up-to-date; they also give patients the
information they need in a way they can understand. In addition, they are
personally accountable for their professional practice and always be prepared to
justify their decisions and actions.
Physicians seek for right information in order to manage the patient and
work effectively. Quite pertinent is the type of health information needs of
the physician and their use for clinical practices. Availability and
accessibility of information sources are very important, simply because they
require accurate, comprehensive information in order to treat patients
effectively and more also the lives of people are in their hands. In other words, access to a wide variety of
information is vital to physicians. But
few studies have been carried out to find out the information behaviours of
physicians working in government hospitals. Specifically, it is pertinent to
know the information behaviour and work effectiveness of physicians in Edo
state. But since so much has not been done in this area there is the need to
fill the gap in knowledge.
The present Edo State was carved out from the then Mid-West region, and
then later known as Bendel State. Edo State was created in 1991 out of the
former Bendel state which lies roughly between longitudes 060 04’E and 060 43’E
and latitudes 05044’ N and 07034’ N. It is bounded in the South by Delta State;
in the North by Kogi State and in the East by Anambra State. It occupies a land area of about 17,802
square kilometres (Fafunwa, 1974). From the 1991 census, the state has a
population of about 2,159,848. The 2014 population estimate is about 5 million.
The main ethnic groups in Edo state are Edos, Afemais, Esans, Owans and Akoko Edos.
Edo State people are agrarian, and they produce rubber, yam, cocoyam,
cassava, maize, melon, pineapple, plantain, banana, groundnut and cashew,
amongst other crops. The major occupations of these people are farming, trading
and fishing. The state is endowed with natural resources such as limestone,
clay, crude oil, wood products and aquatic products. Onoriode, Samson and
Ankomah (2012) affirmed that the vegetation are made up of mangrove and
tropical rain forest in the south and central zones and savannah woodlands in
the north. The income levels of the people are low and about 70% of them live
below the poverty line. Edo State is divided into 18 Local Government Areas
(LGAs) and 192 wards, grouped under three senatorial districts; namely Edo
North, Edo South and Edo Central. Among
the tertiary institutions in Edo State are the following: University of Benin,
Benin City; Ambrose Ali University, Ekpoma; Auchi Polytechnic, Auchi; Ekiadolor
College of Education, Benin City; School of Nursing, Benin City; University of
Benin Teaching Hospital, Benin City; School of Health, Benin City (Agbonlahor,
2002).
1.2 Statement of the Problem
Physicians need accurate and relevant information at the right time in
order to deal with current and emerging diseases as well as other health
related conditions. There is the perception which has been established over the
years by personal experience, and those of others, media reports and the
visible state of disrepair of healthcare infrastructure that the healthcare
delivered in Nigeria is of low quality. Since physicians are major stakeholders
in the healthcare delivery system of any nation, they can play a crucial role
in reversing the perception that many of the government hospitals in Nigeria
are mere consulting centres, a belief that has been reinforced by escalating
medical tourism. Specifically, the information behaviour of physicians in
government hospitals in Edo State may have contributed to the negative
evaluation of government hospitals. The way they gather and use information in
their day-to-day duties is a source of concern. Other areas of concern include
the physicians’ quality of work delivery and the level of professionalism in
their clinical decision-making. It would
also be interesting to know if there are significant relationships between
information needs, information seeking pattern, sources of information,
information access/retrieval, information use and work effectiveness of
physicians in government hospitals in Edo State.
1.3 Objective of the Study
The main objective of this study is to investigate the relationship
between information behaviour of physicians and their work effectiveness in
government hospitals in Edo State, Nigeria. The specific objectives are to:
1.identify
information needs of physicians in government hospitals in Edo State,
Nigeria;
2.
find
out the information seeking pattern of physicians in government hospitals in
Edo State;
3.
find
out the sources of information consulted by the physicians in government
hospitals under study;
4.
find
out physicians method of information retrieval in government hospitals in Edo
State;
5.
find
out the physicians’ information use in government hospitals;
6.
examine
the work effectiveness of physicians in government hospitals in Edo State;
7.
ascertain
the relationship between information needs of physicians and their work
effectiveness in government hospitals in Edo State;
8.
find
out the relationship between information seeking behaviour and work
effectiveness of physicians in government hospitals in Edo State;
9.
examine
the relationship between sources of information consulted and work
effectiveness of physicians in government hospitals in Edo State;
10. find out the relationship between physicians’
information retrieval and work effectiveness;
11. determine the relationship between information use and
work effectiveness of physicians;
12. investigate the composite relationship of information
needs, seeking behaviour, sources, retrieval, and use and work effectiveness of
physicians in government hospitals in Edo State, Nigeria and
13. find out the challenges encountered with information
seeking behaviour of physicians in government hospitals in Edo State.
1.4 Research Questions
In order to achieve the objectives of this study, the
following research questions are
posed:
1.
What
are the information needs of physicians in government hospitals in Edo State?
2.
What
are the information seeking patterns of the physicians in government hospitals
in Edo State?
3.
What
are the sources of information consulted by the physicians in government
hospitals under study?
4.
How
do physicians retrieve information in government hospitals in Edo State?
5.
What
do the physicians use information for in government hospitals in Edo State?
6.
How
effective are physicians in their work in selected government hospitals in Edo
state?
7.
What
are the challenges encountered with information seeking of the physicians in
government hospitals in Edo State?
1.5 Hypotheses
These six hypotheses were tested at 0.05 level of significance.
Ho1: There is no significant relationship between
information needs of physicians and
their work effectiveness in
government hospitals.
Ho2: There is no significant relationship between
information seeking pattern and work
effectiveness of physicians.
Ho3: There is no significant relationship between
sources of information consulted and
work effectiveness of physicians in
government hospitals
Ho4: There is no significant relationship between
information retrieval and work
effectiveness of physicians.
Ho5: There is no significant relationship between
information used by physicians and
their work effectiveness in
government hospitals.
Ho6: There is no significant
combined relationship of information needs, information
seeking pattern, sources of
information, information Retrieval, information
used and work effectiveness
of physicians in government hospitals in Edo State.
1.6 Scope of
the Study
This study
focuses on information behaviour and work effectiveness of physicians in
government hospitals in Edo state, Nigeria. This research is limited to
analysing various methodologies of information behaviour are (information
needs, Information seeking behaviour, sources, information retrieval,
information use) and work effectiveness are( quality of work service, patients
information/knowledge management, clinical decision making, and physicians work
commitment) of physicians in selected
government hospitals in Edo State. The study is restricted to the secondary
level hospitals and tertiary level hospitals in Edo State. It is limited only
to the physicians’ information behaviour and work effectiveness in making
clinical decisions from outpatients, inpatients, and emergency rooms in
government hospitals (that is, federal and state hospitals) in Edo state,
Nigeria.
1.7 Significance
of the Study
There are a number of ways this study would be beneficial to the
society. Specifically, it would make positive impacts on the health sector of
the economy, especially among physicians in the hospital management boards of
Edo State. This is because for physicians to be able to prescribe drugs and
manage patients’ cases effectively health information is very important.
In addition, it would create the needed awareness and sensitivity that
would ginger hospital management boards to provide good libraries with modern
Internet facilities. When physicians and other health professionals are able to
access resources both in print and non-print formats with ease improvement in
effectiveness and efficiency is bound to occur. Equally significant is the
knowledge gap, as a result of the paucity of published works on information
behaviour and work effectiveness of physicians in government hospitals in Edo
State, which the study is designed to bridge. Healthcare services occupy an
important and significant position amongst the decisions made by the
government. Health authorities are
seeking for an optimal way to improve the quality of healthcare in Edo State.
This study would help to meet the need.
Finally, the findings in this study would contribute to the general pool
of knowledge of the existing literature on the effectiveness of the physician
and their information behaviour generally
1.8 Operational Definition of Terms
In the context of this study, certain terms are either used differently
from the daily usage for some clarifications. Hence, their definitions are
necessary for a better and clearer understanding of this study.
1.
Information behaviour: This is the total behaviour showed by physicians in
the process of seeking for information useful to physicians work
effectiveness. It also refers to the
physician’s information need, seeking, sources and use for clinical
decision-making to provide better services to patients and improve quality
healthcare.
2.
Information need: This can be defined as a recognition that your
knowledge is inadequate to satisfy a goal that you have.
3.
Information seeking behaviour: This is all activities involved in purposive seeking
for information as a consequence of a need to satisfy some goals. Persons interact with 3 paths when seeking
for information: manual information
systems e.g. Newspaper or library,
computer-based systems such as www and human interaction (asking questions).
4.
Information sources: This is where information can be obtained by the
physicians, such as books, e-books, journals, e-journals, individuals or
interpersonal literature (CD-ROMs), databases and Internet.
5.
Information use: This has to do with physicians’ use of information
from books and the various sources for clinical decision-making in order to
achieve their goals and
objectives.
6.
Hospital: An institution providing medical
and surgical treatment and nursing care for sick or injured persons. Government
hospital is a health facility, owned by government, where the patients visit
whenever they are sick in order to consult with physicians and get treatment so
that they could be healthy.
7.
Physician: A person trained to practice medicine.
Physicians are healthcare workers who treat and assist patients with a
variety of problems and they work in three healthcare levels: primary (e. g.
family health centres and general practitioners), secondary (e.g. general
hospitals) and tertiary (specialist hospitals).
8.
Work effectiveness of physicians: This refers
to doing the right thing at the right time. Effectiveness deals with goals
achievement. To achieve this, physicians
need to have access to available, accurate, information sources and use them in
order to accomplish a specific purpose. Work effectiveness is the individual
potential contribution in an organization to achieve the organizational or
institutional assigned goals.
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