“De perceptie van de arts-patiënt communicatie vanuit het standpunt ...

be.causehealth.be

“De perceptie van de arts-patiënt communicatie vanuit het standpunt ...

Masterthesis 2010

“The perception of the doctor-patient

communication from the perspective of the

patient in a health care centre in Nicaragua”

Nele RASSCHAERT

Eline SCHEIRE

Promotor: Prof. Dr. Myriam Deveugele

Co-promotor: Dr. Peter Decat


Content

1. Background

2. Research setting and goals

3. Methodology

4. Results

5. Discussion


1. BACKGROUND (1)

Modelo de Salud Familiar y Comunitario (MOSAFC)

A new health care model in Nicaragua

Goals:




• Accessible care

• Integrated care

• Continuity of care

• Cooperation between different health care providers

Importance of an integrated primary health care system

Changing doctor-patient relationship

Central role of communication

BUT: problems with the implementation!


1. BACKGROUND (2)

Evidence regarding doctor-patient communication

Adequate communication = benefits for the doctor ánd the patient

Literature:

Western Countries:

Patient-Centred Care

Shared Decision Making

Developing countries:

Disease-oriented care, a more biomedical aproach

Medical paternalism


2. RESEARCH SETTING

What? Cross-sectional study

Were? Semi-rural health centre Gaspar Garcia

Laviana, San Juan del Sur

Who? Patients older than 15 years old

When? July 16 th – August 12 th 2009

Why? Responding the questions:

- What is important regarding the doctor-patient communication

according to the patients?

- To what extent does the doctor currently meet the patient’s

expectations?

- How can the doctor improve the communication to fit better with

these expectations?


3. METHODOLOGY

Quantitative part

Questionnaire: QUOTE-Communication (NIVEL)

Data handling: Chi-square test

Bivariate Logististic Regression

Significance level: P < 0.05


Qualitative part

Semi-structured interviews with patients


4. RESULTS (1)

Quantitative part: 218 complete questionnaires

Important for the patient: - that they were listened to

- that a diagnosis was made

- that they were given explanation

Expectations least fulfilled regarding:

- taking part in the decision making process

- discussing the different treatment options

- receiving information about possible adverse effects

The mean waiting time: 2h36min


4. RESULTS (2)

Correlations between:

Continuity of care and

- Taking enough time for the consultation

- Giving more explanation



Taking enough time and

- Doctor: empathy, physical examination,

listening, shared decision making

- Patient: less concerns

Asking all questions and

- The doctor listening more and giving more

explanation


4. RESULTS (3)

Qualitative part: 6 interviews

Limited accessibility and availability of care

- long waiting time

- insufficient availability of (free) medication

- lack of a professional attitude of the secretary and nurses

About the medical care the patients were generally

satisfied.

Perception that care in private sector was better

Fear to speak (badly)


5. DISCUSSION

Doctor-patient communication in developing countries is (at least) as

important as in Western countries

The continuity of care already has a positive effect

Certain expectations towards the consultation were already met.

Active participation of the patient should be encouraged

- Shared Decision Making

- Patient empowerment

It is important to take enough time for the consultation

The long waiting time is a bottleneck

Limitations of the study

More research on doctor-patient communicaion in developping

countries is needed


Thank you!

Similar magazines