Patients’ Perception of Doctor-Patient Health Communication in a Rural Community

Abstract

Heritage and Maynard (2006), which traced the main perspectives and lines of development that have emerged in 30 years of recorded doctor-patient interaction in the United States, concluded that it was difficult to generalise repeatedly observable medical interactions. Reasons provided were the complexities of disciplinary, methodological and ideological divisions that these authors (ibid.) viewed as relatively enduring features of the medical field. Based on the findings of that longitudinal study, it is logical to pursue effective healthcare provider-patient communication and to promote health literacy. A community approach could yield plausible solutions as patients mostly deal with the same healthcare providers and are likely to encounter similar communication challenges.In this study, the researchers sampled patients from different educational backgrounds. Considering doctors' tight schedules, often abstract health jargon on doctors' prescriptions, the volatility of oral communication in the explanation of instructions, and the fact that medicine labels in pharmacies in South Africa are written in English and Afrikaans only, there is a challenge of enhancing effective communication with patients. In addition, oral explanations by doctors and pharmacists can be inadequate or patients might forget the information. Consequently, patients are vulnerable to the incorrect interpretation of prescription instructions and medicine use that could have adverse effects on their health.It has to be acknowledged that some studies on health communication yielded positive health outcomes. Where oral communication is concerned, a study by Schillinger et al. (2003: 88), on the extent to which physicians assess patients' recall and understanding of information conveyed during an outpatient encounter, found the following: "Recall and comprehension was associated with improved glycemic control among patients with diabetes mellitus and low functional health literacy". However, Schillinger et al. (ibid.) pointed out that outcomes vary across racial, ethnic and socio-demographic lines, elaborating that "the prevalence of functional health literacy, especially among elderly persons, ethnic minorities and the socio-economically disadvantaged, coupled with the disproportionate burden that type-2 diabetes mellitus places on individuals, suggests that problems with health communication may contribute to disparities".Of interest to the current study is that evidence of positive findings in some studies include or refer to measures taken to improve communication. For example, an American study by Kennedy et al. (2014) focused on a peer-facilitated communication skills building course for service providers and patients at a clinic in Arizona. The findings indicated that service improved after the course and provider participants experienced an 18% decrease in patients' complaints. A study by Williams et al. (2013: 15), on patient reported barriers to provider-patient communication, indicated that a large number of patients co...

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“…This is a significant barrier to the expression of the need for SDM by the patient and the ability of the clinician to understand this need. 27 …”

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