The role of communication in cancer consultations; An exploratory study of doctor-patient-family caregiver communication in Uganda and Ethiopia.
Abstract: Doctor-patient communication is essential for quality of health care. Little has been done aboutdoctor-patient communication in Africa in general, and in Uganda and Ethiopia in particular.In this study, we focus on two issues. First, we describe and analyze how doctors, cancerpatients and family caregivers experience their communication concerning a) generalexperiences and satisfaction; b) breaking bad news to cancer patients and their family caregiversand the ways patients and family caregivers receive bad news, c) language usage duringconsultation meetings, and d) the cultural issues that influence patients’ health seekingbehaviors in Uganda and Ethiopia. Second, we analyze public awareness about cancer diseasesin both countries.Methods: both qualitative and quantitative methods were used. In both countries, 27 doctors,86 patients, 43 family caregivers were interviewed and 46 doctor-patient-family caregiverinteraction video recordings were made. We transcribed all the video recordings and part of theinterviews. In addition, 284 questionnaires were analyzed. We used simple descriptivestatistics.Results: a). Doctors experience challenges associated with influx of patients, language barriers,illiteracy levels, lack of cancer awareness, inabilit ies/unwillingness of patients and familycaregivers to ask questions. Patients and family caregivers are not satisfied with the informationabout cancer and the manner in which doctors give them information, complain about nurses’attitudes and physical environment. There is great need of information about cancer disease. b).Public perception about cancer diseases is low in all age groups, female respondents hear moreabout the disease but male respondents have more knowledge about the scourge, and more needfor information about cancer.Conclusion: Many patients and family caregivers need more information about cancer yet theirdoctors underestimated their need. Problems associated with doctor-patient and doctor-familycaregivers’ communication are so frequent and negatively influence patients’ emotional andpsychological wellbeing. Some of the most common problems include patients’ inability to askquestions, lack of communication skills by doctors, influx of patients and language barriers.Some of these problems can be eliminated if doctors get communication skills training.Communication as a course has to be emphasized in the medical school curriculums in order toequip physicians with the skills needed to succeed when communicating with patients and theirfamily caregivers. More so, the masses should be sensitized about cancer disease since now itkills more people than HIV, Malaria and Tuberculosis combined.
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