'He should feel your pain': Patient insights on patient-provider communication in Rwanda.

Vincent K Cubaka,Janvier B Kayitare,Laetitia Nyirazinyoye,Per Kallestrup,Helle T Maindal,Phil Cotton,Michael Schriver

doi:10.4102/phcfm.v10i1.1514

Vincent K Cubaka, Janvier B Kayitare + Show 5 more

Open Access

https://doi.org/10.4102/phcfm.v10i1.1514

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Abstract

BackgroundPatient–provider communication is an interpersonal interaction between a patient and a health care provider.ObjectiveThis study explored patients’ communication preferences and perceptions on what factors influence the patient–provider communication in primary health care settings in Rwanda.MethodsIn-depth semi-structured interviews with 15 individuals including 8 with limited literacy. A thematic inductive analysis was used.ResultsPatients valued communication with providers and expressed the need for interacting with caring, empathic providers who can share all the information they want and involve them in their own care. Health literacy and power issues were factors that may influence patient–provider communication. Patients with limited literacy appeared to rely highly on health care providers for making decisions about and managing their health care.ConclusionThe expressed preferences, including those of patients with limited literacy, aligned well with the patient-centred care model. There were indications of a power imbalance weighing on the provider’s side. Although patients with limited literacy were reliant on providers for decision-making, they were ready to be more involved in the care, suggesting a potential for improved patient involvement even for patients with paternalistic care preferences. These patients’ insights can impact policies and curricula to optimise clinical practice. Generated knowledge will contribute to the indispensable yet underdeveloped field of health communication in sub-Saharan Africa.Practice implicationsFindings call for more inclusion of patient perspectives in the patient–provider encounter. This could require more training of professionals and research on the topic, both in Rwanda and in other regions.

Highlights

Patient–provider communication (PPC) is a critical component of health care and may influence patients’ health outcomes and well-being directly and indirectly.[1,2]Patient–provider communication is an interpersonal interaction between a patient and a health care provider
Our study shows that patients, with limited literacy, may have strong though modifiable preferences for paternalistic health care providers
This study suggests that limited literacy may be linked to a number of health literacy problems and warrants further study on how best to approach this vulnerable group

Summary

Introduction

Patient–provider communication is an interpersonal interaction between a patient and a health care provider (referred to as provider). Exploring opinions of PPC actors is a prerequisite to the quest for optimising PPC, improving patient care.[3] During a clinical encounter, interests and expectations of the provider may differ from that of the patient, making it important to explore patient views; this is well summarised in one publication as: ‘Listen to the patients. They will tell you what they want and need’.4.

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