Reasons for inpatients not to seek clarity at Dr George Mukhari Academic Hospital, Pretoria.

Langalibalele H Mabuza,Indiran Govender,John V Ndimande,Olufemi B Omole

doi:10.4102/phcfm.v6i1.576

Abstract

BackgroundHealthcare practitioners should provide patients with information regarding their clinical conditions. Patients should also feel free to seek clarity on information provided. However, not all patients seek this clarity.ObjectivesTo explore the reasons inpatients gave for not seeking clarity on information that was received but not understood.MethodsThis was a qualitative arm of a larger study, titled ‘Are inpatients aware of the admission reasons and management plans of their clinical conditions? A survey at a tertiary hospital in South Africa’, conducted in 2010. Of the 264 inpatients who participated in the larger study, we extracted the unstructured responses from those participants (n = 152) who had indicated in the questionnaire that there was information they had not understood during their encounter with healthcare practitioners, but that they had nonetheless not sought clarity. Data were analysed thematically.ResultsThemes that emerged were that inpatients did not ask for clarity as they perceived healthcare practitioners to be ‘too busy’, aloof, non-communicators and sometimes uncertain about patients’ conditions. Some inpatients had unquestioning trust in healthcare practitioners, whilst others had experiences of bad treatment. Inpatients had poor self-esteem, incapacitating clinical conditions, fear of bad news and prior knowledge of their clinical conditions. Some inpatients stated that they had no reason for not seeking clarity.ConclusionThe reasons for not seeking clarity were based on patients’ experiences with the healthcare practitioners and their perceptions of the latter and of themselves. A programme should be developed in order to educate inpatients on effective communication with their healthcare practitioners.

Highlights

Countries world-wide have adopted and adapted The Patients’ Rights Charter which seeks to address comprehensive healthcare for patients.[1,2,3,4] a patient’s right to access information has been assured in each country’s charter, the realisation of this ideal is in the hands of individual healthcare institutions.It is the right of every patient whose clinical condition warrants admission to a healthcare institution to be made aware of the clinician’s working diagnosis, the reason for the admission and the inherent risks of non-admission
We identified seven healthcare practitioner-related and five patient-related themes
This study sought to explore the reasons given by inpatients for not seeking clarity on information received from healthcare practitioners on their clinical conditions

Summary

Introduction

The patient needs to be updated constantly with regard to the management plan, including the estimated length of hospital stay, investigative procedures, medication and any operative procedures envisaged It has been shown in patients with tuberculosis that raising awareness about the patient’s condition improves patient cooperation with healthcare practitioners[5] and guides them toward realistic expectations with regard to the healthcare team’s abilities.[6] On the other hand, patients who receive poor communication from their physicians have been found to have a 19% higher risk of non-adherence to treatment, compared with those who received adequate communication.[7].

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Discussion

Conclusion