Provider–patient interaction in rural Cameroon—How it relates to the patient's understanding of diagnosis and prescribed drugs, the patient's concept of illness, and access to therapy
文摘
ObjectiveThis cross-sectional survey examines the relation between provider–patient interaction and several patient-outcomes in a rural health district in Cameroon.Methods<p>We used structured patient interviews and the Roter Interaction Analysis System (RIAS) for analysis of audio-recorded consultations.Results<p>Data from 130 primary care consultations with 13 health-care providers were analysed. 51 % of patients correctly named their diagnoses after the consultation; in 47 % of prescribed drugs patients explained correctly the purpose. Patients’ ability to recall diagnoses was related to the extent of clarity a provider used in mentioning it during consultation (recall rates: 87.5 % if mentioned explicitly, 56.7 % if mentioned indirectly and 19.2 % if not mentioned at all; p < 0.001). Two thirds of patients were able to describe their concept of illness before the consultation, but only 47 % of them mentioned it during consultations. On average patients who mentioned their disease concept were faced with more remarks of disapproval from providers (1.73 vs 0.63 per consultation; p < 0.01). Although 41 % of patients admitted problems with financial resources to buy prescribed drugs, discussion about financial issues was very rare during consultations. Providers issued financial questions in 32 % , patients in 21 % of consultations.Conclusion<p>This study shows that provider–patient interaction in primary health care in a rural Cameroon district deserves more attention. It might improve the patients’ knowledge about their health condition and support them in beneficial health behaviour.Practice implications<p>Our findings should encourage providers to give more medical explanation, to discuss patients’ health beliefs in a non-judgemental manner, and to consider financial issues more carefully.
