School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda.
Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
PLoS One. 2018 Apr 4;13(4):e0195269. doi: 10.1371/journal.pone.0195269. eCollection 2018.
Delivery of effective healthcare is contingent on the quality of communication between the patient and the healthcare provider. Little is known about primary healthcare providers' perceptions of communication with patients in Rwanda.
To explore providers' perceptions of patient-provider communication (PPC) and analyse the ways in which providers present and reflect on communication practice and problems.
Qualitative, in-depth, semi structured interviews with nine primary health care providers. An abductive analysis supplemented by the framework method was applied. A narrative approach allowed the emergence of archetypical narratives on PPC.
Providers shared rich reflections on the importance of proper communication with patients and appeared committed to making their interaction work optimally. Still, providers had difficulty critically analysing limitations of their communication in practice. Reported communication issues included lack of communication training as well as time and workload issues. Two archetypes of narratives on PPC issues and practice emerged and are discussed.
While providers' narratives put patients at the centre of care, there were indications that patient-provider communication training and practice need further development. In-depth exploration of highlighted issues and adapted strategies to tackle communication drawbacks are prerequisites to improvement. This study contributes to the advancement of knowledge related to communication between the patient and the provider in a resource-limited setting.
有效的医疗保健服务取决于患者和医疗服务提供者之间的沟通质量。关于卢旺达基层医疗服务提供者对与患者沟通的看法,我们知之甚少。
探索提供者对医患沟通(PPC)的看法,并分析提供者呈现和反思沟通实践和问题的方式。
对 9 名基层医疗服务提供者进行定性、深入、半结构化访谈。采用归纳分析,并辅以框架方法。叙事方法允许医患沟通的典型叙事出现。
提供者对与患者进行适当沟通的重要性进行了丰富的反思,并表现出致力于使他们的互动达到最佳效果的意愿。然而,提供者很难批判性地分析他们在实践中沟通的局限性。报告的沟通问题包括缺乏沟通培训以及时间和工作量问题。医患沟通问题和实践的两个叙事原型出现并进行了讨论。
尽管提供者的叙述将患者置于护理的中心,但有迹象表明,医患沟通培训和实践需要进一步发展。深入探讨突出问题和适应策略以解决沟通障碍是改进的前提。本研究有助于在资源有限的环境中增进医患沟通相关知识的发展。