Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.
Family Medicine, McGill University, Montreal, Quebec, Canada.
Pan Afr Med J. 2020 Sep 25;37:88. doi: 10.11604/pamj.2020.37.88.24009. eCollection 2020.
patient-centred care has become a rallying call for improving quality and access to care in countries where health system responsiveness and satisfaction with health services remain low. Understanding patient-provider interactions is important to guide implementation of an effective patient-centred care approach in sub-Saharan Africa. This review aims to overcome this knowledge gap by synthesizing the evidence on patient-provider interactions in sub-Saharan Africa.
we conducted a scoping review using Arksey and O´Malley´s framework. We searched in eight databases and the grey literature. We conducted a thematic analysis using an inductive approach to assess the studies.
of the 80 references identified through database searching, nine met the inclusion criteria. Poor communication and several types of mistreatment (service denial, oppressive language, harsh words and rough examination) characterize patient-provider interactions in sub-Saharan Africa. Nevertheless, some health providers offer support to patients who cannot afford their medical expenses, cost of transportation, food or other necessities. Maintaining confidentiality depends on the context of care. Some patients blamed health providers for consulting with the door open or carrying out concomitant activities in the consultation room. However, in the context of HIV care provision, nurses emphasized the importance of keeping their patients´ HIV status confidential.
this review advocates for more implementation studies on patient-provider interactions in sub-Saharan Africa so as to inform policies and practices for patient-centred health systems. Decision-makers should prioritize training, mentorship and regular supportive supervision of health providers to provide patient-centred care. Patients should be empowered in care processes.
以患者为中心的护理已成为提高医疗质量和改善卫生服务可及性的口号，在卫生系统响应性和对卫生服务满意度较低的国家尤其如此。了解医患互动对于指导撒哈拉以南非洲实施有效的以患者为中心的护理方法至关重要。本综述旨在通过综合撒哈拉以南非洲医患互动的证据来弥补这一知识空白。
我们使用 Arksey 和 O'Malley 的框架进行了范围综述。我们在八个数据库和灰色文献中进行了搜索。我们采用归纳法进行了主题分析，以评估研究。
通过数据库搜索确定的 80 篇参考文献中，有 9 篇符合纳入标准。沟通不畅和几种类型的虐待（拒绝服务、使用压迫性语言、恶言相向和粗暴检查）是撒哈拉以南非洲医患互动的特征。然而，一些卫生保健提供者为无法支付医疗费用、交通费用、食物或其他必需品的患者提供支持。保持保密性取决于护理的背景。一些患者指责卫生保健提供者在咨询时开门或在咨询室同时进行其他活动。然而，在艾滋病毒护理提供方面，护士强调保持患者艾滋病毒状况的保密性非常重要。
本综述倡导在撒哈拉以南非洲进行更多关于医患互动的实施研究，以为以患者为中心的卫生系统提供政策和实践依据。决策者应优先考虑对卫生保健提供者进行培训、指导和定期支持性监督，以提供以患者为中心的护理。应在护理过程中赋予患者权力。
