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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

Labhardt, Niklaus Daniel and Schiess, Kaspar and Manga, Engelbert and Langewitz, Wolf. (2009) 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. Patient education and counseling, Vol. 76. pp. 196-201.

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Official URL: http://edoc.unibas.ch/dok/A6003241

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Abstract

OBJECTIVE: This cross-sectional survey examines the relation between provider-patient interaction and several patient-outcomes in a rural health district in Cameroon. METHODS: We used structured patient interviews and the Roter Interaction Analysis System (RIAS) for analysis of audio-recorded consultations. RESULTS: 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: 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: Our findings should encourage providers to give more medical explanation, to discuss patients' health beliefs in a non-judgmental manner, and to consider financial issues more carefully.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Psychosomatik > Psychosomatik (Langewitz)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Psychosomatik > Psychosomatik (Langewitz)
UniBasel Contributors:Langewitz, Wolf Axel
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Elsevier Science
ISSN:0738-3991
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 May 2013 09:12
Deposited On:26 Apr 2013 06:52

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