Assessment of Communication Barriers Between Health Care Providers and Caregivers of Children With Sickle Cell Disease at Kenyatta National Hospital

Abstract

Background: Sickle cell disease (SCD) is the most common genetic disease in the world and is associated with significant morbidity and mortality. Assessment of gaps in caregiver-provider communication is a crucial step in enhancing better practices in the future and improving the outcomes for the patients, providers and society as a whole. Study objectives: To assess the barriers to effective communication among health care providers (HCPs) and caregivers of children with SCD at Kenyatta National Hospital (KNH). Caregivers’ perceptions on the communication status and ways of improving communication was explored. Methods: Mixed-methods. A cross sectional survey conducted among 91 caregivers of children with SCD and 72 HCPs (doctors, nurses and clinical officers) at KNH. Qualitative methodology employed comprised two focus group discussions (each with eight caregivers), and four key informant interviews with nursing matrons. Results: Short consultation time (41.2%), use of technical terms by health care providers (18.2%) and lack of privacy during consultation (10.7%) were the main barriers of communication reported by the caregivers. High workload (86.8%), insufficient time (55.9%) and lack of training on communication skills (27.9%) were perceived barriers to communication reported by HCPs. The key suggestions provided by HCPs and caregivers were: ensuring communication is comprehensive, conducting seminars and trainings on communication skills and increasing the number of HCPs. Conclusion: It was concluded that HCPs should be trained on effective communication skills particularly on the use of simplified medical terms. In addition, it is crucial to provide comprehensive information whilst ensuring privacy is maintained during the consultation. It was proposed that an innovative brief written guide with visual aids be incorporated.