Factors influencing Doctor-Patient communication: A case study of surviviors of gender based violence at Nairobi Women's Hospital
Otachi, Janet K
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The main objective of this study was to examine the factors influencing the interaction between doctors and the survivors of gender based violence. The study was conducted at The Nairobi Women's Hospital and focused on female survivors of Gender Based Violence, mainly those assaulted sexually. Data was collected through direct observation of the hospital's casualty area, interviewing of 10 doctors, 50 survivors of gender based violence and 4 key informants. The study found that majority of the survivors were youth aged between 18-24 years, had acquired basic education, were married, resided in middle and low class areas and had some form of income whether employed or owned businesses. The factors influencing doctor-patient communication were found to include, doctor's friendliness, non-judgmental attitude, good listening skills and concern. Majority of the doctors reported that they negotiated the treatment plan with their patients depending on their condition. Some patients needed urgent attention and had to be rushed to theatre therefore, they had no time to explain diagnosis. Doctor-patient communication gaps were reflected through such reports as doctor's reception was poor; he/she looked stem and rushed through the procedures. On the other hand, those who felt that the doctor explained procedures before undertaking them reported having asked before the explanation was given. They also reported that their doctor did not take time to explain diagnosis but instead wrote in a card and referred them for further tests. Majority of the doctors reported major challenges to doctor-patient interaction as language barrier, patient's illiteracy, trauma, time constraints and patient's personality. According to the key informants there is a communication gap in doctor patient interaction and a lot is attributed to the trauma faced by the survivors of sexual assault. When the patient feels understood and the care giver is empathetic and understanding, they feel satisfied with the intervention. The study concluded that having good communication skills is essential for doctors to establish good doctor patient interaction. There is a gap in doctor-patient interaction and extra effort to improve communication and relationship with patients would help reduce complaints due to dissatisfaction and improve compliance. Effective doctor-patient interaction and communication is central to doctor and patient satisfaction, to the clinical competence of doctors and to the health outcomes of their patients. The key recommendations were that doctors should have training in basic counseling skills since they are the initial contact persons with the survivors of sexual assault. They should also be empowered with communication skills to address patient's socio-cultural beliefs in a satisfactory manner.