The role of communication in cancer consultations; An exploratory study of doctor-patient-family caregiver communication in Uganda and Ethiopia.

Abstract

Doctor-patient communication is essential for quality of health care. Little has been done about doctor-patient communication in Africa in general, and in Uganda and Ethiopia in particular. In this study, we focus on two issues. First, we describe and analyze how doctors, cancer patients and family caregivers experience their communication concerning a) general experiences and satisfaction; b) breaking bad news to cancer patients and their family caregivers and the ways patients and family caregivers receive bad news, c) language usage during consultation meetings, and d) the cultural issues that influence patients’ health seeking behaviors in Uganda and Ethiopia. Second, we analyze public awareness about cancer diseases in both countries. Methods: both qualitative and quantitative methods were used. In both countries, 27 doctors, 86 patients, 43 family caregivers were interviewed and 46 doctor-patient-family caregiver interaction video recordings were made. We transcribed all the video recordings and part of the interviews. In addition, 284 questionnaires were analyzed. We used simple descriptive statistics. Results: a). Doctors experience challenges associated with influx of patients, language barriers, illiteracy levels, lack of cancer awareness, inabilit ies/unwillingness of patients and family caregivers to ask questions. Patients and family caregivers are not satisfied with the information about cancer and the manner in which doctors give them information, complain about nurses’ attitudes and physical environment. There is great need of information about cancer disease. b). Public perception about cancer diseases is low in all age groups, female respondents hear more about the disease but male respondents have more knowledge about the scourge, and more need for information about cancer. Conclusion: Many patients and family caregivers need more information about cancer yet their doctors underestimated their need. Problems associated with doctor-patient and doctor-family caregivers’ communication are so frequent and negatively influence patients’ emotional and psychological wellbeing. Some of the most common problems include patients’ inability to ask questions, lack of communication skills by doctors, influx of patients and language barriers. Some of these problems can be eliminated if doctors get communication skills training. Communication as a course has to be emphasized in the medical school curriculums in order to equip physicians with the skills needed to succeed when communicating with patients and their family caregivers. More so, the masses should be sensitized about cancer disease since now it kills more people than HIV, Malaria and Tuberculosis combined.