Factors associated with patients’ understanding of their management plan in Tshwane clinics

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Authors

Fernandez, Leticia
Rossouw, Theresa M.
Marcus, Tessa S.
Reinbrech-Schutte, Angelika
Smit, Nicoleen
Kinkel, Hans-Friedemann
Memon, Shehla
Hugo, Johannes F.M.

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Volume Title

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AOSIS Open Journals

Abstract

BACKGROUND: This research focused on patients’ views regarding healthcare services and identified factors associated with understanding of their management plan. AIM: To develop a baseline for patient–clinician collaboration and the extent to which patients felt included and understood their treatment plan. SETTING: Tshwane district (South Africa) public health outpatient clinics. METHOD: Medical students interviewed 447 patients in 22 clinics in Tshwane district. Agreement was measured by the percentage of cases in which patients and clinicians were in accord about a particular aspect of the consultation. RESULTS: About one-third of patients incorrectly answered questions on whether changes in lifestyle or diet were prescribed as part of their treatment. The likelihood that patients understood their plan was associated with seeing the same clinician three or more times; having a consultation in their same or a similar language; patient participation in the diagnosis; and feeling that the clinician had explained their health problems to them. CONCLUSIONS: There is need for greater emphasis on continuity of care, the clinicians’ ability to speak the patient’s language and involving patients in the consultation.
PRESENTATION: Cette étude se concentrait sur les points de vue des patients concernant les services de santé et les facteurs identifiés associés à la compréhension de leur plan de prise en charge. OBJECTIF: Développer une référence pour la collaboration entre patients et médecins et déterminer la mesure dans laquelle les patients avaient le sentiment d’être inclus à la préparation de leur plan de prise en charge et de le comprendre. CADRE: Centres médicaux publics accueillant des patients en consultation externe dans le district de Tshwane (Afrique du Sud). METHODE: Des étudiants en médecine ont interrogé 447 patients dans 22 centres médicaux dans le district de Tshwane. La concordance était mesurée par le pourcentage de cas dans lesquels les patients et les médecins étaient d’accord sur un aspect particulier de la consultation. RESULTATS: Environ un tiers des patients n’a pas su répondre correctement aux questions visant à déterminer si des changements dans leur style de vie ou régime alimentaire avaient été prescrits dans le cadre de leur traitement. La probabilité que les patients comprennent leur plan était associée au fait de consulter le même médecin à trois reprises ou plus, de consulter dans leur langue ou dans une langue similaire, de participer au diagnostic, et au sentiment que le médecin leur avait expliqué le problème de santé dont ils souffraient. CONCLUSIONS: Il est nécessaire de mettre davantage l’accent sur la continuité de la prise en charge, la capacité des médecins à parler la langue de leurs patients, et l’implication des patients dans la consultation.

Description

The authors are indebted to the 2012 class of fifth-year students who took part in this research. We thank them for their commitment to the project as well as their insightful feedback.
J.H. (University of Pretoria) was the project leader. J.H., A.R. and T.R. (University of Pretoria) conceptualised and designed the study. L.F., T.R., N.S. (University of Pretoria) and H.K. and S.M. (University of Pretoria and Foundation for Professional Development) were responsible for experimental and questionnaire design. T.M. (University of Pretoria) made significant conceptual contributions to the article. L.F., T.M. and T.R. conducted the analysis and interpretation of the findings and prepared the manuscript. N.S. contributed to data collection and preparation.

Keywords

Patients, Understanding, Management plan, Tshwane, Clinics

Sustainable Development Goals

Citation

Fernandez L, Rossouw T, Marcus T, Reinbrech-Schutte A, Smit N, Kinkel HF, et al.Factors Associated with Patients’ Understanding of their Management Plan in Tshwane Clinics. Afr J Prm Health Care Fam Med. 2014;6(1), Art. #560, 9 pages. http://dx.DOI.org/ 10.4102/phcfm.v6i1.560