Assessment of doctor-patient communication at Adama Hospital Medical College: A symbolic interactionist perspective

Abstract

This study followed a symbolic interactionist theoretical framework and positivist paradigm to assess doctor-patient communication at Adama Hospital Medical College (AHMC). Specifically, it assessed the communication competencies of medical doctors (with their own inpatients), investigated how inpatients interact with their doctors and evaluated the major barriers to doctor-patient medical communication. A descriptive, explanatory, and cross-sectional study designs were followed. Out of 66 medical doctors of AHMC, 36 were selected as they were more directly and highly involved with bed-ridden patients in six wards and the remaining 22 were much more occupied with teaching and the management of the hospital and were not readily available for this study. A total sample size of 180 (144 patients + 36 medical) respondents were included. An SPSS 16 was used for presenting quantitative data and emerging themes guided the qualitative data analysis. The study found out that all medical doctors practice greeting socially and treat patients with due respect. The qualitative data indicated that some doctors exhibited communicative competence failures, and some lacked the cultural competence needed to comprehend traditional expressions. Due to heavy workload, some medical doctors show lack of interest. However, almost all doctors confirmed that they show interest in the patient’s ideas about their health. Generally, doctors allocated little time with patients who were not in a very critical situation. Almost all medical doctors assumed that they devoted their time to understand the main health concerns of patients and gave much attention. Those patients from the rural communities were often interrupted because they did not talk about their illnesses openly. This implies that some medical doctors lacked a profound knowledge of cultural communicative competence. Patients used traditional and vague expressions. Factors such as avoiding medical jargons, recounting the next steps, giving much care and concern, apportioning sufficient time, and writing legibly have been considered as major elements influencing medical communication. In the three factors (showing interest, understanding, and giving attention), doctors have been evaluated good communicators. This current study identified communication barriers and their possible causes. Some of these barriers have been caused due to poor communication skills, lack of the proper sense of confidentiality, the misuse or inappropriate use of medical jargons, lack of spacious workspace, language difference, the patients’ low level of understanding sickness, patients’ low level of education, inappropriate use of cultural and vague expressions, poor time allocation, patients’ taking too much time due to unnecessary repetitions, the gap between substantive lab evidence versus oral evidence and lack of family partnership and responsibility. Among other suggestions, the study recommends that the hospital needs to design a communication strategy to address these communication gaps.