دورية أكاديمية
أعرض في EDS

Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia.

التفاصيل البيبلوغرافية
العنوان: Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia.
المؤلفون: Kebede BG; Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden., Abraha A; Department of Surgery, School of Medicine, Health Science College, Addis Ababa University, Addis Ababa, Sweden., Andersson R; Department of Infectious Diseases, Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Munthe C; Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden., Linderholm M; Ersta Hospital, Stockholm, Sweden., Linderholm B; Department of Oncology, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg and the Sahlgrenska University Hospital, Gothenburg, Sweden., Berbyuk Lindström N; Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden.
المصدر: PloS one [PLoS One] 2020 Mar 13; Vol. 15 (3), pp. e0230309. Date of Electronic Publication: 2020 Mar 13 (Print Publication: 2020).
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Caregivers/*psychology , Neoplasms/*epidemiology , Patients/*psychology , Physicians/*psychology, Adult ; Communication ; Ethiopia/epidemiology ; Female ; Hospitals, Teaching ; Humans ; Male ; Middle Aged ; Neoplasms/psychology ; Neoplasms/radiotherapy ; Patient Care ; Physician-Patient Relations
مستخلص: Background: Cancer is a growing concern in Ethiopia. Though communication is essential for the treatment process, few studies have looked at communication in Ethiopian cancer care. Due to the large number of patients and scarcity of resources, it is vital to understand how to manage consultations in order to effectively help as many patients as possible in this challenging work environment. Thus, research is needed to analyze and understand the communicative challenges experienced by physicians, patients, and family caregivers, in order to successfully handle patient care in practice.
Objective: We explore communication in Ethiopian cancer care and present the main challenges faced by physicians, patients, and family caregivers.
Methods: This explorative qualitative study was conducted at the Oncology Department of the Tikur Anbessa (Black Lion) Specialized Teaching Hospital (TASH) in Addis Ababa, Ethiopia. A triangulation of data collection methods was used: 91 audio-recorded, semi-structured interviews and 21 video-recordings of authentic interactions during hospital rounds. The aim was to obtain as complete a picture as possible of communication from the perspectives of physicians, patients, and family caregivers. The interviews were analyzed using thematic content analysis and the identified themes were supported by excerpts from the transcribed recordings.
Results: Eight themes emerged from the data. Workload and time pressure, in combination with restricted space for privacy, limited the possibilities for physicians to deliver detailed information and provide emotional support. Furthermore, patient literacy levels, in combination with no or little cancer awareness, financial problems, reliance on traditional and religious treatments, the stigma of cancer, and a fatalistic attitude, resulted in delays in patients seeking care and participating in positive health behaviors, and, subsequently, often resulted in an unwillingness to openly discuss problems with physicians and adhere to treatment. The study also illustrates the paramount role of family in physician-patient communication in Ethiopia. Though family caregivers provide a valuable interpreting support when patients have limited language skills, they can also prevent patients from sharing information with physicians. Another important finding is that family caregivers were often responsible for making decisions about treatment and avoided telling patients about a poor prognosis, believing that conveying bad news may upset them. All of these themes have important implications for the role of ethically acceptable communication in patient-centered care.
Conclusions: This study has identified a number of serious challenges for successful and ethically acceptable health communication in Ethiopian cancer care. The study contributes to our understanding of the complexity around the role of family, combined with patients' dependency on family members for communication, support, and access to care, which creates particular ethical dilemmas for the medical staff. The questions raised by this study concern how to organize consultations to achieve patient-centered health communication, while maintaining a constructive alliance with the family and not jeopardizing the patient's continued access to care. The integration of communication training for medical students in Ethiopia, with a focus on ethical guidelines for family-centered patient consultation suitable for these circumstances, would be an essential step.
Competing Interests: The authors have declared that no competing interests exist.
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تواريخ الأحداث: Date Created: 20200314 Date Completed: 20200626 Latest Revision: 20200626
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC7069641
DOI: 10.1371/journal.pone.0230309
PMID: 32168353
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0230309