Health dialogue elements present during health communication between patients with diabetes and nurses in a Northern Cape local municipality

[摘要] Patients and nurses in health facilities interact daily with the purpose of improvinghealth outcomes. However, it is not known to what extent the elements of healthdialogue are incorporated into each individual patient and nurse interaction. Aconcept analysis of 'health dialogue laid the foundation to identify the presence ofthe antecedent and empirical referent health dialogue elements during healthcommunication between patients with diabetes and nurses in the Northern Cape.The objective of the study was to assess, through observation, the presence of thehealth dialogue elements, namely, antecedents, which are a positive attitude,sensitivity and respect, and training; and empirical referents, which comprise sharedresponsibility and decision-making, a mutually beneficial health plan and contextsensitivecommunication strategies.A quantitative, non-experimental, descriptive, cross-sectional research design wasused. Data were collected using an observational checklist aided by a guideline atpublic and private health facilities (n=16) in the Sol Plaatje local municipality locatedwithin the Frances Baard District. Patients with diabetes (N=88) and nurses (N=22)were observed while they interacted during one-on-one consultations (n=88). Eachnurse interacted with more than one patient. Audio-recordings of interactions wereused to verify and support observations.Data analysis was carried out using descriptive statistics, namely, frequencies andpercentages for categorical data, medians and percentiles for continuous data,calculated per group, and comparing nurse and patient responses. McNemar's test orBhapkar's test was applied to compare the statistical difference in responses betweenthe nurses and the patients.Inconsistencies (48.8%) in the presentation of the health dialogue antecedent elementsand sub-elements of positive attitude and sensitivity and respect during nurse-patientinteractions, were noted. The antecedent element findings for training noted nursetraining in diabetes (19.3%) and in communication skills (30.6%), whilst patient trainingand information about diabetes (48.7%) and communication skills (3.4%) were found.In accordance with the concept analysis of health dialogue, the inconsistencies notedin the presentation of antecedent health dialogue elements imply that it was not likelythat the empirical referents could be realised. However, both nurses and patients statedthat the empirical referent elements of shared responsibility/decision-making, a healthcare plan of mutual benefit and the application of context-sensitive communicationstrategies to convey health messages were experienced during the study.These findings indicate that both nurses and patients are unable to incorporate theantecedent health dialogue elements during interaction with one another. In addition,nurses and patients appear to be ill-prepared to include participatory healthcommunication and health dialogue in interaction.Capacity building of both nurses and patients is recommended to enhance participatoryhealth communication.

[发布机构] University of the Free State