CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

Patient-doctor communication is a very important and essentialbranch of clinical practice. Once it is handled appropriately, it will surely have no choice but to yield a curative effect for the patient, as has been validated in controlled studies. The rate or way in which a doctor conveys information to a patient is as paramount as the information being communicated. Patients, who understand their doctors well are more likely to dictate health problems, understand their treatment options, enhance their behavior as needed, and follow their medication schedules. Previous and numerous research works have shown that effective patient-doctor communication have the power to improve a patient's health as quantifiably as many drugs, probablymaking available a partial explanation for the powerful placebo effect seen in clinical trials.

Over the years, doctors were seen to hone their “soft” communication skills at patients' bedsides, in their rounds as residents, and as students at the elbows of master clinicians. But today, the communication and interpersonal skills of the doctor-in-training are no longer seen as fixed personal styles that transcended during residency but, instead, as a set of measurable and changeable behaviors that can unfold. On the basis of some up and coming literature on the value of effective communication, medical students and postgraduates are continuously given instruction on methods and strategies for listening, explaining, questioning, counseling, and motivating.

Effective patient-doctor communication has been correlated with patient outcomes, together with satisfaction and care, adherence to treatment, and enhanced health status. Research has pointed out numerous factors that affect or influence technical and interpersonal exchange in the patient-doctor relationship, together with verbal and nonverbal communication, empathy and patient-centered care, patient counseling, efficient transmittal of information, rapport, and informed collaborative choice and patient participation. Effective communication has to do with better physical and functional health outcomes among patients with diabetes, for instance, just because of relationships to patient adherence and enhanced chronic disease self-management.

Patient commitment and participation in care, together with question asking, information substitute, and shared decision-making, are to a large extentrelated with the way the health of some patients turn out, specifically, when these are reinforced by doctors. Though patients differ considerably in the information they make available, and doctors also differ in their responses to patients’ communication, demand for information, and zest to be effective participants in their care, patients seem to be more satisfied and experience lesser symptoms and health issues or challenges when they are able to have their needs for information met. Presently, health psychologists and medical educators have gone a long way in both research and otherwise to find outthe best way to inculcate communication skills to doctors and medical students in order to enhance and improve the process and quality of patient care.Numerous training programs have been introduced and weighed, and the assessment of doctors’ communication skills has recently been added to medical board certification. These efforts to enhance and improve and also measure communication skills are timely, as the limitations or constraints to effective communication between patients and doctors are growing. Irrespective of theattestationsshowing that the average length of the patient-doctor encounter has not changed significantly over the years, specific survey data shows that there is a correlation between patient participation in capitated health plans and shorter office visits.

STATEMENT OF THE GENERAL PROBLEM

The increase in the occurrences of diabetes in Nigeria has been a cause for major concern as it has been established that most people are either diabetic or prone to having it in the future. This menace may be as a result of the eating habit or general lifestyle while some attribute it to being genetically transmitted from parent to offspring. Whichever is the case, the effective communication between diabetic patients and health practitioners has deteriorated overtime and this has regrettably increased the diabetes related mortality. Many have attributed the deteriorated communication to illiteracy and poverty while others have been of the opinion that the health practitioners have not done enough in ensuring open communication with diabetic patients.

AIMS AND OBJECTIVES OF THE STUDY

The major aim of the study is to examine the influence of doctor patient communication in ensuring the effective management of diabetes. Other specific objectives of the study include;

1. To find out the correlation between patient-doctor communication and effective diabetes management.
2. To access the factors limiting effective doctor-patient communication
3. To evaluate the impact effective doctor-patient communication has on diabetes patients
4. To recommend ways of ensuring a better communication between doctor patient communication in the effective management of diabetes.

RESEARCH QUESTIONS

1. What is the influence of doctor patient communication in ensuring the effective management of diabetes?
2. What is the correlation between patient-doctor communication and effective diabetes management?
3. What are the factors limiting effective doctor-patient communication?
4. What is the impact effective doctor-patient communication has on diabetic patients?
5. What are ways of ensuring a better communication between doctor patient communications in the effective management of diabetes?

RESEARCH HYPOTHESIS

H0: There is no relationship between patient-doctor communications in the effective management of diabetes.

H1: There is a relationship between patient-doctor communications in the effective management of diabetes.

SIGNIFICANCE OF THE STUDY

The study would be of immense importance to the effective management of diabetes as it would highlight ways of improving the management of diabetes through effective doctor patient communications. The study would also be of importance to students, researchers and scholars who are interested in developing further study on the subject matter.

SCOPE AND LIMITATION OF THE STUDY

The research is restricted to the influence of doctor patient communication in ensuring the effective management of diabetes in Port Harcourt Rivers state.

LIMITATION OF THE STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

DEFINITION OF TERMS

PATIENT: a sick individual especially when awaiting or under the care and treatment of a physician or surgeon the hospital is equipped to handle 500 patients.

DIABETES: a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood.

COMMUNICATION: the act or process of using words, sounds, signs, or behaviors to express or exchange information or to express your ideas, thoughts, feelings, etc., to someone else.

References

Brédart A., Bouleuc C., Dolbeault S. Doctor-patient communication and satisfaction with care in oncology. CurrOpinOncol. 2005;17((14)):351–354. [PubMed]

Brinkman W. B., Geraghty S. R., Lanphear B. P., et al. Effect of multisource feedback on resident communication skills and professionalism: a randomized controlled trial. Arch PediatrAdolesc. 2007;161((1)):44–49. [PubMed]

Duffy F. D., Gordon G. H., Whelan G., et al. Assessing competence in communication and interpersonal skills: the Kalamazoo II report. Acad Med. 2004;79((6)):495–507. [PubMed]

Hall J. A., Roter D. L., Rand C. S. Communication of affect between patient and physician. J Health SocBehav. 1981;22((1)):18–30. [PubMed]

Henrdon J., Pollick K. Continuing concerns, new challenges, and next steps in doctor-patient communication. J Bone Joint Surg Am. 2002;84-A((2)):309–315. [PubMed]

van Zanten M., Boulet J. R., McKinley D. W., DeChamplain A., Jobe A. C. Assessing the communication and interpersonal skills of graduates of international medical schools as part of the United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS) Exam. Acad Med. 2007;82((10 Suppl)):S65–S68.[PubMed]

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