Health Literacy and Doctor-Patient Communication among HIV/Aids Patients in Homa Bay County, Kenya

Abstract

Effective health provider-patient communication, a precursor to building a wholesome, trusting relationship, has been recognized as a vital factor in cultivating suitable self-management practices among patients with chronic infections like HIV/AIDS. However, inadequate health literacy among patients is a well-known barrier to effective doctor patient communication. Therefore, the goal of the study was to investigate the influence of health literacy on doctor patient communication among patients with HIV/AIDS in Homa Bay County in Kenya. Specifically, focused on the influence of, communicative, functional and critical health literacy, as well as patient demographics' moderating effect on doctor patient communication. It was a cross- sectional, hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay County. Data was collected using a self-administered structured questionnaire. Cronbach's alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while the Chi-square test was used to establish the relationship between demographic factors and doctor patient communication. Logistic regression and multiple logistic analyses were used to measure the independent variables' influence on the dependent variable. In summary, 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. Gender, educational level, marital status, and illness duration were all significantly associated with doctor patient communication in this study at p values less than 0.05. The respondents' functional and communicative health literacy levels were inadequate at weighted means scores of 3.23 (SD 1.31) and 3.392 (SD1.152), respectively. Most respondents described doctor patient communication as effective (mean score 3.60, and SD 1.164). Even though functional, communicative, and critical health literacy all had a significant positive influence on doctor patient communication, the study established that critical health literacy had the greatest influence (Nagelkerke R square=0.461) followed by communicative health literacy (Nagelkerke R square= 0.408) and functional health literacy (Nagelkerke R square= 0.318) respectively. The findings of this study have placed health literacy at the center of doctor patient communication. Therefore, effort should be made to profile patients with inadequate health literacy for special consideration during hospital visits if meaningful interaction is to be achieved, especially in the context of chronic conditions like HIV/AIDS.