Healthcare Provider Patient Communication on Diabetes Mellitus Management Practices in Selected Hospitals in Kenya

Abstract

Diabetes is one of the most significant and growing chronic health problems in the world and represents one of the leading causes of disability due to complications. The main objective was to examine the effect of healthcare provider patient communication on diabetes mellitus management practices in selected hospitals in Kenya. The study was carried out at the outpatient diabetic clinics of Kenyatta National Hospital and MP Shah Hospital. The study was anchored on Uncertainty Reduction Theory and Communication Accommodation Theory. This was a causal comparative research design study, with application of quantitative and qualitative methodology. Systematic random sampling for patients and purposive sampling for healthcare providers was used sampling. The sample comprised 421 participants: 400 patients and 21 healthcare providers. Questionnaires administered on patients and self-administered research questionnaires for healthcare providers were used as study instruments. Using SPSS, data was analyzed by utilizing descriptive statistics (mean, median, and percentages) and inferential statistics (chi-square, independent t-test, regression analysis, and Analysis of Variance). First, on patients’ outcome; it established those nonverbal communicative behaviours and environmental context had statistically significant effect on diabetes mellitus management practices overall and similarly observed at Kenyatta National Hospital while at MP. Shah Hospital, only the environmental context had statistically significant effect on diabetes mellitus management practices. According to patients as regards the healthcare providers demographic characteristics of age, gender and the patient’s own socio economic status; only the female healthcare providers gender had statistically significant moderating effect in Kenya overall and at Kenyatta National Hospital and not at MP Shah Hospital. Secondly, on healthcare providers’ outcome, the study established that verbal language use had statistically significant effect on diabetes mellitus management practices overall, at KNH and not at MP Shah Hospital. Nonverbal communicative behaviour had statistically significant effect on diabetes mellitus management practices at MP Shah Hospital and was not the case in Kenya overall and at Kenyatta National Hospital. Patients demographic characteristics of age, gender and the healthcare providers own socio-economic status had no statistically significant moderating effect on DMMPs overall, at KNH and MP Shah Hospital. In conclusion, nonverbal communicative behaviour, overall and at KNH; environmental context, overall, at both KNH and MP Shah Hospital and the female healthcare provider gender, overall and at KNH as per patients: On the other hand, verbal language use, overall and at KNH, nonverbal communicative behaviour at MP Shah Hospital as per the healthcare providers were responsible for improvement in diabetes mellitus management practices. It is thus recommended that healthcare provider patient communication be addressed in healthcare practice; encompass all cadres of the healthcare providers and in all kinds of healthcare settings, public and private as it is still not quite effective in fostering diabetes management practices. Introduce provider patient communication in academic curriculum in training institutions as a requirement in medical practice to train providers on communication skills in general, as well as patients who need to be aware of the core dimensions of patient‐provider communication.