Background:The changing pattern in the doctor-patient relationship is becoming more of a challenge for health care providers. For a healthy and effective doctorpatient relation, trust and communication is considered to play a vital role.Aim: This literature review was conducted with the aim to gather the knowledge and concepts pertaining to communication and trust in a doctor-patient relationship and how they influence patient satisfaction and perceived quality of health care services.Method: Various electronic databases including PubMed, Hinari, Cochrane, Scopus and Google Scholar were used to search for the articles. Related article titles were selected which was narrowed down to abstract of interested articles and the final 17 selected full articles were reviewed.Results: All the articles reviewed showed that both trust and communication were positively related to patient satisfaction and perceived quality of health care services in-terms of better compliance with medication and following medical advice; both in developed and developing country. Though, the determinants of trust differed slightly between rural and urban setting. Apart from the doctor's communication skills, level of interpersonal treatment and knowledge about the patient, respect for the doctors and treatment assurance lead to better trust as well in rural setting. Patient -centered communication with two-way conversation using open-ended questions leads to better communication. Collaborative decision-making leads to better management and better chances of compliance with treatment. Conclusion:The current evidence suggests that patient-centered approach with effective communications skills and trust leads to better management and improved patient satisfaction. This is associated to better adherence to the treatment, better health outcomes and better perceived quality of healthcare services.

Background: With evolving health care industry toward patient centered orientation, inputs from the patients' perspective is valuable. Improved patient satisfaction is associated with increased levels of adherence to treatment processes and recommended prevention, and improved health outcomes. Hence, this study was conducted to assess the current level of patient satisfaction and explore its determinants in the Suva Subdivision health centers, Fiji, 2018. Methods: This was a mixed method cross-sectional study employing both quantitative and qualitative designs. A random sample of 410 participants attending the outpatient services completed the self-administered structured questionnaire. The questionnaire focused on socio-demographic features, waiting time, doctors' communication, and patient trust. Data from 375 questionnaires (response rate of 91%) was analyzed in SPSS where descriptive analysis and univariate and multivariate logistic regression was done at 0.05 level of significance and 95% confidence interval to find the determinants of patient satisfaction. From these 375 participants, 20 participants were purposefully selected for audio recorded interview guided by a semi-structured questionnaire and data was analyzed using thematic analysis. Results: The majority of the patients were generally fully satisfied with their consultation (69.3%). Univariate logistic regression showed that age, gender, education level, waiting time, doctors' communication behavior, and patient trust level were significantly associated with patient satisfaction independently. After controlling for all the variables, gender, number of visits, waiting time, and patient trust were significantly associated with trust. Those who had full trust in the doctors, were more likely to be fully satisfied with their consultation (aOR of 18; p = 0.0001) and those who got seen within 1 h, were more likely to be satisfied with their consultation (aOR of 3.3; p = 0.0001). Though, the patients voiced that getting a satisfying consultation was worth the wait. The doctors' attitude and way of communication also made a difference to the patient's level of satisfaction. Conclusions: This study showed that patient satisfaction is positively associated with patient trust, doctors' interpersonal skills and communication behavior and negatively associated with waiting time. Hence, doctors upgrading their communication skills and health service managers strategizing ways to improve waiting time can contribute to better patient trust and thus lead to better patient satisfaction and positively influence health outcomes.

Objective: This study aims to identify the level of knowledge, attitudes and practices of family planning among women of reproductive age in Suva, Fiji in 2017. Methods: A quantitative, cross-sectional study using a self-administered questionnaire among women of reproductive age who attended three designated health clinics around Suva, Fiji from 15 th March to 28 th April 2017 was used. Using random sampling, those who met the inclusion and exclusion criteria of the study were asked to fill a questionnaire survey. Once the data was collected, it was analyzed with SPSS. Results: About 325 women participated in the study with the mean age of 31.53(± 7.35). Less than half (148 or 45.5 %) of the participants had a good level of knowledge towards family planning whereas 178 (53.5%) of them had a moderate level of knowledge of family planning. An overwhelming majority of the participants (176 or 54.2%) had high level of attitudes towards family planning. Only 3% of the respondents showed poor level of attitude towards family planning. With regards to practice, the participants showed a poor level of practice of family planning at 80 (24.6%) whereas those with good level of practice of family planning constituted only 31 (9.5%). Conclusion: This study provides a useful source of empirical information to policy makers to achieve the desired goals in family planning. These findings of the study will help health care providers promote family planning in Fiji.

Background. Adolescent Sexual and Reproductive Health (SRH) remains a challenge globally. This study aims to gauge the perceptions of parents towards the delivery of SRH education in mainstream public secondary schools in Fiji. Methods. The qualitative study design was used to collect the data from parents in Suva, Fiji, from July to August 2018. A semistructured questionnaire was developed to run Focus Group Discussion (FGD) among parents residing in Suva who had school-attending children from years 11 to 13. Parents were recruited from five schools with the help of students. Twenty-six parents of which 10 were males, aged between 38 and 65, participated in this study. Consent was obtained from each participant prior to the data collection stage. Data collected were transcribed verbatim and were analyzed thematically. Ethical approvals were obtained before collecting the data. Results. Seven themes emerged which included the provision of school-based sex education, parental involvement with school-based sex education, sex education at home, age-appropriate incremental sex education, ethnic variations regarding sex education, barriers and facilitators for the delivery of school-based sex education, and perceived ideal version of sex education. Conclusions. Findings from this study suggest for policy and programs to match parents, schools, and students’ expectations. Effective interventions need to involve and help parents to take a more active part to change policy, program, and advocacy for relevant SRH education.

Introduction: Modifiable and non-modifiable risk factors contribute to the significant rise of non-communicable diseases (NCDs), most notably cardiovascular disease (CVD), in the Pacific Island nations. The aim of this study is to review previously published articles to understand common modifiable and non-modifiable risk factors of CVD among Pacific countries. Methods: This systematic review is conducted using different databases including; Scopus, Medline, EMBASE, and psycINFO. This systematic review is based on the Cochrane review process. All articles published in the English language from 1 st January 2000 to 1 st September 2016, will be included in the study. After reviewing all of the articles' titles, abstracts, and full text, the final articles were reviewed and the relevant data was included in the data extraction sheet. A descriptive analysis was conducted to measure the common risk factors of CVD in Pacific countries. Results: Overall, 45 articles met the inclusion criteria of the study. The results showed that age was the most common non-modifiable risk factor while diabetes, high blood lipid, and high blood pressure were the most common modifiable risk factors of CVD. There were only three interventional studies which had all of the significant influences in reducing the risk factors of CVD when the results were compared with the control group. Conclusion: While it is not possible to change the non-modifiable risk factors for CVD, we encourage policy makers to use the results of this study to develop health promotion strategies to address the modifiable risk factors for CVD. Interventional strategies are highly recommended in the Pacific countries to tackle the modifiable risk factors for CVD.