Communication skills of general practitioners in Nairobi, Kenya: a descriptive observational study

Abstract

BackgroundHigh quality primary care is associated with person-centeredness and effective communication that also supports continuity and coordination of care. In Kenya, there is little knowledge about the quality of communication in consultations by general practitioners (GPs).AimTo evaluate the quality of communication by GPs.Design & settingDescriptive, observational study of 23 GPs consultations in 13 private sector primary care facilities in Nairobi, Kenya.MethodOne consultation with a randomly selected adult patient was recorded per GP, and 16 communication skills evaluated with the Stellenbosch University Observation Tool. A total percentage score was calculated per consultation, and compared with the GPs’ demographics, consultations’ complexity and duration using the Statistical Package for Social Sciences.ResultsThe GPs’ median age was 30.0 years (IQR: 29–32) and median consultation time was 7.0 minutes (IQR =3–9). Median overall score was 64.3% (IQR: 48.4–75.7). They demonstrated skills in gathering information, making and explaining the diagnosis and suggesting appropriate management. They did not make an appropriate introduction, explore the context or patient’s perspective, allow shared decision making or provide adequate safety netting. There was a positive correlation between the scores and duration of the consultations (r=0.680, P=0.001). The score was higher in consultations of moderate complexity (78.1; IQR =57.1–86.7) versus low complexity (52.2; IQR =45.1–66.6) (P=0.012).ConclusionConsultations were brief and biomedical by young and inexperienced GPs. GPs needed further training in communication skills, particularly with regard to person-centredness. Deploying family physicians to the primary care setting would also improve the overall quality of service delivery.

Patients with severe mental illness and their carers’ expectations for GPs’ communication skills: a qualitative approach in Spain

“…It has also been shown to reduce the hyperutilization of primary care consultations 11 . We can therefore affirm that CS during the care interaction between doctor and patient are an essential tool 12 . These skills acquire special relevance when the patient suffers from SMI 13 .…”

“… 11 We can therefore affirm that communication skills during the care interaction between doctor and patient are an essential tool. 12 These skills acquire special relevance when the patient has an SMI. 13 …”

Towards an Effective Communication in the Care of Patients with Long Term Disease in Kenya via Cybernetic—A Systematic Review

“…Another manuscript that we reviewed having meet the requirement of an Effective Communication in the care of Patients with long term Disease in Kenya was a descriptive observational study (Mohamoud & Mash, 2022) [20] that evaluated the quality of communication in consultations by general practitioners (GPs) in Nairobi, Kenya. The study found that while GPs demonstrate skills in gathering information, making diagnoses, and suggesting management, there are areas for improvement in terms of patient-centered care and communication skills.…”

“…Though their weaknesses were that GPs did not make an appropriate introduction, explore the context or patients' perspectives, allow shared decision making, or provided adequate safety netting. Their consultations were brief and had a biomedical approach, lacking skills in whole-person medicine (Mohamoud & Mash, 2022) [20]. Furthermore, GPs lacked training in effective communication skills, particularly in delivering person-centred consultations and that the quality of communication was negatively impacted by the young and inexperienced GPs, who dealt with low-to-moderate complexity and mostly acute problems.…”

“…The audio recordings were assessed using the Stellenbosch University Observation Tool (SUOT), which evaluated 16 communication skills (Louw et al, 2020) [21]. The Statistical Package for Social Sciences (SPSS) was used to analyze the data (Mohamoud & Mash, 2022) [20].…”