Participation by clients and nurse midwives in family planning decision making in Indonesia

Kim, Young Mi; Kols, Adrienne; Putjuk, Fitri; Heerey, M; Rinehart, W; Elwyn, Glyn; Edwards, Adrian

doi:10.1016/s0738-3991(03)00053-3

Cited by 16 publications

(13 citation statements)

References 13 publications

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“…In a study on doctor–patient communication that was conducted in a family planning setting in Southeast Asia (Kim et al 2003), it was also suggested that low education might explain why patients seem unprepared for a participatory consultation style. Strong social hierarchy was put forward as a culture-related explanation in another study, but this study provided limited in-depth analysis (Moore 2008).…”

Section: Discussionmentioning

confidence: 99%

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Doctor–patient communication in a Southeast Asian setting: the conflict between ideal and reality

Claramita

Utarini

Soebono

et al. 2010

Adv in Health Sci Educ

104

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Doctor–patient communication has been extensively studied in non-Western contexts and in relation to patients’ cultural and education backgrounds. This study explores the perceived ideal communication style for doctor–patient consultations and the reality of actual practice in a Southeast Asian context. We conducted the study in a teaching hospital in Indonesia, using a qualitative and a quantitative design. In-depth interviews were conducted with ten internal medicine specialists, ten internal medicine residents, 16 patients in two groups based on education level and ten most senior medical students. The contributions of doctors and patients to the communication during consultations were observed and rated quantitatively by thirty internal medicine residents, 393 patients with different educational backgrounds and ten senior medical students. The ‘informed and shared decision making’ is the central observation in this quantitative study. The results of the interviews showed that Southeast Asian stakeholders are in favor of a partnership style of communication and revealed barriers to achieving this: doctors and patients are not prepared for a participatory style and high patient load due to an inefficient health care system does not allow sufficient time for this type of communication. The results of the quantitative study showed a sharp contrast between observed and ideal communication styles. A paternalistic style seems to prevail, irrespective of patients’ educational background. We found a sharp conflict between ideal and reality concerning doctor–patient communication in a Southeast Asian context. Further studies should examine ways to change the prevailing communication style in the desired direction.

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Section: Discussionmentioning

confidence: 99%

“…This creates a situation that is not conducive to a partnership style of doctor patient communication (Kim et al . 2003). Studies in Western contexts too have indicated that patients’ educational background can influence doctor–patient communication (Murray et al 2007; Willem et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Doctor–patient communication in a Southeast Asian setting: the conflict between ideal and reality

Claramita

Utarini

Soebono

et al. 2010

Adv in Health Sci Educ

104

View full text Add to dashboard Cite

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“…OPTION was designed to analyze decision making in developed-country medical encounters; 13 later, the tool was adapted to analyze client and provider behavior during family planning consultations in Indonesia. 14 For this study, we revised the assessment tool used in Indonesia so that sessions with new and continuing clients could be analyzed together. The revised tool assessed client involvement and provider performance on 13 key decisionmaking behaviors.…”

Section: Discussionmentioning

confidence: 99%

Promoting Informed Choice: Evaluating a Decision-Making Tool for Family Planning Clients and Providers in Mexico

Kim

Kols

Martin³

et al. 2005

IFPP

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CONTEXT:The World Health Organization (WHO) has developed a decision-making tool to be used by providers and clients during family planning visits to improve the quality of services. It is important to examine the tool's usability and its impact on counseling and decision-making processes during family planning consultations. METHODS:Thirteen providers in Mexico City were videotaped with family planning clients three months before and one month after attending a training session on the WHO decision-making tool. The videotapes were coded for clientprovider communication and eye contact, and decision-making behaviors were rated. In-depth interviews and focus group discussions explored clients' and providers' opinions of the tool. RESULTS:After providers began using the decision-making tool, they gave clients more information on family planning, tailored that information more closely to clients' situations and more often discussed HIV/AIDS prevention, dual protection and condom use. Client involvement in the decision-making process and client active communication increased, contributing to a shift from provider-dominated to shared decision making. Clients reported that the tool helped them understand the provider's explanations and made them feel more comfortable talking and asking questions during consultations. After one month of practice with the decision-making tool, most providers felt comfortable with it and found it useful; however, they recommended some changes to the tool to help engage clients in the decision-making process. CONCLUSIONS:The decision-making tool was useful both as a job aid for providers and as a decision aid for clients.

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“…15–18 Even when the patient is the one ultimately making the decision about which method to use, there is often minimal provider engagement with patients to determine their preferences and concerns about methods and how these issues relate to available options. 19,20 …”

mentioning

confidence: 99%

A Qualitative Analysis of Approaches To Contraceptive Counseling

Dehlendorf

Kimport²,

Levy³

et al. 2014

Perspect Sexual Reproductive

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CONTEXT-Underuse and inconsistent use of contraceptives contribute to the continued high rate of unintended pregnancy in the United States. High-quality interaction between patient and provider about contraception is associated with improved contraceptive use, yet little is known about how providers support patients in the decision-making process.METHODS-A random sample of 50 family planning visits by patients in the San Francisco Bay Area was selected from a larger sample of 342 audio-recorded visits to six clinics between 2009 and 2012. In qualitative analysis guided by grounded theory techniques, transcripts were assessed to determine counseling approaches and patterns in the use of these approaches.RESULTS-Providers employed three counseling approaches: foreclosed (in 48% of visits), characterized by discussion of few contraceptive methods and method selection by the patient with no involvement from the provider; informed choice (30%), characterized by detailed description of multiple methods, but little or no interaction between the patient and the provider; and shared decision making (22%), characterized by the provider's interactive and responsive participation with the patient in method selection. Use of these approaches varied by patient's age: Women 25 or younger experienced the foreclosed approach more often than those in the two other agegroups, and patients older than 35 were far more likely than their younger counterparts to experience the shared decision-making approach.CONCLUSIONS-Most visits did not include interactive engagement between the patient and the provider. Contraceptive counseling interventions should encourage providers to responsively engage with patients of all ages to better meet their contraceptive needs.The high rate of unintended pregnancy in the United States 1 places a heavy burden on women, society and the health care system. 2 One factor contributing to this high rate is the underuse and inconsistent use of contraceptives. Not only do 11% of women at risk of unintended pregnancy not use any contraceptive method, 3 but 25% of women using a reversible method rely on condoms, a method with relatively low efficacy. 4 In addition, female contraceptive users report high rates of discontinuation and incorrect use of their chosen method. 5,6 Patient-provider communication during family planning visits is one influence on women's contraceptive use. Health communication has been recognized as a marker of quality health care by the Institute of Medicine, 7 and has been found to be correlated with patient outcomes, including patient satisfaction and medication adherence, across a range of health HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript conditions. 8,9 In family planning care, patient assessment of the quality of interpersonal aspects of care has been linked to contraceptive use and continuation. [10][11][12] Despite this evidence of the importance of contraceptive counseling, little is known about what occurs during routine family...

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Participation by clients and nurse midwives in family planning decision making in Indonesia

Cited by 16 publications

References 13 publications

Doctor–patient communication in a Southeast Asian setting: the conflict between ideal and reality

Doctor–patient communication in a Southeast Asian setting: the conflict between ideal and reality

Promoting Informed Choice: Evaluating a Decision-Making Tool for Family Planning Clients and Providers in Mexico

A Qualitative Analysis of Approaches To Contraceptive Counseling

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