What does patient-centred communication mean in Nepal?
Article first published online: 28 NOV 2007
Volume 42, Issue 1, pages 18–26, January 2008
How to Cite
Moore, M. (2008), What does patient-centred communication mean in Nepal?. Medical Education, 42: 18–26. doi: 10.1111/j.1365-2923.2007.02900.x
- Issue published online: 28 NOV 2007
- Article first published online: 28 NOV 2007
- Received 2 April 2007; editorial comments to author 13 June 2007; accepted for publication 26 June 2007
- *patient-centred care;
- cross-sectional survey;
- rural health;
- ambulatory care;
- patient satisfaction;
Objectives To ascertain the expectations of Nepalese patients regarding aspects of doctor–patient communication and to review a model of patient-centred care for its appropriateness to Nepalese medical communication training.
Methods A cross-sectional survey, using an adapted version of the Patient−Practitioner Orientation Scale (PPOS), was undertaken with a random sample of patients attending a general outpatients department in rural Nepal. An alternative survey instrument, derived from the PPOS, was also used.
Results The following issues were most important to patients: being treated in a friendly and respectful manner; being fully informed, and being given adequate consultation time. Patients were happy for the doctor to be in charge and did not want to seek information outside the doctor’s advice. They expressed a strong preference for receiving advice about preventative care. Patient responses were significantly more ‘doctor-centred’ than those found in comparable studies in the USA.
Discussion Patients expressed strong preferences for some aspects of patient-centred communication (PCC), but were not very concerned with sharing power and control. Models of PCC in Nepal require modification to reflect these local preferences. The importance of good communication techniques requires emphasis in clinical training and practice. Methods of disseminating information need to be enhanced in this low-literacy setting.