Epstein and Street offered an operational definition of Patient-Centered Communication(PCC) (1) eliciting and understanding patient pers...
(1) eliciting and understanding patient perspectives (concerns, ideas, expectations, needs, feelings, and functioning)
(2) understanding the patient within his or her unique psycho-social and cultural contexts
(3) reaching a shared understanding of patient problems and the treatments that are concordant with patient values.
(4)helping patients to share power and responsibility through involvement in making choices.
PCC is now accepted as part of the curriculum in the medical school of most developed countries. However, being a developing nation Nepal has several factors that hinder the development of PCC. Most of the people are less educated, unaware of personal health care and are of low economic status. The ideas of consumer rights and medical litigation are not yet strongly present in Nepalese society. Also, the lack of strong communication skill teaching curriculum for health care professionals adds hindrance to achieve PCC in Nepal.
According to the study carried out by Malcolm Moore on PCC in Nepalese context concluded that the patients wanted to be treated in a friendly and respectful manner, wanted to be fully informed and provided with adequate consultation time. In that study, patients expressed strong preferences for some aspects of the PCC but were not very concerned with the sharing power and control. So the study concluded that the model of PCC in Nepal requires modification to reflect these local preferences.
The attitude of medical students and doctors in Nepal towards PCC was also studied by Moore. Participants generally expressed patient-centred attitudes and thought that doctor-centred nature of relationships should change.
A patient goes to the hospital for treatment so they should be provided with adequate information about their health status and methods of dissemination information need to be enhanced in this low literacy setting. It is equally important to convince patients to participate actively in their consultation and practitioners should not rush and must give adequate consultation time.
Several studies have shown that PCC has been effective in achieving improved health outcomes. Both the patients and healthcare professionals have equal and shared responsibilities for the betterment of healthcare services. Nepal has to do lots of work to improve and strengthen the health care services and adopting the PCC model with required modification can be proved as an effective strategy to enforce the health care system of Nepal.
REFERENCES:
1. Naughton, Cynthia A. “Patient-Centered Communication.” Pharmacy (Basel, Switzerland) vol. 6,1 18. 13 Feb. 2018, doi:10.3390/pharmacy6010018
2. Moore M. What does patient-centred communication mean in Nepal? Medical Education 2008: 42: 18–26
3. Moore M. What do Nepalese medical students and doctors think about patient-centred communication? Patient Education and Counseling 2009;76: 38–43
4. Douglas, A.H., Acharya, S.P. & Allery, L.A. Communication skills teaching and learning in Nepal; what are medical students’ perceptions and experiences? A qualitative study. BMC Med Educ 20, 391 (2020). https://doi.org/10.1186/s12909-020-02330-y
Aarati Bhandari
18th Batch
SHAS, Pokhara University
Thank you 🙂for this genuine information
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