Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient.</p> <p>This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and quality of interactions with their primary health-care providers.</p> <p>Methods</p> <p>Four focus group discussions (two women and two men groups) were conducted among 27 purposively selected patients (13 men and 14 women) from six primary health-care centres in Muscat, Oman. Qualitative content analysis was applied.</p> <p>Results</p> <p>The patients identified some weaknesses regarding the patient-provider communication like: unfriendly welcoming; interrupted consultation privacy; poor attention and eye contact; lack of encouraging the patients to ask questions on the providers' side; and inability to participate in medical dialogue or express concerns on the patients' side. Other barriers and difficulties related to issues of patient-centeredness, organization of diabetes clinics, health education and professional competency regarding diabetes care were also identified.</p> <p>Conclusion</p> <p>The diabetes patients' experiences with the primary health-care providers showed dissatisfaction with the services. We suggest appropriate training for health-care providers with regard to diabetes care and developing of communication skills with emphasis on a patient-centred approach. An efficient use of available resources in diabetes clinics and distributing responsibilities between team members in close collaboration with patients and their families seems necessary. Further exploration of the providers' work situation and barriers to good interaction is needed. Our findings can help the policy makers in Oman, and countries with similar health systems, to improve the quality and organizational efficiency of diabetes care services.</p

Visualising the invisible : exploring interactive video in HIV prevention in rural Zambia

The purpose of this thesis is to explore and develop video as an interactive method that can be used in HIV prevention, in order to facilitate reflexivity, communication and dialogue about HIV/AIDS among people. In this context, interactive video means that a study population and the researcher interact, collaborate, and communicate during a video production and postproduction process: in the planning, performing, editing, viewing and discussing the recorded scenes. The thesis is based on three video cases conducted within a larger framework of an "Interdisciplinary research project into HIV prevention in Africa". Fieldwork was carried out in different contexts within a rural community in southern Zambia during 12 months, spread over a time period of six years 1992-1997. Video case I comprised four phases. Each phase explored a different aspect Of interactive video. Everyday life events, interviews and dramas relating to AIDS were video recorded and played back to groups of people on different occasions. In video case II, six groups (two groups of women, two groups of men and two mixed groups) were organised to conduct role-plays about local perceptions of the concept "quality of health care". There were 10- 15 participants of reproductive age in each group. Each group conducted two role-plays, one depicting the perceived 'actual' situation at a doctor's office, and one the 'ideal' situation. The video-recorded role-plays were then played back to each group for further comments and discussions. In video case III, eleven men and six women who had been trained as peer educators at a commercial farm participated in making a HIV prevention education video. The peer educators wrote the manuscript, acted the different parts and assisted in editing. The video was shown in eight testing sessions. The test resulted in the peer educators adding a scene. The edited video was used by the peer educators in their work on the farm with HIV prevention. The analysis was done on two levels: one level analysing the content of the videotapes in relation to observations made during video recordings and one level analysing the interactive video processes in relation to the research questions and the conceptual framework. The conclusions drawn are based on both levels of analysis with the emphasis on the process. The findings support the view that it is important to take people's practical experiences into account in HIV prevention. It is argued that people can and do express their experiences as performances that are culture-specific. By videotaping performances relating to quality of health care and AIDS and playing them back to groups of community members (both women and men), it was shown to be possible to engage them in reflexive discussions about these topics. The video method was participatory and interactive allowing community members to be involved at every stage of the process. The performances and viewing in combination with reflexive dialogues facilitated Chiawa residents in their search for solutions to problems identified

La vidéo participante : un moyen pour les populations locales de faire entendre leur voix

Freudenthal Solveig. La vidéo participante : un moyen pour les populations locales de faire entendre leur voix. In: Journal des anthropologues, n°47-48, Printemps 1992. Anthropologie visuelle, sous la direction de Colette Piault. pp. 153-158