Browsing by Author "Assefa, Mekdes"

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    An Assessment of health information exchange between Clinicians and People Living with HIV/AIDS on Anti- retroviral therapy at Public hospitals in Addis Ababa
    (Addis Abeba University, 2009-05) Assefa, Mekdes; Enquselassie, Fekre (PhD ,Ass.Prof.)
    Background Good quality of clinician-patient health information exchange promotes patient's knowledge and understanding, health outcomes, adherence to treatment plan, clinician and patient satisfaction and patient's trust on clinicians. Objective The main objective is to assess health information exchange between clinicians and PLWHA attending ART clinics at public hospitals in Addis Ababa. Method A cross sectional survey using quantitative and qualitative methods was utilized. Result 400 & 24 patients in the structured & in-depth interview respectively and 20 clinicians were involved in the study. The median communication score was 78%. Patients have assigned highest ratings for communication elements such as explanation on adherence (87.4%),talking understandably (87.2%), being greeted (80.8%), treated with respect (81%), & shown concern (80.2%). Involvement in decision making (54.8%) and explanation on availability of support and resources (50%) were rated low. Patients self reported better health status (P<0.0001), higher educational status (P<0.0001), longer duration of clinician patient relationship (P=0.006), lesser access to health information (p=0.019) longer visit length (P=0.019) & increased number of patients clinicians saw on daily basis (P<0.0001) were found significantly associated with better communication scores. Like wise better self reported health status (P<0.0001), longer duration of clinician patient relationship (P=0.002), increased number of patients clinicians saw on daily basis (P<0.0001) & older clinicians' age (P=0.027) were associated with better comprehension of health information. Better Health status (P<0.0001), longer visit length (P<0.0001), longer duration of clinician patient relationship (P<0.0001), longer clinicians' experience in care of patients on ART (P=0.029) & increased number of patients clinicians saw on daily basis (P<0.0001) were observed to be associated with patients' increased satisfaction with clinical communication. Clinicians’attitude on information exchange had no associated with communication variables studied. Conclusion Small proportion of patients have perceived the clinical communication to be close to the optimal score (100). However, majority of patients have reported being satisfied with and comprehending information provided during their clinical encounter. Clinician patient health information exchange was observed to be enhanced when patients report better state of health, happens to know clinicians over long period of time and cared by clinicians who see large number of patients on daily basis. Moreover patients were observed to be satisfied and rated the clinical communication higher when they are allowed to spend longer time during visits and have higher educational status respectively.