HEALTHCARE PROVIDER PATIENT NONVERBAL COMMUNICATIVE BEHAVIOUR ON DIABETES MELLITUS MANAGEMENT PRACTICES IN SELECTED HOSPITALS IN KENYA

Geoffrey Ungaya, K. Ngula, H. Mberia, W. Sigilai, S. Sokwalla
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Abstract

Purpose: To examine the effect of healthcare provider patient communication nonverbal communicative behaviour on diabetes mellitus management practices in selected hospital in Kenya. Methodology: This was a causal comparative research design study with application of quantitative methodology. The study was carried out at Kenyatta National Hospital (KNH) and MP Shah Hospital. Systematic random sampling was used to sample patients. 400 participants were involved in the study and comprised 313 patients at KNH and 87 patients at MP Shah Hospital studied between the months of February 2019 and November 2019. The researcher administered questionnaire was used to collect data. The results were summarized using percentages and means or medians for categorical and continuous data respectively. Comparisons were done using chi square test of association of categorical variables and independent t-test for comparison of means. Linear regression and ANOVA were used to test for associations and hypothesis between healthcare provider patient nonverbal communicative behaviour (NVCB) and diabetes mellitus management practices (DMMPs). Findings: The rating of nonverbal communicative behavior was significantly higher at MP Shah Hospital than at KNH, p=0.010. Nonverbal communicative behavior had positive significant effect on diabetes mellitus management practices in Kenya [β=0.15, (95% CI 0.03, 0.27), p=0.016] with similar outcome at KNH [β=0.20, (95% CI 0.08, 0.33), p=0.002] and not at MP Shah Hospital [β=0.03, (95% CI 0.37, 0.42), p=0.899]. Thus, the null hypothesis was rejected in Kenya; the null hypothesis was rejected at KNH; the null hypothesis was not rejected at MP Shah Hospital. Therefore, there was significant effect of NVCB on DMMPs in Kenya, at KNH and not at MP Shah Hospital. Unique contribution to theory, practice and policy: Nonverbal communicative behaviour was responsible for improved performance in diabetes mellitus management practices among patients in Kenya and at KNH. At MP Shah Hospital, NVCB was not responsible for improvement in the DMMPs. The findings reinforce uncertainty reduction and communication accommodation theories basis in the dyadic interaction between patients and healthcare providers. Therefore, NVCB needs to be well conceptualized and incorporated at the health ministry and medical training institutions to equip medical workers with the required communication skills.
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医疗保健提供者患者非语言交际行为对糖尿病管理实践在肯尼亚选定的医院
目的:探讨肯尼亚某医院医护人员患者沟通非语言交际行为对糖尿病管理实践的影响。方法:本研究采用定量方法进行因果比较研究。这项研究是在肯雅塔国家医院(KNH)和MP Shah医院进行的。采用系统随机抽样对患者进行抽样。在2019年2月至2019年11月期间,400名参与者参与了这项研究,其中包括KNH的313名患者和MP Shah医院的87名患者。研究人员采用问卷调查的方式收集数据。分类数据和连续数据分别用百分比和平均值或中位数对结果进行汇总。比较采用分类变量关联的卡方检验和均值比较的独立t检验。采用线性回归和方差分析来检验医疗服务提供者患者非语言交际行为(NVCB)与糖尿病管理实践(DMMPs)之间的关联和假设。结果:医院非言语交际行为评分显著高于国立医院,p=0.010。非语言交际行为对肯尼亚糖尿病管理实践有积极的显著影响[β=0.15, (95% CI 0.03, 0.27), p=0.016], KNH的结果相似[β=0.20, (95% CI 0.08, 0.33), p=0.002], MP Shah医院没有[β=0.03, (95% CI 0.37, 0.42), p=0.899]。因此,零假设在肯尼亚被拒绝;零假设在KNH被拒绝;在MP Shah医院没有否定零假设。因此,在肯尼亚,在KNH而不是在MP Shah医院,NVCB对DMMPs有显著影响。对理论、实践和政策的独特贡献:非语言交际行为是改善肯尼亚和KNH患者糖尿病管理实践绩效的原因。在MP Shah医院,NVCB不负责改善DMMPs。研究结果强化了患者与医护人员二元互动的不确定性减少和沟通适应理论基础。因此,卫生部和医疗培训机构需要很好地构思和纳入NVCB,以使医务工作者具备所需的沟通技巧。
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