“Caught in an x-rays loop”: An ethnographic exploration of doctor-patient interactions at a tuberculosis clinic

Abstract

Background

One of the important barriers to tuberculosis treatment is the low level of alliance between doctor and patient. The alliance can be achieved by establishing quality interactions between doctors and patients. There is an abundance of research on patient-doctor interactions. However, scant literature explores communication strategies to improve interactions between doctors and patients with tuberculosis.

Method

This study utilized an ethnographic approach to explore communication strategies that pulmonary resident doctors used when interacting with tuberculosis patients. Observations were made during communication between resident doctors and patients in the examination rooms, followed by separate interviews to record their perceptions of their previous interactions. The data were analyzed using the ‘Greet-Invite-Discuss communication framework’.

Result

Some communication strategies may positively affect the interactions between doctor residents and their patients, including motivational interviews and using appropriate non-verbal gestures when providing information. However, other communication strategies may negatively affect the interactions, such as the failures to establish adequate rapport with patients, exploring patients' knowledge using close-ended questions, and doctors' domination in joint decision-making.

Conclusion

In sum, the Greet-Invite-Discuss framework may be helpful in analyzing the communication between doctors and patients with Tuberculosis. This study calls for improved communication training for residents in lung and respiratory medicine and further research in educational programs, especially on the quality of interactions between doctors and TB patients.