Factors associated with patients’ understanding of their management plan in Tshwane clinics

BACKGROUND: This research focused on patients’ views regarding healthcare services and identified factors associated with understanding of their management plan. AIM: To develop a baseline for patient–clinician collaboration and the extent to which patients felt included and understood their treatment plan. SETTING: Tshwane district (South Africa) public health outpatient clinics. METHOD: Medical students interviewed 447 patients in 22 clinics in Tshwane district. Agreement was measured by the percentage of cases in which patients and clinicians were in accord about a particular aspect of the consultation. RESULTS: About one-third of patients incorrectly answered questions on whether changes in lifestyle or diet were prescribed as part of their treatment. The likelihood that patients understood their plan was associated with seeing the same clinician three or more times; having a consultation in their same or a similar language; patient participation in the diagnosis; and feeling that the clinician had explained their health problems to them. CONCLUSIONS: There is need for greater emphasis on continuity of care, the clinicians’ ability to speak the patient's language and involving patients in the consultation.