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Communicative chall...
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Girma Kebede, BetlehemGothenburg University,Göteborgs universitet,Institutionen för tillämpad informationsteknologi (GU),Department of Applied Information Technology (GU)
(författare)
Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia
- Artikel/kapitelEngelska2020
Förlag, utgivningsår, omfång ...
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2020-03-13
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Public Library of Science (PLoS),2020
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electronicrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:gup.ub.gu.se/291028
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https://gup.ub.gu.se/publication/291028URI
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https://doi.org/10.1371/journal.pone.0230309DOI
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Background: Cancer is a growing concern in Ethiopia. Though communication is essential for the treatment process, few studies have looked at communication in Ethiopian cancer care. Due to the large number of patients and scarcity of resources, it is vital to understand how to manage consultations in order to effectively help as many patients as possible in this challenging work environment. Thus, research is needed to analyze and understand the communicative challenges experienced by physicians, patients, and family caregivers, in order to successfully handle patient care in practice. Objective We explore communication in Ethiopian cancer care and present the main challenges faced by physicians, patients, and family caregivers. Methods This explorative qualitative study was conducted at the Oncology Department of the Tikur Anbessa (Black Lion) Specialized Teaching Hospital (TASH) in Addis Ababa, Ethiopia. A triangulation of data collection methods was used: 91 audio-recorded, semi-structured interviews and 21 video-recordings of authentic interactions during hospital rounds. The aim was to obtain as complete a picture as possible of communication from the perspectives of physicians, patients, and family caregivers. The interviews were analyzed using thematic content analysis and the identified themes were supported by excerpts from the transcribed recordings. Results Eight themes emerged from the data. Workload and time pressure, in combination with restricted space for privacy, limited the possibilities for physicians to deliver detailed information and provide emotional support. Furthermore, patient literacy levels, in combination with no or little cancer awareness, financial problems, reliance on traditional and religious treatments, the stigma of cancer, and a fatalistic attitude, resulted in delays in patients seeking care and participating in positive health behaviors, and, subsequently, often resulted in an unwillingness to openly discuss problems with physicians and adhere to treatment. The study also illustrates the paramount role of family in physician-patient communication in Ethiopia. Though family caregivers provide a valuable interpreting support when patients have limited language skills, they can also prevent patients from sharing information with physicians. Another important finding is that family caregivers were often responsible for making decisions about treatment and avoided telling patients about a poor prognosis, believing that conveying bad news may upset them. All of these themes have important implications for the role of ethically acceptable communication in patient-centered care. Conclusions This study has identified a number of serious challenges for successful and ethically acceptable health communication in Ethiopian cancer care. The study contributes to our understanding of the complexity around the role of family, combined with patients’ dependency on family members for communication, support, and access to care, which creates particular ethical dilemmas for the medical staff. The questions raised by this study concern how to organize consultations to achieve patient-centered health communication, while maintaining a constructive alliance with the family and not jeopardizing the patient’s continued access to care. The integration of communication training for medical students in Ethiopia, with a focus on ethical guidelines for family-centered patient consultation suitable for these circumstances, would be an essential step.
Ämnesord och genrebeteckningar
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HUMANIORA Filosofi, etik och religion Etik hsv//swe
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HUMANITIES Philosophy, Ethics and Religion Ethics hsv//eng
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HUMANIORA Filosofi, etik och religion Filosofi hsv//swe
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HUMANITIES Philosophy, Ethics and Religion Philosophy hsv//eng
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SAMHÄLLSVETENSKAP Annan samhällsvetenskap Tvärvetenskapliga studier inom samhällsvetenskap hsv//swe
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SOCIAL SCIENCES Other Social Sciences Social Sciences Interdisciplinary hsv//eng
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HUMANIORA Språk och litteratur Jämförande språkvetenskap och allmän lingvistik hsv//swe
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HUMANITIES Languages and Literature General Language Studies and Linguistics hsv//eng
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MEDICIN OCH HÄLSOVETENSKAP Annan medicin och hälsovetenskap Övrig annan medicin och hälsovetenskap hsv//swe
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MEDICAL AND HEALTH SCIENCES Other Medical and Health Sciences Other Medical and Health Sciences not elsewhere specified hsv//eng
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MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Medicinsk etik hsv//swe
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MEDICAL AND HEALTH SCIENCES Health Sciences Medical Ethics hsv//eng
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MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
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MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
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MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Omvårdnad hsv//swe
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MEDICAL AND HEALTH SCIENCES Health Sciences Nursing hsv//eng
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MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi hsv//swe
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MEDICAL AND HEALTH SCIENCES Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy hsv//eng
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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
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MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
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cancer
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oncology
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bioethics
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health communication
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global health
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Africa
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Ethiopia
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family
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Abraha, Aynalem
(författare)
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Andersson, Rune,1951Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine(Swepub:gu)xandru
(författare)
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Munthe, Christian,1962Gothenburg University,Göteborgs universitet,Institutionen för filosofi, lingvistik och vetenskapsteori,Department of Philosophy, Linguistics and Theory of Science(Swepub:gu)xmuntc
(författare)
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Linderholm, Mats
(författare)
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Linderholm, Barbro,1959Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology(Swepub:gu)xlibar
(författare)
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Berbyuk Lindström, Nataliya,1978Gothenburg University,Göteborgs universitet,Institutionen för tillämpad informationsteknologi (GU),Department of Applied Information Technology (GU)(Swepub:gu)xberbn
(författare)
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Göteborgs universitetInstitutionen för tillämpad informationsteknologi (GU)
(creator_code:org_t)
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Ingår i:PLoS ONE: Public Library of Science (PLoS)15:31932-6203
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