Healthcare Provider Patient Communication Environmental Context on Diabetes Mellitus Management Practices in Selected Hospitals in Kenya.

Abstract

The purpose for this study was to investigate the effect of healthcare provider patient communication environmental context during interaction on diabetes mellitus management practices in selected hospitals Kenya. This was a causal comparative research study with application of quantitative methodology. The study was carried out at the outpatient diabetic clinics of Kenyatta National Hospital and MP. Shah Hospital. Systematic random sampling was used to sample the patients. A 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 for 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 environmental context and diabetes mellitus management practices. It was found that 400 patient participants were involved in the study and comprised of 313 patients at Kenyatta National Hospital (KNH) and 87 patients at MP Shah respectively studied between the months of February 2019 and November 2019. The rating of environmental context (EC) was not significantly different between MP Shah Hospital and KNH, p=0.123. However, environmental context had positively significant effect on diabetes mellitus management practices [β=0.45, (95% CI 0.35, 0.56), p<0.001] overall in Kenya; at Kenyatta National Hospital [β=0.50, (95% CI 0.39, 0.61), p<0.001] and MP Shah Hospital [β=0.45, (95% CI 0.27, 0.63), p<0.001]. The null hypothesis was rejected overall in Kenya; at KNH and MP Shah Hospital. Therefore, there was significant effect of environmental context on diabetes mellitus management practices in selected hospitals Kenya. Thus, environmental context had favourable impact and brought about improved DMMPs among patients whether in public or private hospitals. This means environmental context was conducive and hospitable to the patients in the course of care they received all along at these hospitals.This study demonstrated that environmental context is critical in enhancing diabetes mellitus management practices among patients. Therefore, there is need to evaluate environmental context and its various components to realize better communication, hence enhanced improvement on the management of diabetes mellitus. In addition, introduce healthcare provider patient communication environmental context in the medical education curriculum to be part and parcel in training institutions as a necessary requirement in medical practice; develop a standard healthcare provider patient communication environmental context model and with guidelines on its observance by healthcare stakeholders in provision of healthcare services.