Provider perspectives on the role of the patient as an active participant in HIV care

ABSTRACT

The World Health Organization (WHO) advocates for patients to play an active role in their healthcare in order to improve the quality of care delivery. However, there is limited research on provider perceptions of the role of the patient during a medical encounter in an HIV setting in Sub-Saharan Africa. This qualitative study was conducted between September 2014 and August 2015. Sixty healthcare providers were recruited using convenience sampling methods from three sites (Moi Teaching and Referral Hospital, Webuye and Busia) within the Academic Model Providing Access to Healthcare (AMPATH) HIV care and treatment program. In-depth interviews were conducted in either Swahili or English, transcribed and translated if necessary into English. Data was analysed thematically. Provider expectations were mainly influenced by their professional role. Despite this variance, providers expect patients to communicate openly during their clinical encounters. Overall, there was a shift in provider expectations of the patient from a traditional paternalistic role to a more active role. This study provides valuable insight into provider expectations of patients during medical encounters in HIV settings. Findings from this study may contribute to developing appropriate interventions for providers as well as to design patient empowerment initiatives.

KEYWORDS:

• Patient role
• provider perspective
• HIV care

Acknowledgement

The authors would like to thank all the study participants for taking part in the study. We would also like to acknowledge the research assistants, data managers, administrative and clerical staff, for enabling the management, interpretation and publication of these data. We are also grateful to the AMPATH clinical and administrative staff, for their dedication in caring for patients, and their attentiveness in accurately recording their patients’ data. The contents of this are the sole responsibility of AMPATH and do not necessarily reflect the views of USAID or the United States Government.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

All authors made substantial contribution to the conceptualisation and design, acquisition of data, analysis and interpretation of data. The first author (CK) drafted the article and all authors listed played an important role in revising the manuscript for intellectual content. All authors provided final approval of the version to be published and are accountable for all aspects of the work.

Additional information

Funding

This work was supported by the National Institute of Mental Health [grant number K01MH099966]. This research has been supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through USAID under the terms of Cooperative Agreement No. AID-623-A-12- 0001, and the National Institute of Mental Health [grant number K01MH099966, PI: Genberg]. It is made possible through joint support of the United States Agency for International Development (USAID).