Patient-Centered Communication Among Pharmacy Professionals Working in Hospitals and Drug Retail Outlets in Asmara, Eritrea: Knowledge, Attitude, Self-Efficacy and Barriers

Figures & data

Figure 1 Eligibility and enrollment of study participants involved in a study that assessed patient-centered communication of pharmacy professionals in Asmara Eritrea, 2021 (N = 79).

Table 1 Socio-Demographic Characteristics of the Respondents (N = 79)

Variables	Category	Frequency	Percentage
Age (Md = 36.00; IQR = 20; Range = 22–75)	≤40	50	63.3
	Above 40	29	36.7
Sex	Male	43	54.4
	Female	36	45.6
Work setting	Drug retail outlet	55	69.6
	Hospital pharmacy	24	30.4
Work experience (Md = 11.00; IQR = 17; Range = 2–48)	≤20 years	59	74.7
	Above 20 years	20	25.3
Qualification	Diploma	31	39.2
	Bachelor’s degree and above	48	60.8
Training/workshop on PCC	Yes	25	31.6
	No	54	68.4

Abbreviations: IQR, Interquartile range; Md, Median; PCC, Patient-centered communication.

Table 2 Percentage Distribution of Correct Knowledge of PCC Among Pharmacy Professionals (N = 61)

Knowledge Questions About PCC	Frequency	Percentage
PCC allows you to elicit and understand patient perspectives	40	65.6
PCC allows you to understand the patient within his or her unique psychosocial and cultural contexts	41	67.2
PCC allows you to show genuine sympathy to the patients	28	45.9
PCC allows you to involve patients by making suggestions rather that directives to show professionalism	23	37.7
PCC allows you to take patient’s lifestyle, beliefs, cultural background and abilities into consideration	49	80.3
PCC allows you to explain the treatment, treatment plan, possible adverse effects using simpler terms (not medical terms)	31	50.8
PCC allows you to reach a shared understanding of patient problems and the treatments that are concordant with the patient	47	77
Ideally there is a difference between PCC and pharmacy professional-patient communication	24	39.3
Instilling decision making in patients is the duty of both the pharmacy professional and the patient	33	54.1
Providing PCC requires the Pharmacy professional to give the patient enough time to ask and talk about his/her disease and medication	47	77.0
Providing PCC requires the Pharmacy professional to not only fill the prescription and give direction on the medications	8	13.1
Providing PCC requires the Pharmacy professional not to use medical terms to address the patients about their disease and medication	16	26.2
Providing PCC necessitates the pharmacy professional to use appropriate verbal and non-verbal behavior	39	63.9
Providing PCC necessitates the Pharmacy professional to accept the legitimacy of patient’s views and feelings; and is not judgmental	56	91.8
The Pharmacy professional has to offer the patient an opportunity to discuss and share decision making	56	91.8
The Pharmacy professional provides the patient’s clear information about the treatment plan	58	95.1
Providing PCC necessitates the Pharmacy professional to offer choices for the patient	10	16.4

Abbreviation: PCC, Patient-centered communication.

Table 3 Percentage Distribution of Attitude of PCC Among Pharmacy Professionals (n = 61)

Attitude Questions on PCC	Strongly Agree/Agree n (%)	Neutral n (%)	Strongly Disagree/Disagree n (%)
PCC is essential in the setting of pharmacy professional-patient communication	59 (96.7)	2 (3.3)	0 (0)
Providing PCC requires the pharmacy professional to have a good level of understanding of PCC.	57 (93.4)	4 (6.6)	0 (0)
PCC is important for better patient outcome and gives a better patient experience	57 (93.4)	3 (4.9)	1 (1.6)
PCC is currently practiced in all pharmacy setting in Eritrea	9 (14.8)	13 (21.3)	39 (63.9)
Practicing PCC will increase the patient’s confidence in the profession.	58 (95.1)	3 (4.9)	0 (0)
PCC between patient and pharmacy professional is valuable for building a good therapeutic agreement	55 (90.2)	4 (6.6)	2 (3.3)
Providing PCC requires the pharmacy professional to show interest in what patient knows about his disease/medication	51 (83.6)	7 (11.5)	3 (4.9)
A patient should not make a decision on his/her medication	20 (32.8)	6 (9.8)	35 (57.4)
The level of communication with patient could be improved in pharmacy	59 (96.7)	2 (3.3)	0 (0)
The Ministry of Health should take initiative to encourage PCC in all pharmacy settings in Eritrea	55 (90.2)	5 (8.2)	1 (1.6)

Abbreviation: PCC, Patient-centered communication.

Table 4 Percentage Distribution of the Sub-Scales of Self-Efficacy (N = 79)

Items of the Self-Efficacy	Degree of Confidence
	Very low/Low Degree n (%)	Neutral n (%)	Very High/High Degree n (%)
Exploring Patient’s Perspective
Make the patient feel that I am genuinely interested in knowing what he/she thinks about his/her condition	13 (16.5)	32 (40.5)	34 (43)
Make the patient feel that I have time to listen	11 (13.9)	15 (19)	53 (67)
Recognize the patient’s thoughts and feelings	57 (72.2)	16 (20.3)	6 (7.6)
Be attentive and responsive	32 (40.5)	20 (25.3)	27 (34.2)
Be aware of when the patient is scared or concerned	35 (44.3)	19 (24.1)	25 (31.6)
Treat the patient in a caring manner	5 (6.3)	26 (32.9)	48 (60.8)
Make the patient experience me as empathetic	12 (15.2)	29 (36.7)	38 (48.1)
Make the patient feel that he/she can talk with me about confidential, personal issues	13 (16.5)	14 (17.7)	52 (65.8)
Show a genuine interest in the patient and his/her situation	3 (3.8)	21 (26.6)	55 (69.6)
Focus on compassion, care and symptomatic treatment, when there is no curative treatment	28 (35.4)	22 (27.8)	29 (36.7)
Sharing Information and Power
Reach agreement with the patient about the treatment plan to be implemented	58 (73.4)	13 (16.5)	8 (10.1)
Advise and support the patient in making decisions about his/her treatment	51 (64.6)	23 (29.1)	5 (6.3)
Ensure that the patient makes his/her decisions on a professionally informed basis	42 (53.2)	30 (38)	7 (8.9)
Explain things so that the patient feels well-informed	15 (19)	23 (29.1)	41 (51.9)
Inform the patient about the expected side effects, so the patient understands them	6 (7.6)	22 (27.8)	51 (64.6)
Explain how the treatment works	33 (41.8)	23 (29.1)	23 (29.1)
Explain how the treatment is likely to affect the patient’s condition, so that the patient understands	15 (19)	29 (36.7)	35 (44.3)
Explain the medication plan, so that the patient understands them	11 (13.9)	33 (41.8)	35 (44.3)
Dealing with communicative challenges
Be aware when my own feelings affect my communication with the patient	16 (20.3)	26 (32.9)	37 (46.8)
Deal with my own emotional reactions when the situation is difficult for me	19 (24.1)	26 (32.9)	34 (43)
Maintain the relationship with the patient when he/she is angry	20 (25.3)	27 (34.2)	32 (40.5)
Stay focused on what is best for the patient if there is a professional disagreement about the diagnosis and treatment	24 (30.4)	23 (29.1)	32 (40.5)
Avoid letting myself be influenced by preconceptions about the patient	23 (29.1)	14 (17.7)	42 (53.2)
Separate my personal views from my approach in the professional situation	21 (26.6)	18 (22.8)	40 (50.6)

Table 5 Multivariate Analysis of the Predictors of Self-Efficacy of Pharmacy Professionals

Variables	Un-standardized Coefficient	Standardized Coefficient	t-value	p-value
Attitude	0.891	0.295	2.354	0.022
Work setting	−2.400	−0.116	−0.928	0.357
Intercept	18.521		1.222	0.222
R2 = 0.110 Adjusted R2 = 0.079

Figure 2 Barriers to practicing patient-centered communication (n = 70).