Psychosocial Barriers to Clinical Communication in Public Secondary Healthcare: Qualitative Experiences of Clinicians in General Hospitals, Benue State Nigeria
Main Article Content
Abstract
Psychosocial barriers significantly impact communication in clinical settings, contributing to poor medication adherence and negative patient experiences. While much research has explored patients' perspectives, there is a lack of depth in understanding, particularly given the increasing complexity of these barriers, which is exacerbated by emerging public health issues and requires insight into clinicians’ perspectives. This study, employing a constructivist approach and descriptive phenomenology, examines clinicians' experiences with psychosocial barriers in 21 of the 23 general hospitals in Benue State, Nigeria, involving 67 participants. The findings highlight the substantial burden of psychosocial factors such as heavy workloads, dysfunctional facilities, insecurity, and poor staff welfare, which negatively affect communication in the clinical process. Clinicians reported high levels of stress, vulnerability to violence, and inadequate resources, leading to poor professional and patient-centred communication. The study suggests that addressing these psychosocial barriers through better staffing, improved facilities, and a sustainable welfare package is crucial to enhancing clinical communication and the quality of care in the region.
Downloads
Article Details
Section
How to Cite
References
Abiola, T., Udofia, O., & Abdullahi, A.T. (2014). Patient ‐ doctor relationship: the practice orientation of doctors in Kano. Nigerian Journal of Clinical Practice, 17(2), 241–247. https://doi.org/10.4103/1119-3077.127567
Adams, J.M. (2019). The value of worker well-being. Public Health Reports, 134(6), 583-586. DOI: 10.1177/0033354919878434
African Union. (2020). Mobility and Migration of African Health Workers Post COVID-19. Policy Brief III, November.
Aluko-Arowolo, S., Ogundimu, A.O., & Solarin, T.M. (2015). Patient-physician relationship and ante-natal seeking behaviour in public hospitals. Journal of Medicine and Medical Sciences, 6(5), 95–103. https://doi.org/http:/dx.doi.org/10.14303/jmms.2015.077
Ameh, S., Gómez-Olivé, F.X., Kahn, K., Tollman, S.M., & Klipstein-Grobusch, K. (2017). Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model. BMC Health Services Research, 17, 229. DOI 10.1186/s12913-017-2177-4
Angioha, P.U., Omang, T.A., Ishie, E.U., & Iji, M.E. (2020). Employee stressors and wellbeing of healthcare workers in government owned hospitals in Calabar, Nigeria. Journal of Public Administration, 2(4), 36-43. DOI: 10.22259/2642-8318.0204004
Anhange, S.T., Tyovenda, K.R., & Kwaghgbah, A.T. (2022). Doctor-patient communication, patient trust and patient satisfaction among people living with HIV/AIDS in federal medical centre Makurdi, Nigeria. Nigerian Journal of Clinical Psychology, 12(1), 40-45.
Avalere Health. (2015). Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes (Issue September).
Claramita, M., Nugraheni, M. D. F., Dalen, J. V., & Vleuten, C. V. D. (2013). Doctor – patient communication in Southeast Asia : a different culture ? Adv in Health Sci Educ, 18, 15–31. https://doi.org/10.1007/s10459-012-9352-5
Claramita, M., Utarini, A., Soebono, H., Dalen, J. Van, & Vleuten, C. V.D. (2011). Doctor- patient communication in a Southeast Asian setting: The conflict between ideal and reality. Adv in Health Sci Educ, 16, 69–80. https://doi.org/10.1007/s10459-010-9242-7
Demerouti, E., Bakker, A.B., Nachreiner, F., & Schaufeli, W.B. (2001). The job demand-resource model of burnout. Journal of Applied Psychology, 86(3), 499-512.
Donabedian, A. (2003). An Introduction to Quality Assurance in Health Care. Oxford University Press.
Enem, E.U & Bahago, S.B. (2021). Demystifying the impact of covid-19 on the healthcare workers in abuja, Nigeria: counselling inference. A Journal of Education Conundrum, in Conjunction with The Great Thinkers Research Group (GTRG), 119-128.
Engel, G.L. (1977). The Need for a New Medical Model: A Challenge for Biomedicine. Science, 196(4286), 129–136.
Isabirye, A.K., & Makoe, M. (2018). Phenomenological analysis of the lived experiences of academics who participated the professional development programme at an open distance learning (ODL) university in South Africa. The Indo-Pacific Journal of Phenomenology, 18(1),2079-7222.
Larson, E., Leslie, H. H., & Kruk, M. E. (2017). The determinants and outcomes of good provider communication : a cross- sectional study in seven African countries. BMJ Open, 7(e014888), 1–9. https://doi.org/10.1136/bmjopen-2016-014888
Lawal, B.J., Agbla, S.C., Bola-lawal, Q.N., Afolabi, M.O., & Ihaji, E. (2018). Patients ’ satisfaction with care from Nigerian Federal Capital Territory’s public secondary hospitals : a cross-sectional study. Journal of Patient Experience, 5(4), 250–257. https://doi.org/10.1177/2374373517752696
Leng, C. (2019). Communication between the healthcare provider and people of low SES: Application of the COM-B model to find factors that underlie communicative behaviour of healthcare providers. Wageningen University.
Li, H.Z., Desroches, N.G., Yum, Y.O., Koehn, C., & Deagle, G. (2007). Asymmetrical talk between Physicians and Patients: A Qualitaive Discourse Analysis. Canadian Journal of Communication Corporation, 32(3&4), 419–433. https://doi.org/10.1016/S0003-4975(10)62114-5
Mulondo, M., Ndlovu, S., Ndirangu, J., & Tsoka-Gwegweni, J. (2024). Mental health impact of COVID-19 on healthcare workers versus adults in Africa. Afr J Prm Health Care Fam Med.16(1), a4175. https://doi.org/10.4102/ phcfm.v16i1.4175
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2016). Communication Barriers Perceived by Nurses and Patients. Global Journal of Health Science, 8(6), 65-74.
Nwobodo, E.P., Strukcinskiene, B., Razbadauskas, A., Grigoliene, Rasa., & Agostinis- Sobrinho, C. (2023). Stress management in healthcare organizations: the nigerian context. Healthcare, 11, 2815. https:// doi.org/10.3390/healthcare11212815
Ogundoyin, O.S. (2017). Care Communication: Is Patients’ Adherence to Treatment Dependent on Doctors’ Communicative Interaction? MCC, 1(2), 1–18.
Ogunsuji, O.O., Adebayo, O., Olaopa, O., Efuntoye, O., Agbogidi, J.M., Kanmodi, K., Buowari, D.Y., Igbokwe, M., Oiwoh, S.O., Kpuduwei, S.P., Adeniyi, M.A., Fagbule, O.F., Ilesanmi, O.S., & Atilola, O. (2019). Burnout among Nigerian Doctors: A Systematic Review. Nigerian Medical Practitioner, 76(1-3), 24-29.
Ojala, T., Häkkinen, A., Karppinen, J., Sipilä, K., Suutama, T., & Piirainen, A. (2014). Revising the negative meaning of chronic pain - a phenomenological study. Chronic Illness, 11(2), 156-67. Doi:10.1177/1742395314555236.
Onigbogi, C.B., & Banerjee, S. (2019). Prevalence of psychosocial stress and its risk factors among health-care workers in nigeria: a systematic review and meta-analysis. Niger Med J. 60(5), 238–244. Doi: 10.4103/nmj.NMJ_67_19: 10.4103/nmj.NMJ_67_19
Osiya, D.A., Ogaji, D.S., & Onotai, L. (2017). Patients’ satisfaction with healthcare: comparing general practice services in a tertiary and primary healthcare settings. Nigerian Health Journal, 17(1).
Oyadiran, O.T., Agaga, L.A., Adebisi, Y.A., & Lucero-Prisno, D.E. III (2020). Nigeria, COVID-19 and the dearth of health workers. JoGH, 10(2), 020379. Doi:10.7189/jogh.10.020379 Parse, R.R. (2019). Healthcare Venues in Transition: A Paradigm Shift? Nursing Science Quarterly, 32(3), 169–170. https://doi.org/10.1177/08943184198263
Paternotte, E., Dulmen, S.V., Lee, N.V.D., Scherpbier, A. J. J. A., & Scheele, F. (2015). Factors influencing intercultural doctor-patient communication : A realist review. Patient Education and Counseling, 98(4), 420–445. https://doi.org/10.1016/j.pec.2014.11.018
Roskams, M., McNeely, E., Weziak-Bialowolska, D. & Bialowolski, P. (2021). Job demands-resources model: its applicability to the workplace environment and human flourishing. In Appel-Meulenbroek, R., & Danivska, V. (Eds). A Handbook of Theories on Designing Alignment Between People and the Office Environment, First Edition (pp.27-38). Routledge.
Schaufeli, W.B. (2017). Applying the job demands-resources model: A ‘how to’ guide to measuring and tackling work engagement and burnout. Organizational Dynamics, 46, 120-132. http://dx.doi.org/10.1016/j.orgdyn.2017.04.008
Schiavo, R. (2007). Health Communication: From Theory to Practice (First Edit). Jossey-Bass. Shrivastava, S.R., Shrivastava, P.S. & Ramasamy, J. (2016). Exploring the role of communication barriers in healthcare. South African Family Practice, 58(1), 51-52. DOI: 10.1080/20786190.2014.977039
Singhal, S., Vinjamoori, N., & Radha, M. (2022). Healthcare practice: the next frontier of healthcare delivery - Ten big shifts will define the future of care delivery in the United States. Report (May). McKinsey & Company.
Sundler, A.J., Lindberg, E., Nilsson, C. & Palmér, L. (2019). Qualitative thematic analysis based on descriptive phenomenology, Nursing Open, 6:733– 39.
Vance, M.C,. Mash, H.B.H., Ursano, R.J., Zhao, Z., Miller, T.T., Clarion, M.J.D., West, J.C., Morganstein, J.C., Iqbal, A., & Sen, S. (2021). Exposure to workplace trauma and posttraumatic stress disorder among intern physicians. JAMA Network Open, 4(6):e2112837. doi:10.1001/ amanetworkopen.2021.12837.
World Health Organisation. (1946). Constitution of the World Health Organisation. Author.