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    Allopathic medicine practitioners' perspectives on facilitating disclosure of traditional medicine use in Gauteng, South Africa : a qualitative study
    (Springer Science and Business Media LLC, 2023-12-12) Gumede, Lindiwe; Nkosi, Pauline B.; Sibiya, Maureen N.
    Traditional medicine (TM) plays a key role in maintaining health in many societies. Given the requirement for TM disclosure, Allopathic Medicine Practitioners (AMPs) must encourage open communication with patients to persuade those who use TM to disclose. Addressing patient non-disclosure of TM requires this dialogue to be facilitated. We sought to understand and describe how South African AMPs facilitate disclosure of TM use during a consultation with patients who use both TM and allopathic medicine (AM) and how it influences the patients' willingness to disclose TM use.

    Methods

    This qualitative exploratory descriptive study on AMPs at Gauteng district public hospitals in South Africa was conducted between 2021 and 2022. Non-probability purposive sampling was employed to select a sample of 14 AMPs. Individual participants were encouraged to share their unique experiences and interpretations of the phenomenon concerning TM use disclosure. The raw transcribed textual data were processed using ATLAS.ti, and inductive content analysis was undertaken following the coding of the content to identify categories.

    Results

    The data revealed four major categories: 'providing a suitable atmosphere for disclosure,' 'encouraging patients to disclose TM usage to AMPs,' 'patient autonomy,' and 'AMP training'. During a consultation with patients who use both TM and AM, participants expressed their experiences and perceptions of TM nondisclosure. They also discussed several methods for encouraging patients to disclose their TM usage, particularly when TM is used concurrently with AM.

    Conclusion

    This study expands on previously reported findings by describing how South African AMPs facilitate the disclosure of TM use during consultation. Many AMPs struggle to initiate TM conversations with their patients which results in non-disclosure. This study revealed that integrating TM into AM training programmes, promoting cross-practice, and creating a safe environment is necessary for the development and application of the most appropriate approaches that would assist in facilitating disclosure.
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    Exploring communication as a means to deliver patient education for musculoskeletal care by chiropractors in the eThekwini Municipality
    (2023-05-31) Chapman, Frances Cowley; Orton, Penelope; Prince, Cleo Kirsty
    Background: Communication is a fundamental tool used by all healthcare practitioners, as well as chiropractors, in delivering care. Practitioners use communication to connect with their patients to form trusting relationships and obtain clinically relevant information to reach a diagnosis. It is also used to deliver important healthcare information to the patient regarding their condition, relevant lifestyle changes, interventions and outcomes. The way a practitioner has utilized communication, their ability to deliver succinct patient education that is empathetic and relevant to the patients’ life, and preferences are important factors in the success of the treatment and management delivered. Despite this, communication is still considered a complex phenomenon with little concordance on its success experienced by both the patient and the practitioner. Patient education has been identified as a key factor in delivering optimal management and care of musculoskeletal disease, which is a central component of chiropractic scope of practice. It has also been identified as an important component of chronic care management and encouraging self-management, which is a fundamental part of managing risk factors for both musculoskeletal disease and chronic disease. The eThekwini Municipality, the study location, is a socioeconomically diverse region, which historically suffers from language and social disparities, which affect the delivery and success of healthcare. This research adds a unique insight into how chiropractors in eThekwini utilize communication to deliver patient education to their patients. Methodology: A qualitative research methodology was utilized to collect data through semi-structured interviews. The data were analyzed using thematic analysis to extract the meaning and understanding of the interviews. Eight interviews were conducted before data saturation was reached. Results: Three main themes, namely communication skills, communication barriers and communication techniques, emerged from the data with a number of sub-themes. Conclusion: The results revealed that all the participants thought communication skills and patient education were fundamental to how they delivered care. Their perception on the acquisition of these skills were varied and ranged from passive time in practice, foundational at a university level, and necessitating further studies. When exploring the barriers, it was thought that although patient perception was an important factor, this could be as a result of a consumeristic medical system, poor communication on the practitioners part and a lack of a unified profession identity of chiropractic. Socioeconomic, language and cultural issues still affect the delivery of care and adequate patient education, even though South Africa has been a democracy for 29 years. Communication techniques have evolved, including the utilization of communication technologies, which can contribute to patient-centeredness. Paternalistic and diseasecentered communication techniques still underpin manual therapy but patient-centered techniques are emerging.