Barriers to Shared Decision Making Between Healthcare Providers and Patients on Management of Chronic Diseases: A Study of One Referral Hospital in Kisumu County, Kenya

Abstract

Chronic diseases have become prevalent and are affecting the social-economic fibre of society. Communication is key in ensuring that patients have adequate information to manage their conditions. Shared decision-making would also enable patients to play an active role in their treatment. This study investigated communication between patients and doctors on management of chronic diseases at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). This paper specifically focuses on the aspect of shared decision making. The study adopted the relativist-interpretivist paradigm and qualitative approach. The researchers used the case study method and interviewed 15 patients and 10 health providers. In addition, purposive and snowball sampling were used to identify respondents who were mainly drawn from willing participants of the support groups and patients. The data was generated by means of in-depth interviews and focus group discussions. Data analysis was done thematically.  Findings of the study indicate that although health providers are aware of the importance of shared decision making in the management of chronic diseases most of them are not willing to engage the patients and their caregivers. Patients on the other hand feared having their voices heard since they fear taking responsibility if something went wrong. They also believe they lack the knowledge to make informed choices.  This study will inform policy makers in health particularly regarding the management of chronic diseases and will contribute towards the promotion of quality healthcare.