Communication skills of general practitioners in Nairobi, Kenya: a descriptive observational study

Gulnaz Mohamoud; Robert Mash

doi:10.3399/BJGPO.2021.0235

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Figure 1. Distribution of total percentage scores for the consultations (n = 23)

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Table 1. Main reasons for encounter and diagnoses in the consultations

Number	ICPC domains for reasons for encounter	n (%), n = 49	Number	ICPC domains for diagnoses	n (%),n = 31
1	Gastrointestinal	13 (26.5)	1	Gastrointestinal	10 (32.3)
2	Respiratory	9 (18.4)	2	Musculoskeletal	7 (22.6)
3	Musculoskeletal	6 (12.2)	3	Respiratory	6 (19.4)
4	General	6 (12.2)	4	Female genital	4 (12.9)
5	Neurological	5 (10.2)	5	Skin	1 (3.2)
6	Female genital	5 (10.2)	6	Cardiovascular	1 (3.2)
7	Urological	2 (4.1)	7	Male genital	1 (3.2)
8	Skin	1 (2.0)	8	Urological	1 (3.2)
9	Male genital	1 (2.0)
10	Eye	1 (2.0)

ICPC = International Classification of Primary Care.

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Table 2. Evaluation of consultation skills

Number	Consultation skill^a	Not done,n (%)	Partially done,n (%)	Fully done,n (%)
1	Makes appropriate greeting or introduction, and demonstrates interest and respect (n = 23)	12 (52.2)	5 (21.7)	6 (26.1)
2	Identifies and confirms the patient’s problem list or issues (n = 23)	9 (39.1)	12 (52.2)	2 (8.7)
3	Encourages patient’s contribution or story (n = 23)	1 (4.3)	12 (52.2)	10 (43.5)
4	Makes an attempt to understand the patient’s perspective (n = 23)	9 (39.1)	13 (56.5)	1 (4.3)
5	Thinks family, and obtains relevant family, social, and occupational information (n = 23)	12 (52.2)	8 (34.8)	3 (13.0)
6	Obtains sufficient information to ensure no serious condition is likely to be missed (n = 23)	1 (4.3)	3 (13.1)	19 (82.6)
7	Appears to make a clinically appropriate working diagnosis (n = 23)	1 (4.3)	2 (8.7)	20 (87.0)
8	There is a clear explanation of the diagnosis and management plan (n = 18)	0 (0.0)	2 (11.1)	16 (88.9)
9	Gives patient an opportunity to ask for other information and/or seeks to confirm patient’s understanding (n = 18)	2 (11.2)	8 (44.4)	8 (44.4)
10	The explanation takes account of and relates to the patient’s perspective (n = 20)	13 (65.0)	3 (15.0)	4 (20.0)
11	Involves the patient where appropriate in decision making (n = 23)	3 (13.0)	7 (30.4)	13 (56.5)
12	Chooses an appropriate management plan (n = 20)	0 (0.0)	1 (5.0)	19 (95.0)
13	Shows a commitment to coordination of care (n = 15)	0 (0.0)	1 (6.7)	14 (93.3)
14	Shows a commitment to continuity of care (n = 20)	6 (30.0)	1 (5.0)	13 (65.0)
15	Closes consultation successfully (n = 21)	5 (23.8)	5 (23.8)	11 (52.4)
16	Provides appropriate safety netting for the patient (n = 19)	7 (36.8)	5 (26.4)	7 (36.8)