CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Understanding communication in health care practices, especially in relation to doctor/nurse-patient communications, can contribute to patient engagement and perceptions of quality of care. In doctor/nurse-patient interaction, both doctors and nurses bring their individual knowledge, attitudes, feelings, experiences, and patterns of behavior to the relationship. These individual-based behavioral patterns and perceptions of realities in healthcare demand that different communication styles be employed to meet the varying healthcare expectations and needs of patients and their caregivers. However, to deliver effective healthcare requires clear communication as an essential element, and that, in an intercultural healthcare setting, healthcare providers have the responsibility to communicate effectively with people from diverse backgrounds. The impact of poor communication skills by health care practitioners can be detrimental to the quality of care, health practices, and safety, which suggests that communication competence is a required skill for all nurses. It has been observed that physician-patient communication characterized by effective information exchange can lead to greater patient trust and willingness to follow through with the treatment plan, which, in turn, may affect survival. Some researchers have maintained that patient participation in consultations can help physicians to understand their values and preferences and discover possible patient misperceptions regarding treatment effects. These authors indicated that where there is effective communication between physicians and patients, clinical information can be communicated in ways that patients understand, potentiating higher-quality decisions that best match the patient’s circumstances, thus helping to improve health. Furthermore, research has shown that poor communication among nurses (verbal and nonverbal behavior), including impolite speeches, use of harsh and rude language, use of humiliating and provocative words, and abusive language are among the many causes of patients’ reactive violence against nurses (Boafo, 2016). These and many more spurred the researchers to conduct an assessment of the effect of poor communication on healthcare delivery in Nigeria.

1.2 Statement of the problem

Poor communication in healthcare delivery has gained attention in recent times. In many of the healthcare areas studied, nurse-patient communication has been poor, with care providers dominating the process. In most cases, some nurses neglect patients' needs and concerns as well as abuse and humiliate them, especially in maternal/antenatal and primary healthcare settings in public healthcare facilities. Most studies have reported that violence against nurses in most hospitals is caused by patients reacting to nurses' poor communication and maltreatment of patients and caregivers. Healthcare providers must develop a sense of compassion and respect for patients from different backgrounds and cultures.

Healthcare practitioners during health care delivery must know that patients' concerns, expectations, and fears need to be addressed and where their cultural, religious, and contextual needs conflict with the care process. Patients need to be listened to, educated, and provided with the right information to encourage their active participation in healthcare. When communication is poor in health care delivery, it can endanger the patient and delay them from responding to treatment. Thus, it is upon this premise that this study seeks to examine the effect of poor communication on healthcare delivery in Nigeria.

1.3       Objective of the study

The main focus of this study is to examine the effect of poor communication on health care delivery in Nigeria. Specifically the study seeks

1. To understand the importance of communication between the patients and health care providers

2. To investigate if effective communication affects the  quality of patient’s health recovery process and care satisfaction in the health care settings.

3. To examine if there is possibility that nurse’s poor communication skills have been a leading factor in wrong administration of medications to patients

1.4       Research Questions

The research is guided by the following research questions:

1. Is communications of great of great importance between in patients and health care providers in the health care system?

2. Does effective communication affects the  quality of patient’s health recovery process and care satisfaction in the health care settings?

3. Are there possibilities that nurse’s poor communication skills have been a leading factor in wrong administration of medications to patients?

4. Are there prevalence of poor communication in the health care delivery in Nigeria?

1.5       Significance of the study

Findings from the study will be helpful to health care providers and those in the medical line. The result of the study will be pivotal and contribute empirically on the importance of effective communication between patients and healthcare providers as it is of a primary concern in today’s healthcare delivery even as it helps in the therapeutic understanding of diseases, diagnosis and eventual cure as both parties are aided and encouraged to talk openly to each other to unravel and understand the mystery of the health condition(s) before them. The study will contribute to the general body of Knowledge and serve as a reference material for student and other researchers in conducting further studies on related field of study.

1.6       Scope of the study

The scope of this study cover on the effect of poor communication on  health care delivery in Nigeria. The study is however delimited to selected hospitals in Abia State.

1.7       Limitation of the study

The following factors poses to be a limitation during the course of this research

Financial constraint– Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint– The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

Respondent attitude: The majority of respondents failed to collect the questionnaires, and those who do collect them pay close attention to filling out and returning them, while others do not return theirs at all. Others were less accommodating and may have provided untrustworthy information because they were afraid of being exposed, despite the researcher's promise that all information would be treated with the utmost secrecy and only for education purposes.

1.8       Definition of terms

HealthCare Provider: A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices.

Healthcare System: The health care system refers to the institutions, people and resources involved in delivering health care to individuals. A health system consists of all organizations, people, and actions whose primary intent is to promote, restore, or maintain health such as hospital systems, patient care, insurance.

Communication effectiveness:Effective Communication is defined as the ability to convey information to another effectively and efficiently either with good verbal, nonverbal and written communication skills help facilitate the sharing of information between people within a company for its commercial benefit.

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