Patient Centredness in a Black Township

Abstract

A prospectiue study amongst the private general practitioners in Ga-Rankuwa, South Africa Purpose: The purposes of this study were to assess the degree to which a patient-centred approach is used b,v the private general practitioners in the black township where we practise and to test both its short and long term effectiveness. We postulated that patient-centredness would be positively associated with: (i) patients feeling understood; (ii) patient satisfaction; (iii) symptom resolution; (iv) concern resolution; and (v) the long term control of hypertension, diabetes mellitus and asthma. Method: The study was conducted in Ga-Rankuwa, South Africa, a large black township, northwest of Pretoria. A random sample of 10 private general practitioners was chosen. Eligible patients were all those over 16 years who presented with a symptom or one of the three target conditions. Patient-centredness was scclred in terms of the doctor's facilitation of the patient's reasons for coming, including symptoms, thoughts, feelings and expectations, from an audio-tape ofthe entire consultation. Post-consultation interviews were conducted to assess the immediate patient outcomes. Follow-up during the next l2 months was planned in clrder to assess the long-term outcomes, but this was circumvented by failure to obtain sufficient patients with the targeted chronic conclitions.