Patients' Involvement in Decision-Making During Healthcare in a Developing Country: A Cross-Sectional Study.

Patient autonomy and participation have a significant impact on patient satisfaction and compliance with treatment. We aimed to establish and describe the level of shared decision-making (SDM) among the patients in a developing country. Uganda is a low resource country with a 2019 GDP of 35.17 billion US dollars. In some regions, over 60% of Ugandans live below the national poverty line and most of them depend on the underfunded health care system. A cross-sectional, quantitative study was carried out among the outpatients attending Kisenyi Health center IV, Kampala, Uganda. An interviewer-administered questionnaire with a 5-point Likert scale was used to assess patients' SDM. All statistical analysis was performed using STATA 15 software. A total of 326 patients participated in this study. Majority of the participants were females (n=241, 73.9%) and aged 18-35 years (n=218, 66.9%). Only 22 (7%) of the participants knew the name of their consulting doctor. Most of the participants, 84% were given enough time to narrate their symptoms. Overall, only 11.3% (n=37) of the participants had adequately participated in SDM. The overall mean score of participation in SDM was 2.7 (SD:0.8). Participants who knew the name of their consulting doctor were approximately 11 times more likely to participate in SDM (OR: 10.7, 95% CI: 4.2-27.0, P<0.0001). The majority of patients attending Kisenyi Health Center IV did not adequately participate in SDM. Continued medical education should be organized for healthcare professionals to promote SDM.

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© 2021 Nuwagaba et al.

Déclaration de conflit d'intérêts

Dr Keneth Kato Agaba reports grants from The Fogarty International Center of the National Institutes of Health, US Department of State’s Office of the U.S, Global AIDS Coordinator and Health Diplomacy (S/GAC), grants from President’s Emergency Plan for AIDS Relief (PEPFAR) under award number 1R25TW011213, during the conduct of the study. Dr Ali Bananyiza reports grants from Health Professional Education Partnership initiative, during the conduct of the study. The authors report no other conflicts of interest in this work.