Patient-provider encounter: The contemporary Cameroonian story
by Hell, Eudaline Patricia, Ph.D., THE UNIVERSITY OF NEW MEXICO, 2011, 245 pages; 3473430

Abstract:

Most communication scholars recognize that cultural beliefs influence health and interactions about health. Within the African context, religious cultural beliefs constitute dynamic elements of the culture. My dissertation explains the influences of religion and culture on patient-provider interactions in Cameroon. My field research sought answers to the following questions: How do the assumptions of the Western medical model intersect with those of the native culture in patient-provider interactions? How do Cameroonian providers and patients conceptualize health and illness? How does Cameroonian culture, especially native and Christian religious beliefs influence the beliefs and practices of providers and patients? How do interactions between providers and patients incorporate narrative and dialogue? How do providers and patients perceive the quality and ethics of health related interactions?

I used participant observation and field interviews in urban and rural areas in Cameroon as the context for my collection of data. When conducting interviews, I asked questions pertaining to health beliefs and health interactions that produced lengthy narrative responses from providers and patients in Cameroon. My analysis of the 22 transcribed interviews utilized thematic analysis. The data analysis yielded the following results. Cameroonian patient and provider participants used the Western medical model along will other native cultural approaches to health to construct their health beliefs. In ways that differ from other research studies on health beliefs, Cameroonians conceptualize health as physiological, moral, emotional, spiritual and financial. Cameroonians' native cultural beliefs in God, prayer, fear of death and spiritual interventions influence the kind of values that they hold and when they are involved in patient-provider interactions. Cameroonians' values related to community, family, and love as well as their expectations about humanistic care revealed the importance of humility, compassion and gratefulness to the quality of health care. Specifically, my research in Cameroon showed that both providers and patients equate the quality of health care with the quality of patient-provider interactions. My data analysis demonstrates the importance of specific communication behaviors to patient-provider interaction. These communication behaviors centered on expressions of responsibility, listening, time for the other, and treating others as family. These communication behaviors share many features of dialogue and narrative medicine that scholars in the U.S. recommend for quality interactions. Finally, my research identified differences between providers and patients in their perceptions of waiting time and rule following. The patients' responses about reasons for waiting and the perceived length of the waiting time cast a negative light on the providers. Moreover patients' resistance to some of the rules given by providers showed that patients' believe that rules impede the quality of the health care they receive. This dissertation study is an innovative attempt to analyze how culture and native and Christian religious beliefs influence the content and the quality of patient-provider interactions in urban and rural setting in Cameroon. My study shows that traditional cultural beliefs about health and healing continue to influence health interactions. Specifically, the beliefs and practices of providers and patients utilized a mixture of Native religion, Christianity, and the western and scientific model of diagnosis and treatment of patients. The convergence of these different beliefs strongly influences the content and quality of communication in patient-provider interactions.

 
AdviserJanice Schuetz
SchoolTHE UNIVERSITY OF NEW MEXICO
SourceDAI/A 72-12, p. , Oct 2011
Source TypeDissertation
SubjectsAfrican studies; Religion; Public health
Publication Number3473430
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