Nursing

https://www.hsag.co.za Open Access Health SA Gesondheid ISSN: (Online) 2071-9736, (Print) 1025-9848 Page 1 of 8 Original Research Read online: Scan this QR code with your smart phone or mobile device to read online. Authors: Lindiwe Gumede1 Pauline B. Nkosi2 Maureen N. Sibiya3 Affiliations: 1Department of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa 2Department of Radiography, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa 3Faculty of Innovation and Engagement, Mangosuthu University of Technology, Durban, South Africa Corresponding author: Lindiwe Gumede, lindiweg@uj.ac.za Dates: Received: 08 Mar. 2023 Accepted: 25 Oct. 2023 Published: 31 Jan. 2024 How to cite this article: Gumede, L., Nkosi, P.B. & Sibiya, M.N., 2024, ‘Allopathic medicine practitioners’ experiences with nondisclosure of traditional medicine use’, Health SA Gesondheid 29(0), a2381. https://doi.org/10.4102/ hsag.v29i0.2381 Copyright: © 2024. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. Introduction The focal role in establishing a therapeutic relationship between allopathic medicine practitioners (AMPs) and patients is of effective communication between the two (Pasca 2020). The lack of good communication between AMPs and patients during consultations can discourage disclosure. Therefore, AMPs must have good verbal and nonverbal communication skills to interact with patients. These include active listening, enquiring, communicating, and inspiring others to speak (Jahan & Siddiqui 2019). This is also true for patients who use both traditional medicine (TM) and allopathic medicine (AM) (Gall et al. 2019). When working with various patients, cross-cultural communication, which is part of cultural competence, is frequently required (Jahan & Siddiqui 2019). To prevent communication breakdowns between patients who use TM and AMPs, AMPs must adapt their consultation communication to the patient’s specific requirements. According to a recent study, patients who use both TM and AM may not disclose their use of TM because of poor communication between patients and AMPs, a lack of awareness of the potential interaction between TM and AM, and AMPs incorrectly judging the use of TM (Agarwal 2020). Allopathic medicine practitioners are more likely to overlook serious health issues caused by the negative interaction of TM and AM, as well as a breakdown in the connection between patients (who use both TM and AM) and AMPs, because of a lack of proper communication (Bauer & Guerra 2014). Studies suggest that AMPs must probe patients to encourage disclosure and increase the rate of disclosure of TM use (Thandar et al. 2019; Van der Geest & Hardon 2006). Background: A pertinent issue impacting patient treatment outcomes is the nondisclosure of traditional medicine (TM) use to Allopathic medicine practitioners (AMPs). For years, TM has been a controversial practice, with patients often using it alongside allopathic medicine without disclosing their use. It is imperitive to learn and understand the experiences of AMPs regarding the disclosure of TM use in Gauteng province to enable them to provide the best possible treatment outcomes for patients who use TM. Aim: This study aimed to explore the experiences of AMPs regarding non-disclosure of TM use in Gauteng province. Setting: This study was conducted in four district hospitals where outpatient care and services are rendered in Gauteng Province. Methods: An interpretive phenomenological analysis (IPA) design was followed. Fourteen purposefully sampled AMPs participated in face-to-face, one-on-one, and semi-structured interviews. Interpretive phenomenological analysis in Atlas.ti was conducted. Results: Three themes emerged: bedside manner of AMPs; stigmatising TM use; and individual belief systems. The belief of patients’ disclosure hesitancy because of fear of judgment by the AMPs underpinned these themes. Conclusion: Allopathic medicine practitioners are aware that patients who use TM could feel guilty and stigmatised. They acknowledged that patients use TM because of cultural and ethnic reasons, which should not be disregarded. Contribution: The study highlighted that patients do not disclose their TM use because of AMPs’ attitudes, stigmatising TM use, and their prejudices against the cultural beliefs of patients. Allopathic medicine practitioners should establish good communication with patients by providing patient-centred communication to facilitate disclosure of TM use. Keywords: traditional medicine; Allopathic medicine practitioners; non-disclosure; patient treatment outcomes; consultation; stigmatising; belief systems; cultural and ethnic reasons. Allopathic medicine practitioners’ experiences with non-disclosure of traditional medicine use Page 2 of 8 Original Research https://www.hsag.co.za Open Access Over the last decade, there has been little change in the rate of TM use disclosure to AMPs (Foley et al. 2019). However, rates of disclosure of TM use vary according to population demographics and TM classification. A study conducted in Malaysia reveals that patient disclosure was motivated by multiple benefits, including the possibility of receiving advice from AMPs regarding the continuance of TM use or receiving more information about the TM they use (Kelak, Cheah & Safii 2018). The lack of disclosure regarding TM usage holds significance, especially in understanding how AMPs are pivotal guardians in ensuring their patients’ overall health awareness (Foley et al. 2019). According to Johny, Cheah and Razitasham (2017), AMPs tend to be business-oriented and lack human connection with TM patients, which hinders disclosure. Several articles have addressed grounds for non-disclosure of TM use (Agyei- Baffour et al. 2017; Mokhesi & Modjadji 2022; Stubbe 2018). Motivation for non-disclosure may include, but is not limited to, failure of AMPs to inquire about TM use, AMPs reprimanding patients for using TM, and that AMPs have limited knowledge of TM and therefore they would not benefit from disclosing their TM use (Mwaka, Abbo & Kinengyere 2020). Despite documented evidence of barriers to patients’ disclosure of TM use to AMPs, there is a paucity of research examining AMPs’ experiences with nondisclosure of TM use. Therefore, it is important to encourage AMPs to inquire about the patient’s use of TM (Stubbe 2018). The use of TM is common in South Africa and therefore AMPs need to be knowledgeable to better manage their patients for better outcomes (Zingela, Van Wyk & Pieterse 2019). Patients may believe that their TM use is confidential; therefore, AMPs might not be aware that they are using TM and AM concurrently. To ensure patient safety, a thorough investigation of patients’ disclosure of TM use as well as the reasons for non-disclosure is required (Mokhesi & Modjadji 2022). Currently, existing patient–AMP communication does not allow AMPs to link TM and AM in practice; thus, the development of workable methods to guide the process is required (Wardle, Sibbritt & Adams 2018). These methods could assist AMPs in comprehending patients’ non-disclosure, allowing them to enhance treatment and communication with patients who use TM. Several studies have examined the impact of involving patients in healthcare decisions. For example, Krist et al. (2017) found that when patients are involved in decision-making, they have a better understanding of their treatment options and are more likely to make informed choices. Similarly, Bombard et al. (2018) argue that involving patients in healthcare decisions can improve communication between patients and healthcare providers, leading to better service delivery and governance. However, despite these findings, there is still a need for further research to explore the implications of non-disclosure or disclosure on treatment outcomes and the provision of care by healthcare providers (Foley et al. 2019). Purpose This study explored the experiences of AMPs regarding the disclosure of TM use in Gauteng province. Research methods and design Research design and context A qualitative, interpretive phenomenological research approach guided by hermeneutics was followed to explore the lived experiences of AMPs when consulting with patients who use TM (Rodriguez & Smith 2018; Smith 2004). The chosen design was deemed appropriate for this study because it allowed the researcher to begin comprehending the variety of factors of non-disclosure of TM that can affect AMPs based on their perspective and experience, revealing concealed meaning rather than making inferences. The study was guided by a constructivist paradigm, which took a relativist ontology approach and incorporated various intangible mental concepts that were derived from the contextual and experiential knowledge of the AMPs (Guba & Lincoln 1994). The study was conducted at selected district hospitals in the Gauteng province. Four district hospitals were selected for this study because they promote primary health care and serve as a gateway to specialised care. These hospitals are where most patients with chronic illnesses and potential TM users are managed. This study was inspired by the main researcher’s prior experience as a radiographer, who saw several difficulties faced by AMPs when dealing with patients who might be using TM and not disclosing TM use to them. Population and sampling Population in research is the entire group of individuals with similar characteristics from whom data will be collected (Polit & Beck 2017). The study population were AMPs working in the outpatient departments (OPDs), in the district hospitals in the Gauteng Province. A non-probability, purposive sampling described by Polit and Beck (2017), was adopted to select AMPs in the OPD from multiple sites. The researcher selected participants based on ...