|dc.description.abstract||Patients and nurses in health facilities interact daily with the purpose of improving
health outcomes. However, it is not known to what extent the elements of health
dialogue are incorporated into each individual patient and nurse interaction. A
concept analysis of “health dialogue” laid the foundation to identify the presence of
the antecedent and empirical referent health dialogue elements during health
communication between patients with diabetes and nurses in the Northern Cape.
The objective of the study was to assess, through observation, the presence of the
health dialogue elements, namely, antecedents, which are a positive attitude,
sensitivity and respect, and training; and empirical referents, which comprise shared
responsibility and decision-making, a mutually beneficial health plan and contextsensitive
A quantitative, non-experimental, descriptive, cross-sectional research design was
used. Data were collected using an observational checklist aided by a guideline at
public and private health facilities (n=16) in the Sol Plaatje local municipality located
within the Frances Baard District. Patients with diabetes (N=88) and nurses (N=22)
were observed while they interacted during one-on-one consultations (n=88). Each
nurse interacted with more than one patient. Audio-recordings of interactions were
used to verify and support observations.
Data analysis was carried out using descriptive statistics, namely, frequencies and
percentages for categorical data, medians and percentiles for continuous data,
calculated per group, and comparing nurse and patient responses. McNemar’s test or
Bhapkar’s test was applied to compare the statistical difference in responses between
the nurses and the patients.
Inconsistencies (48.8%) in the presentation of the health dialogue antecedent elements
and sub-elements of positive attitude and sensitivity and respect during nurse-patient
interactions, were noted. The antecedent element findings for training noted nurse
training in diabetes (19.3%) and in communication skills (30.6%), whilst patient training
and information about diabetes (48.7%) and communication skills (3.4%) were found.
In accordance with the concept analysis of health dialogue, the inconsistencies noted
in the presentation of antecedent health dialogue elements imply that it was not likely
that the empirical referents could be realised. However, both nurses and patients stated
that the empirical referent elements of shared responsibility/decision-making, a health
care plan of mutual benefit and the application of context-sensitive communication
strategies to convey health messages were experienced during the study.
These findings indicate that both nurses and patients are unable to incorporate the
antecedent health dialogue elements during interaction with one another. In addition,
nurses and patients appear to be ill-prepared to include participatory health
communication and health dialogue in interaction.
Capacity building of both nurses and patients is recommended to enhance participatory