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A good patient? How notions of ‘a good patient’ affect patient-nurse relationships and ART adherence in Zimbabwe

Campbell, Catherine, Scott, Kerry, Skovdal, Morten, Madanhire, Claudius, Nyamukapa, Constance and Gregson, Simon (2015) A good patient? How notions of ‘a good patient’ affect patient-nurse relationships and ART adherence in Zimbabwe. BMC Infectious Diseases, 15 (404). ISSN 1471-2334

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Identification Number: 10.1186/s12879-015-1139-x

Abstract

Background: While patient-provider interactions are commonly understood as mutually constructed relationships, the role of patient behaviour, participation in interactions, and characteristics, particularly ideals surrounding notions of ‘good’ and ‘bad’ patients, are under-examined. This article examines social representations of ‘a good patient’ and how these representations affect patient-healthcare provider relationships and antiretroviral treatment (ART) for people living with HIV. Methods: Using thematic network analysis, we examined interview and focus group transcripts involving 25 healthcare staff, 48 ART users, and 31 carers of HIV positive children, as well as field notes from over 100 hours of ethnographic observation at health centres in rural Zimbabwe. Results: Characteristics of a good patient include obedience, patience, politeness, listening, enthusiasm for treatment, intelligence, physical cleanliness, honesty, gratitude and lifestyle adaptations (taking pills correctly and coming to the clinic when told). Many patients seek to perform within the confines of the ‘good patient persona’ to access good care and ensure continued access to ART; in this way, the notion of a ‘good ART patient’ can have positive effects on patient health outcomes. However, for people not conforming to the norms of the ‘good patient persona’, the productive and health-enabling patient-nurse relationship may break down and be detrimental to the patient. Conclusion: We conclude that policy makers need to take heed of the social representations that govern patient-nurse relationships and their role in facilitating or undermining ART adherence.

Item Type: Article
Official URL: http://www.biomedcentral.com/bmcinfectdis/
Additional Information: © 2015 The Authors.
Divisions: Psychological and Behavioural Science
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine
R Medicine > RZ Other systems of medicine
Sets: Departments > Social Psychology
Departments > Psychological and Behavioural Science
Date Deposited: 29 Sep 2015 13:47
Last Modified: 20 Feb 2019 11:25
Projects: 084401/Z/07/Z
Funders: Wellcome Trust
URI: http://eprints.lse.ac.uk/id/eprint/63800

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