Determinants of Health Communication Quality in Diabetes Management in Bamenda Health District Cameroon
Abstract:
Effective communication is essential in diabetes care because it improves patients’ understanding of their condition, treatment adherence, and satisfaction with care. This study assessed communication practices, provider–patient interaction, and barriers affecting perceived communication quality among diabetic patients in the Bamenda Health District, Cameroon. A cross-sectional study involving 149 diabetic patients was conducted using structured questionnaires. Data were analyzed using descriptive statistics, Pearson’s correlation, one-way ANOVA, and multivariate regression techniques. Findings showed that 86% of participants reported that healthcare providers frequently used simple and understandable language (p < 0.001), while only 15% experienced the explain-back method (p = 0.007). Although 57% perceived providers as empathetic (p < 0.001), only 35.6% reported active involvement in decision-making. Significant positive relationships existed between perceived communication quality and receiving regular updates (r = 0.407, p < 0.001), consideration of patient emotions (r = 0.344, p < 0.001), opportunities to ask questions (r = 0.295, p < 0.001), use of visual aids (r = 0.240, p = 0.003), and encouragement of self-care practices (r = 0.262, p = 0.001). One-way ANOVA revealed significant effects of provider–patient interaction factors such as consultation time, active listening, and compassion (p < 0.001). Multivariate analysis identified the use of visual aids (β = 0.050, p = 0.030) and adequate consultation time (β = 0.087, p = 0.014) as positive predictors of communication quality, whereas time constraints negatively affected communication (β = -0.081, p = 0.009).References:
[1].
International Diabetes Federation. IDF
Diabetes Atlas.11th ed. Brussels: IDF; 2025.
[2].
Mbanya J C, Motala A A, Sobngwi E, Assah F K,
Enoru S T. Diabetes in sub-Saharan Africa. Lancet. 2010;375(9733):2254–66. https://doi.org/10.1016/S0140-6736(10)60550-8
[3].
Cholong B J, Chiatii E A, Aloysius N M.
Determinants of Healthcare Utilisation Patterns among People with Type 2
Diabetes in the North West Region of Cameroon. Eur J Health Sci. 2025;11(1):52–64.
https://doi.org/10.47672/ejhs.2707
[4].
Pan J, Xue X, Li H, Wu L. Determinants of
medication adherence and knowledge among patients with Type 2 diabetes
mellitus: A cross-sectional study in Northwestern China. PLoS One.
2026;21(2):e0343091. https://doi.org/10.1371/journal.pone.0343091
[5].
Ratanawongsa N, Karter A
J, Parker M M, et al. Communication and medication adherence among
patients with diabetes: The Diabetes Study of Northern California (DISTANCE). JAMA
Intern Med. 2013;173(3):210–218. https://doi.org/10.1001/jamainternmed.2013.1216
[6].
Street R L Jr, Makoul G, Arora N K, Epstein R
M. How does communication heal? Pathways linking clinician–patient
communication to health outcomes. Patient Educ Couns. 2009;74(3):295–301. https://doi.org/10.1016/j.pec.2008.11.015
[7].
Powell R E, Stone D, Hollander J E.
Patient-centered communication and chronic disease management in diabetes care.
Patient Educ Couns. 2024;120:108042.
[8].
Epstein R M, Street R L Jr. The values and
value of patient-centered care. Ann Fam Med. 2011;9(2):100–103.https://doi.org/10.1370/afm.1239
[9].
Vasanwala R F, et al. Impact of
patient-centered care on diabetes outcomes. Patient Exp J. 2022.
[10].
Bosire E N, Mendenhall E, Norris S A, Goudge
J. Patient-centred care for patients with diabetes and HIV in South Africa. Int
J Health Policy Manag. 2021;10(9):534–545.
[11].
Atinga R A, Yarney L, Gavu N M. Factors
influencing medication non-adherence among patients with chronic conditions in
Ghana. PLoS ONE. 2018;13(3):e0193995. https://doi.org/10.1371/journal.pone.0193995
[12].
Kugbey N, Oppong Asante K, Adulai K. Illness
perception and self-care practices among diabetes patients. BMC Res Notes.
2015;8:381.
[13].
Nyoni C N, et al. Patient-centred
diabetes communication and outcomes in South Africa. Afr J Prim Health Care Fam
Med.
[14].
Kengne A P, June-Rose McHiza Z, Amoah A G B,
Mbanya JC. Cardiovascular diseases and diabetes as economic challenges in
Africa. Prog Cardiovasc Dis. 2013;56(3):302–313. https://doi.org/10.1016/j.pcad.2013.10.002
[15].
Aikins A D G. Healer shopping in Africa:
Evidence from Ghanaian diabetes experiences. Soc Sci Med. 2005;62(4):867–878. https://doi.org/10.1016/j.socscimed.2005.06.058
[16].
Odonkor S T, Frimpong K, Kurantin N.
Patient-provider communication in healthcare: Perspectives from Africa. BMC
Health Serv Res. 2019;19:1–10. https://doi.org/10.1186/s12913-019-4436-0
[17].
Mash R, Fairall L, Adejayan O, et al.
Morbidity survey of South African primary care. Afr J Prim Health Care Fam Med.
2012;4(1):1–9. https://doi.org/10.4102/phcfm.v4i1.303
[18].
World Health Organization. Health literacy
development for the prevention and control of noncommunicable diseases. Geneva:
WHO; 2024.
[19].
Berhe K K, Kahsay H B, Gebru H B. Adherence
to diabetes self-management in Ethiopia. BMC Res Notes. 2017;10(1):1–7.https://doi.org/10.1186/s13104-017-2474-5
[20].
Waweru L M, Otieno C F, Oti S O, Mbanya J C.
Diabetes management challenges in Kenya. Pan Afr Med J. 2018;29:1–9.https://doi.org/10.11604/pamj.2018.29.31.13723
[21].
World Health Organization. Global Report on
Diabetes. Geneva: WHO; 2021.
https://www.who.int/publications/i/item/9789240032095
[22].
Kruse C S, Soma M, Pulluri D, Nemali N T,
Brooks M. Effectiveness of digital health interventions. J Med Internet Res. 2022;24(2):e26171.https://doi.org/10.2196/26171
[23].
Miller T A, Johnson-Lawrence V. Visual
communication strategies in chronic disease education: implications for
diabetes management. Diabetes Educ. 2024;50(3):231–239.
[24].
Pillay J, Armstrong M J, Butalia S, et al.
Behavioral programs for type 2 diabetes mellitus. BMC Health Serv Res. 2015;15:1–10.https://doi.org/10.1186/s12913-015-1018-3
[25].
Ha Dinh T T, Bonner A, Clark R, Ramsbotham J,
Hines S. Effectiveness of the teach-back method: A systematic review. JBI Evid
Synth. 2021;19(1):132–154.https://doi.org/10.11124/JBISRIR-D-19-00122
[26].
Atinga R A, Yarney L, Gavu N M. Factors
influencing long-term patient satisfaction. BMC Health Serv Res. 2016;16:1–10.https://doi.org/10.1186/s12913-016-1345-2
[27].
Elwyn G, Durand M A, Song J, Aarts J. Shared
decision-making and patient outcomes in chronic disease management: A
systematic review. BMC Health Serv Res. 2024;24:118.
[28].
Fokunang C N, Ndikum V,
Tabi O Y, et al. Traditional medicine in Cameroon. Afr J Tradit Complement
Altern Med. 2012;8(3):284–295. https://doi.org/10.4314/ajtcam.v8i3.65276
[29].
Mwangome M N, Geubbels E, Klatser P, Dieleman
M. Perceptions on diabetes care in sub-Saharan Africa. BMJ Glob Health. 2020;5(6):e002523.https://doi.org/10.1136/bmjgh-2020-002523
[30].
Abebe S M, Berhane Y, Worku A, Assefa A.
Diabetes mellitus in Ethiopia. BMC Public Health. 2020;20(1):1–9.https://doi.org/10.1186/s12889-020-08644-8
[31]. World Health Organization. Global Report on Noncommunicable Diseases and Integrated People-Centred Care. Geneva: WHO; 2025.
