Health care providers counselling of caregivers on their children’s condition at Usmanu Danfodiyo university teaching hospital, Sokoto, North-Western Nigeria

Health care providers counselling of caregivers on their children’s condition at Usmanu Danfodiyo university teaching hospital, Sokoto, North-Western Nigeria Adamu A.1*, Isezuo KO.2, Sani UM.3, Ibitoye PK.4, Ugege MO.5, Garba BI.6, Ali M.7, Ango UM.8, Jiya FB.9 DOI: https://doi.org/10.17511/ijpr.2020.i07.07 1*Adamu Asma’u, Senior Lecturer, 2Isezuo Khadijat Omeneke, Senior Lecturer, 3Sani Usman M., Associate professor, 4Ibitoye Paul Kehinde, Associate Professor, 5Ugege MO., Associate professor, 6Garba BI, Associate Professor, 7Ali M., Lecturer, Department of Pharmacology, Usmanu Danfodiyo University, Sokoto, Nigeria. 8Ango UM., Senior Lecturer, Department of Community Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria. 9Jiya BF., 1,2,3,4,5,6,9Authors are affiliated with the Department of Paediatrics, Usmanu Danfodiyo University, Sokoto, Nigeria


Introduction
Counselling of caregivers about common childhood diseases is an important component of health care   and 29 (6.9%) were counselled by the consultants and house officers respectively as shown in Table 3.  Table 5.  Table 6.  Table 7. Evelyn et al [18] also found that patients from lower social classes receive less quality of counselling than those in the higher socio-economic class.
Furthermore, there seems to be a growing interest in the patient's perception of doctor-patient communication. While in the past patient's perception was not taking into account or no differences in perception were found, more recent studies show that lower SEC patients have the feeling that doctors fail to explain things in a way they can understand and spend less time with them [19]. Health care providers should counsel all caregivers and patients irrespective of their social class and in the language that they will understand [20][21].
Lack of sufficient explanation to patients and caregivers results in poor patient understanding, and lack of consensus between doctor and patient may lead to therapeutic failure [22]. Patients reporting good communication with their doctors are more likely to be satisfied with their care, and especially to share pertinent information for accurate diagnosis of their problems, follow advice, and adhere to the prescribed treatment [23]. When there is good doctor-communication, patients are more satisfied and are less likely to lodge formal complaints or initiate malpractice complaints [24].
None of the health care providers documented the content of health information given to the caregivers, although there are few studies on physician documentation, a similar finding was reported by Nwaneri et al [7]. Studies had shown that doctors have poor documentation practices ranging from non-writing of discharge summary [25] to omission of documentation of vital information of patients [26][27]. Inadequate documentation practices were also reported among the nurses, where more than half of the nurses did not document nursing care for patients [28]. The medical record is valuable for research, audit and medico-legal purpose but its primary function is for patient care [29]. The ability to comprehend and retain information may decline as patients and family members age [33].
The attitude of some health care providers towards their patients was poor in this study, with the majority of the healthcare providers not introducing themselves to 57.8% of the caregivers counselled, this is consistent with the report by Kebashin et al [34]. Nwosu et al [14] in Lagos reported good initial reception to caregivers of children of 81.3% for the doctors and 25% for the nurses.
Majority of the caregivers 156 (71.6%) were counselled in an open ward and only 6 (2.8%) were counselled in a private consulting room. Lack of auditory privacy is well recognised in hospital settings [35]. Privacy and confidentiality are important components of patient care [36][37].
Overheard disclosures adversely affect patients' trust and can lead to a breakdown in the relationship between the patient and their healthcare team [38].
Personal privacy must be respected, even in the course of medical/surgical treatments, diagnostic examinations, specialist visits, medications and so on, it must take place in an appropriate environment and in the presence of only those who need to be there [39]. Ensuring privacy can promote more effective communication between physician and patient, which is essential for the quality of care, enhanced autonomy, and preventing economic harm, embarrassment, and discrimination [40].

Conclusion
This study revealed inadequate counselling of caregivers on their children condition and poor counselling practices among healthcare providers in UDUTH, Sokoto. Hence, there is the need for training and retraining of healthcare providers on counselling of caregivers on their children condition in the hospital.
What does the study add to the existing knowledge Training on counselling of patients should be reinforced at both undergraduate and postgraduate medical colleges. A concise handbook on counselling of caregivers on common childhood disease should be developed to guide and help health care providers to improve the quality of their counselling. There is a need for further studies to explore the reasons for inadequate and poor counselling practices in the hospital.