Doctor Patient Nonverbal Communication and Tuberculosis Treatment Adherence in Kibera Informal Settlement in Nairobi County, Kenya

Purpose: To establish the effect of nonverbal communication on tuberculosis treatment adherence in an informal settlement in Nairobi County, Kenya. Methodology: This was by a descriptive qualitative research design. The sample size was 67 and comprised 10 healthcare workers and 57 TB patients. Purposive sampling technique was used to sample the participants. The study conducted 37 unstructured in-depth interviews and 3 focus group discussions. Data analysis was conducted by first translating the data, then transcribing the verbatim of the in-depth unstructured interviews and focus group discussions. The transcribed data was later analyzed using thematic analysis. Findings: The findings of the study reported that less than half of the patients in the in-depth interviews reported that some healthcare workers avoided eye contact with them when they are in the consultation room and kept writing down notes. About a half of the patients indicated that majority of the healthcare workers expressed positive non-verbal cues which motivated them to adhere to treatment. The findings further showed that non-verbal communication by the healthcare workers in terms of body language could determine a TB patient's adherence to treatment. This nonverbal communication entailed factors like rate of speech, volume of speech, facial expressions and gestures. A higher adherence rate by the patients when healthcare workers exhibited positive non-verbal communication was also reported. Unique Contribution to Theory and Practice and Policy: The constructs of the theories informed the study in terms of treatment adherence by emphasizing the benefits of seeking healthcare early. On practice, healthcare workers needed to be aware of their non-verbal cues when interacting with their patients as they are likely to affect their patients' adherence to treatment. In addition, policy laws on doctor-patient communication nonverbal communication should guide when dealing with patients. The laws should anchor the aspect of non-verbal cues during the healthcare workers' interaction with patients.