Using Body Diagrams and Disease Protocols as Part of an Integrated Approach to the Medical Consultation in Nepal

Abstract

Neither medical assistants nor doctors in Nepal receive adequate training in medical consultation techniques. Patients often leave the consultation with poor understanding of their disease. Moreover, disease management counselling and preventative health counselling are rarely done. In order to address these issues, simple body diagrams and disease protocols were developed and tested in a random cohort survey of 300 outpatients. While 72% of patients who were shown a body diagram achieved basic understanding of their disease, only 38% of patients who were not shown a body diagram understood their disease. This improvement was significant and independent of other factors. Satisfactory disease management counselling was given in 38% of cases, and preventative health counselling in 36%. There was correlation between use of body diagrams and provision of disease management counselling and preventative health counselling. These findings emphasize the need for simple consultation tools such as body diagrams and disease management protocols in developing countries.