Acceptability of a resource-oriented approach (DIALOG+) among patients with chronic physical illnesses in primary health care-Uganda, a qualitative study

• Published in: BMC family practice 2024-12, Vol.25 (1), p.429-8, Article 429
• Main Authors: Alinaitwe, Racheal, Nakasujja, N, Birabwa-Oketcho, H, Dickens, Akena, van Loggerenberg, Francois, Muhwezi, W W, Musisi, Seggane, Bird, V, Priebe, S, Sewankambo, N
• Format: Article
• Language: English
• Subjects: Acceptability; Adult; Aged; Cardiovascular disease; Care and treatment; Chronic Disease - psychology; Chronic illnesses; Chronic physical illnesses; Chronically ill; Comorbid patients; Comorbidity; Diabetes; DIALOG; Feasibility; Female; Focus Groups; Health care; Hospitals; Humans; Hypertension; Interviews; Male; Meetings; Mental disorders; Mental health; Mental illness; Methods; Middle Aged; Mixed methods research; Outpatient care facilities; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Patients; Physician-Patient Relations; Primary care; Primary Health Care; Professionals; Psychological Distress; Qualitative Research; Quality of life; Uganda - epidemiology
• ISSN: 2731-4553; 2731-4553; 1471-2296
• DOI: 10.1186/s12875-024-02681-1

Chronic physical illnesses are often associated with significant psychological distress and chronic mental illnesses are often co-morbid with physical illnesses. Efforts to integrate mental health into primary health care in Uganda are underway. However, there are enormous logistical challenges. Effective resource-oriented and evidence-based interventions such as DIALOG + have the potential to improve treatment outcomes for patients with chronic conditions. We aimed to assess the acceptability of DIALOG + among patients with chronic physical illnesses in Uganda. This was a qualitative aspect of a mixed methods exploratory non-controlled study conducted in chronic physical illness out-patient clinics at two hospitals in Uganda. We conducted fifteen in-depth interviews with patients, ten key informant interviews with clinicians, and four focus group discussions with patients. Thematic data analysis was done through an iterative process. The results support the acceptability of the intervention as evidenced by willingness to participate, better relationships between patients and clinicians, and improved control of both physical illnesses and psychological distress. Participants also talked about ways in which the implementation of DIALOG + could be improved. DIALOG + is acceptable among patients with chronic physical illness in primary health care settings in Uganda.