Examining Doctor-Patient Communication Effects on Patient Treatment Adherence and Satisfaction in Synchronous Telemedicine in Select Health Facilities in Kisumu County

Abstract

Telemedicine has emerged as a transformative tool in healthcare delivery, particularly in resource-constrained settings where accessibility and continuity of care remain a challenge. This study examined doctor-patient communication in synchronous telemedicine within select health facilities in Kisumu County, with a focus on its implications for patient satisfaction and adherence to treatment. The purpose of the study was to assess how communication practices in synchronous telemedicine shape patient outcomes. The study sought to, evaluate the nature and quality of doctor-patient communication in synchronous telemedicine, establish how doctor-patient communication affects patient treatment satisfaction and determine the effects of doctor-patient communication on treatment adherence. The study was grounded in two theoretical frameworks; Communication Accommodation Theory (CAT), which emphasizes how communicators adapt speech and behavior to enhance understanding and relational closeness, and the Technology Acceptance Model (TAM), which explains how perceived usefulness and ease of use influence technology adoption and use. The study was conducted in three health facilities in Kisumu County including Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), Aga Khan Hospital Kisumu, and Kisumu County Referral Hospital (KCRH). The target population comprised patients who had participated in at least one synchronous telemedicine session in the study period. Purposive sampling technique was employed due to data protection requirements and patient privacy considerations, yielding a final sample of 175 respondents. Data collection was undertaken using a structured questionnaire adapted from validated instruments such as the Communication Assessment Tool (CAT). Data were collected through both physical and online administration of the questionnaires. To ensure reliability, the instrument was pretested before deployment for data collection. Data were analyzed using SPSS version 25. Descriptive statistics summarized demographic and organizational characteristics of respondents, while inferential statistics, including Pearson correlation and regression analyses tested the associations between communication variables, patient satisfaction, and treatment adherence. The findings revealed that doctor-patient communication in synchronous telemedicine was rated positively overall, particularly in terms of clarity and attentiveness. Communication clarity emerged as the strongest predictor of patient satisfaction, while empathy was identified as the most influential factor in determining adherence. Regression analysis showed that communication quality explained 38.9% of the variance in treatment adherence. However, empathy and emotional connection were relatively weaker due to the limitations of non-verbal cues in virtual consultations. Digital literacy was also found to significantly predict satisfaction, while perceived ease of use and number of visits were not significant predictors. The study concludes that effective communication in synchronous telemedicine plays a critical role in shaping patient satisfaction and adherence outcomes, but gaps remain in empathy, and relational warmth. It recommends that health facilities in Kisumu County strengthen telemedicine communication standards by institutionalizing clarity, empathy, and responsiveness in doctor-patient interactions through standardized communication policies and structured training. This will enhance patient satisfaction, adherence, and overall quality of virtual healthcare delivery.