Patients' Views and Expectations of Consultations in Primary Care in Malaysia: A Qualitative Study

The increased prevalence of noncommunicable diseases (NCDs) in Malaysia has strained its public health services. Lifestyle changes remain a critical part of the management of NCDs. Primary care doctors are expected to provide lifestyle advice during consultations. Perception and expectations of these consultations directly affect the health-modifying behaviours of patients and the outcome. Understanding patients' expectations in various contexts helps in tailoring good and effective consultations. The Health Belief Model (HBM) is a theoretical framework widely used to predict health behaviours. The authors hypothesise that a good doctor's consultation should cover all six domains of HBM to trigger patients to change their health behaviour.  Methods: This was an exploratory qualitative study using semi-structured interviews with patients recruited using purposive sampling, at three different government health clinics in the Hulu Langat district of Selangor, Malaysia. Data were analysed deductively utilising HBM as the theme for patients' views, and an inductive approach for patients' expectations.  Results: Consultations positively influenced participants' health behaviour. However, the perception of their NCD severity was found to be superficial. Self-efficacy in sustaining changes was a notable barrier. Expectations included comprehensive health advice, empathy, and professionalism. There is a subset of patients who had no expectations coming into these consultations.

Consultations were perceived to improve health behaviour but lack depth in understanding severity and self-efficacy. Patients expect comprehensive, empathetic, and professional consultations. Some had no expectations, which may reflect passivity or trust.