A CROSS-SECTIONAL STUDY ON COMMUNICATION KNOWLEDGE, PRACTICES, AND BARRIERS AMONG PRIMARY HEALTHCARE WORKERS IN AL-RAMADI, IRAQ

Abstract

In resource-constrained, conflict-affected primary healthcare settings, communication hurdles persist despite the fact that efficient communication between healthcare personnel and patients is essential to attaining the best possible healthcare results. The purpose of this study was to evaluate the communication skills, behaviors, and perceived obstacles of primary healthcare workers in Al-Ramadi, Iraq. Between September and December of 2024, nine primary healthcare facilities in Al-Ramadi city participated in a descriptive cross-sectional study. Non-probability convenient sampling was used to enroll 92 healthcare professionals. A structured questionnaire addressing sociodemographic, communication styles, and perceived barriers was used to gather the data, which were then descriptively analyzed using chi-square tests of association. Most participants were under 40 years (77%) and married (65%). Good knowledge was found for eye contact (82%) and open-ended questioning (73%), while gaps existed in responding to emotions (27%), the biopsychosocial approach (34%), and SPIKES protocol (54%). Practice was strong for undivided attention (95%) but weaker for privacy (71%) and shared decision-making (70%). A significant knowledge–practice gap was found for empathy, where practice (73%) exceeded conceptual understanding (39%) (χ² = 21.25, p < 0.001). The most common barriers were patients' diverse social backgrounds (82%) and time limitations (77%). Primary healthcare workers in Al-Ramadi demonstrated fair to moderate communication knowledge and practice, with specific, addressable gaps. To improve the quality of physician-patient communication, specific training programs for the development of empathy and good emotional communication are required, along with institutional initiatives targeted at resolving time constraints.