Strategies for Optimizing Health Workers’ Communication to Improve the Quality of Informed Consent among Patients from Seven Tribes (A Case Study at Mitra Masyarakat Hospital, Timika, Central Papua)
DOI:
https://doi.org/10.47747/jbme.v7i3.3622Keywords:
electronic medical records, healthcare communication, informed consent, intercultural communication, patient-centered careAbstract
This study aimed to analyze the effect of healthcare workers' communication strategies on improving the quality of informed consent among patients from seven indigenous tribes at Mitra Masyarakat Hospital, Timika, Central Papua. Cultural diversity, language differences, and communal decision-making practices create communication challenges that may reduce patients' understanding of medical information. A mixed-methods approach with an explanatory sequential design was employed. Quantitative data were collected through questionnaires from patients and analyzed using multiple linear regression, while qualitative data were obtained through in-depth interviews with healthcare workers to explain the quantitative findings. The study examined effective healthcare communication, intercultural communication training and medical interpreter support, integrated communication strategies through electronic medical records, and the quality of informed consent. The findings indicate that all independent variables positively and significantly influenced the quality of informed consent, with integrated communication through electronic medical records demonstrating the strongest effect. Qualitative findings revealed that language barriers, cultural diversity, and limited health literacy remained the main challenges in implementing informed consent. These findings imply that improving informed consent quality requires strengthening healthcare workers' communication competence, expanding intercultural communication training, providing interpreter support, and optimizing electronic medical record systems to support patient-centered healthcare in multicultural settings.
References
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Betancourt, J. R., Green, A. R., Carrillo, J. E., & Park, E. R. (2005). Cultural competence and health care disparities: Key perspectives and trends. Health Affairs, 24(2), 499–505. https://doi.org/10.1377/hlthaff.24.2.499
Campinha-Bacote, J. (2022). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 33(2), 121–130.
Cipta, A. (2024). Effectiveness of visual informed consent in improving patient understanding among low health literacy populations. Journal of Indonesian Health Administration, 12(2), 115–124.
Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). Sage Publications.
DeVito, J. A. (2016). The interpersonal communication book (14th ed.). Pearson.
Elwyn, G., Durand, M. A., Song, J., Aarts, J., Barr, P. J., Berger, Z., Cochran, N., Frosch, D., Galasiński, D., Gulbrandsen, P., Han, P. K. J., Härter, M., Kinnersley, P., Lloyd, A., Mishra, M., Perestelo-Pérez, L., Scholl, I., Tomori, K., Trevena, L., & Van der Weijden, T. (2017). A three-talk model for shared decision making: Multistage consultation process. BMJ, 359, j4891.
Elwyn, G., Durand, M. A., Song, J., et al. (2020). A three-talk model for shared decision making: multistage consultation process. BMJ, 359, j4891.
Elwyn, G., Frosch, D. L., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., ... Rollnick, S. (2020). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 35(7), 2056–2060.
Espinoza, J. (2021). Professional medical interpreters and patient communication in multilingual healthcare settings: A mixed-methods study. BMC Health Services Research, 21, 1048.
Flores, G. (2006). Language barriers to health care in the United States. New England Journal of Medicine, 355(3), 229–231. https://doi.org/10.1056/NEJMp058316
Ghozali, I. (2021). Application of multivariate analysis with the IBM SPSS 26 program (10th ed.). Publishing Agency of Diponegoro University.
Gustam, M. H. W., & Yuwono, M. (2024). Disclosure of sustainability reporting in the implementation of corporate social responsibility at PT Bank BJB. Journal of Knowledge Management, 18 (2), 57–67.
Hall, D. E., Prochazka, A. V., & Fink, A. S. (2012). Informed consent for clinical treatment. Canadian Medical Association Journal, 184(5), 533–540. https://doi.org/10.1503/cmaj.112120
Indonesia, Ministry of Health of the Republic. (2022). Regulation of the Minister of Health of the Republic of Indonesia Number 24 of 2022 concerning Medical Records. Ministry of Health of the Republic of Indonesia.
Ministry of Health of the Republic of Indonesia. (2022). Regulation of the Minister of Health of the Republic of Indonesia Number 24 of 2022 concerning Medical Records. Ministry of Health of the Republic of Indonesia.
Marlinda, R., Andriani, R., & Rinawati. (2025). Family meeting model at ICU Primaya Hospital Depok using the SPIKES protocol. Journal of Economics and Business UBS, 14(4), 719–733.
Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 4, 47–55. https://doi.org/10.2147/RMHP.S12985
Miles, M. B., Huberman, A. M., & Saldaña, J. (2020). Qualitative data analysis: A methods sourcebook (4th ed.). SAGE Publications.
Nugraha, L. A., Hidayat, D., & Mulyani, K. (2025). The influence of communication style and communication messages of ER doctors on patient satisfaction at Siti Hajar Islamic Hospital Mataram. Cerdika: Indonesian Scientific Journal, 5(6), 1635–1648.
Nutbeam, D. (2021). Health literacy as a public health goal: Towards a new definition and conceptual framework. Health Promotion International, 36(1), 1–10.
Patton, M. Q. (2015). Qualitative research & evaluation methods (4th ed.). SAGE Publications.
Peltier, C., Smith, R., & Johnson, L. (2024). Culturally adapted communication strategies for informed consent in Indigenous communities: An ethnographic study. International Journal for Equity in Health, 23(1), 88.
Republic of Indonesia. (2023). Law of the Republic of Indonesia Number 17 of 2023 concerning Health. State Secretariat of the Republic of Indonesia.
Republic of Indonesia. (2024). Government Regulation Number 28 of 2024 concerning Implementation Regulations of Law Number 17 of 2023 concerning Health.
Sahadewa, S., Hidayat, D., & Rachman, A. (2024). Digital health service management through electronic medical records at the outpatient installation of Kediri Hospital. Journal of Knowledge Management, 18(1), 11–20.
Santos, R., Brown, K., & Williams, T. (2025). Cultural considerations in informed consent among Indigenous populations: A systematic review. International Journal for Equity in Health, 24(1), 45.
Schenker, Y., Wang, F., Selig, S. J., Ng, R., & Fernandez, A. (2007). The impact of language barriers on documentation of informed consent. Journal of General Internal Medicine, 22(2), 294–299.
Schenker, Y., Wang, F., Selig, S. J., Ng, R., & Fernandez, A. (2007). The impact of language barriers on documentation of informed consent at a hospital with on-site interpreter services. Journal of General Internal Medicine, 22(Suppl. 2), 294–299. https://doi.org/10.1007/s11606-007-0359-1
Schramm, W. (1954). How communication works. In W. Schramm (Ed.), The process and effects of mass communication (pp. 3–26). University of Illinois Press.
Schramm, W., & Roberts, D. F. (2018). The process and effects of mass communication. University of Illinois Press.
Seidu, A. A. (2021). Cultural and language barriers in informed consent among multicultural populations. BMC Medical Ethics, 22(1), 145.
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12, 80.
Stewart, M., et al. (2024). Patient-Centered Medicine: Transforming the Clinical Method. CRC Press.
Twimukye, A., Nabukenya, S., Kawuma, A. N., Bayigga, J., Nakijoba, R., Asiimwe, S. P., et al. (2024). "Some parts of the consent form are written using complex scientific language": Community perspectives on informed consent for research with pregnant and lactating mothers in Uganda. BMC Medical Ethics, 25, 149. https://doi.org/10.1186/s12910-024-01147-4
Utami, D. T., Muskitta, F. M., Fardiyani, F., Purwadhi, & Widjaja, Y. R. (2024). Legal analysis of strategic management of patient safety in hospitals. Journal of Indra Husada Health, 12(2), 115–119.
World Health Organization. (2016). Electronic health records: Manual for developing countries. World Health Organization.
Copyrights
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ratna Indriana Donggori, Bayu Wahyudi, Yen Efawati
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright for this article is retained by the author(s), with first publication rights granted to the journal.
This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/)
![http://creativecommons.org/licenses/by/4.0/](https://journal.jis-institute.org/index.php/jbme/management/settings/<a rel="license" href="http:/creativecommons.org/licenses/by/4.0/"><img alt="Creative Commons License" style="border-width:0" src="https:/i.creativecommons.org/l/by/4.0/88x31.png" /></a><br />This work is licensed under a <a rel="license" href="http:/creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International License</a>.){kind=link}