Planetary Health and Patient Dialogue: Exploring Cancer Perceptions Through Doctor-Patient Communication in the rural Homabay County, Kenya

Abstract

This study explores the influence of doctor- patient communication on cancer patients’ understanding, attitudes, and treatment adherence in Homa Bay County, a rural area in southwestern Kenya increasingly affected by climate- induced health system vulnerabilities. Grounded on Ajzen' s Theory of Planned Behaviour and informed by a planetary health perspective, the research investigates how communication dynamics intersect with challenges such as extreme weather, transportation disruptions, and infrastructural decay. A concurrent mixed-methods design combines structured surveys from 120 cancer patients and caregivers with in-depth interviews of 10 medical doctors. Findings reveal significant systemic communication barriers: 72. 5% of respondents reported doctor- dominated consultations with limited patient input (p < 0. 0.01), 68. 3% struggled to understand medical instructions due to jargon use (p < 0. 05), and 61. 2% cited financial constraints as limiting their ability to engage meaningfully in care discussions and follow- up (p < 0. 05). These challenges are compounded by climate- related disruptions, including transportation delays and frequent power outages, which weaken communication continuity and compromise treatment adherence. Despite these obstacles, the study identifies clear pathways for improvement. Empathetic and culturally responsive communication—particularly when adapted to local environmental realities—enhances patient knowledge, confidence, and perceived control, improving treatment adherence. These improvements in communication practices contribute to better health outcomes even amidst ongoing systemic and environmental disruptions. The study recommends comprehensive policy interventions, including climate- responsive communication training in oncology education and clinical protocols. It proposes targeted, evidence-based strategies to strengthen doctor-patient dialogue in climate-vulnerable healthcare settings, thereby contributing to the literature at the intersection of planetary health, behavioural science, and clinical communication. These insights provide a timely roadmap for strengthening equitable cancer care in the era of climate change.