23 - Clinician-Patient Communication Flashcards

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1
Q

What are patient expectations of health professionals?

A
  • Technical expertise
  • Accurate information
  • Empathy/emotional support
  • Access to services
  • Continuity and coordination of care

It is a failure on the part of doctors to communicate caring that lies at the heart of most patients’ dissatisfaction with their decisions

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2
Q

In clinicians who are not sued, what do they do differently?

A
  • Longer consultations (only by 3 minutes)
  • Explicit agenda for patient
  • Asked patients what they would like to discuss.
  • Facilitating behaviours (empathy)
  • Used humour and active listening

Use warm tone of voice

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3
Q

What is the SPIKES protocol?

A
  • Setting
  • Patient perception of condition and its seriousness
  • Invitation from the patient to give information
  • Knowledge: giving medical facts (simple language and avoiding jargon)
  • Explore emotions and Empathise
  • Strategy and Summary
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4
Q

In Duric’s (2003) study on empathy, what were the results?

A
  • Patients whose 1st emotional cue was responded to with empathy gave significantly more cues (than those whose cues were ignored)
  • Patients who received more empathic responses to their cues had significantly reduced depressive symptoms 3 weeks later
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5
Q

What did the 40 seconds of compassion study reveal?

A

“Standard videotape” vs. “enhanced compassion videotape” discussing treatment options for metastatic breast cancer.

Acknowledging patient’s emotional state;

  • Significantly lessened patients’ anxiety
  • Clinician was perceived as warmer, more pleasant and sensitive
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6
Q

What are the benefits in attending to emotional cues/concerns and providing adequate info and emotional support in consultation lead to?

A
  • Faster recovery amongst patients (Average 1 day reduction in hospitalisation)
  • Greater cooperation with treatment
  • Fewer post-hospital complications
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7
Q

What is the best way to present risk?

A
  • Use consistent framing when discussing pros/gains and cons/losses
  • Provide base rates of outcomes
  • Use absolute risk comparisons
  • Provide information about the consequences of the risk
  • Preferred formats are not always the best understood
  • 100 dot/person diagrams: the greatest accuracy/understanding
  • Check and re-check understanding of risk
  • Best graphical format will depend on its intended purpose
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8
Q

In risk communication, what does simplification and analogies help with?

A

Simplification
- Give Gist (high or low risk, will get it or wont)

Analogies

  • low; getting hit by lightening
  • high; getting a cold
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9
Q

What do communication skills not exhibit?

A

They do not;

  • reflect personality or natural talent of clinician
  • improve with age or professional experience

Effective communication skills can be taught, maintained and improved

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10
Q

What were the results of the review of communication skills training?

A

Significant group differences
CST group more likely to;
- Use open ended questions
- Show empathy towards patients

No group differences
- Patient satisfaction and perception of clinician’s communication skills and clinician burnout.

CST courses appear effective in improving information gathering and supportive skills
- BUT, I is unclear which CST programs likely to work.

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