Approaches to consultations Flashcards
define communication w/ regards to a consultation
a complex multilateral process of interaction between both the physician and patient at a verbal and non-verbal level.
importance of non-verbal communication
aids verbal communication as personal attitudes + emotions are communicated at a non verbal level
non-verbal signs (5)
- body language / kinesis - touching - paralanguage -proxemics -general appearance
body language inc (4)
gestures facial expressions eye movement body position
paralanguage inc (3)
tone speed loudness - of voice
Proxemics
spatial factors - the distance between both parties
what approach should be used in FM
Bio-psycho-social approach
what does the Bio-psycho-social approach entail?
involves appropriate use of effective physician-patient interaction which results in the optimization of health behaviour and participation of the patient in the therapeutic process
why is effective communication essential?
if we don’t understand the basics –> subsequent actions may be inappropriate.
TASKS involved in consultation (4)
- open up the consultation 2. elucidate the health problem 3. negotiate actions for the solutions for the solution of health problemos 4. close the consultation
expand - Open the consultation
a patient enters the room - attention should be focused on the patient. introduce oneself
expand - closing consultation
each consultation should be finished, no issues should be left unclarified
SKILLS to be applied by the physician during a consultation
- establishing a contact 2. obtaining info 3. providing feedback 4. maintaining the contact
communicative techniques involve.. (20)
- greetings 2. inviting 3. social contact 4. orientation 5. active listening 6. observation 7. use of open questions 8. use of closed questions 9. help/ encouragement 10. paraphrase 11. confrontation 12. interruption 13. general conclusions 14. explanation 15. prioritization 16. partnership 17. motivation 18. sense of humour? 19. specifying 20. closing
social contact - expand
in cases of primary consultations - a short social convo beforehand can ease the environment and aid the pt to talk more freely
orientation - expand
helps direct the consultation specifies time to inform the patient that notes will be taken throughout the consultation
observation - 2 methods
- active listening 2. observation - via methods of verbal and non-verbal communication
use of open q’s - expand
provide a possibility for long answers thus - more info - better diagnosis - better Rx
use of closed q’s - expand
serve to structure the info. closed q’s tend to follow open q’s
help / encouragement - expand
sometimes pts find it difficult to express their complaints. verbal and non-verbal communication can be used to encourage the patient and allow them to talk towards the desired direction resulting in a more effective consultation plus keeping emotional balance
paraphrase - expand
helps to focus the conversation example used in a book - pt: ‘i have a pain on my right side and sometimes on the left’ physician: ‘do u mean the pain moves?’
confrontation - expand
doesn’t mean an insoluble conflict. if the patient hasn’t adhered to instructions from the previous consultation then need to be more stern
interruption - expand
necessary for direction
general conclusion - expand
summarise patients report - don’t add seasoning!
