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General Medicine 2314 > Approaches to consultations > Flashcards

Approaches to consultations Flashcards

1
Q

define communication w/ regards to a consultation

A

a complex multilateral process of interaction between both the physician and patient at a verbal and non-verbal level.

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2
Q

importance of non-verbal communication

A

aids verbal communication as personal attitudes + emotions are communicated at a non verbal level

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3
Q

non-verbal signs (5)

A
  • body language / kinesis - touching - paralanguage -proxemics -general appearance
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4
Q

body language inc (4)

A

gestures facial expressions eye movement body position

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5
Q

paralanguage inc (3)

A

tone speed loudness - of voice

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6
Q

Proxemics

A

spatial factors - the distance between both parties

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7
Q

what approach should be used in FM

A

Bio-psycho-social approach

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8
Q

what does the Bio-psycho-social approach entail?

A

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

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9
Q

why is effective communication essential?

A

if we don’t understand the basics –> subsequent actions may be inappropriate.

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10
Q

TASKS involved in consultation (4)

A
  1. 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
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11
Q

expand - Open the consultation

A

a patient enters the room - attention should be focused on the patient. introduce oneself

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12
Q

expand - closing consultation

A

each consultation should be finished, no issues should be left unclarified

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13
Q

SKILLS to be applied by the physician during a consultation

A
  1. establishing a contact 2. obtaining info 3. providing feedback 4. maintaining the contact
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14
Q

communicative techniques involve.. (20)

A
  1. 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
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15
Q

social contact - expand

A

in cases of primary consultations - a short social convo beforehand can ease the environment and aid the pt to talk more freely

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16
Q

orientation - expand

A

helps direct the consultation specifies time to inform the patient that notes will be taken throughout the consultation

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17
Q

observation - 2 methods

A
  1. active listening 2. observation - via methods of verbal and non-verbal communication
18
Q

use of open q’s - expand

A

provide a possibility for long answers thus - more info - better diagnosis - better Rx

19
Q

use of closed q’s - expand

A

serve to structure the info. closed q’s tend to follow open q’s

20
Q

help / encouragement - expand

A

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

21
Q

paraphrase - expand

A

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?’

22
Q

confrontation - expand

A

doesn’t mean an insoluble conflict. if the patient hasn’t adhered to instructions from the previous consultation then need to be more stern

23
Q

interruption - expand

A

necessary for direction

24
Q

general conclusion - expand

A

summarise patients report - don’t add seasoning!

25
Q

explanation - expand

A

a clear and simple explanation is paramount. do not use medical jargon

26
Q

prioritization - expand

A

patients often consult the physician w/ many symptoms and complaints so it is important for a physician to prioritize the important concerns and remind the patient of the time constraints if necessary

27
Q

partnership - expand

A

more effective in the long run. the patient will collaborate w// physician and follow required advice

28
Q

motivation - expand

A

social factors influence health problems. thus promote, encourage and support the patient to follow a healthier lifestyle and a balanced diet

29
Q

sense the humour - expand

A

humour should be used sensitively. it can help situations which are emotionally difficult.

30
Q

specifying - expand

A

@ end of consultation specify the actions that need to be followed - both parties should have the same understanding regarding future actions

31
Q

where can the consultation take place? (2)

A

outpatient clinic patients home

32
Q

who can perform home visits?

A

mainly GPs specialists

33
Q

when are home visits usually carried out?

A

within a population predominantly consisting of elderly peeps who require long term care / palliative care or terminal care

34
Q

2 main purposes for home visits …

A

1.diagnostic 2. therapeutic

35
Q

what happens in case of emergency (re: home visits)

A

if a patient calls up and asks for an emergency home visit out of hours or at the weekend. GPs discretion. the physician can decide if he/she will attend or if it’s better to refer the patient to an emergency unit. NB urgency of the visit assessed by the patient is subjective therefore doesn’t always agree with physicians evaluation.

36
Q

benefits of home visits

A
  • the patient feels more at ease - more inclined to confide - dynamics of the home environment can be observed - v. useful! NB - a physician should always keep a bag at their disposal
37
Q

methods for consultations (4)

A
  • direct (face to face) - phone - based on medical records - virtual
38
Q

what usually precedes a home visit?

A

a phone consultation NB - usually made by a family member or carer

39
Q

phone consultations are often related to (non emergency ) (2)

A

treatments already discussed advice concerning issues in raising infants

40
Q

when are consultations based on medical records carried out?

A
  • to help solve an old health problem the physician needs to be acquainted with relevant details.
41
Q

Positive indicators for pt/physician communication efficiency

A
  • cooperation - the contentment of pt and physician
42
Q

negative indicators for pt/physician communication efficiency

A

change of physician grievances physicians mistakes

General Medicine 2314 (6 decks)

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