Chapter 8 Communication Flashcards
Ineffective listening
-creates misunderstandings, waste time, hurts relationships, causes errors
-listening on and off (typically listener thinks four times faster than speaker)
-pre-judging message
-not listening to the end, interrupting
-absorbed in their own thoughts,
daydreaming
-defensive
-leads to poor treatment, weaker relationships, poor documentation (leading to denied payment) less satisfaction leading to decreased reputation and referrals
-good listening skills need to be practice as with any PT skill
Communication through body language and facial expression?
-can convey acceptance or rejection of ideas
=== also it includes clothing, grooming which has cultural connotations===
Body language?
Includes posture and gestures it reveals inner feelings
Open postures?
Conveys the willingness to receive a message
- uncrossed arms/legs
- standing/sitting at patients eye level
- facing person speaking
Closed postures?
-conveys an unwillingness to receive message
Nonverbal communication displaying acceptance:
- smiling /nodding
- Direct eye contact (without staring)
- getting at eye level with the patient
Nonverbal communication displaying rejection/superiority:
- eye rolling/Staring
- looking down or away/Shaking head
- frowning
- standing while talking to seated patient
Nonverbal communication touch:
-can be taken positively or negatively depending on the situation and culture
=== emotional intelligence-being able to recognize emotions in self and others and then being able to address appropriately
PT written communication
- written evaluations, progress notes, discharge summaries, home exercise programs, informed consent, surveys
- write the information as if I was talking to the patient
- use active voice
- use short sentences, common words
Home EX program handouts (HEP)
Organize, concise, and in layman’s terms
-be specific about exercise details
-Number of reps/sets/ many times
daily/ how many times weekly/ the position
-include diagrams when able
-write at fifth grade reading level
-order exercises so patient doesn’t have to change positions repeatedly
-keep it simple and low numbers of exercises
-involve caregiver when possible
Listening?
1•Effective listening involves reflecting on the patient’s message and summarizing it to clarify meaning
2•Builds rapport, Saves time, Builds trust, Reduces errors
Effective Listening Methods-
a skill that can be learned
•Focus on patient, smile and look at them
•Watch nonverbal communication- gestures, facial expressions, tone of voice, posture
•Ask for clarification, Repeat/summarize
•Take notes
•Use positive body language (nodding, eye contact)
•Don’t interrupt
Effective Communication?
1•Ask patients to repeat or return demonstration to ascertain if they truly understand
2•Don’t be fake in any of your communication
3•Open vs Closed Questions
4•Open questions: don’t limit responses; for example: “Describe the pain you are feeling”
5•Closed questions: lead to short, specific responses; for example, “Are you in pain?”
Effective Verbal Communication more tips?
-Vocabulary should be simple, precise and accurate and in terms the patient can understand
1•Speak clearly and concisely in a normal tone of voice
2•Accompany education with written instructions using pictures or diagrams when possible
3•Don’t call the patient by their pathology (say the patient with the heart condition, not the heart condition patient)
4•ALWAYS describe (and demonstrate when possible) the treatment prior to performing it
5•Ask questions to build rapport and get feedback
6•Pause after giving instructions to allow time to process
7•Respond with patience and smiling to requests to repeat
•Verbal Communication is used to:
1•Establish rapport with patient & caregiver
2•Obtain information regarding patient/progress
3•Transmit information to other healthcare providers
4•Provide education & instruction to the patient/caregiver
5•Increase patient HEP compliance & decrease their health risks
•Cultural Diversity & Communication
1•Be knowledgeable- certain cultures appreciate periods of silence (African Americans, Navajo Indians, Asians
2•Limitations in English does not indicate cognitive level/status
3•Linguistic competence- learn & use key words and expressions
Consider the following when communicating with other cultures:
1•Health beliefs and perceptions
2•Attitudes
3•Level of education
4•Table of verbal and nonverbal communication guidelines for numerous cultures, check it out in text, pp.154-155
5•Avoid using family/friends as an interpreter, as it can break privacy laws and may not be accurate
6•Professional interpreters should be culturally sensitive
PT-PTA Relationship depends on:
1•Skills 2•Continuing Ed. Courses 3•State laws 4•APTA resources 5•Personal attributes 6•Expectations made known 7•Communication 8•Department Goals/Policies
PTAs may have one or more supervising PTs
•Each pairing has it’s own unique relationship
Communication Challenges
•Strategies for dealing with Difficult People:
1•Stay calm and professional and respectful
2•Don’t show irritation or anger
3•Focus on trying to solve the problem
4•Listen carefully
5•Encourage participation and explain consequences, but remember, the patient has a right to choose
6•Remember that people deal with grief, pain, and other emotions differently
7•Treat people with mental illness remembering that they are ill
8•Be friendly, consistent, optimistic and non judgemental
9•Working with patients having cognitive impairments requires patience and repetition
10•Don’t talk too much, allow patient to focus
The Therapeutic Relationship
•First Impression is Important
- Establish Therapeutic Relationship:
* Punctuality
shows respect
- Establish Therapeutic Relationship:
* Friendliness
- Smile, Introduce yourself
* Call patient initially by last name or ask for preferred
- Establish Therapeutic Relationship:
* Cultural Sensitivity
It is good to know what is allowed and what is not in a culture
- Establish Therapeutic Relationship:
* Good Communication Skills
- Use layman terms, speak to their cognitive level
* Observe hearing limitations
- Establish Therapeutic Relationship:
* Patient Focused Behaviors-
shows respect and concern
- Establish Therapeutic Relationship:
* Knowledgeable
•PTA should read eval first, ask pertinent questions, answer ?s
- Establish Therapeutic Relationship:
* Trustworthy
You have to show the patient that they can trust you
- Establish Therapeutic Relationship:
* Helpfulness –
even if it is “not your job”
Establish Therapeutic Relationship:
Comfortable-
take a moment to get to know your patient, rapport
Empathy empowers the PT/PTA
1•Listen better to the patient
2•Allows the patient to feel “listened to”
3•Form a therapeutic partnership with the patient
4•Facilitate effective interventions by improved understanding
5•Involve the patient/caregiver in decision-making process
6•Encourage motivation & behavioral changes
7•Empathy is NOT the same as Sympathy
8•Feeling as the patient instead of feeling sorry for them
Empathy:
the ability to imagine oneself in another person’s place and to understand their feelings, ideas, desires & actions
1•In order to feel empathy, one must have self awareness and the awareness of others feelings, desires, & ideas and ability to imagine
2•Is important in the development of morality, beliefs about what he or she does, think, or feel
•The absence of empathy: results in…
1•People exploiting and abusing others
2•Inability to love and relate to others
3•Failure to respect others’ boundaries
4•Inability to accept others’ needs & feelings
•3 Stages of Empathy
1•Cognitive stage-
getting into the position of the patient, listening
•3 Stages of Empathy
2•Crossing over stage-
for a brief moment, imagining what it feels like to be the patient
•3 Stages of Empathy
3•Coming back stage-
return to own feelings
Elements of an effective therapeutic relationship:
1•Valuing the patient/client
2•Being attentive to patient needs & focusing on them
3•Acknowledging the patient/client’s needs
4•Listening to the patient objectively without projecting personal beliefs/values
5•Being genuinely empathetic with the patient
6•Having self-awareness to allow communication of inner feelings, emotions, and ideas
7•Desiring to provide the patient/client with the very best care, conveying expertise and confidentiality
8•Placing the patient in a position of equality
