chapter 9 Flashcards
Models of communication
- Culture, experience, health status, mental
status, age, education and other factors all
play a part - Environmental context also has a significant
impact - Words and nonverbal behaviors are essential
variables in communication - To explain what is wrong, or seek comfort
Patient-Centered Care (PCC)
Key Components of PCC:
- Respect and Dignity: Healthcare professionals honor patients’ perspectives and choices, integrating their cultural backgrounds and personal values into care plans.
- Information Sharing: Providers communicate complete and unbiased information, enabling patients to make informed decisions about their care.
- Participation: Patients are encouraged to actively engage in their care, collaborating with healthcare teams in decision-making processes.
- Collaboration: Care involves partnerships among patients, families, and healthcare providers, fostering a supportive environment.
PCC and communication
The focus in PCC is on mutual understanding between health professional and patient about the patient’s values and needs plus the sharing of responsibility.
Improvisation skills
effective tools in health professional and patient communication by “improving active listening, clear information delivery, and collaborative narrative building.” **“yes and” ** questions
Meeting with a Patient in Person
Health professional should introduce or reintroduce
himself or herself as appropriate
Wear name badge
Explain role in understandable language
Meeting with a Patient in Person
Use patient’s full name as a sign of respect
Ask preferred name—then remember how to pronounce!
Meeting with a Patient in Person
Value of direct contact
- Engaging all possible ways of communicating
* Richer exchange - What about future communications? Emails? Holographs?
Meeting with a Patient in Person
Setting differences
- Home health—more deferential, asking before doing
- ICU—often foreign, threatening
Vocabulary and Jargon
highly technical professional jargon is almost never appropriate in direct conversation with patients because it cuts off communication.
Health Literacy
Translate jargon into understandable terms
* Don’t assume patients who are HCPs understand
information-examples
Health professionals have a duty to teach patients effectively and evaluate their understanding and ability to use health information.
Language Barriers
- Seek the support and assistance of an trained
interpreter when there is a potential language barrier
1.Untrained interpreters are more likely to make errors, violate confidentiality, increase the risk of patient dissatisfaction and poor outcomes.20
2.Family interpreters often speak as themselves rather than merely providing accurate information between parties.21
3.Untrained interpreters often lack knowledge of medical terms, which can lead to miscommunication and misdiagnosis.
4.Untrained interpreters may be emotionally harmed because of the stress of performing an essential activity for which they are not prepared
Cognitive issues
yes/no or forced choice
Talk to patients as equals
While remaining flexible
problem that can result from using technical language
person to whom you are speaking will not be convinced you really want to know how they feel.
Doubt arises about health professional’s
interest—need to become “bilingual”!
Meanings are confused
Example: complaint
Desired results are lost
- When explanation is vague/confusing
- Easy to turn to lab/tests for treatment plan
* Without trying to understand pt narrative - Pt is frustrated/anxious/noncompliant
Clarity
involves speaking at a moderate pace
using simple, direct terms.
* May become stuck on 1 thing that you said
* Patient may be ”awed” by medical person
* Afraid to ask them to repeat
* Life is in their hands
organization
involves the presentation of
ideas and concepts in a logical order.
organization
Complicated information
should be broken
into manageable chunks.
* Summarize—or ask patient to do it!
When information is shared verbally
there should also be written information for the patient.
Written notes or instructions, diagrams, videotapes, and nonverbal demonstrations are highly desirable adjuncts to the spoken word because they may help the person organize the ideas and information more fully and can be used for future reference.
Tone of voice
an change the meaning of
spoken words.
Voice volume controls interaction in subtle
ways.
Controls distance between people—whisper/shout
Test if patients hear what you say
by asking
them to repeat instructions.
Attitudes and emotions have an impact
on communication: (both patient and
HCP)
- Fear—reassure patient
- Grief—comfort, authentic care
- Sense of Humor—use wisely
Anger or Frustration
Health professionals may try to manage underlying negative emotions by pulling away from genuine warmth
making itself known to patients largely through nonverbal signs
Facial expression
smile! Eye contact
Your own facial expression can stimulate good feelings. For example, a genuine smile indicates that you are approachable, cooperative, and trustworthy
Physical appearance
First impressions
* Attire and grooming—what does a white coat
convey?
Touch
(battery=unconsented touching—ALWAYS
explain first!)
Positive effects of touching…caring touch
Proxemics
study of how space is used in human
interactions—sit down to be on patient’s level
Sense of time and physical space
culture difference
Communicating Across Distances
Written communication
requires a high degree of accuracy
* All written communication should define and
state the purpose
* Clarity and brevity are hallmarks of good
written communication
* Vocabulary—fitting for recipient
Consent forms
- If too lengthy—patient less likely to understand
- Both spoken and written=problems prevented
Gestures and Body Language
Understanding subtle and obvious gestures is an important component of learning respectful communication. Patients can also read the health professional’s body language.
When you are stressed, it is a good habit to take a moment to assume a relaxed posture, take a deep breath and shake off tension to ready oneself for effective communication.
Phone, text messages, e-mail, patient portals,
and social media
can all have a place in
communication with patients
Although there are clear benefits of using social media
Some of the consequences of misuse of social media include breached patient confidentiality, possible exposure to lawsuits by patients or others who are entitled to confidentiality, boundary issues in professional relationships and for students and faculty, and impairment of program integrity
Electronic forms of communication:
- Offer speed and convenience
- Require savvy users and access to technology to
be effective - Carry special responsibilities for health
professionals including awareness of boundaries
and privacy issues - Written record of exchange
Telehealth Encounters
(WHO) views telemedicine as one of the most promising methods of health delivery to areas where the need for high-quality health care vastly outstrips the ability to deliver it.
patient portals and secure messaging (SM)
Patient portals are “secure online websites that require username and password and are linked to a patient’s personal health record providing 24-hour access from anywhere with an Internet connection.
SM, where patients can send nonurgent health-related messages to providers, upload photos, ask follow-up questions about a treatment, view test results, and make appointments
Effective Listening
(1) to improve listening acuity so you hear the patient accurately and
(2) to ascertain how accurately a patient has heard you.
frame of mind
may distort meaning
Active listening
requires undivided attention
Choosing the Right Words
and Means
- Ascertain the level of literacy and health
literacy - Consider factors that affect health literacy
such as context, the teaching method used,
etc. - Provide educational information in simple,
plain language using “universal precautions”
in literacy to communicate with all patients.
universal literacy precautions
health professionals should strive to communicate with all patients in simple, plain language, using lay language whenever possible to minimize the risk for any patient misunderstanding of the information provided. Additionally, there are communications tools like Ask3 that empower patients to ask three basic questions at the end of every clinical encounter The questions are: What is my main problem? What do I need to do? Why is it important for me to do it?
Effective Listening
- Be selective in listening.
- Concentrate on central themes.
- Judge content rather than style.
- Listen with an open mind.
- Summarize what you hear before speaking
again. - Clarify before proceeding.
