communicating with patients Flashcards
Central building block of the physician – patient relationship which leads to an ideal delivery of care
Communication
The ability to be fully present in the moment of the interview with the person who has come for help and care
Listening skills
Educational principles
Feedback Reinforcement Individualization Facilitation Relevance Multiple channels
A key element in establishing the 3R’s of an interview
Rapport Respect Relationship
Active listening skills
Attending Bracketing Leading Reflecting content Reflecting feeling Reflecting experience Focusing Probing
I am listening to you and I understand where you are coming from.
Attending
L – lean forward O – open stance V – voice of compassion E – eye contact R – relaxed position S – sit at an angle
Setting aside our biases, prejudices and preconceived notions about the situation or condition that the patient is talking about
Bracketing
Integral part of patient care
Health education
Rflecting
Paraphrasing
Articulate the feelings for the patient
Counselor takes note of the patient’s gestures or nonverbal cues
Perception checking
Content
Feeling
Experience
Content
Barriers to effective communication
Time demands Interruptions Technology
Open invitation for the patient to talk about anything that he / she wishes
Indirect leads
Usually consist of open-ended questions
Probing
Explore what the news means to the patient Offer REALISTIC hope Inquire about the patients emotional and spiritual needs Offer resources for assistance as indicated
Encourage and validate
Enumerate the problems brought up by the patient and identify which one is the most troublesome
Focusing
The patient is asked to choose which issue is most important
Focusing
Be prepared to discuss basics of treatment and prognosis
Advanced preparation
Assess and respond to emotional reactions Be aware of body language Be supportive and empathetic Avoid criticizing health professionals
Deal with reactions
Often an unpleasant task that must be approached with the patient’s best interest in mind
Breaking the bad news
Familiarize yourself with relevant clinical information
Advanced preparation
Patient’s generally desire frank and empathic disclosure of a terminal diagnosis or other bad news
Breaking the bad news
Doctor – counselor makes a judgement call where the patient should go
Direct leads
Use appropriate touch Meet everyone Have family support present
Build a therapeutic environment and relationship
Allow for silence and tears Ask the patient to restate what has been said Always allow time for questions
Communicate well
Share additional information frankly using common language and compassion
Communicate well
