Communication skills: children and language and cultural barriers Flashcards
What % of children suffer with disruptive and unco-operative problems?
20-25%
What is unco-operative behaviour correlated with?
Age - younger children
and invasive procedures
What are the different ways a child can show verbal distess?
Crying
Moaning
Complaining
Screaming
What are the different ways a child can show behavioural distess?
Flinching
Blocking
Thrashing
Turning away
What are other contributers to uncooperaive behaviour?
Early experiences - negative - classical conditioning and role models - observational learning
Pain experiences - Sensitivity/lower thresholds
What is behaviour management?
The means by which the denatl health team effectively performs dental treatment and thereby instills a positive dental attitude
Why are developmental milestones important
They represent what an average person can do around a particular age - varies from child to child
What important things are babies able to do at 6 months?
Lift head and chest When held, sit back straight move head to follow movement Reach and grab Distressed by sudden noises Understand cause and effect
What groups of people have language barriers?
Children
Elderly
Disabilities
Non-native english speakers
What are the language barriers in people with disabilities?
Non or little language Confused speech Foreign language Accent/dialect Slang Deafness
What are the problems with communication with non-native english speakers?
Cant use jargon
Complex sentences
Not giving information in a clear way
Giving offence through over-familiarity
What is culture
An integrated pattern of learned beliefs and behaviours that can be shared among groups
Includes thoughts, styles of communicating, ways of interacting views of roles and relationships values, practices and customs
What does culture explain?
How we explain and value our world
And provides us with a lens through which we find meaning
We are all influenced by and belong to, multiple cultures that include, but goes beyond race and ethnicity
What is culture competence?
A matter of basic ethics
Acknowledgement of the importance of culture in people’s lives
Respect for cultural differences
Minimisation of any negative consequences of cultural differences
How does culture influence oral health?
Beliefs about the cause of disease How illness is experienced What treatments are appropriate How treatment should be provided who should provide treatment Can affect people's perception of tooth decay
What can miscommunication result in?
Under/non-utilisation of care Poor compliance Increased OH disparities Poor QOL poor treatment and health outcomes
What can be the problem with taking into account a patient’s culture?
need to not stereotype them
Culture is not all defining - always want to be treated as an individual
Variations exist within subgroups
How can you stereotype the person?
By seeing the individual as member of their culture
What is the ideal when it comes to culture?
Develop, refine and enhance their sutural competence across their professional lifetimes
How to develop cultural competence:
Open attitude - open to different views and beliefs
Self-awareness of own beliefs
Other awareness of other cultures
Cultural knowledge - what influences OG
Cross-cultural skills - style switching ability to communicate
What are the attitudes central to professionalism?
Curiosity Respect Empathy Humility Sensitivity Awareness
What are the effective communication skills needed?
Eliciting, understanding and reponding to the patient’s persepctive
Information gathering
Explanation and planning
Building the relationship
What are the barriers to going to the dentist for different ethnic groups?
Language barrier
Cost
Anxiety
Generational difference
What are the 4 parts to the CCF?
Initiation
Gathering information
Building the relationship
Explanation and planning
What needs to be done when have cutural barriers at the initiation?
Check the pronunciation of name and how to greet
Sensitivity to wish to have a family member there or interpreter present
What needs to be done at the gathering information stage?
Explore beliefs about causation and expectations of treatment and family, marital, religious, use of complementary/alternative sources of healthcare
What is done at building the relationship stage?
Aware of differences in non-verbal behaviour (touch, proximity)
Value ideas and beliefs, non-judgementally without stereotyping
Avoid making assumptions
What is done at explanation and planning?
Work with an interpreter if necessary
Check patient understands information and concerns have been addressed frequently
Try to give real choices based on backgrounds and situation
Cultural beliefs and oral health care
Interpretation of symptoms
Beliefs and causation
Attitudes towards illness and disease
Use of beliefs about efficacy of complemantary or alternative sources of healthcare
Gender and age expectations about roles and relationships
Role of dentist and social interations related to power and ways of showing respect
Psychosocial issues
What questions should you ask youself when working with the elderly?
Are there special physical problems related to ageing in this person?
Have hearing loss or neurological problems comprised this person’s ability to communicate
Are there limitations to the clinical management and treatment of the patient
Are relative or friends assisting this person? do they need to be involved?
What is different about the initiation when working with the elderly?
Develop rapport with patient and carer if present
Listen attentively during the screening
what is different about the gathering information when working with elderly?
Ask clarifying questions, summerise and check fequently
Pick up verbal and non-verbal cues
Clear language
Explore beliefs about causation, impact on life, expectations of treatment and family/community networks/support
What is different about building relationship and provide structure when elderly?
Aware of differences in non-verbal behaviour (touch proximity)
Demonstrate sensitivity, empathy and patience
Avoid making assumptoins
Summarise and signpost frequently
What is different about explanation and planning when elderly?
Chunk and check throughout
Check patient understands info and concerns have been addressed frequently
Use diagrams and written information
Try to give real choices based on background and situation
