Communication - Verbal and Non Verbal Flashcards
What is Doctor-Centred communication?
One –way process.
* More control over the situation.
* Doctor asks questions to get
information and provides advice
as a result.
* Patient answers questions and
asks a few questions.
* Patient is passive with little
influence on the consultation.
What is patient-centred communication?
- Two-way process.
- Doctor and patient both
participate. - Patient is encouraged to
communicate and express
himself / herself. - Patient answers and asks
questions. - Patient is active, participates and
has more influence on the
consultation.
What are the five basic communication tasks for the medical interview?
- Initiating the Session.
- Gathering information.
- Building the relationship.
- Explanation and planning.
- Closing the session.
What are closed questions?
One-way communication (sender-message-receiver).
* Restricted range of possible answers, e.g. yes / no questions.
* No extensive feedback required.
* Used when instructing patients, or when immediate
information is needed, or in emergency situations.
What are open questions?
- Two-way communication (sender-message-receiver-sender).
- Normally begin with how, why, what, when, where.
- How do you think this treatment / new outlook will help you?
- Why do you think you are feeling this way?
- What do you think could be a possible cause / solution?
- When do you think all this began?
- Where do you think you could find a support group to help
you when you return home? - May elicit important but unpredictable information that may not be
accessible otherwise. - Patients are allowed to express themselves freely and provide
extensive feedback, detailed answers. This may help staff
understand patients’ needs.
What is paraphrasing?
Refers to the re-statement of the meaning of a message using other words
What is summarizing?
Usually occurs at the end of the interaction and it is based on:
* clarification of what has been said
* clarity of understanding
What is active listening?
Active listening is a way to encourage patient to explore their thoughts and
feelings.
Techniques:
➢ Mirroring: reflecting back the client’s words or postures to encourage
expansion, e.g.:
Client: “I feel empty” You: “empty?”
But don’t do this too overtly because may seem sarcastic so you can verify what
they’re feeling by saying: “ it seems as though you are…. Is that right?”
➢ Empathy building statements: showing attention and attempts to understand
patient’s perspective: e.g. “I imagine that…”
➢ Silence: allow the client uninterrupted time to think
What is an ‘I’ message?
An “I” message is an assertion about the feelings, beliefs, values, of the
person speaking, without putting the listener on the defensive.
* Used to take ownership for one’s feelings rather than implying that they are
caused by another person
* I-messages can also be used in constructive criticism
What is jargon?
professional terminology
What is a leading question?
A leading question is worded in a way that suggests, directly or indirectly, a
particular answer ( e.g. “don’t you think?” and “why don’t you want
to…?”).Instead, encourage the patient to explore their own solutions and
options
What are factors that affect communication?
Emotional State
Social factors
Age
Gender
Confidentiality
How can bodily contact make a patient feel?
You have to be aware that bodily contact can cause unease in the patient so when you need to perform a physical examination, indicate to the patient that the procedure is a necessary part of their care and offer reassurance.
* It can be a sign of status and power. People who initiate touch are often seen as more powerful, dominant and assertive.
* Health professionals touch patients but patients don’t usually touch health professionals before they have initiated contact.
What are levels of non verbal communication?
Attending and listening: physically and psychologically. The way you orient and
position yourself, pay attention, listen and respond.
Micro-skills of attending: SOLER
S: Sitting, adopt posture indicating involvement. Sitting directly in front of patient
can make them feel threatened, an angled position is good.
O: Open posture: no crossing legs or arms, to indicate you’re open to patient and
what they have to say. Be aware of patient’s posture and inconsistencies between
what they say and their nonverbal language.
L: Lean sometimes forward to patient but not too much and not all the time
because it may be interpreted as intimidating. Shows you are interested and
concerned and are willing to take time to listen.
E: maintain Eye contact steadily as a way to say you are with them, listening and
you want to know what they have to say. Influenced by cultural groups and gender.
Constant stare could result in patient feeling threatened and uneasy. General rule
of thumb: maintain eye contact which is not too prolonged with the help of natural
glances away.
R: try to Relax and implement the above in a natural and relaxed manner, if you
are relaxed the patient is more likely to relax as well.
What is paralinguistics?
Paralanguage: What is expressed verbally other than words.
Some research shows that up to 38% of communication consists of paralinguistic messages.
Features:
* Speed of speech - fast or slow.
* Tone of voice - high or low pitch.
* Flow - flowing or stilted.
* Volume - quietly or loudly.
* Intonation - animated or flat
* Clarity - clear or mumbled.
* Fitted pauses - ums, ers, grunts and gasps.
* Silence - prolonged gaps between comments or torrent of words.
Paralinguistic cues communicate to your patient that you are listening and can prompt your patient to
continue talking without explicit verbal prompt (e.g. “um”, “uh-uh”).
When the doctor has a warm, friendly tone, patients are more likely to ask questions, engage in
discussion, trust their doctor’s diagnosis and follow instructions.
