Communication with Children and Families Flashcards
1
Q
____________ is very important
A
Introduction
2
Q
what important to do when interacting and communicating with a child and their family?
A
- Be friendly and smile
- Acknowledge child early on
- Get down to their level
- Utilise play
- Consider the communication techniques needed - What are the parents looking for? What will engage the child?
- Practice asking child agenda/age appropriate questions
- Reflect on your own agenda
3
Q
Examining infants (what not to do…)
- What went wrong?
- How was play utilised?
- What communication techniques were ineffective?
- Why was this approach taken?
- What would you do differently?
A
- Examined on bed- away from parent
- No interaction with child
- No use of toys
- Use of medical jargon
- Description potentially perceived as pathology (“liver”)
- Unrealistic expectation (“Stop her wriggling”).
- Reflects focus on own agenda
Consider your facial expressions
4
Q
Examining infants (a potential approach…)
- What went well?
- How was play utilised?
- What communication techniques were effective?
- How was the parent involved?
- How were challenges dealt with?
- Why was this approach taken?
A
- Well positioned and comfortable
- Use of toys/distraction
- Maintains dialogue throughout
- Responds to child’s actions (smiles/eye contact)
- Describes normality (jargon was present for student education)
- Utilises parental skill of distracting child
- Acknowledges + accepts challenges (“wriggly/nappy”)
- Reflects consideration of child and parent’s agenda
5
Q
Examining Toddlers (what not to do…)
- What went wrong?
- How was play utilised?
- What communication techniques were ineffective?
- Why was this approach taken?
- What would you do differently?
A
- Persists despite obvious distress
- Parent separated
- Patronising (“Oh Please”)
- Unrealistic (“Tell her to stop crying”)
- Ineffective (compromising inspection and auscultation)
- Clearly not appropriate
- However under stress these things do happen
6
Q
Examining Toddlers (a potential approach…)
- What went well?
- How was play utilised?
- What communication techniques were effective?
- How was the parent involved?
- How were challenges dealt with?
- Why was this approach taken?
A
- Well positioned on parent’s knee (accepts suboptimal to avoid distress)
- Utilises play (Illustration and distraction- visual and linguistic)
- Maintains dialogue throughout (always observing)
- Gradual exposure (listens through clothing)
- Eye contact (listens to back, positioned at front)
- Changes order (auscultation, then palpation, then percussion)
- Stops when child upset, settles and resumes
- Opportunistic assessment for trachea and clubbing at the end
- Reflects effective communication techniques
7
Q
Explaining things to Parents:
Junior Ineffective
- How will the parent feel and why?
- How have their ideas, concerns and expectations been addressed?
- Have they received effective closure?
- Why has the doctor taken this approach?
- Does the doctor relay correct medical information?
- What might you do or say differently?
A
Discussion (Parent’s Perspective)
- Low priority implied as doctor focused on his agenda (other tasks to do)
- Illness trivialised (“just a cold,” “see this a lot” flippant + dismissive)
- At fault/guilty over missed preventative therapy
- Worried about recurrence risk
- Hospital agenda placed above own needs
- Questions and (increasing) concerns dismissed
- Now has unnecessary ideas and expectations regarding investigations
- Unsure about next steps after ineffective closure
Discussion (Doctor’s Perspective)
- Doctor is busy and has other tasks to do
- Night shift compromises cognitive processes
- Building up paediatric experience and recognising common illness
- Wants to prevent illness admissions
- Aware of the recurrence risk
- Aware that some febrile seizure reflect CNS infection
- Recognises the needs of other unwell patients
- Factually correct in (almost) all of what he says
- The doctor is actually a very competent paediatrician
8
Q
- How will the parent feel and why?
- How have their ideas, concerns and expectations been addressed?
- Have they received effective closure?
- What techniques help the doctor take this approach?
- How does the doctor relay medical information?
- How does the doctor demonstrate insight?
- What phrases/questions might you use in the future?
A
Discussion (Parent’s Perspective):
- Doctor has acknowledged challenges/stress of a hospital admission
- Allowed to speak and finish points made
- Concerns (including what was seen) acknowledged
- Aware of recurrence and sibling risks
- Big worries (meningitis/ epilepsy) addressed without needing to ask
- Hears key information (no harm) several times
- Knows next steps for her and child (needs anticipated)
- Given opportunity for further questions (now and later)
Discussion (Doctor’s Perspective):
- Shows insight into the parental perspective.
- Seeks to understand/clarify the parental understanding
- Clearly describes the condition acknowledging understandable concern
- Addresses recurrence/sibling risk but emphasises key negatives
- Proactively anticipates concern (meningitis/ epilepsy/harm)
- Focuses on markers of health and reflects on experience of other children
- Explains the (lack of a) role for investigations.
- Clearly describes next steps (anticipates parental needs)
- Repeats key information and ensures mother is satisfied with discussion
- Provides opportunities for questions (now and later)
9
Q
Knowledge is important but…
- Parents want to be understood
- And not made to feel at fault
- And have things explained clearly
- Children don’t what to be there (or sick)
- Think what interests the child/adolescent
- And sometimes chat about non-clinical stuff
A