Communication with Children and Families Flashcards

1
Q

____________ is very important

A

Introduction

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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
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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

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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
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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
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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
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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
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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)
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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
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