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clinical skills > Communications 2 > Flashcards

Communications 2 Flashcards

1
Q

What happens in an eye examination?

A

Initial meeting
History and symptoms
Clinical investigation
Conclusion and summery

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2
Q

How many % are asymptomatic referrals?

A

> 15%

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3
Q

What type of asymptomatic referrals do you get?

A

POAG >50%
Diabetic retinopathy
Amblyopia
Naevi

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4
Q

What is good communication?

A

Increase patient understanding
Encourage good rapport with practitioner
Improves compliance
Enhances patient satisfaction

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5
Q

What is bad communication?

A

Leads to gross dissatisfaction
Going to another practice
Litigation

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6
Q

What may influence the interactions?

A

Patients health beliefs

  • Family and friends
  • school or workplace
  • prev healthcare experience
  • culture and religious beliefs
  • internet
  • verbal or non verbal behaviour
  • prev experience of practitioner
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7
Q

What are pre conceived myths?

A

Does not understand instructions

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8
Q

What type of information are there?

A

Cognitive

Affective

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9
Q

What is cognitive information?

A

The stuff you need to know, ie patient wearing glasses, is there a family history of something

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10
Q

What is affective information?

A

Unspoken information- how nervous patient looks

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11
Q

What are common problems in interview?

A 
failure to control the interview, 
premature and restricted focus
lack of clarification 
lack of systemic interview procedure 
lack of precision 
failure to prepare patient 
lack of self awareness 
deficiencies in question style
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12
Q

What is the relevant information needed to be obtained?

A 
Open V closed 
Direct V indirect 
Compound
Leading 
Questionnaire 
Probing 
Facilitative 
Clarification 
Validation 
Confrontation
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13
Q

What is Open question?

A

More than one answer

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14
Q

What is closed Question ?

A

One answer

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15
Q

What is direct Open?

A

Why did the elephant cross the road?

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16
Q

What is direct closed?

A

Find X

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17
Q

What is indirect question?

A

Dont really sound like a question

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18
Q

What is compound question?

A

Can be quite confusing for the patient

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19
Q

What is leading question?

A

This lens makes it blurry doesnt it?

20
Q

What is a questionnaire question?

A

Offers range of possibilities

21
Q

Probing question?

A

To elicit precise information about symptoms

22
Q

What is funnel question?

A

Start with open question

Narrow question down

Response

23
Q

What is facilitative question?

A

Encourage remarks eg please continue

24
Q

What is clarifying question?

A

Summarise history and symptoms

25
Q

What is validating question ?

A

Normally an assumption from the effective information

26
Q

What is confronting questions?

A

Occasionally may need to confront patient before continue eg you seem quite angry about your glasses why is this?

27
Q

What are the measuring and investing type of techniques?

A

Memory
Ability to generalise
understanding of concepts
Ability to communicate

28
Q

What complication can you find?

A 
Concise and clear 
Specific to what you found 
Non verbal reinforcement 
Categorisation 
Primacy and recency effects
Call for commitment 
Summary 
Body language
29
Q

What if patient cant respond well?

A

Then direct questions to carer but ensure you include the patient

30
Q

What disabilities can px have?

A

Cerebral palsy
Downs syndrome
Autism

31
Q

How many people have learning disabilities?

A 
1.2 million in UK 
Third are children 
40% have eye problems 
37% have hearing problems 
50% receive no regular eyecare
figure increases with age
32
Q

What do you avoid at all cost?>

A

Sympathy, fear and hostility
Pathos or hopelessness
Over identification with patient or carer
Do not assume patient responses are wrong
Do not mistrust their state of mind

33
Q

Orientation?

A

Pre arranged visit
Staff awareness
pre exam questionnaire

34
Q

How many have hearing disabilities?

A

14% of population
8.7 million people
vast majority over 65 years

35
Q

What do you do with elderly patients?

A

Consider memory problems, check mobility consideration

establish attitude

36
Q

What tip do you consider for a silent patient ?

A

Warm, friendly manner

inverted funnel approach-initialy closed question

37
Q

What tip do you consider for a talkative person?

A

Closed question
polite interruption
Be aware on non verbal behaviour and ensure you look like your listening

38
Q

What tip would you consider for a nervous patient?

A

Warm, friendly manner
avoid jargon
closed question

39
Q

What tip do you consider for a aggressive or angry patient?

A 
Remain calm 
maintain good eye contact 
Open body posture 
acknowledge their feelings
Direct address the problem 
if patient very aggressive leave door open
40
Q

What tips do you consider for know all patients?

A

Directly acknowledge the situation in non confrontational manner
consider using more technical terms in this scenario

41
Q

How do you tell someone the bad new?

A

Ensure privacy
Respect confidentiality
Good open body language
Good eye contact

42
Q

What should you not do with a patient when telling them bad news?

A

Do not sympathise

Do not patronise

43
Q

What should you do about a patient that will hear the bad news?

A

Ask what patient already knows

listen to how patient tells you

44
Q

What is aligning ?

A

Start at the level of the patient understanding and use same vocabulary

45
Q

What is educating?

A

Give info in small chunks. keep language clear and simple. check that the patient understands what you are telling them

46
Q

How do you respond to the patients reaction?

A

Acknowledge all reactions and feelings
Be empathic
Deal with crying and other strong emotions

47
Q

How do you close?

A

Summarise the main points

Ask if the patient has any questions

clinical skills (13 decks)

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