Culturally Competent Communication Flashcards
Why is effective communication important in pharmacy?
Patients need to understand how to effectively and safely use their medications. Most drugs are self-administered)
Allows pharmacists to gather critical information
Benefits patient to know they are being heard
Reduces misunderstanding and conflict with patients
What are some qualities critical to effective healthcare communication?
Trust: What you are saying reflects what I want and need
Informed consent (legal and ethical requirements): with no understanding there is no consent
Good decision making: Need to gather all of the information about what patient wants and is willing to do
Effective self-management of disease: Adding to the patient’s knowledge and ability to adhere to prescribed treatment(s).
What is the communication process?
A two-way process that demands considerable communication skills from both the patient and provider of care
(each of us is a receiver and sender)
What are some Communication Process Models?
Ritual Model
Transmission Model
Transaction Model
Describe the Ritual Model
Communication is based on shared patterns (polite remarks that aren’t expected to be given an answer)
Ex. Q: How’s it goin’? A: Its aight my G
Thus ttype of communication can occur in a pharmacy when it should not happen
Ex. Ph: Any questions about your medication?
Pt: No (even if patient has questions)
This means some patients do not express their actual experiences with pharmacists
Describe the Transmission Model of Communication
Focus is on providing information in a one-way direction (pharmacy dump)
Active patient participation is possible, but not encouraged (questions seem to slow interaction down)
There is an assumed knowledge/power differential between provider and patient (makes patients less likely to ask questions)
Describe the Transaction Model of Communication
Opposed to the transmission model, conversation goes both ways
Information is sent and received in stages by both the patient and pharmacist
Feedback and discussion create context for subsequent information sent and received by both patient and pharmacist (this can be uncomfortable for pharmacists, if they are asked a question that they do not have an answer to reply with)
What factors complicate communication between a patient and healthcare provider?
Patients who are under physical and emotional distress
An overuse of professional jargon and technical language
The patient’s time with a care provider is often limited and rushed
A failure of many providers to appreciate the patient’s POV (the patient isn’t difficult, but their situation can be)
How can language be a barrier for non-native English speakers?
Difficult to establish rapport with various health professionals including pharmacists
Lack of appropriate health information in other languages, resulting in poor understanding of medications and potential adverse effects.
Because official channels are in English, non-English speakers may over rely on informal social networks and social media for their health-related information
What are some cultural factors that affect how information is exchanged between individuals?
High vs. Low Context
Individualism vs. collectivism
Emotional Expression
Touching and Space
Power Distance
Other…
Describe the concept of High and Low Contest communication
Low context communication: the sender assumes the receives knows very little and must be told “everything” (explains every detail)
The receiver expects communication to be as explicit (spoken or written information)
Describe the concept of high-context communication
The sender assumes the receiver knows the relevant situation/circumstance
The receiver quickly understands concerns and messages with minimum information from the sender
High context individuals are more concerned with the emotional quality of an interaction than the meaning of individual words
Misunderstanding could occur when low and high context communicating individuals interact with each other.
Are high vs. low context communication correlated with how individuals value time?
Yes,
Monochromic time: emphasis on creating and maintaining schedules, and being on time (low context)
Polychronic time: values involvement with others vs. Keeping appointments and schedules (high context)
What is the difference between individualism and collectivism?
Individualism: social pattern in which the person is primarily motivated by own preferences, needs, rights and desires
(Wants of the group are secondary, personal goals are primary)
Collectivism: the person gives greater priority to the needs of the group (family, work unit, community) (what I owe to my family and community)
How is collectivism and individualism relevant to patient communication?
In healthcare, tendency toward one or the other can be seen with the degree of family involvement in both care and decision making.
Members of collectivist, high-context families, groups, and cultures also tend to adopt indirect communication styles (can be challenging for the HCP to interpret patient preference)
Is increased emotional expression always a sign of aggression?
In some cultures, loud or raised voices indicate tension or aggression, while in other cultures, loud voices indicate an exciting and enjoyable conversation among friends
Correct interpretation is critical (but do not jump to conclusions, only possible if you have rapport with patient)
What is some non-verbal communication used in healthcare?
Expressions, touches, and gestures often convey stronger messages than verbal communication. (Can reinforce or contradict the verbal message)
Appropriate amount of touching based on cultural norms
Ex. Handshakes, hugs, kisses, etc.
Significant differences across cultures; also within cultures based on age or status
What is the place of touching and space in pharmacy practice?
It is challenging in healthcare where touch is seen as integral to the care and comfort of our patients (most patients view touch as a caring gesture, but it can be culturally inappropriate)
The amount of personal space also varies across cultures
What is power distance?
It refers to the distribution of power within a group of society
Vertical: concentration of power “at the top”. Many with little or no power (tendency to be more formal with deference to those in position.
Horizontal : power more widely shared with a more egalitarian view of one another (less deference and hesitancy to ask questions)
What are some other cultural issues between HCPs and patients?
Lack of knowledge among providers of cultural differences in values, and behaviours can increase risk of misinterpreting messaging (humility and self-reflection)
Fear and distrust among patients. This is common when people come from different cultures first meet
Stereotyping: Assume characteristic seen in one person is present in everyone in a group
What is the L.E.A.R.N model of communication?
L-Listen with empathy and for understanding (listen first and ask relevant questions)
E- Explain your view of the problem to the patient (bring your professional judgement)
A- Acknowledge similarities and differences
R- Recommend appropriate treatment (patient needs to consider whether they are willing to take advice)
N- Negotiate with the patient over what is possible for the patient (what can I help you with)
Our job as healthcare professionals is to ensure our patients are able to meet their health-related goals
