module 6 communication Flashcards
therapeutic communication improves
relationship patient provider trust accuracy efficiency supportiveness health outcomes satisfaction
therapeutic communication bridges gap betwen
evidence based literature and individual patient choice
Influences communication
values culture religion social status gender age development education
non-verbal communication
facial expressions
tone
eye contact
patient centered approach
- understanding patients perspective on disease process of illness
- interpreting and considering patients psychosocial status
- shared decision making
- valuing patient perspective and values
Calgary-cambridge guide: gears
Gears that work together INITIATING SESSION - gathering information - physical exam - explanation and planning CLOSING SESSION
calgary-cambridge guide: perspective
biomedical
patients: FIFE questions
FIFE questions
F: feelings - r/t illness, especially fears I: ideas - explanations of the cause -- "what do you think is going on" F: functioning - impact on daily life E: expectations - of the NP and the illness
Prochaskas stages of change
Pre-contemplation Contemplation Preparation Action Maintenance Relapse
Prochaskas Pre-contemplation stage
no intention on changing behavior
Prochaskas Contemplation stage
aware a problem exists but with no commitment to action
Prochaskas Preparation stage
intent on taking action to address the problem
Prochaskas Action stage
active modification of behavior
Prochaskas Maintenance stage
Sustained change
New behavior replaces old
Prochaskas Replase stage
Fall back into old patterns of behavior
Adult learning principles
problem-oriented have experience internally motivated ready to learn self-directed
Motivational interviewing key strategies OARS
Open-ended questions
Affirmations
Reflective listening
Summarize
mindfullness
paying attention on purpose in the present moment non-judgmentally GOAL: take negative thoughts about ones past or fears of the future and listen to emotion and thoughts, recognize feelings that rise and subside, and thoughts are just thoughts.
benefits of mindfullness
social and academic performance improves sleep and self-confidence improve immune function changes maladaptive stress coping reduced anxiety and depression
Motivational interviewing tools
agenda setting: client determines priorities
getting permission
open ended questions
reflective listening
summarizing
eliciting self-motivational statement: change talk
willingness and importance: confidence
cognitive behavioral therapy strategies
interactive, short term, problem oriented therapy
Focus: how ones thoughts, feelings, and behaviors interact
Goal: modify unrealistic assumptions and change them by correcting cognitive distortions, reframing negative expectations, improving social skills and problem solving.
cognitive behavior therapy steps
- identify the situation: what made me upset?
- Name the feeling: what what my response?
- Determine the thought: what am I thinking that is making me feel this way? How is this a thought problem?
- Challenge the thought: What evidence do I have for this thought? is there an alternate way to look at the situation?
- Made a decision: Do things mostly support my thought or not?
