w12-8 Flashcards
Skills for effective patient communication
- Clinical knowledge
- Ability to convey the information and communicate
- Perceptual skills (HCP observations, feelings and thoughts - which impact on communication)
Aim for HCP: To convey information that is relevant and in context to the patient through tailoring their communication
To build Resilience:
- Build supportive relationships with patients
- Think positively
- Embrace your own strengths
- Choos to do the type of work you enjoy
- Be prepared to act. - focus on what they can do to overcome challenges or difficult situations
- Take care of your health and wellbeing
- Laugh and be grateful for the positives - have some enjoyment in the workplace
Advice for insurace
Listen to patient
Don’t act defensively
Dont offer compensation
Dont try to fix things too quickly
Make a written record
Contact your insurer/ professional association
Dealing with professional differences of opinions:
- Statement
Clear, confident statement without appologies - Reply
Use careful and respectful listening to identify the needs and wishes of the other person and reply appropriately. - Negotiation
Provide offers of help and compromise, no backing down on basic conviction - Resolution
Maximum possible satisfaction of everyones needs
State clearly without emotion - relax posture and voice - Listen attentively.
How to convey information and reccomendation?
S ituation
B ackground
A ssessment
R recommendation
To facilitate healthy change:
- Use a person-centred, non-judgemental therapeutic approach that respects autonomy.
- Form behavioural goal intention
- Convert the intention into action and maintenance.
Why people may not want to change
Not a current priority
May perceive they are healthier than they are.
What determines health outcomes?
health behaviours determine health outcomes
Trans-theoretical model:
Used to identify patient state of mind in change
1. Precontemplation
2. Contemplation: thinking of changing in the next 6 months
3. Preparation: change in next 30 days
4. Action: The person has changed in the last 6 months but is at a high risk of relapse
5. Maintenance: changed for last 6 months and is maintaing it.
Motivational interviewing
What, How, reduce, by and goal?
What: A way to strengthen patient motivation for change, with a focus on the patient’s attitude for change.
How: HCPs must show active and reflective listening not advice-giving.
Reduce resistance by: Support change that is consistent with the patient’s values
By: Help the patient identify thoughts and feelings that cause unhealthy behaviours and develop new thought patterns tp support behaviour change.
Goal: Help them believe it is possible to change and form an assumption that they can and will develop healthy behaviour
Hcps need positions the patient to understand what three things for change?
- The importance of change for the patient (willingness)
- Confidence and ability to change (ability)
- Priority for change (readiness)
The spirit of MI:
- Collaboration
When discussing health intervations - resistance and confrontation can be avoided by
- Adopting a respectful partnership
- Building rapport and trust
- Focusing on mutual understanding
- Avoid conversations presenting as the expert
- Avoid dismissing patient views and opinions - Evocation - change talk
Help patient delveop their own motivation and reasons to change based on what the patient cares about
- Additionally it will be more likely to last
- Draw out patients own ideas rather than imposing HCP ideas or telling them what to do. - Patient autonomy
True power lies in patient
- Empower patient but give them responsibility
- Allow patient to lead - multiple ways to change
Use of MI strategies without applying the spirit of MI is ineffective
Principles of MI:
- Express empathy - seek to understand without judgement - reflective listening but does not mean condoning patient behaviour
- Support self sufficiency - endeavour to help patient believe change is possible
Ask about other changes the patient has made
Share success stores - Roll with resistance
Resistance will occur if forced or rushed (stages of change)
Autonomy is impinged -loss of control
The patient is ambivalent about change -not ready
Approach resistance without judgment - respect and empathise - Develop discrepancies: assist the patient to understand discrepanticies with current behaviour and future goal
Explore pros and cons
Guide them toward self identified goals
Help them to understand there ambivalenc
Techniques + strategies to increase motivation
- Communication skills
O - ask open-ended questions
A provide affirmations
R reflect patient statements
S summarise patient comments - Strengthening commitment to change-change talk
a) Preparatory change talk
- Desire
- Ability
- Reason
- Need
b) Implementing change talk
The more someone talks about change - the more they are liekly to do it
Guide patient to make expressions of change talk
- Commitment
- Acitvation
- Taking steps
c) Evoking change talk
Elicit and clarify a persons intention to change by asking a series of targeted questions
Disadvantages of current behaviours
Advantages of making life after making a change
Optimism for change
Intention to change
