Communication with Special People and Special Occasions Lecture 5 PDF

Communication with Special People and Special Occasions Lecture (5) ⚫​ Special people are suffering from some physical, and/or mental, and/or psychological. They include; deaf patients, blind patients & children and...

Communication with Special People and Special Occasions Lecture (5) ⚫​ Special people are suffering from some physical, and/or mental, and/or psychological. They include; deaf patients, blind patients & children and parents. The following sections will discuss each type of special people separately. ⚫​ Deaf patients Deaf is a partially or completely lacking in the sense of hearing. Dysphasia and aphasia are referred to partial or complete loss of verbal communication with people. Deafness in patients is usually not immediately obvious and has to be discovered. Old people don‘t like to admit any hearing loss even when it has become socially embarrassing. These are eight points to remember when talking to deaf patients: 1- Do smile a greeting and face the patient when you speak so that he can lip read "Lipsy". 2- Speak slowly but not loudly and do not exaggerate your lip movements. 3- Stop talking when you turn away from the patient or move behind him. 4- Make sure that the patient can see you when you speak and do not have to face a bright light. 5- Make use of the appropriate facial gesture to reinforce what you say. 6- Talk in a simple language. 7- Write down all difficult words, appointment dates and prescriptions, and give the patient and instruction sheet for even the simplest forms of treatment. 8- Learn about manual alphabet, this will help the physical therapist in better way. ⚫​ Blind patients 1 Blind is the loss of vision (unable to see). Some blind people dislike wearing glasses, and put with foggy vision‫ رؤية ضبابية‬for the sake of appearances. There are seven points to remember when talking to blind patients: 1) Blind people can hear. So, always talk to the patient directly but not loudly. 2) Greet the patient with a hand-shake or touch on the arm, say who you are, and mention others around you. 3) Always say what you are doing and what you are going to do. 4) Always make sure that there are no steps or equipment in the way when the blind patient has to move. 5) If you want the patient to move, for example to a plinth, tell him to stand and give him your arm to hold. 6) Let blind people speak and ask questions. 7) If you give the patient an instruction sheet, read it to him slowly, before handling it to him. ⚫​ Children and parents Communication with children is practiced well by most of us. Some bad custom, we want to eliminate with our children, that if any child do something wrong his parents tell him that "I will go with you to doctor". Then the child cries because he does a bad act and doctor gives the punishment. So, the child may concern the visit to the physical therapy unit as punishment to him. Physical therapist should try to throw these ideas from child's thought. In physical therapy session for a child always remember: · Put the child at ease by shaking hands, asking his name, talking about his friends, and asking about his progress at school. The relaxed child talks spontaneously and often. · Always talk directly to the child. Ask him questions. Look to a parent for confirmation or reply only when necessary. · When explaining the diagnosis or plan of treatment to parents, include child in discussion. · Talk to a child as you would with an adult, and do not disregard information volunteered. ‫ال تتجاهل المعلومات التطوعية‬ 2 · Children with a fatal illness, there is no need to evade the truth. Parents at this situation have no rights to tell their children a bad news. Physical therapist should keep talking and listen. You will have to respect a child's confidences and keep his secrets. · Children ask a lot of question because they are learning about life. Try to answer them sensibly. Ethical Rules in Special Occasions ⚫​ There are some special occasions that meet the physical therapist during dealing with patients and in professional discipline as well. The following responses can be changed according to the circumstances. This needs a good judgment from the physical therapist. (I) Special Occasions Concerning Patients 1- Patients refuse physical therapy. If the patient refuses physical therapy, this may be due some reasons. Same expected causes of patient's refuse a- The patient ignores the effectiveness of physical therapy‘s modalities. In this case, it is the responsibility of the physical therapist to explain the effects of physical therapy modalities in a simple way. b- The patients have a bad experience or wrong idea about physical therapy. In such case, it is the responsibility of the physical therapist to correct these bad experience and wrong ideas. c- The patients have no idea about physical therapy. In this case, it is the responsibility of the physical therapist to explain the rule of physical therapy in compilation of surgical or medical treatment. It is the essential part of physical therapy in the rehabilitation team. d- The patients have no desire to receive physical therapy. In this case, the physical therapist tries to convince the patient with physical therapy in direct and smooth way. e- The patients may be psychologically disturbed. In this case, it is mandatory to discuss the physical therapy procedures with the patient in presence of colleague, nurse and/or one of his relatives. If the patient accepts, it is advised to do the physical therapy modalities in presence of one of the individuals mentioned above. If 3 the patient still refuses the physical therapy and the physical therapist cannot deal anymore with such case, so there is no need to do more effort with such patient. 2- Patients ask unknown question. ⚫​ If the patient asks an unknown question(s) (related to the program or modality) to the physical therapist –and the physical therapist do not know the answer- it is preferable to explain the most related subjects to the patient; otherwise, postpone the answer to the next visit. Then, honestly read again or ask expertise physical therapist to gain the appropriate answer. In the next session or visit of the patient, explain to him the proper explanation of his previous question. 3- Old aged Patients. ⚫​ These are sensitive patients, i.e. psychologically sensitive and sensitive to any modality of physical therapy. Great care of handling those patients should be followed. Time of session may take long time not for the methods applied but in explanation of such methods. ⚫​ Physical therapists should be patient in applying therapeutic exercises and do not hurry the patient up to fulfill all program. 4- Mentally retarded Patients. ⚫​ Remember that these types of patients need great help and advice. During physical therapy sessions, it is usually in presence of one of the closest relatives of the patients. 5- Patients want to know the program of physical therapy of other patients. ⚫​ The only proper answer is "NO" without any unnecessary discussion. This is one of the professional secrets physical therapists swear to keep it. Physical therapist should not feel any embarrassment (blame) to tell the patient about confidentiality of others. 6- Patients have skin diseases. ⚫​ Physical therapist has the rights to protect himself against infectious diseases. Also, he should protect other clients from these infectious 4  diseases. The following procedures should put in consideration when dealing with patients has skin diseases: a- Wear gloves before the first examination and during the session. b- Cover the therapeutic plinth with disposable sheet, to throw it in closed package after the session. c- Wash your hands as well as the plinth with alcohol. 7- Patients ask about special life of physical therapist. ⚫​ The patients have no rights to ask physical therapist about his special life. The patient is not a friend or relative to physical therapist. Good dealing and tactfulness of the physical therapist towards his clients, don not give them the availability to ask such questions. (II) Special Occasions Concerning Physical Therapists 1- Perfect timing and general appearance, ⚫​ Perfect timing is one of good criteria of physical therapist. This should be achieved in his general work, clinic and private cases. Because of the time expended in physical therapy session, it is preferable to give the patients a separate time to come to the clinic or hospital (for example does not ask all patients to come at same time). This will give the physical therapist enough time for each client. General appearance of the physical therapists may affect the patient's response to the treatment. 2- Administrative skills and positions. ⚫​ Administrative skills are acquired through adequate training. Honesty during work is one of criteria of good administrative skills. 3- Fees of sessions. ⚫​ Sliding Scale System "SSS" is most appropriate scale commonly used by organization and hospitals to select cost of physical therapy intervention or other services. This cost can be applicable in general hospital, private clinics and in home visits. This issue is explained in standard "7" of "international standards of physical therapy services” and standard "4" of "international standards of physical therapy practitioners". 5  ⚫​ A barrier to communication is something that keeps meanings from meeting. It is false to assume that if one can talk he can communicate. ⚫​ Barriers to successful communication include message overload, when a person receives too many messages at the same time, and message complexity. Some barriers to communication are: ⚫​ Physical barriers : Physical barriers are often due to the nature of the environment. Example: noise, poor lighting etc. Noise: is any occurrence that inhibits effective communication; it can occur at any point in the process. Noise is the causative factor for the message being mis-communicated or misunderstood due to the problem either in the medium chosen or encoding or decoding or in some stages of the process. ⚫​ Semantic barriers : 6 Semantic refers to meaning of language used. Often the same word is interpreted by different people in different ways according to their mental attitude and understanding. Poorly explained or misunderstood messages can result in confusion. Mistakes in grammar can disrupt communication, such subject verb agreement, abrupt change in tense etc * Physiological barriers: Physical diseases that prevent effective communication, such as deafness or blindness. * Socio-psychological barrier: Certain attitudes can also make communication difficult. ⚫​ For instance, great anger or sadness may cause someone to lose focus on the present moment. Disorders such as Autism may also severely hamper effective communication. ⚫​ Other barriers based on social psychological barriers are : a. Attitude an opinion: if information agrees with our opinion and attitude, we tend to receive it favorably but if it ends to run contrary to our accepted beliefs, we do not react favorably. b. Emotion: Emotional states of mind affect communication. If the sender is exited or nervous, his thinking will be blurred and he will not be able to organize his message properly. c. Closed mind: Related to person with ingrained prejudice and not prepared to reconsider his opinions. d. Status conscious: are common in organization are afraid of communicating upward any unpleasant information. e. Inattentiveness: people often become inattentive while receiving a message in particular, if the message contains a new idea. f. Poor retention: studies show that employees retain only about 50% of the information communicated to them. Poor retention may lead to imperfect responses which may further hamper the communication process. 7