Week 11. Communication Fall 2024 - Tagged PDF

The to Introduction Communication Health ScienceProcess Communication  Learning Outcomes Explain importance of effective communication in health care Describe relationship between effective communication and patient well-being List and describe the 6 steps of th...

The to Introduction Communication Health ScienceProcess Communication  Learning Outcomes Explain importance of effective communication in health care Describe relationship between effective communication and patient well-being List and describe the 6 steps of the communication process Define and explain the use of the 4 types of questions Explain the meaning of nonverbal communication and give examples Explain the meaning of active listening  Communication Exchanging messages between sender and receiver Communication is successful when receiver interprets sender’s message as it was intended  Communication Messages can be exchanged in at least 4 ways: – Orally – Nonverbally – In written form – Electronically  Communication in Health Care In order to function effectively, modern health care systems rely on efficiency and accurate delivery of large amounts of information Diagnoses and treatments are based on variety of data that must be shared among many health care providers It is critical that all information be both accurate and timely  Communication in Health Care Excellence in communication essential in health care 1. Increase in number of health care delivery systems Effective delivery of patient care depends on coordination of information among various facilities and staff members 2. More complex payment systems Patients need clear communication to determine which treatments and drugs are covered  Communication in Health Care Excellence in communication essential in health care (cont.) 3. Decrease in time spent in hospitals 4. Increase in chronic diseases Importance of patient education regarding wellness and healthy lifestyles  Communication and Patient Well-Being Patient wellbeing depends on more than technical competence; studies have shown that health and treatment outcomes are influenced by quality of communication between patients and health care providers Health care providers need to develop respect and understanding of individual patients and their needs  Communication and Patient Well-Being Stressors for patients: – Intimidation “Pressure” of health care setting – Fear and anxiety about negative test results or diagnoses and treatments – Costs of care – Fear of pain and discomfort during necessary treatments – Fear of losing control All these can negatively affect patient recovery  Communication and Patient Well-Being Health care providers can help relieve patient stress by: – showing compassion (kind), – provide appropriate information – and answer their questions  Communication Process Communication is not only talking and listening Effective communication in health care is referred to as therapeutic communication – Aimed at meeting needs of patients – Requires developing and applying communication skills Each communication encounter is unique  Communication Process 1. Set communication goals 2. Create the message 3. Deliver the message 4. Listen to the response 5. Offer feedback and seek clarification 6. Evaluate encounter  1. Set Communication Goals Decide what is to be accomplished Casual communication is spontaneous “Natural” and requires little or no planning (example, “hi, how are you?”) In health care settings, communication is more purposeful and contributes to providing appropriate patient care  1. Set Communication Goals For example, nurse - instead of asking patient, “How are you?” which usually results in programmed response of “fine” - asks, specific questions like: 1. On a scale of 0 to 10 with 0 being no pain and 10 worst pain possible, what is your pain level?  1. Set Communication Goals - asks, specific questions like (cont.): 2. Do you have any questions about the surgery? 3. Can you identify 3 measures you could do at home to reduce your anxiety?  1. Set Communication Goals Communication goals in health care situations: – Gather information from patient – Give instructions to patients (about medications, life style changes) – Report information to coworker who is taking over the care of the patient (change of shift report)  1. Set Communication Goals Goals to include in every patient interaction: – Show sincere concern for patient’s welfare (warm smile; do not act hurried; listen carefully) – Establish trust (eye contact as appropriate; explain why test, treatment is necessary; – explain in advance everything you are going to do; – follow through with anything you say you will do: if you say, you will come back in 5 minutes, come back in specified time) – Enhance patient’s self-esteem (involve patient in decision making; address patient properly; provide for privacy; ask patient on how he/she wants things done, when appropriate) –  1. Set Communication Goals Factors to consider when setting goal: – Patient’s level of understanding (does patient speak Arabic?; is patient very young?; does patient have learning disability?; what is level of education of patient?) – Emotional factors (does patient’s behavior indicate fear or anxiety?; is patient ready to accept the information that is to be offered?)  1. Set Communication Goals Factors to consider when setting goal (cont.): – Physical factors (is patient in pain? Is patient on medications that make him drowsy? Does patient have hearing or visual impairment that affects communication?) – Urgency of communication (must the communication take place now? Is this appropriate setting for the communication?)  Question True or False: – Today’s health care services are so technologically advanced that there is little point in allowing patients to participate in making decisions about their health.  Answer False Patients should be involved in decision making whenever possible  2. Create Message Information must be presented in a manner that the receiver understands Avoid medical terminology with patients - √ high blood pressure - X hypertension Use general language  2. Create Message Must be clear and accurate Organize long messages – Rank items in order of importance – Give overview and then details – Break information into chunks  2. Create Message When asking questions to create message Types of questions: – Closed-ended Can be answered with one word or phrase Used to collect factual information, like background information from patient. Examples: - Q: where you born in the UAE? - A: Yes - Q: what is your date of birth? - A: January 25, 2008  2. Create Message Types of questions (cont.): – Open-ended Cannot be answered with simple “yes” or “no” Require more complete response and are used to encourage patients to provide more detailed information Examples: - Q: how did you fall? - A: while I was going up the stairs,….. - Q: what medications do you take? - A: I take …..for……  2. Create Message Types of questions: – Probing Asks for additional information or clarification Examples: - Q: you mentioned that your stomach hurts, can you tell me where exactly does it hurt, when it started, and type of pain - A: the pain is right here (patient points to location),  2. Create Message Types of questions: – Leading Question in which all or part of the answer is included in the wording of the question Should be avoided because they encourage the receiver to give the answer believed to be correct or what the health care professional wants to hear Examples: - Q: you don’t smoke cigarettes, do you? vs. - Q: do you smoke?  Question “What is your date of birth?” is an example of a/an _____ question. A. Probing B. Open-ended C. Closed-ended  Answer C. Closed-ended Response to question is one word or short phrase that functions like one word – Therefore closed-ended  2. Create Message When asking questions: – Allow time for response – Do not interrupt or finish sentences for the receiver – Take care with leading questions Because patient may simply agree with you – Reword questions if receiver does not seem to understand the question  2. Create Message Humor appropriate when used carefully – Helps relieve tension – Can promote open discussion of sensitive issues Patient jokes to mask fear – Listen carefully – Patient may need help dealing with fear 3. Deliver Message Address patients directly whenever possible – Young and elderly patients – Use titles to show respect – Ask patients how they wish to be addressed  3. Deliver Message Take care not to breach confidentiality Maintain communication with patients who cannot speak to respond  3. Deliver Message: Nonverbal Communication Delivers up to 70% of meaning of oral message Nonverbal communication includes the following: – Tone of voice – Touch Can be reassuring, but use with care Use an appropriate compassionate touch to show your concern and support.  3. Deliver Message: Nonverbal Communication Nonverbal communication includes the following: – Body language Gestures can be positive or negative – Smiling – Crossing arms – Rolling eyes An open stance. A closed stance.  3. Deliver Message: Nonverbal Communication Nonverbal communication includes the following: – Facial expressions Avoid showing negative reactions – E.g., impatience, disgust – Physical appearance Sign of health care professional competence and regard for patients  Gestures  Movements of the hands and arms.  Health care workers must be sensitive to cultural variances with regard to gestures. Gestures and their meanings around the world  Question Leaning toward the speaker when you are listening is usually a sign of: A. Aggression “Anger ” “Hostility ” B. Interest C. Difficulty understanding  Answer B. Interest Leaning toward speaker – Sign of interest in what speaker is saying  3. Deliver Message: Physical Environment Can affect delivery of message Factors to consider: – Light source: can patient see you clearly? – Sound distractions: can patient hear you clearly? Are there unnecessary noises that are distracting? – Privacy: are there other people who can hear the communication? – Focus on patient: are you more focused on taking notes than on the patient? – Patient comfort: is patient in pain?  4. Listen to Response Active Listening – Active process Concentration Attention Observation  Question Which is the most important characteristic of active listening? A. Taking notes while listening B. Maintaining eye contact with the speaker C. Focusing fully on what the speaker is saying  Answer C. Focusing fully on what the speaker is saying Active listening may involve other actions, but focusing fully on speaker is the underlying characteristic 4. Listen to Response: Empathy Empathy – Effort to understand other peoples’ thoughts, feelings, and behaviors – “Walk a mile in my shoes” Communicate awareness of patient’s feelings  5. Offer Feedback and Seek Clarification Feedback – Method for receiver to check understanding of what sender says Types of feedback: 1. Paraphrasing Rewording of sender’s message in receiver’s own words - example: “I understand you to say that you have experienced these headaches every day for the past two weeks. Is that correct?”  5. Offer Feedback and Seek Clarification Types of feedback: 2. Reflecting Prompting receiver to complete or add to original message -example: “you say that it is difficult for you to do the exercises the therapist has recommended because _____.” (pause and allow time for response)  5. Offer Feedback and Seek Clarification Types of feedback: 3. Asking questions Requesting clarification and additional information - “ can you list for me the three steps you will take when giving your son his medication?” 4. Requesting examples Asking for examples to clarify and fill in meaning  Question “I hear you saying you feel better after you’ve done the exercises, I taught you last week” is an example of: A. Paraphrasing B. Reflecting C. Asking a leading question  Answer A. Paraphrasing Paraphrasing – Stating in own words what you think sender said  6. Evaluate Encounter Determine if communication goal met If not met, identify difficulty Continually evaluate communication throughout encounter  6. Evaluate Encounter: Communication Barriers Barriers can block effective communication Examples of barriers: – Cultural differences – Language differences – Defense mechanisms – Physical distractions – Pain Communication: Important points 1. Culture 2. Personal space 3. Health care beliefs 4. Patient Privacy  Culture Culture gives direction to all aspects of life and provides a set of lenses through which the world is seen and interpreted. – Values and beliefs – Social organization – Family structure – Language – Religion – Everyday activities Belief systems and customs are developed over time to help people make sense of their world. Behaviors that are considered positive in one culture may be a sign of disrespect in another.  Culture Differences among people are sometimes based on cultural background. Making assumptions about individuals based on the group to which they are believed to “belong” is disrespectful because it takes away from their worth as individuals. It is essential that health care professionals learn to observe, ask meaningful questions, and listen carefully to the responses.  Cultural differences – Realize and appreciate that there are many valid approaches to life. There is never an “only way” or even a “best way” – Enrich and improve their own lives by increasing their knowledge of other cultures and discovering new ideas they might want to incorporate – Avoid making the assumption that everything health care professionals do and say will be understood and appreciated – Understand that certain beliefs might be held and certain customs might be practiced because of an individual’s background – Be sensitive to the possible needs of individuals who appear to be from specific cultural backgrounds and avoid taking actions that might be offensive until more information can be obtained. – Ask appropriate and useful questions  Dominant Culture Refers to what are generally considered to be the foundational beliefs and ideal behavior of a society or country. Example: – “being on time” and “using one’s time effectively”. – The need to work efficiently. – The need to shake hands firmly when meeting new people.  Personal space Comfortable distance for conversation – Eg: In U.S a distance of about 18 inches is considered appropriate for people who know each other very well – Middle Eastern societies, people stand very close together when talking. Varies among cultural groups Harmless touching in one culture may be improper in another. It is important to be aware that the degree to which any type of physical contact is tolerated varies during medical procedures.  Health care beliefs Vary widely among cultural groups Differences include the following: – Definitions of good health – Causes of disease – Methods of treatment – Example: Treatment methods, such as medications, must be proven to be both effective and safe through carefully controlled clinical trials. the relationship among the mind, body, and spirit. Illness may result when the harmony among these three human components is disrupted.  Health care beliefs Religious and spiritual beliefs influence many health care practices – Shamans – Faith healing – Illness as will of God or punishment for sins – Prayer – Evil eye  Patient Privacy Avoid speaking in public about patients Do not discuss patients in social conversations Do not discuss patients in front of them if they are not included in conversation