Uploaded bySiddhartha Sinha
Principles of communication in Healthcare (AETCOM)
This document discusses principles of effective communication for doctors. It outlines key elements of communication like the communicator, message, method and recipient. It emphasizes active listening skills like listening to words, voice, demeanor and context. Good communication during consultations requires understanding patients culturally and educationally. Doctors should address patients respectfully, be unhurried, ask open-ended questions and make reassuring gestures. Non-verbal communication like body language also conveys important messages and building rapport through techniques like mimicking can improve understanding. Potential barriers to communication include environmental factors, difficulties with the message or interactions between doctors and patients.
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Principles of communication in Healthcare (AETCOM)
- 1. Principles of Communication DrSiddhartha Sinha Dept Of Orthopaedics
- 4. What is it? •Communication is an essential skill especially for doctors • “ The successful passing of a message from one person to another”
- 5. Elements of communication The communicator Themessage The method of communicating The recipient The response
- 6. Principles of facilitating communication The rapportbetween the people involved The time factor, facilitated by devoting more time The message, which needs to be clear, correct, concise, unambiguous and in context The attitudes of both the communicator and the recipient
- 7. Communicating during a consultation Required fora complete diagnosis (physical, emotional and social) Cultural considerations Education level
- 9. Positive doctor behaviour • Atfirst contact: • Address the patient by his or her preferred name • Make the patient feel comfortable • Be ‘unhurried’ and relaxed • Focus firmly on the patient • Use open-ended questions where possible • Make appropriate reassuring gestures
- 10. Active listening Most importantskill--- active process How do you listen? Ears Eyes Touch Brain ( awareness about situations and emotions) ( EMOTIONAL RESONANCE)
- 11. Skills • Listen to •the messages that are buried in the words or encoded in all the cues that surround the words • to the voice • the demeanour • the vocabulary, and the gestures of the other • the context • verbal messages • linguistic pattern • bodily movements • listens to the sounds, and to the silences.
- 12. Elements of listening •checking facts • checking feelings • encouragement • Reflection • Listen with understanding, in a relaxed, attentive silence
- 13. What are reflective questions? • Youseem very sad today. • You seem upset about your (something/ someone). • It seems you’re having trouble coping. • You seem to be telling me that … • Your main concern seems to me to …
- 14. Encouraging Attitudes • caring •empathy • respect • interest • concern • confidence • competence • responsibility • trust • sensitivity • perceptiveness • diligence
- 15. Communication strategies • Modify language. •Avoid jargon. • Provide clear explanations. • Give clear treatment instructions. • Evaluate the patient’s understanding. • Summarise and repeat. • Avoid uncertainty. • Avoid inappropriate reassurance. • Arrange appropriate referral (if necessary). • Ensure patient is satisfied • Obtain informed consent
- 16. Follow-up • Be availablefor telephone calls. • Ensure patients obtain results of investigations ordered. • Ensure any promised follow-up is carried out. • Phone the patient if you have any lingering concerns (this could be handled by the receptionist). • Arrange referral if inadequate response to treatment. • Act as an advocate if necessary (e.g. pressing for hospital admission)
- 17. Use of analogy • Whencommunicating concepts/problems to people such as in counselling, • Creative use of comprehensive common analogies • Meniscus injuries : shock absorbers • Femur fracture: hip fracture
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- 21. Doctor–patient interaction • Poorpast relationships and experiences leading • unresolved interpersonal conflict • an incorrect diagnosis • poor treatment outcome • indifferent compliance in following treatment • paying accounts • Personal differences, openly expressed, create subtle barriers, • age, sex, religion, • culture, social status • doctor/patient roles (occasionally influenced by political factors) • Communication skills of doctor and patient, both as the sender and receiver of messages • Personal honesty and integrity of both parties in dealing with difficult messages • Psychosocial problems that will establish barriers (e.g. psychiatric illness or speech impediments) • Familiarity between patient and doctor (e.g. friends or relatives)
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- 25. Road Blocks togood communication Judging 1. Criticising: ‘You didn’t bother to follow up that test’ 2. Name-calling: ‘You are becoming a worrisome drug addict’ 3. Diagnosing: ‘I can read you like a book’ 4. Praising evaluative: ‘You’re a good patient—I know you can manage this Sending Solutions 1. Ordering: ‘You must stop smoking’ 2. 6 Threatening: ‘If you don’t change, you will be dead meat in 12 months’ 3. Moralising: ‘I cannot condone that sort of behaviour— it’s wrong and you will pay the penalty’ 4. Excessive/inappropriate questioning 5. Advising/patronising: ‘When you’re in Thailand, be perfectly good’
- 26. Avoiding the other’sconcerns 1. Diverting/changing the subject: ‘What did you think of the election result?’ 2. Logical argument: ‘This wouldn’t have happened if you …’ 3. Reassuring: ‘What are you worrying about? Hundreds of people have to face up to that …’
- 27. The seven sinsof medicine 1. sloth 2. spanophilia (love of the rare) 3. obscurity 4. bad manners 5. over-specialisation 6. cruelty 7. common stupidity
- 28. Non-verbal communication • gestures •postures • position • distances (non-verbal communication or body language)
- 29. • Develop anability to recognize non-verbal cues • Improves communication • Rapport • understanding of the patient’s fears and concerns. • Recognizing body language can allow doctors to modify their behavior • promoting optimum communication
- 30. Interpretation of body language •Cultural variations • Some universal
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- 35. • You mustthen deal with it. • May require confrontation, • diplomatically bringing these cues to the patient’s attention • exploring the associated feeling further. • A hunch or gut feeling can be better understood, reinforced or corrected by skilled observation and interpretation of body language.
- 36. How can you interpretnon- verbal clues ?? • Watch television without sound for 15 minutes each day and check your interpretation each 5 minutes. • By the end of 3 weeks, he suggests, you will have become • a more skilled body language observer.
- 37. Rappot building techniques Mimicking •Body language • Speech ( Careful) • Posture • Pace • Limb positions Mirroring • body angles of the person you are talking to can be copied. • A mirror image is formed of their position so that when they look at you they see • Avoid uncomfortable mirroring of gestures and limb positions • Partial mirror
- 40. Pacing • rhythm orpace that can be revealed through breathing, talking, movements of the head, hands or feet. • Copy the pace of another person, it will establish a sens of oneness or rapport with them. • X` • you can change their pace by changing yours. This is called leading Vocal copying • Copying intonation, • Pitch • Volume, pace, rhythm, breathing • Length of the sentence before pausing
- 41. Protect yourself!!! • Unfortunateeffect of making you feel that you are ‘drowning’ in their problems. • Break the rapport • Diplomatically go into a leading phase
- 42. Key features ofgood communication • Active listening • Appropriate address (i.e preferred name of the patient) • Empathy • Open ended Questions • Summarising • Checking and understanding feelings • Good closure
Editor's Notes
- #20 The hospital environment will encourage the ‘sick’ role and generally is not conducive to good communication because of a low level of privacy. A busy practice affected by time constraints on doctor or patient will infl uence communications seriously
- #21 The nature and content of the message may be uncomfortable for the doctor or the patient or both. emotionally charged, complex or subtle content, such as sexual problems or abuse, malignant disease, drug abuse, bereavement, malingering and psychiatric disorders patient may find the message difficult to comprehend because of inappropriate delivery or explanation by the doctor Bad follow up strategies ( not keeping appointments), NOT TAKING PHONE CALLS Use interpretors Failure to detect/ identify obvious symptoms and failure to reassure the patient
- #37 Allen Pease