Allied health 1

• Communication


  Exchanging messages between sender and receiver, successful when receiver understands the sender's message as intended
• Communication in health care


  • Excellence in communication is essential
  • Increase in size of delivery systems
  • Need for intercommunication
  • More complex payment systems
  • Decrease in time spent in hospitals
  • Importance of patient education
• Shift in causes of death to heart disease, cancer, COPD, and stroke
• Patients need


  Clear information about wellness and healthy lifestyles
• Communication and patient well-being

  • Need for respect and understanding of individual patients and their needs
  • Good communication increases speed of patient recovery
• Stressors for patients


  • Intimidation of health care setting
  • Fear and anxiety
• Poor communication can lead to fatal errors
• Health literacy


  Ability of patients to obtain and process basic health information
• Effective health care communication

  Aimed at meeting needs of patients, requires developing and applying communication skills
• Communication process


  1. Set communication goals

  2. Create message

  3. Deliver message

  4. Listen to response

  5. Offer feedback and seek clarification

  6. Evaluate encounter
• Set communication goals


  Decide what is to be accomplished, therapeutic communication usually at deeper level than everyday conversation, must be clear and specific
• Examples of goals


  • Obtain information from patient
  • Give instructions to patients
  • Report information to coworker
• Goals in every patient interaction

  • Show sincere concern for patient's welfare
  • Establish trust
  • Enhance patient's self-esteem
• Factors to consider when setting goal

  • Patient's level of understanding
  • Emotional factors
  • Physical factors
  • Urgency of communication
• Create message


  Avoid medical terminology with patients, use general language, use simple language if necessary
• Message must be


  • Clear and accurate
  • Organized if long
  • Ranked in order of importance
  • Given with overview and then details
  • Broken into chunks
• Types of questions


  • Closed-ended
  • Open-ended
  • Probing
  • Leading
• When asking questions


  • Allow time for response
  • Take care with leading questions
  • Reword questions when necessary
• Humor


  Appropriate when used carefully, helps relieve tension, can promote open discussion of sensitive issues, patients may joke to mask fear, listen carefully as patient may need help dealing with fear
• Deliver message


  Address patients directly, use titles to show respect, ask patients how they wish to be addressed, take care not to breach confidentiality, maintain communication with patients who cannot speak to respond
• Nonverbal communication


  Delivers up to 93% of meaning of oral message, includes tone of voice, touch, body language, facial expressions, physical appearance of health care professional
• Physical environment


  Can affect delivery of message, factors to consider include light source, sound distractions, privacy, focus on patient, patient comfort
• Listening


  Active process, requires concentration, observation, avoid mental arguments if you disagree, do not focus attention on creating your own response
• Feedback


  Method for sender to check receivers of the message, types include paraphrasing, reflecting, prompting, asking questions, requesting clarification and additional information, requesting examples
• Evaluate encounter


  Determine if communication goal was met, if not met identify difficulty, continually evaluate communication throughout encounter
• Communication through the life span

  • Children: reduce fear, involve as much as possible
  • Adults: do not assume understanding, use teach-back
  • Older adults: great variation, strive for respectful tone, may need to discuss difficult age-related topics
• Communication barriers


  • Cultural differences
  • Language differences
  • Defense mechanisms
  • Physical distractions
  • Pain
• Patients with special needs

  • Terminally ill: may experience loneliness, may want to share fears and concerns
  • In pain, medicated, or disoriented: identify self, speak slowly, maintain eye contact, use simple short messages, repeat and review, use touch if appropriate, schedule best time
  • Suffering from dementia: do not confront, use short sentences, agree or distract, respond to feelings, offer suggestions not corrections
  • Depressed: invite discussion of feelings, offer hope but do not tell to cheer up, allow for silence
  • Anxious: maintain calm, monitor anxiety, keep message simple, stick to one topic, use feedback to check understanding
  • Hearing impaired: observe behavior, ensure visibility, speak slowly and clearly, turn off noise, do not shout, announce change of subject
  • Visually impaired: announce presence, explain procedures, give detailed oral instructions, tell when leaving, give info about doorways and obstacles
  • Speech impaired: use pantomime, gestures, drawings, writing, communication boards
  • Angry: remain calm, do not respond in anger, do not argue, listen carefully, express concern, answer questions, ask for help if necessary
  • Do not speak English: empathize, smile if appropriate, determine interpreter, speak slowly and clearly, repeat in different words, use pantomime and gestures, write message
• Special applications of communication skills

  • Telephone communication: speak clearly, project warmth, avoid monotone, give caller chance to speak, never chew gum or eat
  • Patient education: set goals, create instructional message, deliver instruction, listen to questions, check understanding, evaluate
  • Group presentations: clarify purpose, determine audience needs, organize material, speak at moderate rate, look at audience
• Gossip is unnecessary, negative conversation, avoid at workplace
• Avoid speaking in public about patient information, do not discuss patients in social conversations or in front of them if they are not included