Basic Concepts of Communication with Patient and Family.ppt

8/14/2019 Basic Concepts of Communication with Patient and Family.ppt

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BASIC CONCEPTS

OF MEDICAL

COMMUNICATION

PUTU SUTISNA


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Lectures main objectives:

To describe the importance of goodcommunication with patients

To describe the factors that may influence the

outcome of communication between thedoctor and patient

To explain the technique of conductingeffective communication with patients thatinvolves questioning, listening and facilitating


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Communication

imparting, conveying or exchanging of ideas,

news, knowledge etc.


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Several methods of communication:

Two friends talking

Radio/ TV

Newspaper/book

Wrting a letter

Telephoning/fax

Teaching/lecturingDoctor or nurse with patient


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Purposes of Communication

are to:

form & maintain relationship

give information

convey feelings

persuade

solve problems

alleviate distress

make decisions

give reassurance


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Aim of a physician

(since ancient time):

To cure sometimes,relieve often,

comfort always


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Communication in Medicine

Doctorpatient/family

Doctordoctor

Doctorcommunity


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Main areas covered in Block MC

1. A.Taking medical history and review of bodysystems

B. Giving information to patient

C. Special approach to specific patient/situation2. Paper presentation and discussion

3. Writing medical letters & notes, and CV

4. Scientific writing

(5. Health education & health promotion forcommunity at large)


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Good communication skills can be learned.

Prerequisites:

Written instructions (references)

Opportunities to practice

Feedbacks (SGD)

Discussion on performance (SGD)


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Doctor-Patient

CommunicationInfluencing Factors

Patient-related factors

- Physical symptoms

- Pathological factors related to illness

- Previous experience of medical care

- Current experience of med care


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Doctor-related factors

-Training in communication skills- Self-confidence in ability to communicate

- Personality

- Physical factors (e.g. tiredness)

- Psychological factors (e.g. anxiety)


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Interview setting requirements

- Privacy

- Comfortable surroundings- Appropriate seating arrangement


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Guidelines for conducting

interview with patientA. Beginning

1. Greet patient by name, shake hand (?)

2. Ask patient to sit down

3. Introduce yourself

4. Explain purpose of interview

5. Say how much time available

6. Explain need to take notes


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B. Main part of interview

1. Maintain +ve atmosphere, warm manner,

eye contact

2. Use open questions, esp at beginning

3. Listen carefully

4. Be alert and responsive to verbal & non

verbal cues

5. Facilitate patient verbally & non-verbally

6. Use closed questions when appropriate


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7. Clarify what patient has told you

8. Encourage patient to be relevant

C. Ending

1. Summarize what patient has told you2. Ask if patient wants to add anything

3. Thank patient


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Key skills for communicating effectively withpatient

Questioning

Listening

Facilitating


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1. Questioning

Main purpose of interviewing patient:to obtain information about patients

conditionaccurate, complete and relevant

Good communication with patient alonecontributes to correct diagnosis in 80% of

cases


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Open questions should be used as much as possible

to obtain great deal of information from patient

Would you please tell me how you have been

feeling in the past few days?

I understand that you have had pain. Would you

please tell me more about it?

Can you tell me what brings it on?etc


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Closed questions

Give patient little choice in the way to answer

Usually elicits little information, only yes or

no.

Have you beenfeeling unwell today?I see from your GPs notes that you have had chest

pain. Do you still have the pain?

Was it tight or dull pain?

Did it go down your arm?

Did it get worse when you exercised?


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Advantages of open questions

More relevant information in given time Patient feels more involved

Patient can express all concerns and anxieties

about problems

When to use close questions?

To obtain specific information not yet given by

patient

In emergency cases


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2. Listening

Features of active and effective listening:

Gathering and retaining information

accurately

Understanding implications for patient of

what is being said

Responding verbal & non-verbal signals or

cues

Demonstrating you are paying attention and

trying to understand


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Non-verbal cues:

Eye contact

Posture

Gestures

Facial expressions

Way voice is used


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3. Facilitating

Related with effective listening. Aim to help patientto talk fully about problems.

Verbal way

Please go on and tell me more about your pain.

Yes, I understandplease continue.

Non verbal ways:

Leaning slightly forward toward patient

Making eye contact

Nodding head at appropriate time


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Communication

with FamilyHow family can help?

Provide emotional & social support

Provide practical support

Provide understanding of beliefs about illness

& treatment


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Provide information about family historyHelp avoid/overcome bad patient compliance

Overcome difficulties arising from secrets

Anticipate/address problems that may affectother family members


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NOS

Too many or complicated questions

Not allowing patients to tell story in their own

words

Unnecessary interruption

Failing to pick up verbal & non-verbal cues


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Patients respect doctors who

are warm and sympathetic

are easy to talk to

introduced themselves

appear self-confident

listen to the patients and respond to their

verbal cuesask easy-to-understand questions


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Summary

The ability to communicate effectively andsensitively is essential in medicine

Communicating effectively with patients involves thecore skills of questioning, listening and facilitating

Good communication leads to: accurate historytaking and diagnosis, patients compliance withtreatment plan, patients satisfaction with the care

given

The skills of good communication can be learnt andretained


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THANK YOU

Documents

Basic Concepts of Communication with Patient and Family.ppt