Dynamics of Care in Society Communication 1 Objectives: Identify & define the concepts & elements of communication theory
Recognize a communication dilemma Identify nonverbal aspects of communication Utilize sensitivities & problem solvng skills to achieve interpersonal communication that Formulate appropriate communication strategies to detect & avert breakdowns in communication
Differentiate between open & closed ended questions Develop skills to design open-ended questions Determine the appropriate questions to ask patients Be familiar with appropriate, caring Communication defined: a sharing of information or ideas, including content as well as the
feelings or emotions Verbal & nonverbal behavior within a social context ListenTalk to your doctor Health reporter John Hammarley summarizes communication tips Methods of COMMUNICATION ne on one mall group arge audience
ass communication TV, radio, film, newspapers, internet FORMS OF COMMUNICATION: 1. VERBAL: spoken words, manner, tone, non-language sounds (sighs or sobs) 2. NON-VERBAL: touch, eye contact, kinesics (body movement),
proxemics (personal space) 3. WRITTEN: letters, memos, chart COMMUNICATION PROCESS Channel: medium Copy in Note s
Communication Process Flow of communica tion between a medical assistant and a
patient THE SENDER The one who initiates the message or communication. Puts the thought, idea, experience or act into a form that can be transmitted. THE MESSAGE
The thought, idea or expression from the sender. Often a dual message, verbal and nonverbal simultaneously. THE RECEIVER The one to whom the message is sent. The receiver is prompted (by the message), to analyze, interpret and respond.
THE FEEDBACK Observations Health care workers use their senses to: See Color of skin, Touch Pulse
Dryness or swelling or edema Presence of rash temperature of or sore skin Color of urine or Perspiration stool Swelling
Amount of food Smell Hearing eaten Respirations Body odor Unusual odors of Abnormal body breath, wounds,
sounds Coughs urine or stool (feces) Speech Video: Drew AGT tion Challenges Communica OMMUNICATION BARRIERS/CHALLENGES
Educational/intellectual level: ex. medical terminology unfamiliar to patient Psychological/Emotional: grief, anger, anxiety, perceptions, pride, financial concerns Physiological: Impairments in cognition or hearing, age, sex , developmental stage Environmental: noise, lighting Person cannot see, hear or receive the message
Visual disability; Hearing disability; Environmental problems: poor lighting Noise speaking from too far away Person cannot make sense of the message Different languages are being used, including sign
language; People using different terms, such as slang, internet or text jargon; One of the speakers has a physical or intellectual disability, such as memory loss or a learning dysfunction. Non-verbal signals not clear ex:crying tears of joy
Please answer the question below. . . . . . . . . . . . . 3 1 . What is preventing you from reading the ?instructions on the board
Communicating with the Hearing Impaired Use body language such as gestures and signs. Speak clearly in short sentences. Face the individual to facilitate lip reading. Write messages if necessary. Make sure hearing aids are working properly
Person misunderstands the message Cultural differences: different cultures interpret non- verbal and verbal, and humour, in different ways; Assumptions about people: assumptions about race, gender, disability etc. can lead to stereotyping and misunderstanding; Emotional differences: very angry or very happy people
may misinterpret what is said; think about sarcasm Social context: conversations and non-verbal messages understood by close friends may not be understood by strangers. Communicating with the Visually Impaired Use a soft tone of voice. Describe events that are occurring.
Announce your presence as you enter a room. Explain sounds or noises. Use touch when appropriate. Communicating with Patients with Aphasia or Speech Impediments These patients may have difficulty remembering
the correct words, may not be able to pronounce certain words, and may have slurred speech. The health care worker must be patient Allow them to try and speak Encourage them to take their time Repeat the message to assure accuracy Encourage them to use gestures or point to objects Provide pen and paper if they can write Use pictures with
Communication Appkey 6min 2013communicate messages Culture/language Eye contact in some cultures, its not barriers: acceptable, and looking down is a sign of
See: the Language Line respect Terminal illness in some cultures, the patient is NOT told his/her prognosis, and family members are responsible for making care decisions Touch in some cultures, it is wrong to touch someone on the head. Others may
limit touch between male and female Personal care in some cultures, only family members provide personal care Stereotyping, prejudice, bias Stereotypes such as dumb blonde or fat slob cause us to make snap judgments about others that affect the communication process. Health care workers must learn to put prejudice aside and show respect for all individuals.
Distractions: Attention, Environment, Hunger, Pain (Textingwhere does it fit?) Be an active & critical listener Encourage Sound open and positive. Be attentive. Fact Find
Ask Questions(Who, What, Why, When, Where, & How). Avoid distractions Use eye contact MD interviews Computer 1min Take notes ig Bang Bad Listening 4min ay Romano
Learns Active Listening 4min ay Romano demonstrates active listening 4mi Strategies Use reflections open ended questions statements to repeat back what you heard ex. Mr. Wellness, you were saying that the new medication is
making you vomit. Use paraphrasing use your own words to restate what you heard ex. it sounds as if you are saying you do not want to take the medication Use open ended questions to gain further information (activityopen vs closed ended questions)
Ex. Can you describe the type of pain? Closed ended questions are necessary for times when specific information is required. Ex. Are you in pain right now? Summarize Listen with an accepting attitude. Use encouraging words that will invite them to continue on.
"Mmm, hmm" "I see." "Right." Uh, huh." "Tell me more." "Sounds like you have some ideas on this." "I'm interested in what you have to say." "Let's talk about it." Use nonverbal actions to show you are listening. relaxed posture head-nodding
facial expression relaxed body expression eye contact Use Silence is natural and sometimes appropriate in conversations Conversation Starters Always make sure you have time to listen and
talk before you start. If you want to encourage talk, avoid questions with yes, no, or just one word. Start with Tell me about or What do you think about You might start a conversation by mentioning a television show: What do you think about the boys in that ad? Do you know anyone who is like that?
NEGATIVE IMPACTs ON COMMUNICATION Giving an opinion Offering false reassurances Being defensive Showing approval or disapproval Stereotyping Asking why Changing the subject
Things to avoid while being an active listener Do not interrupt. Do not interrogate. Limit the number of questions you ask so that you are "drilling" them. Do not try to think of your response in your own head while you are listening.
Avoid phrases like: "Are you sure." "You shouldn't feel that way." "Its not that bad." You're making something out of nothing." "Sleep on it. You'll feel better tomorrow." Do not be judgmental allow speaker to feel that they can
NON-VERBAL COMMUNICATION What is the message for each? NON-VERBAL COMMUNICATION Includes: 1.Appearance 2.Kinesics or body movement Facial expressions Gestures Eye movement
3.Facial expressions 4.Posture & gait 5.Tone of voice 6.Touch Can create positive or negative feelings, Watch for nonverbal cues that show how the patient feels about being 7. Eye contact 8. Proxemics (personal space) Larger when talking to a stranger
Becomes smaller the better you know someone Typically larger between two men than between two women Differs from culture to culture of How are these
a reflection professionalism ????? Give an example of how non-verbal clues create misperceptions ????? NON-VERBAL COMMUNICATION may vary with culture What is the message for each?
Friends (Summary)Non-verbal Comm. TIPS FOR MAKING SURE PATIENTS WITH LOW HEALTH LITERACY (patients' ability to understand their disease and how to manage their care) GET THE APPROPRIATE MEDICAL INFO 1. Look for patients who need help: A patient can read and write with average skill and still not understand
2. Avoid jargon: the language you use. many well-intentioned physicians make the mistake of using technical terms, then trying to define them. (also remember most Americans read at th 3. Use the teach back method:
Avoid asking patients, "Do you understand?" most will say they do even when they are confused. "I want to make sure I did a good job teaching you. Tell me how you are going to do this when you get home. Ask them to repeat your instructions in their own words . Watch this method 5min 4. Avoid unnecessary details:
yet be specific when necessary. Address one problem or issue at a time, or on separate meetings 5. Use pictures: Illustrations often convey instructions better than words. (Sample pictogram s on next slide) 6. Enlist the aid of a family member or friend or translator
4 Es: gement /Enlistment /Empathy /Education ch empathy 4min Patient Interviews General guidelines Listen actively Ask appropriate questions Record information accurately Protect patients privacy Be organized
Avoid attending to distractions Let patient know who will see her next and when Basic interview techniques Reflecting: using open-ended statements to repeat back what you have heard Paraphrasing: using your own words to repeat what you have heard Clarification: asking for an example or further details Open-ended questioning: what, when, how? Summarizing: reviewing what you have heard in a condensed form Silences: allowing time to formulate thoughts
New patient interviews Patients medical & family history Brief review of body systems Patients social history Patients medications
Established patient interviews Review patients chart for health problems Ask questions about current medical problems & changes in health Ask about known allergies Record patient information
Patient Education Assess Plan Implement Evaluate Document
HAZARDOUS SUBSTANCE SYMBOLS Visuals For Communication Project
