Dr.

Ragaa Shawky
Lecture: Communication skills & Health education.

Communication skills & Health education

Rational to study communication: in healthcare settings, communication takes place
between HCWs with their clients and colleagues as: It is the key element in maximizing
access to quality of healthcare and it must be achieved by medical students before
graduation.

Definition of Communication: it is a dynamic process with a double way flow in which

feelings, ideas and information are expressed as messages sent, received and
comprehended.

Aims of Communication:
1- To give information. 2- Diagnostic accuracy. 3- To solve problem.
4- To satisfy needs. 5- To build trust. 6- To reassure patient.
7- To change knowledge, attitude and practice (KAP).

Elements of Communication
1. Sender: is the person who sending the message. Every person in the community could
act as a sender through his job as: PHC team, medical students, school personnel and
community leaders (especially in rural areas).

2. Message: Message (Message = Health Information) is the content of the communication

act (topic of health talk).

3. Methods & Forms:

Methods of communication could be:
1- Direct: Face to face (Personal approach). 2- Indirect: Mass media approach.
Or could be: auditory, visual, audiovisual methods and role play (education by doing).
Forms of communication:
Verbal communication Non-verbal communication
All what is Saying or Writing: Movements & Signs:
1- Language 1- Body language:
2- Paralanguage (vocalics): as eye contact, body movement.
- Quality of voice.
- Vocal interferences: Interruption, 2- Object language:
hesitation, silence. as dress, equipment.
- Emotional tone of voice.
- Loudness, rate, pitch of voice. 3- Space language:
- Accent. as distance, forbidden zone.
 Dr. Ragaa Shawky
Lecture: Communication skills & Health education.

N.B: Non-verbal communication (NVC) has different interpretations according to culture

of the community, e.g.
• Setting behind a desk can reinforce barrier between health workers and community.
• Looking at watch or looking away may be taken as showing boredom.

4. Receiver: Are the audiences or the target population; they should participate in the
communication process and this depends on their: age, gender, educational level, interest
and attitude and socio-cultural background.

5. Feedback (+ve or -ve): It is the final stage of communication that lets the educator
knows if audience understood his message, e.g., Head nodding, asking questions by the
receiver and requesting or giving information related to the message.

N.B. Effect of communication is the end result of communication process which may be
emotional (Attitude), cognitive (Knowledge) and physical (Practice).

Criteria of Effective Communication:

1. Sender: 2. Receiver: 3. Message: 4. Environment:
1- Popular, influential 1- Ready to learn. 1- Clear, Concise, 1- The venue: suitable,
and interested in work. 2- Not occupied by Culturally accepted (3C). quiet, with comfortable
2- Suitable education urgent or worrying 2- Specific, Scientifically temperature.
and qualification. matter. correct, Simple (3S). 2- No interruption from
3- Appropriate 3- Interested in the topic 3- Reasonable, Realistic, other people.
experience & training. either because it touches Relevant (3R). 3- Suitable time.
4- know personal and a special problem or a 4- Appealing and
social characteristics of public problem. interesting.
the recipients. 4- Response should be
5- He practices what he appropriate and arise
advices. from the message.

Barriers of Communication:
1. Sender: 2. Receiver: 3. Message: 4. Environment:
1- Lack of self- 1- Selective perception. 1- Unclear or confusing. 1- Venue: unsuitable,
confidence. 2- Personal values and 2- Difficult words. noisy, with
2- Lack of motivation. beliefs. 3- Not interesting to uncomfortable
3- Lack of training. 3- Lack of interest in the audience. temperature.
4- Lack of feedback. topic. 4- Unrealistic, irrelevant. 2- Interruption from
5- He doesn’t practice 4- Unwillingness to other people.
what he advices. change. 3- Unsuitable time.
 Dr. Ragaa Shawky
Lecture: Communication skills & Health education.

6- Language & 5- Negative attitude

Inadequate quality of toward message e.g.
voice. family planning.
7- Disagreement
between verbal and non-
verbal message.
Communication Skills include:
A- Verbal Communication Skills. B- Non-verbal Communication Skills.
Basic Rules
Verbal Communication Non-verbal Communication
CLEAR: ROLES:
C Clarify R Relax
L Listen O Be Opened
E Encourage L Lean forward
A Appreciate E Eye contact
R Reassure S Show you are listening.

A- Verbal Communication Skills:

1- Questioning skills:
The health care provider asks questions that encourage the client to talk about himself.
Types of Questions
1. Open-ended questions 2. Close-ended questions 3. Confirmatory questions
- It can be asked by What, Why, - It can be asked by (Who, - These questions are asked to
How, Explain Describe and When, Where, How often, confirm understanding of the
Discuss. How many and Does). patient.
- It can’t be answered by ''Yes'' or - It can be answered by ''Yes'' - Examples:
''No'' or a one-word response. ➢ Please tell me what you understood?
or ''No'‘ or one word response.
- It is more informative than - These questions are Probing
close-ended questions, because question to clarify and to
they give the opportunity for a understand.
full answer.
- Examples:
- Examples: ➢ Do you mean or are
➢ How do you feel about you saying that? (to repeat the
having chemotherapy? counselee message).
➢ You definitely took 3
tablets/day? (to check
accuracy).
 Dr. Ragaa Shawky
Lecture: Communication skills & Health education.

2- Listening skills: The health care provider listens to be able to understand the problem
that brings the clients to the clinic. Listening is an active process that differ from hearing
as it involves:
1- Conscious effort to listen to the words, the way they are said to be aware of the
feeling shown and hidden.
2- Observation of the non-verbal messages that helps in identifying the inner feeling
and check the meaning of the verbal message.

B- Non- Verbal Communication Skills:

Importance of non-verbal communication:
1. Reinforces the verbal message. 2. Regulates the verbal message.
3. May replace the verbal message. 4. May contradict the verbal message.
There Are 3 Categories of Non-Verbal Skills:
1. Body language 2. Object language 3. Space language
as body movements, posture, as dress, beard, hair and as distance and forbidden zone:
facial expressions, eye contact, equipment. - Intimate (45 cm).
way of walking, personal - Personal (45-120 cm).
appearance, gesture, mimics, Social (120-360 cm).
touch, hand movements, leg - Public (>360 cm).
movements and head nodding.

Practical Applications of Communication in Healthcare: Health education, Breaking

Bad News and Counselling.

Counseling: is the process used to help people to take decision. Counselors never try to
push people to accept their advice but they encourage them to choose the best solution.
Setting of counseling could be medical center, outpatient clinics, schools and hospitals.
The basic rule of counseling is:
GATHER: G: Greet, respect and trust, A: Ask about the problem, T: Tell them relevant
information, H: Help them to make decisions, E: Explain any understand, R: Return to
follow-visit.

To establish a good relationship between physician and patient; rapport and communication
are prerequisite. Rapport is the emotional element contributing to good relationship
between physician and patient, e.g.
- The atmosphere of the waiting area.
- The doctor greeting to the patient.
- The degree of confidence the physician gain.
Dr. Ragaa Shawky
Lecture: Communication skills & Health education.

Health Education: is a process of transmission of health-related information to the target

group aiming to promote health, prevent illness, cure disease and facilitate rehabilitation
through voluntary adaptation of individual to healthy attitudes and behaviors.

Methods of Health Education:

1. Direct Method: Face to Face approach or Personal approach in which health education
directed to individual, group or community.

2. Indirect Method: Mass Media approach or Mass communication in which health

education message is transferred through mass media.
Mass Media
Broad casting: Radio and TV
Written word: Includes newspapers, magazines, booklets, pamphlets.
Teaching aids: Slides, scientific films and video cassette.
Posters: Should be attractive, contain one idea, clear to get the idea just at a
look, and changed from time to time.
Cinema: Social and health problems of the community can be effectively
presented.

Personal approach Mass media approach

Reach small number of people. Reach large number of people.
More effective (face to face) One way method & can’t assess its effect.
Recipient share in discussion. Recipient can’t share in discussion.
Valuable to discuss confidential issue, e.g. May be not effective due to illiteracy, no
family planning. available media.