Scribd
Upload
4 views

Lect 12 Medical Communication Skills

Uploaded by

ekudakwashe01
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
4 views

Lect 12 Medical Communication Skills

Uploaded by

ekudakwashe01
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 30

MEDICAL

COMMUNICATI
NG SKILLS
MRS TAFADZWA

1
COMMUNICATING WITH
PATIENTS

 Communication is imparting,
conveying, or exchanging ideas.
 The ability to communicate effectively
and sensitively is central to all medical
activities.
 Evidence suggests that good
communication leads to accurate
history taking and diagnosis, patient
compliance with treatment and patient
satisfaction.
 Communication skills can be learnt.
2
PURPOSES OF
COMMUNICATING
 Reassurance
 Solve problems
 Alleviate distress
 Give information
 To form and maintain relationship
 Convey feelings
 Persuade
 Make decisions
3
WHAT IS GOOD
COMMUNICATION?
Study by Dr Peter Maguire on
patients interviewed by medical
students. Patients preferred
interviewers who :
 Were warm and sympathetic
 Were easy to talk to
 Introduced themselves
 Appeared self confident
 Listened to and responded to
 Asked questions which were easily
understood and precise
4
Why is communication
important?
 For the patient, good communication:
 increases satisfaction and knowledge
 decreases anxiety and distress
 helps facilitate decision-making and
coping
 For the doctor, good communication:
 assistsin accurate history taking and
diagnosis
 Increase patient satisfaction
 Increase patient adherence
5
6
Communication models

 Specifically considers communication in the context of health.


The model emphasises the way in which a series of factors can
impact on the interactions in healthcare settings based on three
elements:
 1. RELATIONSHIPS: The model illustrates the four major types of
relationships that exist in healthcare settings;
 a) Professional – Professional
 b) Professional – Client
 c) Professional – Clients significant others
 d) Client – Significant others
 2. TRANSACTIONS: health transactions include both verbal and
non verbal health communications as well as the content and
relationship dimensions of messages
 3. HEALTHCARE CONTEXTS: the settings in which health
communication occurs Both health professionals and clients bring
unique characteristics, beliefs, values and perceptions to the
healthcare setting which effect how they interact (Northouse &
Northouse,1998
7
Model of health
communication
• Looked at key communication skills and how to acquire them
discussing the importance of good communication skills in
medical care and the maximising impact it can have on treatment
adherence
• They conducted a clinical review using original research studies
into doctor-patient communication They noted the key tasks in
communication that good doctors should be able to:
• Elicit the main problem and the patients perception of the main
problem
• Understand the physical, emotional and social impact of the
patients problem and its impact on the patient and their family
• Tailor information to what the patient wants to know, checking
their understanding
• Determine how much the patient wants to participate in
decision making (when treatment options are available) and
discuss treatment options so that the patient understands the
implications
8
RESEARCH EVIDENCE

 A study done in Florida (Hickson G,B;


Clayton E,W) compared malpractice
claims made against them with
those had not been sued. It was
found that patients were most likely
to complain about aspects of
communication rather than technical
aspects of care. The most frequent
complaints were: would not listen,
would not give information, showed
lack of concern or lack of respect for
the patients.
9
 A report of a survey carried out in
Britain includes a quote from a patient
with breast cancer:’ They told me I was
going to have a mastectomy. No
choice, no explanation. They don’t
discuss much with the patients. I would
have preferred that they had explained
more’.
 In countries where patients are less
likely to sue their medical practitioners,
patients still express dissatisfaction
about how the medical practitioners
communicate and relate to them.
10
FACTORS AFFECTING
DOCTOR-PATIENT
COMMUNICATION
Physical setting
 Non-verbal behaviour
 Verbal communication
 Patient-related factors
 Doctor-related factors.
-The characteristics of the doctor (gender, level of
experience, personality)
-the characteristics of the patient (gender, social class,
age, education, desire for information)
-Differences between the two – in terms of social class
and education, attitudes, beliefs and expectations
 Situational factors – such as patient load, level of
acquaintance and the nature of the problem
11
PATIENT-RELATED FACTORS

 Physical symptoms
 Psychological factors related to illness and/or
medical care
 Previous experience of medical care
 Current experience of medical care

12
DOCTOR-RELATED
FACTORS
 Training in communication skills
 Self-confidence in ability to communicate
 Personality
 Physical factors (e.g. tiredness)
 Psychological factors (e.g. anxiety)

13
DOCTOR-PATIENT
INTERVIEW
 Most consultations take place in a
hospital ward, outpatient clinic
 In each case effort should be made
to provide a setting which facilitate
communication
 Provide privacy, avoid interruptions
and make sure that the lighting
and temperature are comfortable
 Consider arrangement of seats

14
Dr patient interview
physical setting

physical setting
Seating

Privacy

Noise and Interruption

15
NON-VERBAL BEHAVIOUR
NVC refers to behaviour, other
than speech, which influence
social interaction. Aspects of
 Proximity Head nods
NVC: Posture  Touch

 Eye contact  Paralinguistic features


 Facial Expression  Silence

16
BEGINING THE INTERVIEW

 Greet the patient by name and shake hands, if it


seems appropriate
 Ask the patient to sit down
 Introduce yourself
 Explain the purpose of the interview
 Say how much time is available
 Explain the need to take notes and ask if this is
acceptable

17
THE MAIN PART OF THE
INTERVIEW
 Maintain a positive atmosphere, warm
manner, good eye contact
 Use open questions at the beginning
 Listen carefully
 Be alert and responsive to verbal and
non-verbal cues
 Facilitate the patient verbally and non-
verbally
 Use closed questions when appropriate
 Clarify what the patient has told you
 Encourage the patient to be relevant
18
Open questions

“What seems to be the problem?”

 A: This type of question encourages the


patient to talk and tell their own story
 D: Interviews may take longer and be
more difficult to control
 Use open questions as much as
possible, particularly at the start

19
Closed questions
“Does it hurt when you cough?”

 A: Closed questions allow you to establish factual details


quickly
 D: They often allow the patient’s concerns and anxieties to be
missed
 Use closed questions only when appropriate

20
Probing questions

“Exactly where does it hurt?”

 A: Probing questions allow you to clarify factual details


 D: Probing questions restrict the information provided by the
patient
 Probing questions should be used when clarification is needed

21
Leading questions
“I suppose the coughing is worse at night?”

 A: There are no advantages to using leading questions


 D: Leading questions specify the answer you expect to get
 Leading questions are best avoided at all times

22
Multiple questions
“ When did the cough start? Does
anything seem to bring it on? Is is
worse at night?”
 A: There are no advantages to
multiple questions
 D: Patients usually forget the earlier
questions and just answer the last
question
 Multiple questions are best avoided
23
Comparison questions

“Would you rather stay at home or


be admitted?”

 A: Comparison questions allow you


to establish factual details quickly
 D: Comparison questions restrict
the information given by the
patient
 Comparison questions should be
used Less frequently
24
LISTENING

 Patients appreciate and respond


positively to doctors who listen
carefully
 Listening involves not only
receiving information but also-and
more importantly-being ‘in tune’
with the speaker and responding
appropriately
 Active or effective listening
demands effort and concentration.
Includes facilitation, clarification,
reflection
25
ENDING THE INTERVIEW

 Summarize what the patient has told you and ask


if your summary is accurate
 Ask if they would like to add anything
 Thank the patient

26
Other verbal aspects
 Reflective questions repeat the
emotional content of the patient’s
comments
 Social chit-chat helps you establish
rapport with patients
 Empathy helps you understand the
patient’s perspective
 Sympathy enables you to
commiserate with the patient
27
Problems with Doctor –
patient communication
• Deterioration of Doctors’ communication skills
• Nondisclosure of information
• Doctors’ avoidance behaviour
• Discouragement of collaboration
• Resistance by patients (Ha, Anat & Longnecker,

28
Conclusion
 Good communication is central to effective medical practice
 Several factors influence verbal communication, e.g., patients’
beliefs
 Different questions elicit different types of answers

29
Reading

 Lloyd M & Bor R (1996)


Communication skills for medicine.
Churchill Livingstone, New York.
(pp 9-22)
 Faulkner A (1998) Effective
interaction with patients. Churchill
Livingstone, New York. (pp. 49-74)

30

You might also like