communicationwithpatient.pptx
- 1. Communication with patients Dr. Zubair Ahmad Bhat Junior Resident, Pharmacology, Govt. Medical College, Baramulla, J&K.
- 2. No greater opportunity, responsibility, or obligation can fall to the lot of a human being than to become a physician. In the care of suffering, the physician needs technical skill, scientific knowledge, and human understanding……. Tact, sympathy, and understanding are expected of the physician, for the patient is no more collection of symptoms, signs, disordered functions, damaged organs, and disturbed emotions. The patient is human, fearful, and hopeful, seeking relief, help and reassurance.
- 3. Definition… Communication is the process of sharing information or messages for the purpose of common understanding. Effective communication with patients on various aspects is important ‘Patient –centered care’ recommended also by WHO Following features are important in communication in medical profession: Sympathy – it is an effort to understand another person’s feelings or behavior with kindness and compassion.
- 4. Definitions… Empathy: Empathy is the ability to feel other people's emotions, coupled with the ability to imagine what someone else might be thinking or feeling, suffering by ability to imagine oneself in another’s situation. Ethics: Ethics is the study of morality – careful and systematic analysis of moral decisions and behaviors and practicing those decisions in day today life. Medical ethics is application of fundamental moral principles of ethics that apply values and judgments to the practice of clinical medicine and in scientific research.
- 5. Principle of Medical Ethics: • Beneficence: A physician must act in the best interest of the patient • Non maleficence: Physician must not harm a patient through careless, malice or dislike or even through treatment. • Autonomy: This principle is focused on the patient's independence or liberty. • Justice: Justice refers to fairness with respect to the distribution of medical resources without considering their economical , social or any other status.
- 6. What is purpose of doctor-patient communication? •Creating good inter-personal relationship: The doctor must show empathy, respect, genuineness and warmth. • Exchanging information: The doctor should seek information about the clinical problem from the patient by being a good listener and then giving information. • Making treatment related decision: He/she should provide information about the disease, drugs, life-style and dietary changes etc.
- 7. Doctor -patient interaction: Non-verbal communication • Offering seat, touching the patient, nodding head, eye to eye contact. Verbal communication • Patient complaints • Prescriber’s questioning about complaints: length, severity • Prescriber’s explanation about diagnosis/ diseases • Prescriber’s explanation to patient’s question • Prescriber’s explanation about treatment particularly drugs
- 8. Coding of ideas : 1. Language (verbal, written) 2. Para-language (tone, pitch, accent of voice) 3.Non-verbal or body language (face, eye, other gesture, body positioning, appearance) Approx.% of meaning conveyed by the three codes: 1. Language-7% 2. Para-language-38% 3. Non verbal or body language-55%
- 9. Active listening • Listening is a communication skill every doctor should cultivate. • It is the foundation of all communication and relationship skills. • A doctor must: • Commit time to listen without interruption • Absorb what patient want to convey • Be open-minded, sensitive, empathetic • Be able to concentrate without distractions (mobile/ laptop)…. or interruptions
- 10. Explanations on the following: • Name of drug: generic name & brand name • Therapeutic effects, side effects • How to take the drug, when to stop • Patient’s question about treatment • How to prevent the disease / exacerbation •Other information about diet/exercise Effective communication results into accurate diagnosis, more effective treatment or medical intervention, more speedy recovery & better realization of quality of life
- 11. Steps to Good communication skills with patient • Initial greeting (friendly & helpful), building rapport with the patient • Offer Seat make comfortable • Body posture -non threatening (warmth in questioning style) • Maintain eye contact, listen complaints actively ,sensitively • Interruption and facilitation, when needed use of silence at times • Discuss personal and psychosocial issues of relevance • Explain treatment available/given, directions for follow up with clarity of expression • End of interview with solving doubts to satisfy patient .
- 12. Avoid / Don’ts of communication – Cynical or pessimistic talk – Misleading false hope – Creating guilt complex – Losing temper
- 13. GATHER - in family practice • G = Greet patient in a friendly way • A = Ask about complaints • T = Tell them about methods available • H = Help the patient to decide • E = Explain use • R = Plan return visit
- 15. Drug Adherence: • Medication adherence also known as drug compliance or adherence refers to the degree to which the person follows a treatment regimen. It involves taking medication on time and follow schedule as directed by the health care provider to achieve desired benefits.
- 16. Guidelines for ensuring adherence to drug treatment: It is essential to provide step by step guidance on how to use/ administer different medical devices/dosage forms. Information should be provided in a simple language, that the patient/caretaker can understand. Make sure the patient has understood the instructions. Written instructions too may be provided in patient’s vernacular language
- 17. Drug adherence…. – Whenever possible, involve patients in decision making regarding their treatment so that they have a sense of ownership in the treatment plan. – Address key information about the drugs (what, why, when, how, and how long) – Check adherence on follow up visits….by various means can ask to bring empty blisters of medicine to cheque..intake of tablets…etc…
- 18. Drug adherence…. – Inform the common side effects and those that patient should necessarily know. – Provide medication calendars or schedules that specify the time to take medications, medicine related information sheets or specific packaging such as pill boxes indicating the time of dose – Motivate & Monitor adherence on follow up visits
- 19. The most common reasons for non-adherence are: • Frequent dosing • Denial of illness • Poor comprehension of the benefits of taking the drug. • Cost
- 20. Good communication about prescriptions to the patients can avoid irrationality to some extent. Irrationality can also be due to the patient's part because of the following reason: • Patients ask for a quick cure (asking for an injection in place of oral treatment) • Poor health education and wrong beliefs (taking too much dose for quick relief) • Self-medication of other drugs without prescription • Misinterpretation of information given on prescription • Non-compliance (not taking a complete course of therapy).
- 21. Thank you